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Building a Great EHR Requires Extensive Subject Matter Expertise


Building things that others can use as tools of their trade requires an in-depth understanding of their work and how they do it as well as subject matter expertise.

Any time you intend to make a decision or do something, it makes a big difference whether or not you have in-depth, first-hand knowledge of the subject. If you operate on the basis of hearsay, on what the "experts" or vendors say, or what you believe that everyone else is doing you may get little more than a nasty surprise.

I say believe because others rarely disclose, or realize, the real reasons that they act as they do. Whatever they know, and it may be a lot, they don't know your unique situation, your environment, or your goals but you can be sure that they want to appear to be smart and perceptive leaders in their field. What they say will be chosen more for its PR impact than because they have a deep-seated urge to reveal their true thoughts and feelings. There are some experts that are worth listening to because they can help you increase your knowledge. You can identify experts of this kind because they concentrate on teaching; by providing take-home lessons, explaining theory, presenting parables, pointing out heuristics - all aimed at equipping you to make your own decisions rather than telling you what you must do.

Everyone knows, deep in their heart, that accurate, detailed, unbiased knowledge is essential to good decision making but is hard to come by. It takes time, hard work, more time, experience gained in the school of hard-knocks, and still more time. It also takes the ability to think clearly and yet still more time. Poor planning or bad luck can cause you to run out of time to proceed deliberately. If so you have no choice but to operate on the knowledge you already have and your intuition and roll the dice. In football I believe they call it a "Hail-Mary pass."

This is a universal truth, not something peculiar to EHR. It applies to choosing a spouse, buying a car, building a building, in short, anything.

When I mention references to other blogs and commentaries, I don't know how many of you read them but you should read this one: "Domain Knowledge or a Lack Thereof" by Jacques Mattheij.

The lesson is too risky to ignore. If you didn't know this before, now you do.

What are you going to do about it?

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