EHR and Football

Some might think that this is going a little off topic, and that my mind is already looking forward to a big start to the NFL season this weekend and college football in full swing. I certainly won’t deny my love of some good football. I’m not sure why it’s so fun to watch, but it is. I have so many good memories watching football. Seems I’m not alone since I saw a tweet that said “An interesting commentary on the country. 4 million watched the Democratic Convention. 21.81 million watched NFL Football.”

With that said, I’m all about comparing EHR to other things we see in life as a way of learning and improving. I think analogies like this can be really valuable ways to see EHR in a different light.

I first started thinking about EHR and football when I saw this tweet from Charles Webster, MD:

Welcome (Your football post? bit.ly/PUpfLQ Here’s mine! bit.ly/SdiRq5) @dirkstanley of @speakflower CMIO & Hospitalist

— Charles Webster, MD (@EHRworkflow) September 7, 2012

Here’s a section of his blog post about EHR and football:

Medical office staff members interact in ways that are similar to a football team. For example, they have an offensive line whose responsibility it is to efficiently, effectively, and flexibly move an encounter from waiting room to checkout. There’s a quarterback who calls plays. Sometimes it’s the physician who directs staff to administer a vaccination or auditory test; sometimes the plays are called automatically based on the reason for the patient’s visit, such as “well child” versus “ear ache.”

Tasks are “passed” among team members, such as a nurse gathering vitals and checking medications and allergies before passing the assessment and treatment tasks to the physician. “Dropping the ball” results in inefficiency that slows the encounter and ineffectiveness that affects patient care and physician revenue.

The defensive line may be less obvious, but it consists of threats to the accomplishment of efficient, effective, flexible workflow. It is the offensive line’s responsibility to protect this workflow. For example, the phone nurse blocks defensive line interruptions that would otherwise distract the physician from maximizing use of the most important and constrained resource in the practice, his or her time. Anyone (or anything) who contributes to the hassle factor of practicing medicine is part of the defensive line.

You should check out his full article where he asks a bunch of interesting questions as well.

I think the best comparison to football comes when you consider who’s the leader of the team. In football, it’s essential to have strong leadership to be able to coordinate and inspire everyone on the team to do their job. I’ve seen many times where clinics have very poor leadership. Much like a football team, this leads to a lot of problems and issues.

In football they often talk about being “assignment sound.” That means that each player on the field has a specific assignment and they need to perform that assignment. They shouldn’t vary from it, because when they do they leave their other teammates in a bad position. Many medical practices implement an EHR with no plan in mind at all. It’s hard to be assignment sound when you don’t even know your assignment. Of course, this goes back to having good leadership as well.

Another problem in football is not only having a good plan, but inspiring the team to execute the plan. We’ve seen over and over again where the coach loses the football team. The team no longer listens to the coach, so no matter how much planning he does it doesn’t matter since he can’t inspire his team to execute it. EHR implementations can learn a lot from this idea. Your EHR implementation needs to have a well thought out plan, but it also needs a “coach” that can inspire the team to execute that EHR implementation strategy. It’s not enough to have a plan if your team isn’t going to support it.

I’m sure there are other good comparisons of EHR to football. Maybe we could even talk about the big business of football and how that compares to the big business of healthcare. One difference between football and EHR is that in football there’s only one winner. In EHR, everyone can win.