You can’t believe the play that little athenahealth gets in Washington, DC… and thank goodness for it because no one has a clue about HIT.

How could they really?

I mean, there are 535 people in our federal legislature (give or take) and there are like a million different market spaces in the nation. This is why I have such a hard time with federal control of things. It’s impossible for them to  know what’s going on…there are just not enough hours in the year.

As I’ve been thinking about care coordination and the complete lack of sustainable models or entrepreneurship in that space, it occurred to me that it’s currently not clear that it is legal for RECEIVERS of electronic health information to pay senders for the value of that health information. This means that the sender has no real motivation to send useful, relevant data in a timely manner (I know I’d pay the doc who sent me exactly what I needed about a patient more than I’d pay the doc who sends over a 30-page PDF) and that our industry will take a long time to understand the true health information exchange needs of providers.

I wanted to bring the concept with me to the Hill that Meaningful Use, in my opinion, is use that is meaningful to a medical care provider in the actual doing of business. In a space with such clear demand, we’ve got to let innovators develop a way to supply information that the market (providers of care) needs, if we want to improve outcomes and reduce costs.

So I flew down to Washington and it was tons of fun… me and Lauren Fifield and the lobbyist and a full dance card on Capitol Hill.

First, we met with Sally Canfield, policy director for Sen. Marco Rubio, R-Fla.

She’s a true health policy veteran who likes getting—and will give you—the straight story. She’s also one of the only people on the Hill with whom I could speak at my normal (lightning) pace and know she can keep up. We talked about everything from the potential fall of hospitals (Need a hospital?  Just scan the horizon for a construction crane)…to the alarming rate of physician employment…to making Meaningful Use really meaningful…to encouraging care coordination…to life in the cloud.

Then we met with Rep. Tom Price, R-Ga. Since he’s a physician, he has great insights into the medical world given his years of practice.

We talked about:

  • Enabling care coordination through innovation and entrepreneurship
  • Defining Meaningful Use as helping doctors exchange meaningful data
  • Using the data to improve outcomes and patient care, at the point of care

Next was Sen. Johnny Isakson, R-Ga. Another Johnny! And a nice guy to boot.

We talked about:

  • Our new office in Georgia and our recent acquisition of Proxsys, which is now known as athenaCoordinator
  • The Meaningful Use dashboard, how athenahealth has been promoting transparency and using data to make Meaningful Use meaningful
  • A potential location idea for our expanding Georgia office!

Around lunchtime that day we met with Rep. Chellie Pingree, D-Me. She’s my neighbor up in Maine.

We talked about:

  • The Maine health care ecosystem
  • The cloud model for health information
  • Dollars from secondary payers currently being left on the table by the Defense Department and the VA
  • The Meaningful Use Dashboard

In the early afternoon, we met with Rep. Paul Ryan, R-Wis. You’ve probably heard of him and he’s already made his mark as a thought leader who strongly believes in the free market.

We talked about:

  • The need to develop technology structures that do not allow for “silo-ed” information
  • The potential that Meaningful Use could be meaningless if we continue to delay timelines and accept exchange requirements that do not foster the actual exchange of meaningful data
  • Pushing for data usage and transparency in the MU program, as seen in The Meaningful Use Dashboard
  • The relatively low amount of venture capital in health care and the need for an economically sustainable model of information exchange

Then we walked to the Capitol building with Rep. Diane Black, R-Tenn. She’s a former nurse who has been an active member, and vocal in the HIT space.

We talked about:

After a mid-afternoon conference call, we went over to the Senate side and met up with Sen. Mike Enzi, R-Wyo., and then Sen. Scott Brown, R-Mass., to talk about the market-driven, and therefore sustainable, approach to care coordination.  And, as always, it was a pleasure to see Sen. Susan Collins, R-Me. We talked about the job opportunities athenahealth has been creating in Maine and happenings at Point Lookout. We also talked about making Meaningful Use meaningful and letting the program run without further delays or watered-down measures to ensure that only providers demonstrating MEANINGFUL use would receive payments. We also touched on care coordination and the need to let entrepreneurs and innovation drive us.

So you may be asking…why are we doing this? What is the benefit?

If you do ask, I’ll answer.

Jonathan Bush co-founded athenahealth, a leading provider of internet-based business services to physicians since 1997. Prior to joining athenahealth, he served as an EMT for the City of New Orleans, was trained as a medic in the U.S. Army, and worked as a management consultant with Booz Allen & Hamilton. He obtained a Bachelor of Arts in the College of Social Studies from Wesleyan University and an M.B.A. from Harvard Business School.

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15 Responses for “Mr. Bush Goes to Washington”

  1. BobbyG says:

    “So you may be asking…why are we doing this? What is the benefit?”
    __

    Some things are in fact rather obvious.

  2. Matthew Holt says:

    One Democrat was all you could muster up Jonathan? After they (not the Repugs) were the only ones who so nicely voted in $35bn to make you (and admittedly a lot of non-cloud based EMR vendors) even richer. Doesnt sound too fair and balanced to me! Or won’t they talk to someone with your last name

  3. BobbyG says:

    Corporate Welfare recipient and total hypocrite.

    See “Athena Health CEO Jonathan Bush on the RECs”

    ‘Jonathan Bush, Chairman and CEO of AthenaHealth discussed his opinion of the Regional Extension Centers (RECs). During the quarterly earnings call, Mr. Bush was asked how the REC strategy could be improved. He replied, “A bullet. Give the money back. Quick bullet, they won’t even know. There’s no one in the office, so there’s no one to even take the boxes out”.’

    From the CalHIPSO press release:

    Jonathan Bush, Chairman and CEO of athenahealth said, “Many California physicians find themselves in the exact same situation as physicians all across this country, trying to adapt to a world where electronic health records are becoming a necessity – but this change isn’t easy. The good news for California doctors is they’ve got a great organization in CalHIPSO to turn to for support and we look forward to bringing our deep understanding of the benefits cloud-based EHR services can bring to a host of new physicians and helping them receive financial reimbursements for embracing the future of healthcare.”

    Mr. Bush interviewed on EHRtv at HIMSS 2009, asked about the impact of the ARRA/HITECH Act:

    [0:40] “Part of me is ecstatic because, why not have more ‘schtimulus,’ and, part of me is, like, well, now we’re gonna ‘schtimulate’ all these losers, and, so, why couldn’t we just let them die, and we’ll just do it ourselves?”

    http://regionalextensioncenter.blogspot.com/2011/05/athena-health-ceo-jonathan-bush-on-recs.html

    So, Jonathan, “what is the benefit?” Well, to WHOM?

    You seem to have done quite handsomely via that which you otherwise conveniently or unreflectively disdain, and regarding which you are now effusively lobbying in Washington. Paranoid much about the potential clawing back of the MU incentive money and it adverse Street impact for ATHN?

    “there are like a million different market spaces in the nation.”

    Markets properly exist to serve humanity to the extent possible. Not the other way around. Moreover, health care “markets” differ materially (in the ethical sense) from markets for shoelaces or wheat or Philips head screws or flat screen HDTVs or furnishings or menu choices at fast food chains.

  4. John Ballard says:

    Thanks, Matthew.
    This roster reads like a Who’s Who of retrograde political types.

    “ROBERT FRANK: The political conversation these days seems to be dominated by the idea that, if the society tries to act collectively, it’s always going to make matters worse. But you can’t just turn selfish people loose and hope for the best. In those cases, both in nature and in the marketplace, you get very bad results oftentimes.”

    http://www.pbs.org/newshour/bb/business/july-dec11/makingsense_11-18.html

    • BobbyG says:

      “The political conversation these days seems to be dominated by the idea that, if the society tries to act collectively, it’s always going to make matters worse.”

      Yeah. That is such fatuous crap. Give me five minutes of Socratic with these clowns.

    • Nate Ogden says:

      “But you can’t just turn selfish people loose and hope for the best.”

      If a single selfish person is bad then a selfish society would be millions of times worse. Medicare and Medicaid being examples of a selfish society that enriched themselves by stealing from the future. When you grant a selfish society the dictorial power of government there can be no more powerful opportunity for failure. A selfish individual does not cause the collapse of a nation like a society does.

  5. John Ballard says:

    Fobert Frank’s blog at Wall Street Journal.

    http://blogs.wsj.com/wealth/

    Go for it. He’s the expert.
    I’m just a fatuous old fart who doesn’t know better.
    (From the time stamps on the last two comments, I have a hard time believing you bothered to even watch the video link which was about eight minutes long. )

    • BobbyG says:

      Already saw it. Nothing new there for me.

      ROBERT FRANK: The political conversation these days seems to be dominated by the idea that, if the society tries to act collectively, it’s always going to make matters worse. But you can’t just turn selfish people loose and hope for the best. In those cases, both in nature and in the marketplace, you get very bad results oftentimes.

      PAUL SOLMAN: So then yours is the message of the benevolent economist, if you will, who says both left and right are, in some fundamental sense, wrong because they don’t understand both the value of the market from the left and the importance of government from the right?

      ROBERT FRANK: That’s exactly the point of the argument, yes, that — that there really is much more to the market than its critics realize, and the people who say government can do no good for the society are way off base. They don’t understand the fundamental conflict that often arises between individuals and groups.

      PAUL SOLMAN: To Bob Frank, then, as to Charles Darwin, success is a balance between the urge to cooperate and the impulse to compete, a balance in the origin of our species and in its continued evolution.

  6. Peter1 says:

    “I mean, there are 535 people in our federal legislature (give or take) and there are like a million different market spaces in the nation. This is why I have such a hard time with federal control of things. It’s impossible for them to know what’s going on…there are just not enough hours in the year.”

    It’s because most of those hours are spent dialing for dollars (Oh, and trading stocks on insider information) not reading or investigating legislation.

    “You are solving the wrong problem.”

    • BobbyG says:

      Yeah.

      “You can’t believe the play that little athenahealth gets in Washington, DC… and thank goodness for it because no one has a clue about HIT.”
      ___

      No one except those whom you lobbied, right, Mr. Bush?

  7. BobbyG says:

    “So you may be asking…why are we doing this? What is the benefit?
    If you do ask, I’ll answer.”
    __

    OK. We’re waiting.

  8. bill anderson says:

    Hi
    I think you miss the point.
    EHR etc is not to improve comms between doctors. It is first last and always to facilitate effective healthcare with(many) fewer doctors.

  9. BobbyG says:

    “…As for the auditing process, he [ AthenaHealth CEO Jonathan Bush ] said that it’s his understanding that CMS will only audit a practice in reaction to a complaint. “Who would complain that a doctor attested inappropriately? No one, so no one will be audited,” he said.”

    I would suggest that OCR start, then, with Athena clients.

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