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"Far better it is to dare mighty things ...

January 12, 2009
by James Feldbaum
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“Far better it is to dare mighty things, to win glorious triumphs even though checkered by failure, than to rank with those poor spirits who neither enjoy nor suffer much because they live in the gray twilight that knows neither victory nor defeat.”

So said Theodore Roosevelt.

Who can’t list a hundred shortcomings of our efforts to create a universal electronic medical record? Anyone with a pen can be a critic. We struggle with complicated technical issues, governmental interference/control, economic constraints on both the national and local level, provider resistance, near paranoia about privacy, and crippling inertia. So what?

Let’s think about the state of the automobile twenty-five years ago. Most everyone had a car or drove one. Each model year we enjoyed some new enhancement that built on the success of previous technology. We drove. We drove without shoulder seat-belts, energy absorbing bumpers, front/side/roof/window airbags, electronic stability control, reverse back-up sensors, disc breaks, and anti-lock brakes. We accepted the evolution of safety features. We didn’t demand perfection. In a few years we will have collision avoidance systems built in to our vehicles. Should we garage our cars and wait?

We are obsessed with privacy to the point of paranoia. Privacy alone is such an emotional issue that the lack of guarantee could scuttle our enthusiasm for the EMR. Interestingly, most of the security breaches of the EMR are not in the technology, but from human factors (misplaced laptops). Twenty-five years of safety improvements in our vehicles are statistically negated by a beer or two or by our incessant use of the cell phone while driving.

Personally, I worry much less about privacy and the present imperfect state of our technology than I do about our inaction. Let’s focus on getting every American safer more affordable healthcare.

Have no fear of perfection - you'll never reach it.

Salvador Dali (1904-1989)

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James Feldbaum

Jim Feldbaum is a physician consultant specializing in clinical transformation, CPOE, and...