Part of the reform discussion should include reform that requires and/or will only come about through EHR.
The other part of the discussion should be about reforming EHR. Neither will work without the other
September 20, 2009
EHR: What questions remain unanswered?
“We need to talk about your TSP reports.” Office Space—Possibly the best movie ever made. Ever worked for a boss like Lumbergh? Here’s a smart bit of dialog for your Friday.
Peter Gibbons: I work in a small cubicle. I uh, I don’t like my job, and, uh, I don’t think I’m gonna go anymore.
Joanna: You’re just not gonna go?
Peter Gibbons: Yeah.
Joanna: Won’t you get fired?
Peter Gibbons: I don’t know, but I really don’t like it, and, uh, I’m not gonna go.
Joanna: So you’re gonna quit?
Peter Gibbons: Nuh-uh. Not really. Uh… I’m just gonna stop going.
Joanna: When did you decide all that?
Peter Gibbons: About an hour ago.
Joanna: Oh, really? About an hour ago… so you’re gonna get another job?
Peter Gibbons: I don’t think I’d like another job.
Joanna: Well, what are you going to do about money and bills and…
Peter Gibbons: You know, I’ve never really liked paying bills. I don’t think I’m gonna do that, either.
One more tidbit:
Peter Gibbons: Well, I generally come in at least fifteen minutes late, ah, I use the side door – that way
Lumbergh can’t see me, heh heh – and, uh, after that I just sorta space out for about an hour.
Bob Porter: Da-uh? Space out?
Peter Gibbons: Yeah, I just stare at my desk; but it looks like I’m working. I do that for probably another hour after lunch, too. I’d say in a given week I probably only do about fifteen minutes of real, actual, work.
I like to think of Peter as my alter-ego.
When I’m playing me in a parallel universe, I’m reading about a surfer dude cum freelance physicist, Garrett Lisi. Even the title of his theory, “An exceptionally simple theory of everything,” seems oxymoronic. He surfs Hawaii and does physics things—physicates—in Tahoe. (I just invented that word; it’s the verb form of doing physics, physicates.)
Ignoring that I can’t surf, and know very little physics, I like to think that Garrett and I have a lot in common. I already know Peter Gibbons and I do. So, where does this take us?
It may be apparent that I look at EHR from a different perspective than many of others involved in this debate; I’m the guy who doesn’t mind yelling ‘fire’ in a crowded theater. The guy who will never be invited to speak at the HIT convention unless they need a heretic to burn for the evening entertainment. I can live with that.
Like Garrett, I too see an exceptionally simple theory in everything, especially when it comes to improving business. It’s not rocket surgery, but then, it was never meant to be. You’ve seen the people running it, they are definitely not rocket surgeons—before someone writes, I know it should be scientists.
Sometimes I like to look at the problem from a different dementia—Word didn’t have a problem with that usage. I look at EHR and ask myself three questions:
1. Why do people really believe the existing national roll out plan will work?
2. How did the plan ever get so complex?
3. How much money will be wasted before people look for a realistic solution?
What do you think?
Revising patient interactions via social media and CRM
For those who don’t have time for 140 characters, or who don’t have much to say, I’ve created an alternative, smidge.com. The Urban Dictionary defines a smidge as a small amount of something, short for smidegeon.
This will revolutionize the interaction between patient/customers and the healthcare provider. We all know how annoying customers can be. Why should providers continue to enable bad behavior? They call, fax, email, and tweet. Enough already.
It’s time providers show a little backbone, show the customers who’s in charge.
Here’s how smidge.com works. Each time a customer interacts with you, give the patient their smidegeon account. Explain to them that this is their private way to communicate with you. It’s instantaneous, totally secure, and it operates 7 x 24 x 365. No more navigating IVRs, no more being placed on hold, no longer will they be transferred to another agent, never again will they be monitored for quality control purposes. Let the customers know that anytime they want to smidge, the world is theirs.
Explain to them that you are doing away with archaic forms of interacting; closing your call centers, throwing away your fax machines, and deleting your presence on the web. What are the advantages to your firm? They’re almost too many to document. Think of the capital savings. No more IT expenditures to support those millions of whining customers. No more CSRs complaining about not being allowed to browse the web, or about not getting their mid-morning break.
And now for the best part. In order to minimize bandwidth and storage costs, each smidegeon only allows the user to use each letter of the alphabet one time, meaning the largest smidge can’t exceed 26 characters. The longest message one could get is, “The quick brown fox jumps over the lazy dog”. That being the case, there will no longer be any justification for the customer complaining that your company didn’t resolve their problem.The roles will be reversed. The upper hand will now go to the company.
How? Let’s look at an example. The patient wants to smidge the following change of address information, “We are moving on October 13 to 1175 Harmony Hill Road, Spokane, Washington. Please forward our bill.” Since smidges don’t allow numbers, we’ve already simplified the message, and the ease of entry. Now, if we translate the message into a correctly formatted smidegeon, we get the following message, “We ar moving ctb Hny l d Spk f u b d.” Now, how can you be expected to understand that kind of nonsense? If you can’t understand it, how can your patients possibly blame you?
