I rarely write on Sunday, but with my wife and the kids in Miami for the month while I serve as the EHR Czar, I thought I would share a few thoughts with you.

I went to a reception a few nights ago with some healthcare executives in the Philly area.  It was one of those events whereby the caterer thought the chi-chi crowd would do back-flips over canapés of fava beans stuffed with cheese made from the breast milk of yaks.  One of those events where you can’t complain without being as obvious as someone walking the streets of Tehran wearing a Star of David T-shirt.

Sometimes  you get an ah-ha about life which is so profound it must be shared with friends.  I got one of those today while making a breakfast of smoked salmon, capers, and New York bagels.  I retrieved a clean plate from the dishwasher.  I knew when I finished breakfast I would have to empty the dishwasher–a task that always irks me.  The lights brightened, the sky opened, and I learned something most consultants would try to kiss their elbows to understand.

We have two dishwashers–machines, not people.  Naturally, that cuts down on the number of times we have to empty the dishwasher.  Mind you, my discovery only works for people whose spouse is out T town and for homes who have two dishwashers.  Here’s the deal.  Wash the dishes in one dishwasher.  Sooner or later you get hungry.  You think about going to the cabinet to grab a plate and the it occurs to you that you already have a clean plate in the dishwasher; along with a drinking glass, and utensils.  Why not use them?  And after dining–and this is the revelation–place the newly soiled dishes in the other dishwasher.  Guys, this re-engineering of the traditional kitchen processes eliminates the need to ever empty the dishwasher.  Everything in the dishwasher is caught in an infinite loop, eliminating the need for kitchen cabinets.

This new process brought to mind an episode of ‘Happy Days’ when The Fonz explains to Ritchie how bachelors make a salad to conserve wasting time on extraneous business processes.  The Fonz told Ritchie to hold the head of lettuce above the sink and pour salad dressing on the lettuce, thereby eliminating the need for a plate.

Where were we?  That is unplanned an alliteration.  Given that, how do I make this worth your time?

Permit me to address the C-suite.  Does it seem to you that those people in your firm are paid for working hard, or for delivering results?  I think they are paid for working hard, for looking like they are working hard, for doing the things people in their esteemed position ought to be doing.

They are busy.  Why?  Because those who are not perceived as being busy are fired.

Who at your firm is delivering results?  Who is defining what the results needs to be?

Someone needs to define the ah-ha moments for your organization.  Somebody needs to take charge, to know that it is possible not to unload the dishwasher, to know that there is no value in stuffing the fava beans with the cheese.

saint Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy

1475 Luna Drive, Downingtown, PA 19335
+1 (484) 885-6942

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