Her words weren’t meant to be a defense, but they were perhaps unknowingly in response to the nearly constant barrage of criticisms levied by HealthCare.gov critics, still unflinchingly opposed to President Obama's health-care reforms.
The words belonged to outgoing Health and Human Services Secretary Kathleen Sebelius, whose resignation was announced in early April, and were spoken during a keynote at Health Datapalooza, a national conference focused on liberating health data, and connecting the people and entities interested in and dedicated to improving patient outcomes.
Sebelius' comments, which focused on data innovations in government, came only weeks after threats from House Oversight Committee Chairman Darrell Issa, R-Calif., warning Sebelius that she may be found in contempt of Congress for lack of disclosure of documents related to the launch of HealthCare.gov. Issa, a vocal Obamacare antagonist, had communicated the warning following a submission of documents that he alleges are suspiciously redacted.
Yet as the final speaker in the three-day event, Sebelius’ comments didn’t attempt touch Issa's specific criticisms — or any other Obamacare attacks, for that matter. They instead chronicled the successes of HHS and the Obama administration's successes in health IT.
Sebelius received a standing ovation from 2,000-plus audience members -- of entrepreneurs, technologists and health-care stakeholders. And she set the tone for her talk by narrating a retrospect that began in 2009 when she was first appointed by the president.
“We were a decade into the 21st century and yet the federal government was still operating with a 20th-century mentality when it came to technology, innovation and, particularly, the free flow of information,” Sebelius said.
Seeing the need for improvement, she said the president made it clear that priority was to be given to opening up the government’s massive databases of health-care information, and that data should be used as a vehicle to stimulate economic growth. It also should be used in ways that allow citizens, policy makers, researchers and physicians to be in control of their own health care.
“Many times [in the past], information was held back because leaders didn’t trust the public; other times it was because it was simply a matter of disorganization,” Sebelius said. “We knew that that data could help drive innovation.”
Sebelius said much of her time at HHS was spent implementing the daunting mission of updating fickle legacy systems and centralizing data from hundreds of databases and multiple agencies. However, the work has paid off, she said, crediting her department for releasing more than 1,000 open data sets and many data tools to the public.
By her own observation, Sebelius said the rise in greater government health-care information combined with the administration’s economic initiatives to remedy the recession have led to an unprecedented level of entrepreneurial activity in health care. Startups such as Purple Binder, a community services platform, and Aidin, a Web platform that connects patients to post-acute health-care providers, are just a few examples of companies that have been propelled by HHS data.
“We’ve seen more health-care startups emerge in the last five years than we’ve seen in the previous two decades,” said Sebelius.
Beyond open data, she added that a major culture change has taken place as the HHS has pushed hospitals to move more of their health records into electronic formats. In 2009, Sebelius said only 1 in 8 hospitals used a basic form of electronic health records (EHRs). Now, she said, EHR usage is the dominant form of health recording.
“We are now over the tipping point, where most hospitals and most providers are using electronic health records," she said, "and the paper filers are the outliers."
As Sebelius readies to step down, she said she knew the positive reforms she’s supported will be continued by the administration, and likely, by those who come after as government continues to systematically improve health care while reducing patient costs.
“These reforms represent a march of progress that can only go in one direction, and that direction is ‘forward,’” she said, referring to the president’s second-term campaign slogan.
In anticipation of Sebelius’ exit, the president nominated Sylvia Mathews Burwell to fill the soon-to-be vacant position. In May, a panel from the Senate Finance Committee endorsed Burwell, who is all but assured to be confirmed by the full Senate when she is submitted for consideration sometime this month.