Arnold Epstein, MD, Chair of the Department of Health Policy and Management at Harvard University School of Public Health, said he didn't think the final definition put enough focus on research in methods of care delivery. For example, whether nurse extenders can play a larger role in patient care, or ways patients can keep better track of their medications.
And Ellen Sigal, founder of the research think tank Friends of Cancer Research, called it "convoluted" and "complicated."
But in the end, most said it was something they could live with, at least until the board decides to rewrite it again. Or maybe they were just worn out and wanted to go home.
"We just need to come up with a decision and move this forward, or face embarrassment after all these months of trying to make a decision," Collins said, adding that he was "loathe" to make any negative comment in the first place, after all the work that had gone into it.
"As someone who has been involved from the very beginning, I do want to say that this has been extraordinarily difficult," said Harlan Krumholz, MD, Director of the Yale-New Haven Hospital Center for Outcomes Research and Evaluation.
"Bravo," said Carolyn Clancy, MD, director of the Agency for Healthcare Research and Quality. "The scheduling challenges alone for this rather large group are close to giving me a headache."