Influencing Policy: Principles

In preparation for beginning the advocacy process in support of HIT and HIE, there are certain preparatory steps important to the success of this effort. The steps are as follows:

• Coalition Development - Organize the multitude of stakeholders involved with your community, regional or state HIE effort. Participants are likely to include physicians, employers/payers, health plans, hospitals and consumers, for example. Invite participants to an initial organizational meeting focused on advocacy, explain your anticipated advocacy activities and purpose, as well as offering information you have collected on relevant current activities taking place in Congress and the Administration.  Lay out the next steps, collect contact information and begin to think strategically about your short and long-term advocacy goals and coalition building. Develop a mechanism to regularly update your advocacy coalition on political developments that impact your agenda. The winds of change can blow into advocacy and public policy landscape quickly and having the most current information is key to your ultimate success.
• Messaging – Determine the key messages you wish to communicate to your elected representatives.  These messages should be succinct and to the extent possible, relate to pending Congressional legislation, proposed regulation or Administration initiatives. For example, if the issue is regulatory barriers, such as Stark and Anti-kickback, frame the issue with examples of how current law hinders physicians from accessing EHR software and affects patient care.
• Advocacy Function – Within your health information exchange (HIE), assign individuals as advocacy leads. Specific responsibilities include liaison with local and state organizations, as well as national coalition partners such as the eHealth Initiative, and contact with elected representatives, Federal agencies and the press. Once contact is made with selected offices, advocacy leads can identify selected members of the coalition to participate in scheduled meetings. It is recommended that at least one representative from each of the stakeholder groups in your HIE attend advocacy meetings. Understand that your meeting may be short due to a staffer or Representative’s full meeting schedule.  Nevertheless, your feedback and viewpoints are very valuable to them.  During your visit, ask what meetings or hearings may be upcoming that relate to HIT, HIE and the topic of your visit.  Offer yourself as an on-going resource for these events and for HIT and HIE issues.
• Develop Case Studies – Making the case for legislative or regulatory changes requires the development of good information on how the issue in question would affect patient care.  Support your point of view with the development of case studies, fact sheets and/or backgrounders to illustrate your proposal or issue.  When drafting these documents, discuss not only successes, but also efforts that did not succeed as a way to illustrate lessons learned and policy imperatives. Avoid industry jargon, technical terms, or writing in an academic style.  Aim for clear, easy-to-understand and hard-hitting examples to make the point.
• Follow Up - Finally, follow up with elected Representatives to see if there are questions and check on progress. Ask for a confirmation to be sure that your request or material was received. Persistence is important to be sure your voice is heard, particularly with multiple constituents and competing agendas.