Intelligent Healthcare Information Integration 8/29/09

Of Spices, Garnish, and Flavor Integration

Cooking, while not my passion, is always something I love. HIT, my passion, is not something I always love. Despite the discrepancies in appreciation, the former can lend insight into the latter. To illustrate, let’s take a little jaunt around the chowder pot…

Not that I am one, but a good chef will tell you the right ingredients make or break the creation of any dish. So, first, we want to insure the freshness and quality of the components which are going into our dish. If we try to build our foundation upon stale or outdated stuff at the start, we’ll only end up overseasoning in an attempt to turn a poor base into something it just never can become: fresh.

Speaking of seasonings, spices cannot be overemphasized. Appropriate use of spices in an intelligent and relational blend is the pièce de résistance, the icing upon the cake. The cake must be scrumptious, but the icing provides the “wow!” So, too, the soup must be solidly constructed from the best stock and the most delightful amalgamation of the finest available elements; however, it is the right use of the spices which elevate mere cold soup to an elegant vichyssoise.

Underspice, and the outcome is bland, lacking in pizzazz. Overspice, and the palate is overwhelmed and confused. But, with attention to the interactions of the flavors – spices with spices as well as spices with main ingredients – the individual elements integrate to transform the dish into a starburst of flavor sensations only achieved by their proper integration.

The heat necessary, at the right moments and at the right temperatures, can bring about the conjoining of flavors we seek, but not if we are inattentive to its application. As with custard, we might even need a bain-marie (a protective pan of water) to help guard our creation from the onslaught of direct flame. But, don’t be mistaken: the flavor sensations we seek will never arise if not allowed the time to assimilate under just the right conditions or if not tempered with just the right fire.

Preparation to the moment of presentation is only partiellement fini. Without question, the garnish and overall appearance of a dish, just like the wrapping of a gift, can turn a meal into a masterpiece. A present may be appreciated, but beautiful wrapping heightens the anticipation of the gift within. So, too, what the eyes see even before what the nose smells or the tongue tastes can greatly enhance (or diminish) the appreciation of even the finest culinary concoction.

Now, for the clarification:

• HIT/EHRs need up-to-date (fresh) ingredients.
• Building upon outdated (stale) platforms and software (ingredients) will yield an EHR (broth) no amount of techno bells and whistles (spices) or gorgeous GUI (presentation) or marvelous marketing and support (garnish) can overcome.
• The oven of time and incubator of “in vivo” use of these tools has cooked a few to finesse, many others to overdone and perhaps best fed to the dog.

A master chef knows a quality meal is only good for a brief period. Most grocery items have an expiration date. Even Budweiser has a “Born On Date” indicating that it has only 110 days before freshness has passed. Maybe EHRs, many of which are well past their prime and only capable of continued use by those tolerant of the dull and tasteless, should adopt a similar ethos to enable continued “freshness” of our HIT banquet.

I don’t even butter my bread. I consider that cooking.  – Katherine Cebrian

Dr. Gregg Alexander is a grunt-in-the-trenches pediatrician and geek. His personal manifesto home page…er..blog…yeh, that’s it, his blog – and he – can be reached through http://madisonpediatric.com or doc@madisonpediatric.com.