How many times have you been involved in one of those EHR committee meetings whose purported purpose was to elicit ideas?  I find it to be a helpful barometer to scout the room and see if the person who offered an idea at last month’s meeting was invited to this month’s meeting.   To survive across months of meetings requires a lemmingesque ability to walk in silence to the edge of the cliff.

Don’t be fooled into offering an idea simply because the leader is doing that tricky thing about using silence to see who will get so uncomfortable that they just need to hear a voice–their own.  Mistakenly, you believe that someone is actually interested in what you have to say, and you toss your idea into the black hole that used to be your career. Your idea is met with silence, the kind of silence you hear on a warm summer night. You swear you can discern the chirping of individual crickets outside.

Those voices you’ll been talking about in counseling are trying to warn you.  But to no avail, out it comes; “How come we’re not doing those work flow things they talked about?”  “Why did Our Lady of Perpetual EHR Hospital use and RFP to select their EHR vendor?”  “Why is radiology bulding their own EHR?”  “How come nobody is worried about whether this system will allow the referral docs to connect?”

You notice that your brother-in-law, the CMIO, has moved his chair away from yours.  Your best friend’s eyes are locked on his Blackberry.  It’s only then you learn that you and your colleagues aren’t petting the same dog. I think EHR implementations are a lot like that. There’s a lot of talk about doing something new, but more often than not it’s just talk.