In praise of nay-sayers

One of the first things that happens in the early stage of almost any complex undertaking is a parade of nay-sayers: the people who have all of the reasons it can’t be done. If they don’t show up it is a sign that the goals of the undertaking have not been set high enough.

Yesterday (June 16) the HIT Policy Committee published its ‘First Draft’ of Meaningful Use. (See links on the sidebar)  There are the usual cries of “It can’t be done” which suggest the goals are set high enough to require more than business as usual. That’s good news.

The task of those committed to completing the definition of meaningful use is to sort out the cries that point to real problems that need to be addressed from those that are simply complaints.  There are huge benefits in terms of time and cost to implement if problems are found and solved during early discussions rather than later during implemented.

Sometimes the solution is to clarify the goal, sometimes to change it, and sometimes to use widespread discussion to find a way to do what appeares to be impossible.  The importance of widespread discussion is particularly important where the subject is as complex as electronic medical records with little understanding of the needs of some of the users. (See Expanding Scope – Increasing Complexity )

Are the goals set too high? I hope so because that’s the stimulus for discussions and potential breakthroughs in quality of care and cost reduction. Will they change? Almost certainly, but there is a great deal of work ahead to determine what changes need to be made. We have been here before with Y2K and HIPAA and succeeded.

One way to sort the contributions from complaints is to look for the positive along with what sounds negative. Just negative? Probably just a complaint. Positive and what appears to be negative? Probably all or mostly contribution. A very good example of contribution is a post by Chilmark Research that both complements and critiques the draft.

Here’s to the nay-sayers and to those who use their cries of “It can’t be done!” to good advantage to discover and solve problems early.


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