May I have receipt for my EHR in case I return it?

A hospital in our area just dedicated a new wing.

For months the job site was a maze of people, duct, and tools.  It cost $145 million.  Affixed to the new wing is a plaque displaying the name of the architect, the contractor, the mayor, and the rest of the adults who made it happen.  While it was being built there were numerous permits, certifications, and sign-offs taped to the building.  Their purpose was to ensure the public that the adults were keeping an eye on things.  A phase of work couldn’t be started until the prior phase had all the requisite sign-offs.

Those in authority had to be licensed.  Had to be certified as qualified.

They have another project underway.  One that costs more than the new wing and impacts more people.  This one doesn’t have a blueprint.  There are no building permits.  No certifications.  No licensed professionals.  You can’t even see it.  There are no hard-hatted workers.  No foreman.  You know who’s in charge of the project?  A hospital executive—prior experience—zero.  Has he ever built one before?  No.  Does he know what to do when he encounters risks, pitfalls?  No.  There is one other person running the show—a vendor—that should let everyone get a good night’s sleep.

Would anyone let this same executive be in charge of building a new wing?  Of course not.  Why then do we not employ the same standards for what will turn out to be the most expensive and far reaching non-capital project that the hospital will ever undertake?  If you think you know, please share your answer.

By the way, I asked one of those executives how it was that he happened to be selected to lead the EHR project.  “I forgot to duck,” he quipped.  I guess that’s as good a reason as any.


4 thoughts on “May I have receipt for my EHR in case I return it?

  1. If the budget is truly over 145 million, there should be room in there to hire you. If the hospital is ‘in your area’ then you should put in a proposal. I’m sure the guy who can’t duck would appreciate the help.


  2. Paul, good points. Software is a different animal than a building. Enterprise software is more like a airport with many different systems, personel, and machines that must be coordinated.

    Coming from a software consulting background where I have assisted many company in selecting multi-million dollar Software system, I see that there are several key problem in Healthcare when it comes to software.

    1. Most healthcare system know nothing about software other than supporting desktops application. This is changing for the larger systems.
    2. Once you take on a software solution that you customize for your specific need you take on a lot of technical liability, that doesn’t go away. If you are not careful, software can become your primary business, not healthcare.
    3. Most let the providers select the system. I Do understand that the provider are key in the selection and providing the requirements but selecting a enterprise software system has to included more the how the User Interface looks and and feels
    4. Some let HIT select the system? The same HIT that was setting up computers before we started to talk about EHR. You must vet your employees like they are consultants, Do they have the skills to make this type of decision?

    On the refund side, I know of one hospital system that is on their third EHR in about 4 years. Each one of the systems are top rated EHR but there were a lot of complaints and the administration folded and some were fired. I asked some of the provider why the system was removed and all of them had no idea. Most were unhappy with the system for a while but learned what they needed to use it.

    All software has it problems, but most top rated EHR will do the job. It may not be exactly like you use to do thing but it can get the job done. Remember, the best tool for any job is the one you know.

    Here I go tillting at windmills again,


    • Jeff, that sort of reminds me of Einstein’s definition of insanity–doing the same thing more than once and expecting a different outcome. Thanks as always for your insightful comments.


    • Jeff:
      Well said! I might quote you on that “The best tool for any job is the one you know.”
      I hear complaints all the time about the software system, and the number one question is “Would the other system have had this problem?” The answer is “probably not this exact problem, but a similar one.” No system is going to be perfect so how much will you spend chasing after that ideal?


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