War games

I am…The Consultant

I am not your friend. I am not the enemy. I am not really anything to you other than the guy who exists to tell you how it is, how it isn’t, and how it should be.

Consulting can be a lonely existence

Rule number one of healthcare IT consulting: do not involve yourself with the social, idiosyncratic, emotionally charged discord of your client site. Even if you have a personality that oozes trust, knowledge, and general likability, do not become emotionally attached to any one person or group of people.

In a few months you won’t be there for these people. Your life and career is vested in yourself and that of your consulting company. Building notoriety as an impartial, go to person is a fantastic thing. That alone is all the more reason to stay out of the political drama.

It can be hard to be me

Setting aside your personal likes and dislikes and the human tendency to pick a side can be very difficult. Separating yourself from the drama to produce the best possible result for all parities is your goal. Achieving this goal is easier said than done. I’m young. I tend to agree with many young, progressive health care professionals on the state of healthcare and the endgame when it comes to the way a system should be built. However, my guiding underlying principle of pre-go live building sometimes conflicts with the young, progressive part of me.

CPOE is something that requires MD buy in. You can’t build a system with the hopes and desire to fix all of the nursing issues and pharmacy issues by sticking it to the doctor workflow. You have to keep it simple, streamlined, and as likable as possible for the docs. This is true at least in the beginning. Once you are live and are optimizing, then you can start to require those docs to address alerts, clean up their overly superfluous nursing orders on transfer, and their medication profiles.

Young clinical informatics specialists hate the KISS philosophy

KISS stands for Keep It Simple Stupid. It is something I hold near and dear to my heart. You will not succeed if the docs revolt against you and to prevent this you have to keep it simple.

Keeping it simple for docs usually means more back end work for pharmacy and nursing. Young, adventurous nurse and pharmacist informatics specialists tend to want to use their new positions to fix everything in their niche and are extremely resentful of the idea that the initial build has to be driven to baby the physicians and give them what they want at the price of making nurses and pharmacists suffer. No one wants to hear the reality, but in the end it is what it is.

An army of one

I love consulting. In no other profession can I make statements, piss people off, and leave knowing that it doesn’t matter if I just made a mortal enemy because in a few months the system is their problem and I will be long gone. In the past those mortal enemies remained a thorn in my side for years after I acquired them.

I wage my war and win no matter what the final decision because in the long run I have no vested interest in what the final outcome of the project is other than my reputation. Each and every I told you so moment, if properly documented and expressed to those in charge, are learning experiences for them and another notch on my belt for me.

I won’t develop any long term friends doing this job, but I won’t have to put up with long term mortal enemies anymore either. Consulting is not for everyone, but for a person like me who prefers to focus on the positive and save the drama for my family life, this job is paradise found.

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