“We need to talk about your TSP reports”

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If you recognize the stapler, you know the movie.  “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 healthcare IT and reform from a different perspective than most; 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 AMA 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 the business of healthcare. It’s not rocket surgery, but then, it was never meant to be–before someone writes, I know it should be scientists.  It’s process, change management, leadership and foresight.

Sometimes I like to look at the problem from a different dementia—Word didn’t have a problem with my usage of that word.  I look at healthcare and ask myself three questions:

1. How did they ever get so siloed?

2. How did they ever get so so big without a cohesive IT strategy?

3. Is it possible to reverse both of those AND improve the business.

I am convinced the answer is yes.

5 thoughts on ““We need to talk about your TSP reports””

  1. 1. How did they ever get so siloed?

    Budgets and politics. IT and clinical areas have separate budgets for technical acquisitions especially in large single hospital systems. The physicians (which usually have far more clout than most in healthcare IT management) can pick and implement systems that have little or no IT oversight. IT standards are viewed as a hindrance and many physicians have little tolerance for such things. IT gets to hold the bag in the end when it comes time to integrate (which of course was not put in the budget). On the other hand, a lack of IT planning for things that can potentially serve several departments can frustrate physicians so they go rouge.

    2. How did they ever get so so big without a cohesive IT strategy?

    Healthcare IT can be its own worst enemy in some ways. For example, imaging is an area that begs for better strategy. You can have radiology and cardiology and obstetrics all in the same hospital using different PACS systems that can’t talk to each other. Also, vendors don’t sell these one-off systems to be fault tolerant – they would lose the sale. Classic example, the cardiologist wants to see the chest X-Ray from the cardiology PACS but can’t because it’s on the radiology system. This is where IT can promote integration by moving towards vendor neutral archiving and greater redundancy.

    3. Is it possible to reverse both of those AND improve the business.

    Yes, and end up with less costly, integrated and redundant systems.

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  2. First of all, I like Physicates, will likely use it in conversation. I have used rocket surgery before 🙂

    Secondly, Scott is right

    and lastly, I agree with your assessment that things will not be getting better any time soon.

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