EHR throws a curve ball

There are not many things which when they work, work to the exclusion of all others. (Word tried to let me know I can’t use the same word twice in a row in the same sentence. Word underestimates my abilities.)

I recently watched the movie *61. The movie documents the 1961 Yankees as Roger Maris and Mickey Mantle both chased Babe Ruth’s longstanding record of 60 home runs in a single season. Great movie if you happen to think baseball is a metaphor for America.

I wrote in a prior posting that I grew up in Baltimore, grew up with the O’s—that’s the Baltimore Orioles for those of you who regard synchronized swimming as a real sport.

So before I lose you, the let us get down to why I am writing and why you are reading.

Baseball is full of stats and facts. That is why those of us who love the game do in fact love it. Baseball knows how a right-handed batter from Dubuque with a three ball two strike count is likely to fare on Tuesdays at an away game at night with a full moon with a left-handed pitcher with a one run lead in the late innings with two men on base. There are more stats on arcane matters like this than there are on how Hillary wore her hair and the color of her polyester pantsuit when she met with the Bosnians.

That in and of itself makes baseball relevant. America will continue if Hillary never again meets with the Bosnians. It will not continue without baseball—it is important to pronounce the word “base—-ball,” the way James Earl Jones spoke it in Field of Dreams. (I am not familiar enough with the rules of grammar to know if the name of the movie should be italicized or in quotes, but I know you get the point; grammar be dammed.

Here’s something most of you may not know. Before every game, in the bowels of the stadium, the umpires perform a decades old ritual. When baseballs arrive from the factory, they arrive with the sheen on them that all newly manufactured products have—forgive me for ending in a preposition—a sheen that makes it difficult for the pitcher a gain proper purchase on the ball.

Baseball tested a number of solutions—tobacco juice, shoe polish, sauces, oils—to enable pitchers to grab the ball. In the mid-1930’s a baseball player discovered a solution. He found a mud in a tributary of a river in Palmyra New Jersey that did the trick, and he started marketing the mud to the American League. Why the American League? Because he hated the National League.

Since that time every baseball for every MLB (Major League Baseball) game has been rubbed down using this mud, rubbed down, a gross at a time, by and prior to the umps calling the game. That is a lot of rubbing—you do the math.

What in the wide-wide-world-of-sports can this have anything to do with healthcare? Thanks for asking. It has to do with finding a solution, a singular solution. EHR. EHR is FUBAR—you figure it out. There are as many hospitals who swear by the solution you selected as those who do not. Your solution as to how to take the sheen from your EHR are being replaced by other hospitals who claim to have found a better solution.

Roemer’s Rule One—all complex problems have simple solutions. Got milk? Got EHR? It is not about the specific EHR…it is about what you choose to do with it. CIOs and CEOs do not often select the wrong EHR—they select an implementation strategy that would fail if all they were doing was implementing the latest version of Microsoft Office.

As complicated as Washington makes EHR appear, there are simple solutions. It has almost nothing to do with the software; it has to do with what your organization does with the software.

What do you need? You need the New Jersey mud, the mud that places all reasonable EHRs on the same playing field, the mud that solidifies that the results you will achieve depends not on the EHR you selected, but if what you decide to do with the rubbing compound—the mud. Anyone can pick an EHR. Few can figure out why the one they have chosen makes a difference.

Baseball fans know an obscure fact. Prior to every major league game, every baseball in every stadium is rubbed down with mud, a mud unique to a single spot on New Jersey. The baseballs are all the same, the mud is the same. Yet, some teams win, and some lose. What does this tell you? It tells me it is not the ball, and it is not the mud.

The difference between the winners and the losers must be attributable to something else. What else? I guess it has something to do with what they do with the ball.

Kind ‘a like EHR. I guess it depends on what you do with it once the ball is in your hands. How is your EHR team doing? A lot of teams are asking the ump for another ball, another $200 million dollar ball. Think that will work?

Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy