Commercial Sources for Options and Insights
Where does blogging fit in?


I was thrilled this morning to read Gartner's Wes Rishel, in a private list serve (
AMDIS), making some points that he
elaborates on his public blog. I am deeply indebted to him and several other Gartner analysts for dramatically raising my understanding of many critical issues. Two examples for Gartner subscribers: Wes's tutorial last year (2008) on EMPI, and, an earlier piece, HL7v3 needs a midcourse correction
and here's why.
The specific blog post I'm referring to here is:
Hey, Washington Post, Wake Up!
Any and all CIO reading HCI blogs need to be conversant on this topic. EMRs and HCIT are being inappropriately bloodied. This blog post elaborates the issues, in vintage, beautiful Gartner style.
I've got lots more to share, but I'd prefer you read Wes, come back and comment!
- Joe Bormel's blog
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Comments
Anthony,
I agree with your formulation.
The management question, then becomes how do we assure that we're recognizing reason, emotion and making the right bets.
Responding to ARRA-2009 is putting pressure on vendors and providers, triggering these emotions and the resulting conflicts. Wes Rishel is pointing out that the negative emotional posture we're seeing is to be expected in the trough of disillusionment. And that posture is dangerously incomplete. It takes emotionally strong and balanced executive leadership to make good, adequately inclusive decisions.
Your point, i.e. "making the right move" really requires communication, clearly articulated and tracked assumptions, and a dose of reality. I think we're going to see a lot more conflict in the coming months, because of these emotional dynamics. I recommend the following article and Leonard's work in general:
Putting Your Company’s Whole Brain to Work
Conflict is essential to innovation. The key is to make the abrasion creative.
by Dorothy Leonard and Susaan Straus (HBR, July 1997)
here are two clippings...
Leaders who can make themselves vulnerable enough to listen broadly and clearly will have a much smoother and more effective path through these challenging times.
Joe,
I agree with you about Wes Rishel's outstanding work, and I, too, was very impressed with his EMPI tutorial.
Certainly, there are going to be those who "bloody" EMRs according to their individual agendas. But the positives far outweigh the negatives on this technology. Anyone doing due diligence on EMRs and HCIT in general should come to the same conclusion. To implement an EMR should not be an emotional issue.
Where emotion will likely come into play is when a CFO/CIO type must recommend to which EMR his or her hospital will commit the substantial resources it takes for such an implementation. After all, this can be a career, make or break, decision. This underscores the need to form an all inclusive stakeholder team that collectively buys-in to a system/vendor. And as you aptly state in your reply to Anthony's comment, communication is critical. Leaders must send messages that are clear, concise and consistent. And in return, they must listen to, not just hear, stakeholder responses if they are to correctly process information to make a rational decision, thereby helping to reduce the issues raised by emotion.
Anthony is correct. There are no absolutes as to timing when it comes to the right time to buy. But I think it's safe to say that when it comes to EMRs, opportunity is knocking in the form of the ARRA. It would be irresponsible to ignore it.
By the way, a friend sent to me The Washington Post op-ed you referenced. To anyone who has more than a passing knowledge of EMRs, it was blatantly obvious the authors ively wrote about the technology in an attempt to skew reality.
In spite of the newspaper's buyouts and other recent cutbacks, there are sufficiently talented and knowledgeable staff members who should have reviewed the op-ed and refused to accept it. However, to The Post's credit, my friend tells me that a letter-to-the-editor was later published that refuted the op-ed and took its writers to task. Although other letters were submitted, as noted by Wes Rishel, the paper responded in a perfectly acceptable manner. Hopefully, in the future, the editors will be more responsible at the front end of this process.
Jack
I'd like to share a line I listen to (and wrote down) this AM while on the bus into work. It is from Shelby Foote's tome on the Civil War. The specific reference is not salient here, but the sentiment is: "There was no better example during the war of what the combination of careful planning, ingenuity and great daring could accomplish under intelligent leadership." audiobook, The Civil War, Volume 2, Chapter III, 1:57 mark
Joe. The cause of the condition Wes describes above is that very few people can overcome their emotions with reason. For example, a fear of being left behind can cause someone to make an unwise purchase, a fear of risk can cause someone to miss the boat. In both cases, emotion has overcome reason, someone's personal hang-ups (call Freud), have gotten in the way of good sense. No one can get the timing of a buy exactly right, just as no one can figure out when a stock is at its low or high. As long as we are using good sense and reason, rather than emotion, we have a good chance of making the right move.