Baseball, Healthcare and Scads

Last week I was at a retirement ceremony for yet another of the senior managers I worked with before I hit the beach. This person wore many hats and was superb. She was particularly good at strategic planning and the anticipation of trends to help guide the future of NorthBay Healthcare. As far as I am concerned, she was the epitome of out-of-the-box thinking. After thirty-two years of such guidance at NorthBay, she left the organization with grace and great appreciation from those of us who had worked with her.

At the retirement ceremony I discussed with her top assistant in planning, also a long-time staff member, the tremendous amount of data which is now available courtesy of the deservedly maligned electronic health records providers now use. These creations have made the medical record the focus of patient care rather than the patient herself. Work flows have had to bend to accommodate the needs of the record monster.

One huge problem—while the electronic health record is capable of collecting scads (“scads” is a highly technical term meaning “a lot”) of data, it is not very good at regurgitating the information in a useful fashion. That, in turn, has led to the creation of a legion of consultants who for a handsome fee will try to make sense of the information flood. Think of the electronic health record as a shark circling the patient and the data gurus as the pilot fish feeding off the parasites on the shark. Everyone benefits except those whom the sharks are feeding on–the patient, the hospital and the doctor.

I know that seems a harsh judgment, but it was the reality I saw and which was reconfirmed this week when I spoke to the planning assistant. The billions of dollars which providers were incentivized to spend for electronic health records have resulted in much information with no place to go. The electronic health record vendors have gotten rich by selling a product which is a dead end.

It may be that we are asking and expecting too much of the electronic health record at least in its current form. More information can be overwhelming and that could in itself lead to errors.

Baseball teams now use analytics to develop game plans and govern decision making during the course of a game. Some of these baseball geeks can even be found in the dugout during games dodging tobacco spittle from the grizzled manager. However, the data points they use are relatively small in number and are based upon using past tendencies to project future outcomes. Even then, when you get down to the real nitty-gritty (another highly technical term), the team with the best players wins. What comes first, good data or good players and what is more important?

As I pondered this in a disorganized fashion at the retirement ceremony, I thought back to the many decisions this planning vice president and I made over the years and how often we made good decisions with only a little data available to us. Her creativity was just as important as data and led us to do things which the data either was silent on or indicated we should not do. Maybe we had bad data or perhaps intuition and vision still have a role to play in guiding an organization’s future. That vision thing can be very useful.

Like in baseball, data can be useful. Also like in baseball, the healthcare system with the best players wins most often in spite of what the data indicates. That senior manager who retired last week proved that.