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

March 29, 2009
by Joe Bormel
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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!

Wes' post connects ARRA-2009's 'Meaningful Use' with the Hype Cycle

And here are a couple of verses by analyst Nick Jones

The optimists buy, when the hype is too high,
While tech’s risky and too immature,
The pessimist waits, until it’s too late,
And the ROI’s totally sure

The sensible man, delays, if he can,
Till the point when the hype cycle turns,
He’s happy, not stressed, because he invests,
At the time that’ll bring best returns



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.

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

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.


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...

Depersonalize Conflict  Diverse cognitive preferences can cause tremendous tensions in any group, yet innovation requires the cross-fertilization of ideas. And because many
new products are systems rather than stand-alone pieces, many business projects cannot proceed without the cooperation of people who receive
different messages from the same words and make different observations about the same incidents. The single most valuable contribution that
understanding different thinking and communication styles brings to the process of innovation is taking the sting out of intellectual disagreements that turn personal.

Understand Yourself
Start with yourself. When you identify your own style, you gain insight into the ways your preferences unconsciously shape your style of leadership and
patterns of communication. You may be surprised to discover that your style can stifle the very creativity you seek from your employees.

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.