For Good Policy Making, Facts Must Matter

“None of the required core or menu objectives in Stage 2 requires communication with other health care providers. This means steps toward interoperability are neither being required nor measured.”

That’s what six United States Senators actually say in a new report from the Republican caucus that is critical of progress made in the electronic health records meaningful use program. The senators, along with six sets of aides and any other “experts” who may have assisted with the report, clearly didn’t do much homework.

They missed these objectives clearly designed to compel provider-to provider data exchange: Provide a summary of care for transitions of care or referrals, generate and transmit electronic prescriptions, and incorporate lab results into EHRs as structured data. There also are multiple other objectives clearly aimed at accelerating interoperability, such as giving patients access to their records, use of secure messaging, submitting syndromic data to public health agencies and reporting cancer cases to registries.

To prove that the meaningful use program is failing, the senators cited relatively low figures of EHR adoption during 2011--the first year of the program--from a dated Government Accountability Office report. They used the report on the simple premise that it had the most recent data from an agency outside the Department of Health and Human Services. But the GAO report used HHS data and the senators knew that because they referenced a chart of HHS figures. This is intentional deception: using updated HHS data through 2012 would have shown substantial acceleration of EHR adoption over just the first two years of the program, undercutting their argument.

I was a political reporter for many years and remember when knowing what you are talking about was valued in a legislative body. Members who came to govern listened to those in both parties who had become subject matter experts; they were the ones who developed and guided informed consensus policy.

There still were plenty of political battles, but common ground was found and things got done because ideologues with no agenda except to self-promote and spew nonsense were relegated to the back benches and their bills never made it out of committee. The ideologues were a minority. Now, both parties are full of them, making compromise almost impossible and efforts to return to informed decision making difficult at best.

There is nothing wrong with Congress overseeing the executive branch; that is a constitutionally assigned duty. And the opposition party generally does a better job of oversight. The GOP senators have valid concerns about EHRs accelerating the ordering of unnecessary care, lax data security, and worries of sustainability after incentive payments run out.

If opposition lawmakers had not shown their true colors—that they don’t like the idea of the President having a successful program--then an airing of their concerns could result in improving the meaningful use program. But when the opposition party has a stated top priority of ensuring that the President of their nation fails on all counts, then facts, truth and informed decisions no longer have value.