DOCtalk by Dr. Gregg 3/26/14

Is Being OK OK?

In the fields of healthcare and technology, perfection is essential. In healthcare, anything less may get you sued. In the tech world, if it doesn’t get you sued, you certainly won’t be in business for long if your tech offerings are filled with glaring flaws. (Imagine how long you’d keep using your iPad or smart phone if it remained annoyingly glitchy.)

Contrast this with the popular mantra, “Don’t let perfection become the enemy of the good.” This is such a perfectly human sentiment; it recognizes both our penchant for overthinking and our inherent inability to ever be truly perfect.

Whether you’re OK with “OK,” “O.K.,” “ok,” or “okay,” being OK implies acceptability. It implies good enough. It implies sufficiency. It implies decent. But, is it OK in healthcare IT to be OK?

Trying to make everyone happy is quixotic. It’s never going to happen. Someone won’t like how you did this, or they won’t like how you said that, or they just won’t like your approach. Thus, you just know that all of your best efforts are, at some point with some person, going to fail. Despite all the minutia minding and detail addressing, someone will be displeased with you.

In healthcare, you try to do your best. You try to address your customers’ needs as best you can, try to make sure to “do no harm,” try to attend to the pertinent details, all while hoping that payment reform and insurance requirement changes and federal or state regs will allow you to keep trying to serve your patients…and pay your bills.

In the land of HIT, it’s pretty much the same. There’s no health IT vendor on the planet who has 100 percent customer satisfaction. No matter how good your tools are, no matter how cutting edge your designs, no matter how responsive your tech support, someone somewhere is going to find fault. (I must admit that sometimes I’m one of them!) No HIT vendor anywhere does everything well…despite what their marketing folks may say.

When I look at EMRs or EHRs, one of the most important things I look for is a sufficient number of “happy factors” that make my overall user experience pleasant enough that I can overlook the missed or poorly addressed elements. Honestly, there haven’t been that many systems that engender a feeling of “Oooo…this is cool” often enough. Many have some of those moments; few have enough of them.

When HIT consulting, I try to stress the end user experience to the vendors, even while understanding their resource limitations and developmental timeframe restraints. Vendors can spend all of their resources trying to make each little detail perfect. But, there are so many darn details in any EHR/EMR, that I’m sure even Epic doesn’t have the resources to attend to each one completely, despite its Fort Knox of cash and (not so) small city of employees. Top off all the medical minutia with the seemingly endless requirements for MU, ICD-10, PCMH, ACO, HIPAA, P4P, PQRI, and a laundry list of other acronyms requiring attention, and it’s easy to see that the details demanding developer deliberation are virtually limitless.

Is it possible, then, in either healthcare or health IT to decide that good enough is good enough? Can you be OK with being OK?

You can. I’m certain of it. (Frankly, I don’t see any other option most days!) And, OK is good. You may not be able to “please ‘em all,” but if you strive for perfection and achieve OK-ness, that’s really an accomplishment. Humans are not, almost by definition, perfect. You can sometimes be great, sometimes be not-so-great, and overall be perfectly OK. You take your best shot each day and hope you hit somewhere in the good part of the old Pareto’s Principle (80/20 Rule.)

The hard part isn’t achieving perfection. That’s a pipe dream. The hard part is learning to be OK with being OK, even as you still strive for more. You always want to try for perfect, but you have to be able to see that less than perfect can still be good.

Good.

Fine.

OK.

Psychiatrist Dr. Thomas Harris once told us that we’re all OK in “I’m OK – You’re OK.” Even if you don’t agree with his overall approach, the sentiment stands: it’s just fine to be OK, in healthcare IT or anywhere. Just be a grand OK. Be an exceptional OK.

OK?

From the trenches…

“I’ll lean on you and you lean on me and we’ll be okay.” – Dave Matthews

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).