DOCtalk by Dr. Gregg 5/22/14

HIT Curveballs

As is said: _hit happens. We’ve all heard that phrase (usually the full, four-letter version). It’s a nice, short summation of the inevitabilities of life. No matter what you do or how you plan, life will always throw you curveballs. No matter how well read you are, no matter how highly educated, no matter how credentialed, no matter how exquisitely trained, no matter how closely or loosely you choose whom to trust – everybody gets thrown off stance by an unexpected curveball every so often. (Sometimes, you may even get sliders, knuckle balls, or those throw-you-for-a-real-loop spitballs!)

If you do all the homework you can – study up on types of pitches, watch hours of film on pitchers and their styles, spend innumerable hours in the batting cage, rip yourself with hours on the Nautilus – you’ll still get a ball that you just weren’t expecting. Whiff. Swing and a miss. Steeee-rrrrrr-iiiike!

In the land of HIT, it happens all the time – to vendors and consumers alike. Vendors may not like it any better than their customers, but there is a bit of a difference. HIT vendors get many of their curveballs from regulations, or sometimes from their own poor planning or development. HIT consumers, on the other hand, can get just as many curveballs from regulations, but they can also get really brushed back by those curveballs thrown by HIT vendors. (Vendors rarely get stressed by any consumer pitches, but consumers can’t avoid dealing with HIT vendor pitches.)

Another important difference is that, pretty much across the board, HIT vendors are in this space to make money off of HIT. Consumers, on the other hand, are trying to use HIT to accomplish tasks like delivering healthcare and getting reimbursed for the care they provide.

When a HIT consumer gets a curveball from their HIT vendor, it can really cause the home team strife. It isn’t like the consumer is a reseller; they can’t just find a replacement product to hawk. And, they get no value merely from owning (or leasing) the HIT product. The consumer relies upon HIT tools as critical underpinnings for their mission: to deliver health care. The consumer trusts their HIT to provide the information necessary for medical decisions. They use it to document their efforts and to obtain reimbursement for said efforts. Increasingly, they use it communicate with those for whom they care.

HIT has become central to the mission of healthcare, having become a key member of the care delivery team. If the tools don’t work, if something changes to cause them to work less efficiently, or if they develop “future unfriendliness,” then the care delivery process becomes threatened. That is an unacceptable pitch, for any healthcare team, big or small.

When a provider decides to invest in a HIT tool, it is far more than just a product purchase. Yes, it is an investment of money, but perhaps even more significantly, it’s an investment of time, energies, workflow construction, staff training, sometimes patient orientation and training, and more. The entire healthcare delivery system for that provider office is impacted by these tools. When one of the chosen HIT vendors throws out a curveball – via acquisition, merger, business failure, or product development redirection – the swing-miss impact is felt throughout the practice, from their figurative fingers to their metaphorical toes.

The impacted providers must now either:
(a) hobble along with their lame duck tool for as long as they can,
(b) find a replacement tool into which they can invest even more time, money, energies, workflow construction, etc.,
(c) pull out what’s left of their hair and go back to reliable, old pen-and-paper and suffer the MU consequences, or
(d) find an ACO to wash away all their operational and financial woes.

Being at the plate when one of these vendor pitches comes past is thoroughly frustrating. Whoosh. Whiff. Steeee-rrrrrr-iiiike!

(And there’s no ump with whom to argue the ruling.)

From the trenches…

“Baseball is a game where a curve is an optical illusion, a screwball can be a pitch or a person, stealing is legal, and you can spit anywhere you like except in the umpire’s eye or on the ball.” – Jim Murray

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).