The Misunderstood Art of Perfection and How, Seemingly, Health IT in the US has Leveraged it to Completely Suck.

Prolific author Seth Godin writes the following in his post, Abandoning perfection.

“Perfect is the ideal defense mechanism, the work of Pressfield’s Resistance, the lizard brain giving you an out. Perfect lets you stall, ask more questions, do more reviews, dumb it down, safe it up and generally avoid doing anything that might fail (or anything important).
You’re not in the perfect business. Stop pretending that’s what the world wants from you.
Truly perfect is becoming friendly with your imperfections on the way to doing something remarkable.”

Health IT has a problem with perfection, and nothing can kill real progress like perfection. I favor safety. I favor correctness. I empathize with the desire to get it right. Mostly, however, I favor progress.

Big pharma commercializes drugs with all manner of ill side effects and we’ll open our arms and wallets because the light-hearted social interactions in the ad and almost-unnoticeable disclaimers told us our world would be cloud-nine amazing. But, we can’t agree on policy and methodology to share data that might prevent the need for those tasty pills altogether?! Epic and Cerner (et al) figured out how to write an EHR (and in Cerner’s case one that the DoD feels is worth at least $9 BILLION DOLLARS), but they haven’t cracked sharing data? Hello? ONC, are you in there?

Why? Because no one wants to be the goat.

And this isn’t just an interop issue. It’s a consent issue, it’s a HIPAA issue, it’s an incentives issue, it’s a political issue, it’s a trust issue and there’s no perfect answer (do you see what I did there?). But, there are answers that would create progress. In the current national conversation pundits have a tendency to talk about health IT like many corporations talk about improving customer service. That is, the room mostly nods in agreement that it’s a good idea but few can articulate actual, meaningful next steps and others seem to favor status quo over potential failure from unknown tactics.

We don’t need to solve the whole problem at once. Pick your metaphor here — they’re all applicable (Rome, 1000 mile journeys, eating the elephant). We need incremental progress. We need ideas that don’t or won’t work for everyone. We need early adopter providers and early adopter patients to leap over the chasm together. Health IT is so enormous (in the context of the US healthcare system) that even small successes can impact a huge number of people in the healthcare ecosystem. We understand (or forgive, or accept, or whatever) this from big pharma and from just about every other industry on the planet but seemingly not in health IT. Indeed, we seem more committed to pointing out how ideas can’t work (or haven’t worked) than we are to adopting solutions and policies that may produce incremental progress.

No one has crafted the perfect plan, and if you don’t have a plan for where you’re going you’re probably already there. I’ll trade in perfect for good enough and I hope everyone in health IT follows my lead.