In the first, I had convinced my graduate school professor of operations management that since I took operations research in college that I could “audit” his class and be the teaching assistant. I used the term auditing to mean I didn’t have to attend the class or do the home work. From the school’s perspective, it did mean I had to take the final. As I learned sitting at my desk, wishing I could think of any excuse to move my pencil across the pristine pages of the blue book, apparently there is a difference between operations research and operations management. Whatever the difference was, it accounted for the blank pages staring up at me.
At the end of the exam the only marking in my book was the note I wrote to the professor, “I think we both know I know how to do this however, I froze. If you need to fail me, I understand.” He gave me a “C”. I saw him when I visited Vanderbilt last year, and he recognized me and remembered the story—I like to keep my audience riveted.
The other dream has to do with my lone Poly-Sci class as an undergrad. I am a proponent of the notion that I can answer almost any question provided I can reframe the question into one I can answer. The exam instructed us to answer a question about a book I hadn’t read. My only choice was to reframe the question, equating it to one from a book I had read. I gave what I thought amounted to a fairly reasoned response to “my” version of the question. The professor agreed that I had, and then wrote on the cover of the exam book that he too used the same device when he was in college. It had not worked for him and he wasn’t going to allow it to work for me.
I think many of those grappling with EHR would benefit from reframing the question. Many view the question as, “How do I accomplish what the folks in Washington want me to do?” Sometimes that question might deserve an answer. In the case of EHR I do not think it does. In fact, I think answering the question, and then building a plan around your answer can make EHR more difficult, and it can move you away from your business goals.
A better question, at least for your hospital or practice is, “Does it make sense for me to accomplish what the folks in Washington want me to do?” Has Washington demonstrated enough leadership over EHR, Meaningful Use, Interoperability, or reform to justify following? Have they provided enough clarity, defined a set of business objectives, or justified their reasoning? Does their reasoning fit your business model?
I bet it does not.