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Our “good dog, bad dog” relationship with electronic health records

Last month, after extensive research, numerous site visits, and a range of preparatory training sessions, my family welcomed a new dog into our home. He’s a Belgian Malinois—one of the smartest, most versatile, and capable breeds on the planet. Beyond their original work of herding animals, they dominate agility and dock diving sports, and are now favored by the police and military for their bravery and athleticism. Their most famous representative to date is Cairo, the four-legged member of Seal Team Six that recently got to meet the President. If there were ever a super dog, this is it.

However, ours is a puppy. He poops in the kitchen, cries if left alone, and barks at his reflection in the mirror. It’s up to us to be diligent in training, socializing, and monitoring for him to reach his full potential. Right now that means having the whole family going to class, establishing standard operating procedures, and logging everything that goes into or comes out of him.

Quite honestly, even splitting the late night potty breaks with my wife, it has been exhausting.  In addition, while the cost to acquire him was relatively modest, we have far exceeded that amount in food, treats, toys, lessons, cleaners, medications, crates, collars, leashes, and even retro-fitting a sprayer in the kids’ bathtub. Standing outside at 4 a.m., I sometimes ask myself what I have gotten myself into. However, each day he gets a little better, further integrating himself into our family. Even just a few weeks into it, we can’t imagine our home without him.

Oddly enough, hospitals and doctors often go through a similar process with their electronic health record (EHR) systems. The process to prepare is long and complicated, implementation is frequently more challenging than expected, and the total cost of ownership can be surprising. It is an enormous undertaking impacting nearly every part of an organization. Ultimately, though, organizations that have gone through this transformation reap the benefits and would not entertain the notion of going back. Still, with what for many is a daunting process, ambivalence remains. This was highlighted by a recent event in which several associations called for a delay in the deadline for Stage 2 of Meaningful Use. On the other hand, lack of access to electronic records has been blamed for adverse events.

Eventually, we expect to have ubiquitous adoption of EHRs with extensive information exchange and powerful analytics. However, during the maturation process, some will see the see special ops K9 jumping from a helicopter and some will just see poop on the rug.

by Harry Greenspun, MD, Senior Advisor 

Deloitte Center for Health Solutions 

Harry Greenspun, MD, Deloitte Consulting LLP Harry Greenspun is the senior advisor for health care technology and transformation at the Deloitte Center for Health Solutions. He has held a diverse range of clinical and executive roles across the health care industry, giving him a unique perspective on current and future challenges.


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