The overview post that started this series can be found here. As new posts in the series are added the forward and back links will be updated in order for readers to "walk the posts" in quasi presentation like format.
The diagram below illustrates some of the key concepts that must be incorporated into any HITECH/HIPAA compliance strategy roll out, and moreover, these concepts apply in general to an EHR implementation as well.
In essence, these Key Concepts represent the "soft" parts of an EHR/compliance strategy that have nothing directly to do with technology per se, but everything to do with its success. As Tom Peters has consistently said: "the soft stuff is the hard stuff." In short, while consultants/gurus come in with grand visions, things get messy quick on the ground.
Providers and facilities will gravitate to cookbook methodologies where none exist. Solving wicked problems is just a different kind of beast.The healthcare industry will need to look outside of itself and borrow knowledge and lessons learned from other industries. It took the "software industry" decades to understand that software development was a "wicked problem" and therefore, unlike bridge building, a different set of methodologies were required.
Agile methodologies now dominate commercial Web 2.0 / 3.0 software development, but they did not originate there. This methodological approach is well suited for solving problems that are messy and undefined (i.e. most of the hard problems that we now face as a society and certainly the challenges faced by the healthcare industry).
From our perspective the importance of agile is not related to a particular methodology BUT rather to the underlying philosophy that underpins it. Again to paraphrase Tom Peters, "you only find oil if you dig wells, wicked problems can only be solved by "failing fast." Fast enough to really understand the problem and then make the necessary corrections. This applies conceptually to both compliance and and to an EHR implementation.
That said, the counterintutive concept of "failing fast" (i.e. as the most effective way to ensure success) is arguably anathema to both lawyers and healthcare professionals--therein lies the crux of the problem.Part II of this series can be found here.
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