Week 5

          This week's topic provides an interesting follow-up to our previous Population Health chapter which also dealt with finding the proper metrics to determine success.  I consider myself to be extremely data driven but I often catch myself making the mistake of advocating metrics which aren't actionable.  I love to get in the weeds and discover intricacies about a process which makes it very easy for others to say, so what?  I will respond that it's extremely interesting and they will reply that it doesn't matter if that doesn't tell us anything actually useful.  One question this issue raises is whether or not a project should be undertaken if there's not a reliable way to measure whether it worked.  This can happy on either a small or exceptionally large scale.  In the IT space it is possible to switch to a new firewall that is supposedly safer even when the old one had never been breached.  How do you measure an improvement over a 100% success rate?  Additionally, in the case of an EMR implementation, so many aspects of the organization change that there are too many success indicators.  If you succeed in 38 metrics and fail in 35 metrics is the measure a success?  If you make a composite metric is there any way to properly weight criteria?
          It was interesting that we introduced the idea of self-plagiarism just before this unit as my topic for our research paper in Finance last year was determining the financial impact of EMR implementations.  The key takeaway was that it takes years to assess the true impact and that even so it is incredibly difficult to isolate the effect it actually has on the organization.  Many organizations have seen large increases in net income several years after putting in an EMR but how do you truly know that the increase was because of the EMR and not something else?  Even attempting to measure it doesn't really accomplish anything.  If you lose money by putting in the EMR it isn't as if you are going to just stop using it or you can sell it and recoup your losses.  That is one of the things that has made the decision frighteningly for healthcare organizations.  It is something that you clearly have to do but there is almost no ability to cut losses or change course once you set off on the path.