I didn’t even notice that the bathroom was top-to-bottom ’70s salmon or that the kitchen appliances looked like props from The Brady Bunch. I was looking at the neighborhood, the street, the lot size and the general layout of the house. I was in love, but my wife was in a slight panic.
“If we get this house, you must promise we’ll get that bathroom redone,” she pleaded.
“Sure, sure,” I said, gazing at the unkempt but promising backyard.
Since then, we’ve watched lots of House Hunters and, every time a similar scenario comes up, she shouts at the TV: “Don’t believe him — he’ll never actually do it!”
Regular readers of this column know I made a bit of an investment in my yard recently, but what you don’t know is I had to green light the long-promised bathroom remodel to get those funds released.
Combined, the two projects represent quite a chunk of change and, as anyone who’s done home-improvement projects such as a bathroom remodel knows, scope creep can cause the costs to inch ever upward. To avoid this, we (I) had to draw a hard line.
“If I go one cent over our budget, my husband will divorce me,” my wife wrote in an email to our contractor.
While this is a (slight) exaggeration, the truth is we can only afford so much before bad things start to happen. The first is stress — that terrible feeling one gets while watching the account balances tumble. This is quickly followed by unpleasant belt tightening — I think of this as draining the oil from the car, and things at home turn rough and screechy.
After that comes debt, more stress, and more belt tightening. If bad luck strikes — and it usually does — a furnace goes or a roof starts to leak, and your “living on the edge” quickly turns into going over the cliff.
I got to thinking about this dynamic while reading (See item on Norton) about how some hospitals are starting to feeling the pinch from their oversized and ever-growing IT investments. And remember, these are not just one-time and sizeable capital investments, but long term and ongoing financial obligations. Some are certainly going beyond what they should be spending, simply because the government is spurring them on or because “it’s the right thing to do.”
While there is no question that, in general, healthcare IT investments are the good and right thing to do, that doesn’t mean they are always fiscally feasible. Just because we may want, or feel entitled, to a certain tile in the bathroom doesn’t mean we can continue paying our mortgage if we get it.
In fact, just this week at the NJHIMSS Spring Conference, Virtua Health CIO Al Campanella, when asked about the industry’s biggest risk associated with the drive to implement HIT, replied: “It’s, how are we going to finance all of it? We’ll get there, but most hospitals are non-profits, many consist of old buildings that need to be replaced — where is all this money going to come from? I think that is our biggest obstacle.”
For some, that obstacle is very real, and it limits their choices to certain products. We recently produced a Webinar that focused on a lower-cost alternative to the traditional vendor choices. It was interesting to hear the speakers talk about how certain options just weren’t on the table.
Staying within your means might be frustrating, but it’s the right and responsible thing to do. The play now, pay later (or never) mentality is what’s gotten millions into trouble from which they cannot escape (just listen to the Dave Ramsey Show).
Remember, going millions beyond what your HIT budget should be won’t improve patient safety if it ultimately forces your doors to close.