What are your asks?

So on Monday I got to meet the director of the Government Relations Department of ACOG, Lucia DiVerne as we had a staff meeting. She is poised, smart, and organized. There is a lot going on in the office right now with the new administration, the stimulus package, health care reform around the corner, and the CLC coming up at the beginning of March. (Side note- I am so very excited for the CLC and to have some other PIROGers here with me! It's going to be so much fun and such an amazing learning experience!).

I had my first Hill visit scheduled for the next day with Senator John Kyl's health Legislative Assistant and I was really nervous and had no idea what I was supposed to talk about. I figured by this time that if I seriously knew nothing of this world, the person I would be talking with who works here in Washington dealing with all these acronyms and abbreviations would know little of mine. It's quite true. We do not have to be experts on the legislation- that is for the lobbyists to know. We are the experts on our patients. We know the stories we see day after day. The mom who couldn't afford the amniocentesis when her triple screen indicated a chromosomal abnormality, the elderly woman who never had that post-menopausal bleed that occurred two years ago worked up because she didn't have insurance who is now hemorrhaging and almost surely has cancer, the post-partum woman who has depression but you don't know how you'll follow up with her because her post-partum visit is the last visit medicaid will pay for... the woman with no prenatal care who died of organ failure after an emergent delivery. These are the stories of each Congressperson's constituents, and it's up to us to share them.

So, on Monday I met with Joe and Nevena, the two lobbyists, and we discussed what my "asks" would be when meeting with Staff on the Hill. Here's what we decided:
1. Whatever health care reform takes place, we need to have prenatal care included.
2. Health IT- it's in the stimulus package as it currently stands. And in the bill, in order to qualify for the Medicare EHR bonus payments a physician has to be a "meaningful EHR user". What does that mean? What does it look like? We are asking for clarification of who will decide the parameters and what it might look like for an ob/gyn.
3. Comparative Effectiveness Research is also in the Stimulus package. We agree with the need for evidence-based research but we want to ensure that this research will address eh specific needs of sub populations. We don't want, "drug A works well and it's the cheapest so that is what will be covered" when drug A may not be safe to use in pregnant women, or elderly woman, or may not work well in a specific minority group.

So, there are my asks! Prenatal care, who will set up the parameters for "meaningful EMR" and what will that look like, and getting some language put into the comparative effectiveness research for sub populations.