EHR-Shift Happens

When my youngest daughter, who is also my oldest daughter was two, we had her straight-jacketed in her car seat as we headed off to run a few errands.  Cute as a button and immobile—just like the book says.  My wife had nicely fixed what was left of her hair—to our surprise, her four-year-old brother had given her a haircut the day before—with a pink beret.  As she had nothing else to do in the back seat, she toyed with the beret, eventually removing it.

After a few miles, checking on her via the rear-view mirror I noticed the beret was nowhere to be seen.  Ninety-nine times out of a hundred, that would mean she had dropped it out of reach, or tossed it to one of her invisible friends in a one-way game of catch.  I asked her where the beret was—sorry for ending in a preposition, but I have a call with a client in a few minutes and do not have the time to ensure I am writing this with the proper King’s English.

Her reply was to simply point to her mouth and giggle.  I repeated the question and she repeated her response.  Being the Super Dad; my son’s term for me, I eased to the side of the road.  We checked the floor of the car, check her car seat, and under her blankets—no beret.  We replayed the question for the third time and received the same response.  We checked her mouth—no beret.  We were hesitant to believe the charade-like communications of a two-year-old.  Nobody in their right mind would swallow a beret.  Then we started to think about the situation.  Bright, shiny, colorful things probably all look like candy to a two-year-old.

We called my sister-in-law, a pediatric nurse practitioner, and an executive at Children’s Hospital of Philadelphia.  She made it clear that we needed to head to the hospital, do not pass Go; do not collect two hundred dollars.

We drove to the ER.  They did their magic, and we were soon looking at her image of her tummy—that’s the most clinical term I know to describe the situation.  There was the beret—we could not tell if it was pink, but we were hopeful that this had to be the same one about which I am writing.

As it turns out, the problem did not lay with her ability to communicate, it lay with our inability to believe that someone without an MBA—feel free to substitute MD or PhD—could define the situation accurately.

I do not have time for a segue, so let us jump into this.  It is easy to ignore what others are saying when a bunch of acronyms a printed on a business card after the presentation of your name.  Been there, done that, too well educated for whatever opinion you may care to offer on the topic.

My docs, and goodness knows I have several of them, I trust with my life—and I have.  These same docs, I would not trust to manage the P&L of a lemonade stand.  This has nothing to do with their IQ, it has to do with their training.  They would not trust me to insert a chest-tube, even though I have watched several episodes of Life in the ER.

At some point, we need to take a hard look at who is best to do what for whom.  Acronyms, in and of themselves, do not qualify one to make business decisions, especially in a virulent environment like healthcare.  Reform, EHR, ONC, Meaningful Use, Certification.  Shift happens, and is happening.

Sometimes there is value in listening to the two-year-old.

saintPaul M. Roemer
Chief Imaginist, Healthcare IT Strategy

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

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