Guerra On Healthcare: Preventing EMR Planning Paralysis
If you wait for answers before implementing an electronic medical record, you'll likely fall behind on getting meaningful use incentive funds.
The statistics on successfully launching a business are so abysmal it's a wonder anyone even bothers to try. They are so stunning, in fact, it's these same statistics which gave me the most anxiety when I prepared to launch my business at the beginning of last year. It's said that something like 80% of all new non-franchise businesses fail within the first year, and 80% of the 20% that make it through that initial year fail within the next five.
While doing other research into how to launch a business successfully, so as to join the tiny cohort of those who've survived the aforementioned gauntlet, I came across books that caused further anxiety. The message of these authoritative missives was that you must have an iron-clad, detail-laden business plan to serve as your exact roadmap for at least the first six months of operation. After laying out some initial plans and goals, I began to feel that laboring to inject greater specificity into my plans would pay diminishing returns, as there was little chance that what I knew at the time would be applicable three months hence.
I flashed back to this feeling recently, when reviewing one of my blogger's submissions. Jorge Grillo, CIO at Canton-Potsdam Hospital in N.Y., has been writing an incredible series on his organization's transition from Meditech Magic to Meditech 6.0. In his latest installment, Part 4, Grillo says he had a "Wow, I should have had a V8" moment when a prospective consultant advised that many of the issues which would come up during the migration could not be anticipated or prepared for. In essence, Grillo was advised there were limits to his preparation.
An attempt to over-prepare can have one of two negative consequences, both of which have been hinted at. The most dangerous of these is that an attempt to nail down every detail -- and the possible stumbling blocks which are unearthed in such an exercise -- leaves one incapable of action. This is commonly called "paralysis by analysis." The second possible outcome, still detrimental, is that time, energy, and money are frittered away on preparations which evolving circumstances quickly render obsolete.
Rarely has an objective been less suited to extensive preparation than the implementation of an electronic medical record (EMR) under current legal, business, and political conditions. To be clear, I'm not talking about simply implementing the technology, which Grillo makes clear is chock full of complexities and obstacles of its own. But I'm more strongly referring to the Health Information Technology for Economic and Clinical Health (HITECH) haze which hangs like a 19th century London miasma over the healthcare IT industry. What has made this haze even thicker is the recent injection of other voices into the discussion, some of which are so loud, clear, and authoritative they must be taken very seriously (think President's Council of Advisors on Science and Technology, PCAST, and Institute of Medicine, IOM, reports).
With so much unclear, a great many organizations are likely suffering from paralysis by analysis. For those hoping for meaningful use funds, there is no time for excessive contemplation. For others, there is no need, because despite the fact that so much is unclear, it's best to take the course Grillo's consultant advised, the one he found so encouraging.
This is also the course I took when launching healthsystemCIO.com -- prepare every detail of your journey as far as the horizon but no farther, for only when you reach the next vista will the optimal course to be taken reveal itself.