Wednesday, June 8, 2011

Over Capacity

I went to The Walking Gallery tonight. The jacket representing the stories of my community wasn't done yet. Instead, like many others, it carried this picture (from the back of Lisa Shah's jacket). It is the perfect representation of where our health system is today.


Over capacity. And no matter how many 3 AMs anyone sees, it will take more than we ever anticipated to make up the difference. Am I disappointed to leave without a jacket? Of course I am, but I got what I really came for, which was more stories about patients that are served by the standards I and others in the Standards Community develop. And there still will be a jacket, one of high quality -- and which will last, even if it didn't meet an arbitrary deadline.

There is one story, one jacket, and one person which struck me vividly tonight. If I were judging best of show, this jacket would be it.


It tells the story of patients at the cross-roads. I wore that gown Monday (nothing serious). On my way to DC, I worked on HIT, HIE, EHR and EMR, and will continue to do so. The young lady (Leah) wearing the jacket has, according to one ONC staffer, 1 class left to finish medical school. Leah herself told me that she took a year off from medical school to work at ONC and that she's on the "Meaningful Use" team. I told her that this is an opportunity that comes along once in a lifetime. I don't think she really understands the impact she, or so many others in the room today will have on our healthcare system. We cannot understand how large an opportunity this is right now. It is so immense that at the same time it is broken, and fixing things; Bass-akwards and foward thinking. insane and exciting, crazy and creative, full of awful deadlines and awsome achievements.

We all stand at that same juncture, tearing out our hair at the insanity of the deadlines, the crazyness of the regulations, the impossible deadlines to define, create, update, develop, sell, implement and deploy meaningful applications. We've got less than four yesars. Most nations give themselves a decade or more to try what we are in half that time. Insane? Yes. Inane? No. We will do amazing things. Things to be proud of. That will mean more times being awake on the wrong side of 3, 4, 5 or even 6AM. It will be worth it. We will only understand it after we are through it; when we can tell the stories of these times to our children or grand-children. "In my day, kiddo, the doctor never even gave you your records..."

I think about that young lady, and I'm jealous. I wish I'd had the opportunity she has at that same age. At the same time, I'm also happy to be where I am. As my wife always tells me, you had to be where you were to get where you are. And I think we have to be here, to get where we need to be.

-- Keith

P.S. Here are some more pictures of The Walking Gallery that I took tonight. Ted Eytan also took some great shots.  More details about some of these jackets can be found on Regina's blog.

P.P.S. My jacket will hopefully be makeing its debut next week at the SIFramework meetings in DC.

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