Unintended Consequences or Not everything works out as planned …

Coors Field. Reds at the Rockies
So the planning went great. A day at the Rockies game with the inimitable Epic ambulatory team, a cool, hardworking group of young, fast-learning folks.

Word comes that UCHealth is a Rockies corporate sponsor and we have tickets for the team to sit in the Rockpile, centerfield, nonshaded bleachers in 92 degrees. Sign me up!

So, I came in to work early, cranked out some awesome spreadsheets, knocked off early and headed to the game.

Bonus: I planned to park near home and take the new University of Colorado RTD A-train to and from Coors Field.

University of Colorado A train

Here we are! Time for some hot links and beans!

I wear this polo shirt every 10 years or so, whenever the opportunity arises.

Union Station: downtown reinvented.
Get up to the famous Rockpile…

Find my seat, settle in for a fun afternoon…

Hey, where is everybody? I’m only a few minutes late for the 3:10pm start …

Empty bleachers
Hmm, they’re announcing the 7th inning stretch. Something wrong with this picture. Look at the ticket again. 1:10pm start. Seems that the website was citing Eastern time. 🙁

AND, 90 degrees for 2 hours had most folks wilting and ready to head home. Rockies down 2-6 anyway… I had just missed them.

Not everything works out as planned.

Hot tip: do not add insult to injury by missing your train stop on the way home, whilst writing your self-pitying blog post. It could happen.

Wrong station on the way home.

CMIO’s take? just like in informatics, ‘The best laid plans of mice and men go oft awry.’ Several examples come to mind:

Issue: University specialist physicians often forget to write referral letters back to referring physicians and patient’s primary care physicians. Idea: why don’t we automatically route a copy of their note to the referring physician and PCP? Unintended Consequence: nicely formatted, custom-built sub-specialty letters with names and contact info are replaced with the generic letter necessary for the automatic process. After some scrambling, things are getting better.

Issue: physicians often do not record ‘exercise as a vital sign’ in the patient’s medical record despite exhortations by experts that this could help prompt Americans to exercise more, and track healthy habits. Idea: One of our cardiologists helped build a module to remind docs to do so: type of exercise, days exercised per week, minutes exercised per session. Simple! Elegant! (He wanted to set this as required for all outpatient visits across our system: all 2 million of them per year). Unintended Consequence avoided: our physician informatics team informed him that, until he gets agreement from physician leadership representing the many physicians who would be affected by this one change, we would NOT turn this module ‘on’ as a required element. Whew!

Any recent unintended consequences come to mind? Leave a comment. Happy July!

Author: CT Lin

CMIO, UCHealth (Colorado); Professor, University of Colorado School of Medicine

2 thoughts on “Unintended Consequences or Not everything works out as planned …”

  1. The flip side of UC is serendipity. So how many times do we have something happen that is beneficial which we did not expect?

    We be happy to write in more detail about my experiences with the caveat that serendipity is like altruism — all in how you look at things.


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