The Sweetest Words

My best man Erik once said "the six most beautiful words in the english language:  'You were right, I was wrong' - I can never tire of hearing that phrase spoken to me."

I'm just finishing up a very interesting project:  The whole direction healthcare needs to be going is in the safe and reasonable sharing of patient data across the inpatient and ambulatory and post-acute care spectrum.  Patients need to know that every provider they see knows what they've been through, and that what they tell THIS provider will be shared with the next.

But the way healthcare is stratified and siloed, it's been very hard to do this.  So I was brought into a project to design a working framework for a regional health system - a hospital with 150 employed physicians across 60 offices, working with an affiliation of 150 more independent private practice and specialty physicians.  Over a dozen medical record systems, no shared network, and most worryingly, we saw several meetings devolve into shouting matches.  These people want to share data about patients, but could barely tolerate communicating with each other.

We approached it as both a governance and cooperation project AND a technical project.  My first architecture suggested that BOTH sides move a little and put data into a co-owned system that they'd all maintain.  We got serious pushback from the health system side, and the kept making changes to my architecture... by the end of last week, it was looking as though our proposal was literally to endorse two parallel systems, one for the health system, one for the private practices to share.

Of course that would be twice as expensive, and it wouldn't fulfill the core requirement of data sharing that we were brought in for, but i was able to somehow draw a bunch of "interconnect" pipes so that evern though they were parallel, they were replicating data, so it was sort of like sharing, only we each have our own copy.

FINALLY this week, I had a really good conversation with some of the key sponsors (who were having a little sticker shock at the cost of the parallel solution) and got them to come ALL the way back to my original recommendation.  The CIO actually sent a note to his team saying he finally understood the benefits of the shared architecture, and credited me with having the right vision from the start.

Today was my final presentation to the board here in Michigan:  There were still some strong reactions in the room - mostly from some of the "parallel-istas" who hadn't yet seen the light, but I knew that the key sponsors finally understood.  And most gratifying, at the end of the meeting, a core group of 5 doctors, a mix of the privates and employed, who had previously been actually yelling at each other....  they sat and talked about the benefits they'd all see in this architecture.

It was something that got me thinking that this might actually do something positive for the patients out here.  And it felt good...   And let's be honest, it felt good to have them finally understand that I WAS RIGHT.   HA!

But it is also a strange thing to say "here you are - the next steps are yours" and know I'm not going to be working on this unless they call us back for a new engagement.  Part of the consulting "thing" is that you need to learn an environment really well, figure out what they really need, help them start down that path, and then you need to move on, because us consultants are EXPENSIVE.

There are definitely BAD consultants who don't go deep, don't learn what's unique about a site, and don't leave an actionable plan.  I pride myself on not being that bad consultant, but the problem with going deep is that I wind up caring... and it can be hard not to see them through the engagement.  I have to wish them well and hope they do the right things.

So it's bittersweet to finish an engagement like this.  Those nights of tweaking Visio diagrams until midnight...   it's wrapped up and done.  So now I'm sitting in a cute tiny airport waiting for the one flight that will take me home today.