EHR: When you are in a hole, stop digging

 March 21, 2011 07:05

I was thinking about the time I was teaching rappelling in the Rockies during the summer between my two years of graduate school.  The camp was for high school students of varying backgrounds and their counselors.  On more than one occasion, the person on the other end of my rope would freeze and I would have to talk them down safely.

Late one day, a thunderstorm broke quickly over the mountain, causing the counselor on my rope to panic.  No amount of talking was going to get her to move either up or down, so it was up to me to rescue her.  My total amount of rappelling experience was probably only a few more hours than hers.  Nonetheless, I went off belay, and within seconds, I was shoulder to shoulder with her on the face of the cliff.

The sky blackened, and the wind howled, raining bits of rock on us.  I remember that only after I locked her harness to mine did she begin to relax.  She needed to know that she didn’t have to go this alone, and she took comfort knowing someone was willing to help her.

That episode reminds me of a story about a man who fell in a hole.  The man continues to struggle but can’t find a way out.  A CFO walks by.  When the man pleads for help, the CFO writes a check and drops it in the hole.  A while later an EHR vendor walks by—I know this isn’t the real story, but since I am the one writing I’ll tell it the way I want.  Where were we?  The vendor.  The man in the hole pleads for help and the vendor pulls out the contract, reads it, circles some obscure item in the fine print, tosses it in the hole, and walks on.

I walk by and see the man in the hole.  “What are you doing down there?”  I asked.

“I fell in this hole and don’t know how to get out.”

I felt sorry for the man—I’m naturally empathetic—so I hopped into the hole.  “Why did you do that?”  He asked.  “Now we’re both stuck.”

“I’ve been down here before” I said, “And I know the way out.”

I know that’s a little sappy and self-serving.  However, before you decide it’s more comfortable to stay in the hole and hope nobody notices, why not see if there’s someone who knows the way out?

Drafting someone to sort out your EHR problems doesn’t do anything other than add another name to the org chart.  Work plans and org charts are very similar in one key respect—they both have a lot of blank space between the all of the boxes.  And, that is where a lot of the problems arise—in the blank spaces, spaces that have to do with planning, process improvement, and change management.

Everyone is implementing an EHR, but not everyone is doing it correctly.  There is a very special set of IT skills needed to meet the challenges of a failed or failing project.  People with those skills are disaster recovery specialists.  They are the people who jump in the hole with you because they have been in the hole before and they know the way out.

2 thoughts on “EHR: When you are in a hole, stop digging

  1. I like your version of the story 🙂

    Getting providers/decision makers to embrace the voice of experience (rather than that of colleauges, salespeople or “the internets”) is a challenge but when they do it makes such a difference in implementation.

    Great post, as usual


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