I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).
I wrote this piece in February 2007.
One reason we hospital IT types aren’t taken seriously is the “grocery story” analogy. You know, when some well-meaning government official, non-healthcare CEO, or your next-door neighbor smugly proclaims, “There’s more automation in the grocery story checkout line than in most hospitals.” Ha, ha, what an insightful observation – first time we’ve heard that one.
Randy Spratt, McKesson’s CIO, recently trotted out the old warhorse in an interview with Fortune. I’m sure his intention was benign (i.e., “buy more of our barcoding stuff to enlarge my executive bonus”) but perhaps his lab systems background makes him insensitive to how steamed nurses get when someone trivializes the barcode verification process on their end. If it were easy, everyone would be doing it.
(Hint to Randy: those same nurses are often involved in barcode system selections, with one of their possible choices being your employer’s product. Better stroke them a little next time.)
Ann Farrell, BSN, RN and Sheryl Taylor, BSN, RN sent me a list of why the grocery store analogy is not only inappropriate, but offensive to nurses. Their list was detailed, persuasive, passionate, and soon to be published, so naturally I decided to go more for the ironic and humorous by creating my own imitative list. Until their higher purposed tome sees daylight, this will be your amuse-buche.
If grocery stores were like hospitals:
- They would buy Doritos by the bag, but would have to repackage and label individual chips and then track every chip – who bought it, who ate it, and whether they ate it in an appropriate quantity and with only complementary foods and according to dynamically calculated nutritional needs.
- They would have to set up an internal barcoding factory since grocery makers would refuse to barcode their products until all stores collectively agree to pay extra.
- Each clerk would serve 15 checkout lanes simultaneously.
- Every customer would enter the store at precisely 9:00 a.m., 1:00 p.m. and 6:00 p.m. and clerks would have to check all of them out within 15 minutes.
- It would be the clerk’s job to prevent customers from buying both Doritos and potato chips since they serve the same purpose.
- Barcode scanners would be poorly designed by programmers, grocery store managers, and former clerks who haven’t worked in a store in 10 years. Clerk training would require two days and a 500-page manual.
- Stores would not be self-service. Instead, clerks would take the customer’s list, try to decipher their illegible handwriting, and run around the store to assemble several such orders for different customers at the same time. Each item would have to be documented twice: one when pulling it from the shelf and again when giving it to the customer. Customers would be encouraged to change their lists constantly. Most stores would not have the capability update the clerk’s list electronically, so the clerk would have to scratch off and write in items on the same ratty sheet of paper.
- Somber-looking inspectors could show up unannounced demanding to see a list of customers who bought hot dogs in the last year or the complete grocery purchases of a specific person named John Smith, but only the right John Smith.
- Clerk supervisors, exasperated over loss of productivity, would suggest keeping paper copies of commonly used barcodes to save time over scanning the real thing, flagrantly bypassing the whole purpose of buying the system in the first place.
- Instead of wheeling their cart to the checkouts, customers would ring the little “I need help” button wherever they happen to be, requiring the clerk to lug the cash register to their location to scan their item.
- The loyalty card of every customer would have to be scanned before selling them anything, even if they ruined its barcode by taking it into the shower.
- Soda would be sold like paint – the clerk would have to mix and label whatever flavor the customer wants using stock ingredients.
- Once barcodes were scanned, instead of being recorded electronically, the information would print a duplicate paper receipt to be filed forever.
- Clerks ringing up the wrong price could kill the customer, would be barred from future clerk jobs, and could be jailed.
- When working alone in a 24-hour store after everyone else has gone home, the clerk would cut meat, mop the floors, make pastries, unload the truck, show compassion, attend to family needs, and humor abusive superiors who take credit for accomplishments that mostly occurred while they were offsite making ten times what the clerk is paid.