How Intentional EMR Integration is like Learning to Play Guitar

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Last week, my fifteen year-old daughter Emily attended a beginner guitar camp.  By the end of the week, she could play more than sixteen songs.  Sixteen!

I started playing guitar more than five years ago, and sadly can play more or less the same number of tunes.

My strategy, on the other hand, has been to learn more complicated arrangements that take me months to learn.  Rather than starting simple, I went right to boiling the ocean.  Finger picking and base runs sound great when I play on the couch by myself, but what I really love is playing around the camp fire with people singing.  Ironically, if you want people to sing, you need four or five chords and lots of strumming – not fancy arrangements.

The difference (never-mind that she is 25 years younger) is that Emily’s guitar teacher started the week by asking the group what they wanted to play.  He intentionally went after simple arrangements with the same four or five chords and lots of strumming.  His objective was to get the kids off to a good start playing songs they like, and it worked.

My experience integrating patient data in healthcare falls into the same two categories: Intentional and boil-the-ocean.

Intentional EMR Integration

The best indicator that you are on an intentional EMR integration project is that non-IT people are stomping their feet to get a real problem solved.  There is no question about why you are doing an intentional project because there will be no shortage of stories that demonstrate why the current state is broken.

Boil-the-Ocean EMR Integration

Boil-the-ocean projects have a more schizophrenic feel.  Their “vision” is often presented with technical diagrams featuring lots of acronyms and no people.  They require a technical or vendor bias since they mostly lack a direct connection to the organization’s vision.  When there is foot stomping, it’s about schedule and cost, not great integration.

My Promise!

I have helped to flush a lot of money down the toilet on boil-the-ocean HIE and EMR integration projects.  My intent is to swear them off, starting today! No more statements of work with abstract or purely technical objectives, no more pleading for stories or examples.  If nobody is stomping their feet, if there is no story, we’re walking away.

By the way – We had some family over last weekend.  Both Emily and I were hoping for a chance to drag the guitars out, so we practiced quite a few of her songs for an hour the night before.  The fire was blazing, the guitars came out, and it was awesome.  I mean awesome awesome.  My younger daughter Libby even jumped in with the ukulele.

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