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DOCtalk by Dr. Gregg 4/25/11

April 25, 2011 News No Comments

Brilliance Makes It Look Easy

Gene Kelly. Fred Astaire. I wish those guys were leading the charge for HIS development.

No, I don’t think that EMRs need to sing in the rain or that practice management systems could benefit from dancing on the ceiling. What every HIS system to date could use, though, is the “duck on the pond” effect that these two pros had completely mastered.

You know the “duck on the pond effect”: the appearance of gliding smoothly and serenely across the pond while little webbed feet are paddling along furiously below the calm, still waters. Those who provide that effect, no matter their profession, make it look like anybody could do what they do. They make it look so easy and effortless.

Astaire and Kelly always made it look so simple. Yet, both were the ultimate in “efforting.” They were relentless in their pursuit of perfection, working themselves, and their co-stars, into blistered and bleeding toe exhaustion when trying to nail down a routine. The end result of all this blood, sweat, and (I’ve read) tears was unparalleled mastery of their craft and brilliance in their performances. Kelly’s muscular machismo and Astaire’s suave elegance were the result of tremendous under-the-water paddling.

There just simply aren’t many EMR or EMR-related systems out there that really have this Kelly-Astaire idea down. Most of them do a whole lot of stuff under the covers, sure, but their dance isn’t smooth, their “paddling” is evident. On top of their waters, it’s choppy.

On the EMR stage, this lack of behind-the-scenes work and the shoddy showmanship is manifested time after time. We have many, many EMRs which are like back-up dancers: they can do the basics, but that star finesse is just not there. If the developers don’t put in the relentless pre-show effort, the audience (the end users) will have to suffer through the performance. We’ll get through it, but it is rough and uninspiring.

Some developers do seem to have started to “get” the power of this pursuit of perfection. Instead of sending out an understudy, they have seen how much is gained by putting a truly well-trained star on stage. They’re creating tools with the simplicity of use that all end users, medical or otherwise, crave. Some of the new iPad-savvy EHRs are showing some of this refinement. So are some of the new iPad / iPhone / Android medical apps.

Here’s a perfect, specific example: Medicomp and their new Quippe tool. They certainly understand how much you can do under the covers while making it look so danged simple on top. Their experience, though, may show just how unready much of the industry yet is for such superstars. I’ve heard technorazzi say, “Oh, it’s just a bunch of XML-tagged text.” End users might not see how hard it is to make it look so easy, but once we see how smooth the surface show is, we want more. It surprises me that any EMR technico wouldn’t see how much goes on, and has gone into, making the “dance” look so smooth. Maybe they, too, don’t see the power, the feet furiously paddling, under the surface.

But, that’s just the kind of power I’m praying for in my next EMR – the kind that seems like anybody could do it, a system with those Gene and Fred work ethics, grace, and “it looks so easy”-ness. I want this super paddling below and an EMR “glide” on top.

For NHIN success, we need many more such “stars.” Despite my “I want it now” angst, I think it’s inevitable that we’ll start to see these traits begin pervade the whole of the HIT industry. I’ll even wager real money that those vendors who don’t clue in to this concept sooner will come to envy those who do.

Once these ideals are more widespread in the EMR realm, just think how far we might be. Even more, imagine once all HIS tools are empowered by those same qualities, but from Ginger Rogers. She, as you probably know, could even do it all backwards – and on gorgeous, high-heeled, Inga-esque footwear!

From the trenches…

“Some people seem to think that good dancers are born.” – Fred Astaire


Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, directs the Pediatric Office of the Future exhibit for the American Academy of Pediatrics, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

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