What’s the best EHR strategy for me?

Electrician_Cartoon_2Sometimes it pays to hire an expert.  Given the uncertainty around standards and interoperability, selecting and implementing an EHR may be one of those times.
Maybe a real life example will help to illustrate the point. I had just purchased my first home. It was located not too far from downtown Denver and the home was built in 1898. Like most homes built in that era, this one lacked many of the things that we consider essential; closets, plumbing, electricity. There were few if any overhead lights in the house. As a new homeowner with a freshly minted MBA, I was on a pretty tight budget. One of the department stores in downtown Denver was going out of business and was selling everything including their fixtures. Being cost-conscious, I thought this may be an opportunity to find a bargain. So I grabbed my wire cutters and drove downtown.

It looked like they were having a fire sale. (That term will have more meaning in a few moments.) As I entered the store hundreds of people were scattered about, going from table to table loaded with purchases. Some people were walking out with shelves and fixtures, other people with shopping carts full of clothing. Looking up, I saw an attractive set of track lighting. It was located directly beneath a large table that was piled high with purses. I found a folding chair, and set it smack dab in the middle of the purses and climbed up. For the briefest of moments that seemed to settle the feeding frenzy that was occurring directly beneath me. Undaunted, they let me go about my work as they went about theirs, ripping and snatching purses and satchels from each other’s hands.

I rocked my feet back and forth on the chair’s plastic cushion to ensure I had correct purchase of the chair on the table. The light canisters were about a foot from my head. Just so you think I’m not a complete idiot I looked up to ensure that the lights were off. Even I knew you didn’t cut down a light that is lit. After all, did I mention I have an MBA? So here’s where it gets interesting. I reach up with my left hand and cut the wire that led from the light fixture and into the ceiling. In a fraction of a second I entered and left the Twilight Zone. Everyone in the store  experienced several of their senses at once. There was a bright flash of purple light, a large crackling sound, and the smell of burnt ozone.  Everyone appeared to be moving in slow motion. I reached up, pulled down the lights, hopped off the table, and made a beeline for my car.

After the tingling in my hands had subsided I reached over and looked at the wire cutters. For those of you not familiar with wire cutters I’ll describe what they should look like. They function much like a pair of scissors and the idea is for them to be able to strip off the plastic sheathing that surrounds the copper wire. Accordingly, there is a series of holes that run from small to large along the two sides of the blades. Behind that section, closest to the fulcrum, is the cutter, the part I used to slice through the wire. That part is not designed with a hole. Unfortunately, my wire cutters now had a freshly melted hole in that area. It appears that when I reached up to cut the wire the electricity was still on–which may account for the crackling sound, the smell of burnt ozone, and the purple flash.

By now, I was scared. I turned on the TV, the local news, to see if I needed to turn myself into the police, to see if in fact I was responsible for having burned down an entire store with several hundred people in it. So where does that leave us? Although this isn’t rocket surgery (just so you  know, that was intentional), there are times when it pays to hire somebody who’s done something at least one more time than you.  I’m pretty sure that when all is said and done, having someone manage the process of selection, implementaion, and workflow alignment may prove to be one of those times.

So if you want my advice, hire an electrician.


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