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Tuesday, February 21, 2012

Unanticipated Concequences, Process and Predictability

Meaningful Use has been all the buzz at HIMSS, but not in the way that HHS would have desired this week. Someone yesterday suggested that since we are in Vegas, we should start a betting pool on when it would drop.

I was talking to my 13-year old on Sunday about it, and the challenges that we faced at HIMSS. She knows how frustrated I've been. "Why can't they talk about it?" She asked me. "There's a process they have to go through, " I explained "and until it is released, they cannot say anything about what will be in it because it could provide unfair advantage to anyone who wasn't there when they did discuss it before it became publicly available. And, that's the law, and there really is a good reason for it."

I think the one lesson learned here is that the unintended consequence of having a process, is that sometimes it can get in the way of other objectives. Where it produces predictability in terms of quality, it can have undesirable impacts on time, and vice versa.

From the perspective of a standards developer who has been observing ONC impatience with standards development, I now get to see how the shoe fits when it is placed on their feet. In standards development, there are consensus-based processes, and those processes require the right amount of time to be beneficial. It doesn't matter that you wanted this yesterday, it's going to take as long as it takes to get it done right, and those needing the results will have to wait if they want a quality product.

While process does provide for predictability, it doesn't do address all factors equally. There are always trade-offs. Maybe this will be a lesson that can be learned from on all sides.

1 comment:

  1. We all know that good care outcomes, availability of care, and chronic disease prevention & management is still a crap-shoot in the US. Would it be possible to get a more precise Vegas line on how much relative weight is given to measuring care outcomes, availability, and population health in MU-2?