Be very afraid

white_high_heelsI remember two things from my lone sociology class in college.  Somebody name Emile Durkheim—given that I cut almost every lecture, I continue to amaze myself that I spelled his name correctly—he did something about suicide rates, and one thing about inherent fear—we are born with knowledge of two types of fear; heights and loud noises.  I was born with a third, the fear that comes from thinking that one day I might slip out the door wearing white shoes after Labor day—see how timely this is?

There’s been a common thread for the last few days among the social media-ites—sometimes you are forced to make up a word or two.  The thread of which I write is fear, a fear that started in anticipation, and has been building since last week.  Muculent palms, jitters, slight schizophrenia.  The anticipation of the voices, “And he did hear a sound rising over the snow. It started in low… then it started to grow.”  Sorry for the Grinch reference, I’m trying to work through this.

It starts with notifications; emails, letters.  Doctor’s name and phone number.  Emergency contact information.  Write it three times in case we lose the first two.  Then comes the demand for tools—don’t dare go to sleep without completing this; pencils, scissors, crayons…Backpacks.  Lunch boxes.  I can’t wake them up.  They open one, look at me, and roll over.  They say things like, “This is what all the kids are wearing.”  They look you in the eye and lie, “I brushed my teeth.”  “If you don’t fill out the forms I can’t go back tomorrow.”

They fail to recognize that we have multiple degrees.  And if they did realize it, they would not care.  You may be a big shot between 8 and 5, but right now you’re just dad, and why don’t we have any fruit roll-ups for my lunch.

So, how was your day?  For me the voices have subsided, but the sweaty palms will return just prior to the school buses.

I look at healthcare reform and EHR and think, the only thing to fear is reform itself.

I’ve been asking friends for their input about our conversations here, and somebody whose opinion I value highly suggested I write what my audience wants to hear.  I can’t do that—that’s what the other bloggers do—feel good, but this, but that, cheerleaders.

This is difficult, at least if you want it to work.  There’s no shame in asking for help.

drevil

The wildebeest postulate

wildThe Kalahari; vast, silent, deadly. The end of the rainy season, the mid-day heat surpasses a hundred and twenty. One of the varieties of waterfowl, most notably the flame red flamingo that nested in the great salt pans in Botswana, has begun its annual migration. In the muck of one of the fresh-water pools that had almost completely evaporated, writhes a squirming black mass of underdeveloped tadpoles. A lone Baobab tree pokes skyward from the middle of the barren savanna. In its shade, standing shoulder to shoulder and facing out, a herd of wildebeest surveys the landscape for predators.  Sir David Attenborough and PBS can’t be far away.

Some things never change. I make my way across the freshly laid macadam to meet the school bus. Fifty feet in front of me is a young silver maple tree, the tips of its green leaves yielding only the slightest hint of the fall colors that are hidden deep within. The late afternoon sun casts a slender shadow across the sodded common area. One by one they come—soccer moms; big moms, little moms, moms who climb on rocks, fat moms, skinny moms, even moms with chicken pox—sorry, I couldn’t stop myself—as they will every day at this same time, seeking protection in its shade. My neighbors.  It’s only seventy-five today, yet they seek protection from the nonexistent heat, a habit born no doubt from bygone sweltering summer days. A ritual. An inability to change. In a few weeks the leaves will fall, yet they will remain in the shadow of what once was, standing shoulder to shoulder facing out, looking for the bus. A herd. Just like wildebeest.

The kids debus–I just made that word, hand me their backpacks, lunch boxes, and hundreds of forms for me to complete.  I look like a Sherpa making my way home from K-2.

I shared this perspective with the moms, and have halted most of my bleeding. I can state with some degree of certainty that they were not impressed with being compared to wildebeest. So here we go, buckle up. By now you’re thinking, “There must be a pony in here somewhere.” Some things never change; it’s not for lack of interest, but for lack of a changer. For real change to occur someone needs to be the changer, otherwise it’s just a bunch of people standing shoulder to shoulder looking busy. How are you addressing the change that must occur for EHR to be of any value?  EHR is not about the EHR, it’s about moving from a 0.2 business model to 2.0.  Someone who sees the vision of what is is—sorry, too Clintonian—must lead.  Be change.

One of the great traits of wildebeest is that they are great followers.

sing4

What did you do in reform daddy?

sorry for the quality, I drew this in high school

sorry for the quality, I drew this in high school

Tenth grade biology class was on the second floor.  One of my best friends said that for five dollars he would jump out of the window during class, sort of like falling out of the stupid tree and hitting every branch on the way down.  Others took the bet.  Lemmings.  They all jumped.  Speaking in parenthesis for a moment, this same friend was interviewed on Larry King on September 11, 2001, discussing how to run covert ops on Bin Laden.  I haven’t slept well since I learned that.

As I talk with clients and several of the healthcare thought leadership, I see consensus building around a lemming-like acquiescence about reform, especially as relates to EHR.  That wasn’t much of a segue, but my children stared school today, and I am still in shock from having let me seven-year-old pack his lunch—very different food groups.

I read an article in a much respected—I wrote ‘very’ instead of ‘much’, Word didn’t like it.  Learn something every day—publication that the primary business driver behind EHR is that it is perceived as a mandate.  (Sorry, that was written poorly—I may have to fire that guy.)

If that’s why your organization is doing it, do yourself a favor and stop.  The ROI from the stimulus money will not make EHR worth your while.  How will you know if you did it for the right reasons?  When you get to the end, if you aren’t able to say, “I wish we had done this years ago”, you’ve done something very wrong.

drevil