The potential reversal of AHRQ's fortunes was probably driven more by DC budget wrangling than the perceived value of the agency's work. Still, its supporters, some of whom rely mightily on AHRQ grants, made a lot of noise and had some fun tooting the agency's horn.
It looks increasingly like the federal Agency for Healthcare Research and Quality will survive the attempt by Congress to shut it down. But it probably won't be because of the memes supporters sent out on social media.
Memes, those photos with goofy text you've probably seen on Facebook, are designed to exponentially filter out through social media. They were just one part of a campaign launched by "Friends of AHRQ" – a coalition of hospitals, researchers, and providers intent on preserving the agency's federal funding.
The goal was to generate support for the agency after the US House of Representatives approved a budget this summer that would have shut down AHRQ.
The potential reversal of AHRQ's fortunes was probably driven more by DC budget wrangling than the perceived value of the agency's work. Still, its supporters, some of whom rely mightily on AHRQ grants, made a lot of noise and had some fun tooting the agency's horn.
The Bipartisan Budget Act, passed on Oct. 30, adds $80 billion to the federal budget over two years. It will allow Congress to avoid the kind of budget gridlock that shut the federal government down in 2013.
Emily Holubowich, a spokesperson for Friends of AHRQ, predicted that the agency will still see some budget cuts, but not the 100% cut proposed by the House and not even the 30% cut that was in the Senate budget bill. Based on a decade of watching the DC budget process, she predicted either flat funding or a cut of 5% to 10%.
It's not clear how much of the new money will go to the Department of Health and Human Services, but Holubowich is optimistic: "We certainly feel that with the passage of the Bipartisan Budget Act, the outlook is a lot better for AHRQ than it was in June."
The failure of the agency to promote itself and to more effectively communicate its mission to Congress and the public was cited as one of the reasons lawmakers felt safe cutting the program.
"It's been a clarion call for both the community and the agency," Holubowich says. "It's not enough to do good work. You have to go out there and talk about it and talk about it to the right people."
So the Friends of AHRQ, which is hosted by health service research group Academy Health, posted an advocacy tool kit for supporters. It included "key messages," a Twitter hashtag (#saveAHRQ) and talking points such as "Health services research benefits us all," as well as sample blog posts, letters to lawmakers, and tips on working with the media.
In addition to launching the hashtag, the group has been promoting "Tweet Days." It reports that the campaign has produced close to 2,500 tweets from 860 participants.
Not everyone stays on script. The tweets I found range from wonky to goofy to angry:
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Not that the agency didn't take the traditional lobbying routes, too.
More than 200 organizations lent their names to a letter sent to key members of Congress. Former MEDPAC chair Gail Wilensky, PhD, wrote a piece for JAMA. Health Affairs editor Alan Weil wrote a piece entitled "We Would Be in the Dark Without AHRQ." And Jeffrey Lerner, the CEO of the non-profit ECRI Institute delivered his message to the public through an op-ed on The Philadelphia Inquirer's website. He, like many others, thinks AHRQ needs to do a better job getting its message out.
The general public will be willing to support the agency, if they understand what it does, Lerner said. For example, many don't know specifically what NIH or FDA do, but they want medical research and safe drugs.
"People want the best treatments," he said. "We use words that I think are hard for people to relate to – like 'comparative-effectiveness research'. It's not a user-friendly term for the general public. But if you say 'Would you like to be able to compare a products or services or medical procedures and find out which one is best for you?' If you speak in that language, you are going to get a 'yes.'"
Furthermore, in the language of hospitals, Lerner noted that AHQR research is used by Medicare to make coverage decisions.
Friends of AHRQ's Holubowich says that the proposed cut was a reminder that, in the age of budget austerity, no agency can assume that Congress will recognize the value of its work. "You have to be out there," she says, "There is a saying in Washington that if you are not at the table, you're on the table."