Curbside Consult with Dr. Jayne 9/15/25

I recently got together with some of my longest-standing healthcare IT colleagues. We were reminiscing about “the good old days” when health systems implemented EHRs because it was the right thing for patients.

Our organization took that further. We knew that when we could better demonstrate that we were doing the right thing for patients, we could legitimately claim top-decile quality. 

Our health system was supportive of the effort. It believed that proving better care and lower costs would justify higher contracted rates. We had seen similar moves by organizations that had already ditched paper charts, and we were impressed by their ability to generate quality data without expensive manual audits. We wanted those successes.

A couple of offices had chronic problems with “missing” charts. One file clerk spent most of her day looking for charts that had last been touched by a specific provider. It turns out that he was taking charts home to complete his documentation. Sometimes they would be in the trunk of his car, sometimes at home on his dining room table.

It’s funny that so-called pajama time documentation predated EHRs, but I’m sure fewer people were taking physical charts home. Most likely they just stayed at the office to do the after-hours work that is often required to care for patients.

When we implemented the EHR in his office and couldn’t find charts to scan, we became the bad guys for identifying the problem. Until then, his office manager covered for him, which is amazing in a post-HIPAA world with charts being left on a dining room table where a family member could browse.

We also reminisced about the vendors we had worked with over the years, some in a good light and some with less than positive sentiments. All of us had encountered unscrupulous sales reps, vaporware pitched as real, and systems that didn’t remotely perform as advertised.

Initially, all of the companies we worked with on our EHR project were publicly traded. That gave us visibility into the financial health of the company and whether it was likely to be around to support us in one, three, or five years. This was before health tech unicorns were even a thought.

In retrospect, I’m glad we were doing our project during that time. It was hard enough to deal with the operational challenges and trying to perform clinical workflow transformation magic without worrying that a vendor was spinning nonsense or likely to go out of business mid-implementation. This has become much more difficult during the startup era, as we’ve seen so many companies deliver empty promises that eventually translate to negative financial margins.

We talked about the vendor executives we’ve worked with. The industry has archetypes – the wild dreamer, the steadfast engineer, and everything in between. There are those whose actions stick with you because their way of conducting business was so impossibly bad.

I remember one executive who tried to tell us that as customers, we were at fault for his company’s defective software because “your thinking is constrained by the technology of today.” Unfortunately, that happened at a point in my career where I hadn’t fully honed my poker face and was irritated on behalf of my physicians. I’m told him that it wasn’t about my thinking, but his half-baked tools that made caring for patients harder.  

I remember one vendor exec who used the word “synergy” every few minutes in a way that wanted me to channel my inner “The Princess Bride” with a response of, “You keep using that word. I do not think it means what you think it means.” Among this small circle of healthcare IT friends, I can make them laugh by simply making a hand gesture that one vendor executive made all the time, as if a professional coach told him to do it regardless of whether it was appropriate to the situation.

Some executives went above and beyond to care for customers. They provided daily updates when things weren’t going well and took personal accountability to ensure that solutions were delivered.

We worked with one vendor that had members of their support, product, and development teams camped out at our facilities for weeks following a challenging upgrade. I’m proud to be friends with some of those folks to this day, and I am grateful for a partnership that was deeper than today’s vague use of the word. Sometimes it’s the little things that make a difference, and knowing that someone is trying to make things right is worth its weight in gold.

Ultimately, our conversation landed on the idea of integrity and the vendors that were honest even when it was difficult. It’s sometimes challenging to tell the truth when it puts you or your company in a bad light. Too many people sacrifice the truth to stay liked or to avoid de-installs. 

I’ve also run across a couple of companies that are so morally and ethically focused that it makes you think twice, because consistently taking the high road is something that feels like an exception rather than a rule. I’ve come out of a handful of meetings during my career where I’ve wondered whether I was in some kind of alternate universe, but in a good way. Those situations are rare, but I’m grateful to model them in my own work.

Among my group of friends, we have well over 100 years of healthcare IT experience. We thought of the advice that we would give to the current crop of vendors that are trying to earn our business. The concept that resonated the most was that of honesty, being willing and able to tell the truth even when it is difficult or unflattering to the company. 

Sometimes good people make decisions that hurt others. Simply admitting what happened goes a long way, whether it was personally your fault or not. We respect leaders who say “I am sorry” more than those who make excuses or go silent hoping things blow over.

In a complicated industry, plenty of companies could benefit from adjustments to what they think is business as usual. As a decision-maker I’m glad to steer business to those who do right not only by their customers, but by patients.

What is your most memorable example of vendor integrity? Have you worked with a company that stands head and shoulders above the rest? Leave a comment or email me.

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