“Well, it’s not an eat-in kitchen, and there’s no other place to put a table, so you’d have to eat all your meals at the dining room table,’ my father cautioned, as he showed us around the house.
“Richard,” my wife said with a slightly irritated tone. “I like this house, and I’ve told you before that I don’t really care about having an eat-in kitchen.”
Two years later, and happily settled in a house which does have a place other than the dining room to eat, my wife has commented more than once. “Thank God we don’t have to eat all our meals at the dining room table — it would be dirty all the time and probably scratched up by now. Your Dad with right.”
My father’s been a full-time realtor for more than 15 years, and loves the job. He’s a people person, relishes being out and about, and enjoys showing houses. His method of selling or, as he puts it, “helping people buy,” is to offer advice even when it’s hard to hear. There are so many strong emotions involved with house buying that, often, people see only what they want and ignore things they don’t. But if my father sees a problem with a house, he’ll speak out.
“I never want to run into one of my customers after I help them buy a house and hear they made a mistake,” he says. “It’s my job to make sure they don’t make a mistake — at least to point out any problems I see so they can make a decision with all the facts.”
In short, my father perceives his relationship with his customers to be of the fiduciary variety.
“In a fiduciary relationship, one person, in a position of vulnerability, justifiably vests confidence, good faith, reliance and trust in another whose aid, advice or protection is sought in some matter. In such a relation good conscience requires the fiduciary to act at all times for the sole benefit and interest of the one who trusts.” — Wikipedia
Whether such a fiduciary relationship exists between hospitals and their healthcare IT vendors is at the heart of a disturbing case between the Girard Medical Center of Crawford County, Kansas and Cerner. In its complaint, the hospital says it did, but was not lived up to by Cerner. “Cerner possessed a fiduciary relationship with Hospital, rather than a mere distant business relationship.”
The hospital claims this right because of its vulnerability. “Hospital relied upon the represented experience and proficiency of Cerner and its employees to implement the System, as Hospital lacked the requisite knowledge and sophistication to design, develop and implement solutions comparable to the System.”
In response to this complaint, the case was referred to arbitration, in accordance with a stipulation in the original contract. The hospital filed to have the arbitration clause voided and the case heard in court, but this was rejected. Thus, we’ll likely never hear Cerner’s side of this sad tale.
Why is it sad? Because a facility described in one story as, “a rural hospital which services mainly uninsured patients and the elderly,” has likely flushed hundreds of thousands of dollars (or more) down the drain on its aborted HIT installation and, now, associated legal fees. It’s also sad because Cerner’s move into this market segment has probably suffered a significant black eye, as I suspect the case will give many prospective clients pause about the HIT giant’s ability, or willingness, to provide the handholding they need.
No matter what its response would have showed, Cerner’s played a losing hand. The vendor should have done a better job (as one of its competitors is famous for) of vetting Girard to ensure it was tall enough to ride this ride. This would have guaranteed the critical meeting of the minds I’ve written about before. Of course, anyone can make a mistake, but such a “shame on me” moment at Cerner should have been followed by a resolution to get Girard up on its electronic feet, no matter how financially painful. If I’ve learned anything about business in the last 2.5 years, it’s that every single client must be referencible.
At the other end of the referencible spectrum is, of course, “client suing me.” That, unfortunately, is where Cerner sits, and that’s where Girard sits. In its beds, unfortunately, sit patients without the benefit of some pretty sophisticated healthcare IT.