Saturday, November 14, 2009


When my daughter was growing up, she watched a program called CatDog about the seamless integration of the two animals. "Their" life required constant communication and mutual understanding of the underlying cat and dog cultures.

During the work of the last 4 years, the "healthcare informatics crowd" has been labeled the cats and "internet/health 2.0 crowd" has been labeled the dogs.

At times, I've even been called the leader of the cats.

On Friday November 13, during an HIT Standards Committee Implementation Workgroup call, we reviewed the FACA blog and related postings on the blogs of Sean Nolan, Wes Rishel, Adam Bosworth. One of the participants commented that David Kibbe and I wrote blogs that converged on the same ideas. This is an achievement worth reflection.

Harmonization is the decision by consensus of a path forward that is good enough for everyone.

Compromise is the acceptance by everyone of a path forward that leaves everyone equally unhappy. If often occurs when two stakeholder groups become fatigued enough to put their differences aside.

In my blog this week, I suggested we change "No, because" to "Yes, if" and define the right tool for the job, recognizing the roles of CCD/CDA and CCR/PDF. David Kibbe did the same on the FACA blog.

Also, on the FACA blog, a posting called this right tool for the right job approach "a mistake". The comment received 48 supporting votes and 45 opposing votes - a nearly perfect balance between two points of view.

I think this means we got to 90% of the answer through harmonization and the last 10% through compromise. At the November 19 HIT Standards Committee meeting, we'll discuss all the lessons we learned in the Implementation Workgroup that led us to develop guiding principles such as embracing the simplest standards needed for the specific business need. Yes, there is a role for CCD/CDA and CCR/PDF.

David - welcome to CatDog. We'll have a great life together.


Alesha R. Adamson said...

Here's a link to the 2009 Health 2.0 Cats and Dogs panel hosted by Matthew Holt.

Cats and Dogs ~1hour

On the panel:
Glen Tullman, CEO Allscripts
David Kibbe, AAFP
Jonathan Bush, AthenaHealth

Note: there is a wee bit of profanity and Jonathan appears to be in his boxer shorts, but otherwise this is workplace friendly.

Keith W. Boone said...

There's a lot more to interoperability than one standard, and it takes a good deal of effort to make it work. We seem to be forgeting the last "BOTH AND" discussion that allowed us to move on and "make it work". Must we repeat that again?
See Moving Forward.