One Stop Shopping Plus Mail Order

imageA few weeks ago, I received an email about an old post about managing a walking contest in SharePoint. Ironically, we are preparing to kick off the 2014 version of that contest in about 2 weeks and once again, we are managing it in SharePoint. I like to use these little side projects to demonstrate what SharePoint can do out-of-the-box. Some might ask “why focus on out-of-the-box? SharePoint can be so much more.

Their question is not quite correct and I am lying just a little bit.

The problem with their question is that “SharePoint can be made to be so much more” but the making can take a lot of time.

The lie that I’ve told is a lie of omission. I didn’t tell you that my box is bigger than Microsoft’s box. My box includes things like HarePoint Workflow Extensions and Nintex Workflows. HarePoint’s extensions add some very cool features to SharePoint Designer workflows and Nintex, well Nintex Workflows are like a slice of SharePoint Heaven here on Earth.

So, truth be told, I like to show people what we can do very quickly in SharePoint with the tools that we have available to us. That’s important for a reason that most IT departments don’t consider often enough.

Sometimes, people don’t ask for things because they think those things will be hard to build or expensive or that they will take too long.

They aren’t trying to save my time or my budget; they’re just trying to avoid being told “no, you can’t have that.

In the 2014 version of our SharePoint-driven walking contest, we have added two new features. Both are aimed at improving the user experience and both came at the request of my new young colleague Stacy. Stacy is not only the architect on this project, she’s the user. She’s managing the walking contest and she’s building the site with some help from me.

For those of you who are unfamiliar with a walking contest, it’s pretty much what you would imagine:

  • Our company is divided into teams.
  • Each person tracks and records their steps each day during the contest.
  • At the end of the contest, the team with the most steps wins a team prize and the person with the overall highest number of steps wins an individual prize.

Stacy wanted to make two improvements to the accounting process for the contest. She wanted to add options for mobile entry and she wanted a dashboard of sorts for reporting progress.

Mobile entry was easy but, again, it uses a few tricks from our bigger box. You can send your entry into a SharePoint Remote Entry library by including the subject line “10-11-2014 8,996” i.e. the date and the number of steps. A SharePoint Designer workflow, aided by HarePoint’s Regular Expression actions parses the subject line and adds the steps to your step count. A second workflow adds your step count to your team’s total.

We could do all the processing in one step, but I like breaking things into small chunks. That is a carryover from my history of coding in Smalltalk, but it’s a good practice for SharePoint. Small workflows are easier to test and they are easier to “debug” since there really isn’t a “debugger” available in SharePoint.

Employees with iPhones can also easily enter their steps via a mobile view of the Steps Entry form. Actually, anybody could do this, but “iPhone” is linked with “easy” because our MaaS360 mobile device management software allows us to push that mobile form through our firewall without the need for a VPN connection (which people hate to make on their phones).

Finally, we needed to build that dashboard, but we decided to make it functional instead of just informative – that’s where the “one stop shopping” comes from. We started with a Web Part Page and we added an Announcement part and an Instructions part in those top-of-the-page whole width zones. Then we added three useful parts. On the left, we have “My Steps” which is a view of the Steps list filtered on the current user. In the center, we added a view of Team Status that shows the current ranking of teams and on the right; we added a simple entry form for steps.

image

I have to admit, this is the first time I have ever put an entry form on a dashboard. It works. Having the entry form on the page makes this page the only thing people actually have to look at. My Steps, My Team and, as I look at my steps and realize that I forgot to enter yesterday’s value, I can do it without leaving the page.

Stacy’s homework assignment is to add a chart to graphically display some of these statistics and to make the page a little prettier. Mine is to start walking.

Plan Faster

imageThat’s the Jack Rabbit pictured at the right. It’s a roller coaster in Kennywood Park outside of Pittsburgh and it’s been rolling since 1920. It has changed over time, but it still offers the basic promise of a thrilling ride. It’s still a very important part of the overall joy of spending a day at Kennywood. I’m sorry, this isn’t my vacation blog, and I do have a point. The world of information management is changing very fast, but we can still keep the whole package viable, if we manage change correctly.

About a year ago, we made the decision to use Citrix ShareFile. I started to explain that a while back, and I promised a more detailed explanation, but I’m not going to provide that today. One reason is that the ShareFile we decided to use has changed. It’s changed quite a bit, as has every other file-sharing service. If I explained the features we liked about ShareFile this time last year, you might say: “you can get 10x that amount of file space today for free!” You would be wrong. You can get closer to 50x today for free if you look in the right places.

That isn’t the point, that can’t be the point.

That could never be the point. You could never make business decisions based solely on price, but you clearly can’t do that today when it comes to file sharing and online storage.

The point, my dilemma, the next IT problem, is that the pace of change is exceeding our ability to plan like we used to. Remember Roadmaps? Remember when the industry leading vendors would tell you what they were planning to do over the course of the next 3-5 years? I do. I remember being able to take those roadmaps, with a few grains of salt, and build our 1-3 year plans from them.

Forget that.

You can’t do that anymore.

We selected a product/service (ShareFile) in October 2013. By the time we explained our plans to use that service to a committee representing our customers in April 2014, it had changed significantly. Now, as we are getting ready to roll out the solution, it has changed even more. It’s OK. It still does what we want it to do. And, the changes are mostly good, or the kind that might be good someday. I don’t have this stuff all figured out, but here are a few things I think we have to keep in mind as we try to hang onto this ride:

Maintain control – You can’t run your business if you cede control to vendors who are fighting for their own survival. You might not be able to specify the details of your plan as it extends very far into the future, but you still have to have a plan.

Maintain focus – If you’re saying “how can I plan when technology is changing so fast?” you might be focused on the wrong thing. You might be focused on the tools. My plan is to support the business needs of our company. ShareFile is a tool that I am using to meet those needs.

Be the buffer – If you think your head is swimming in a sea of technological change, think about your non-technical coworkers. You might be able to (I’m dropping the metaphor before I have to talk about someone drowning) deal with the pace of change, but they can’t. They shouldn’t have to. Remember, they have a day job. Even if you are using a cloud-based solution, you can control the pace of change through the solutions you build.

Avoid kit solutions – I buy a lot of tools, but the ones I won’t buy are the 18-piece battery powered every-tool-you-ever-need kits. I don’t buy them because when the batteries die and the new-fangled batteries aren’t being made to fit that kit, I’ve lost 18 tools. SharePoint might be a kit. I’m not saying you shouldn’t buy it, but we have narrowed our plans to use SharePoint to stay closer to what we think are its core capabilities. ShareFile basically does one thing. It’s a thing we need, so we’re good.

Avoid capital expenditures – One side-effect of cloud-based solutions is a move to subscription fees vs. capital expenditures. That’s a good thing. Large capital expenditures have to work over a long enough time to provide the return on the investment that you made to acquire them. The return on investment ends when those 18 inoperable tools have to be carted to the curb.

Communicate – Even though you can’t introduce change to your coworkers as fast as it’s being introduced to you, you have to change things faster than they want you to. Let people know what you’re thinking and where you are heading. Let people know when your plans start to change. Let them know that you’re managing rapid and uncontrollable change on their behalf.

Buckle-up, keeps your hands in the car at all times and enjoy the ride.

Pardon the Abused Analogy

It’s summer and for me that always means DIY home improvement projects. That translates to short work weeks and limited blog fodder. I told myself “if I have nothing, I’ll write nothing,” but sometimes little things crawl into my head and seem important. This week’s DIY project produced just such a moment. Take a quick look at the three photos below.image

These are from three home improvement projects. The little support structure on the right was required to replace a badly worn outside faucet. It should have been replaced years ago, but having to work in the corner of the burner room, tucked uncomfortably between the oil tank and the main water supply, caused me to put it off as long as I could.

All three are photos of “platforms” – used to literally support the worker. In the early days of SharePoint, we were often quick to point out that “SharePoint isn’t a product, it’s a platform!” Yes it is, but just as all platforms are not the same, we are witnessing the fact that all SharePoints are not the same. Platforms, as those three pictures illustrate, need to be well-matched to the activity that they are supporting. image

At the risk of stretching this analogy to the breaking point, consider that the makeshift scaffold that I stood on while removing and rebuilding this complex bit of plumbing was an “on premises” platform. It was fixed, limited in functionality and accessible only by the “privileged” few or one in this case who were in the room with it. The platform on the left invokes a “cloud” mental image and fits that image quite well. It was flexible, scalable and was easily abandoned when no longer required. The middle platform is clearly (OK, not clearly) a hybrid model; perhaps the best of both worlds but suffering the limitations of each.

Just as none of these physical platforms could be used in all three home improvement projects, no one installation of SharePoint will be well suited to all of our business needs. In some cases, no version of SharePoint might be the right version. In fairness, you can substitute any other product name for SharePoint. As platforms evolve or change or de-evolve by shedding features we used to like, their appropriateness needs to be reevaluated. It can’t be as simple as saying “we use SharePoint so we’ll do what we have to do to continue using it.” Microsoft may like that, but I’m sure my boss wouldn’t.

Liking Nintex

imageSummer is a funny time in most small shops. Projects start and stop as people take time off and attentions get diverted to the periodic crisis or to fill-in for an absent coworker. The downside for someone trying to craft a blog entry at the end of each week is that there isn’t much to work with. Those of you that come here don’t come to hear about the meetings I attended or the fires I put out. The upside is that this post will be short.

One of the interesting things I did this week was to build a SharePoint Workflow using Nintex Workflow. I’ve used Nintex before, but this time, I was teaching someone else how to build a “proper” workflow. The workflow is another part of our Payables process and it allows our accountants to delete a payable that has been submitted and approved for payment. Yeah, sometimes people make mistakes. To prevent someone from making those mistakes worse, this workflow needs to verify that a series of conditions are true. The payable hasimage to be at a specific status. The person running the workflow has to be a member of accounting. A bunch of people have to be notified, the activity has to be logged and we also have to let people know if any of those conditions aren’t met and the workflow has to be stopped.

All of those things can be done using a SharePoint Designer workflow. So, why does the title point out that I like Nintex Workflows? Well, that’s the point of this post. Here is my list of the things I like about Nintex Workflows:

I can add multiple logical conditions into the kick-off point of a single “Run if” block. You can see that illustrated in the image at the top.

I can act against multiple list items in one step. For example, I can say “go find all the allocations that have the same payment_request_ID as this imageitem and delete them.” You can’t do that in SharePoint Designer in SharePoint 2010

I can give an intelligent name to each workflow step. So, the above example step can be called “Delete Allocations” – I like that.

I can copy steps. We need to create a log entry regardless of the imageend-state of the process. Since some of those states cause the workflow to stop, I need to have the “Create Log Entry” step in multiple places which is very easy to do. Copy. Paste. Configure. Done.

I can drag and drop steps in and out of Condition blocks and Impersonation blocks which is very helpful when you realize that you have the right action but that it’s happening in the wrong place.

I can export and import entire workflows. In fairness, I think I can do this in SharePoint Designer, but I have had problems with that process and this worked like magic. I built the basic structure of this workflow from an earlier workflow that lets the person who submitted the payable to delete it before it’s approved.

And, my favorite thing – you work in a browser as opposed to a somewhat finicky, somewhat unpredictable and somewhat predictably bad stand-alone product.

That’s it for today. Not much of a product review, but I think you can understand why I like Nintex. And, I said it in fewer than 600 words.

Proximity Revisited

imageEarly in the life of this blog, I wrote several posts about ‘proximity’ and how important that attribute is to the user experience. I was recently reminded of that fact, and I realized that I my previous examples were too limited.

I was talking about designing a home page or a site page with all the appropriate web parts and without any of the inappropriate web parts. So, if you need to see a task list and a calendar, both of those should be represented on the page, not just sitting over in the quick launch area. Conversely, if you don’t want to have a picture on your site, then you should delete the one of those pretty people.

I also mentioned proximity in association with building dashboards. Having everything that you need being available at a single glance is the key benefit of a dashboard, so I guess my emphasizing proximity wasn’t much of a revelation. I also talked about proximity in terms of business process automation. As our engineers work though the recommendations resulting from their inspections, we tried to give them a view of each recommendation’s life-cycle that was meaningful.

It sounds like I covered all the bases. But, you know that I’ve never written a blog post with less than 250 words, so I must have missed something.

Earlier this year we built a payables process in SharePoint. People can select a vendor, enter a payment request (invoice) and spread that invoice around (allocate) to all the various GL accounts that are affected by it. For example, when we buy a new laptop for someone, we might buy them a case. Those are different types of expenditures.

I have always looked at accounting from a “money in” or “money out” perspective but our accountants seem to be in agreement with my Management Accounting professor – you have to pay attention to stuff like this.

Anyway, the system does all of that stuff reasonably well but there are a few things that the accountants wanted it to do better. Fortunately, one of the women in accounting is also working part-time with my team. One of the things she told me that they want isbetter views of the transactions at all of the various points. They have a view that shows payment requests that are pending, requests that still need someone’s approval, payment requests that are approved but not processes, as well as requests that have been paid and requests that were voided. Seriously, money in / money out works a lot better.

When I sat with her to find out what they wanted, Iimage experienced that old familiar feeling. The presence of that gap – the gap between what people can imagine and what they can’t. In this case, that gap separated the end users from what we SharePoint folks know as Data View Web Parts. As we work together, we are bridging that gap.

She said that they need more detail in the view(s). When I asked “why?” she said “sometimes, we need to know things about the vendor, or we need to know what GL accounts had been affected by this payment.” That made sense, except for the “sometimes” part. I don’t like views that show things that are only needed sometimes. I prefer views that show what you need ‘all the time’ but can be made to show what you need ‘sometimes’ on demand.

I wired up a imagelittle example of one view with the addition of two Data View Web Parts. One web part contained more detail about the payment request and one contained more detail about all of the allocations. I connected those web parts – OK – I really want web part to be one word…webpart, why can’t we just call them webparts – Sorry, I just had to say that. I connected those web parts to columns in the view. SharePoint easily let me show those columns as links, and now when they want the additional detail, they can click on the link and populate the web parts. If they click on the payment request ID, they get its details and its allocations. If they click on the amount, they just get the allocations. Easy-peasy.

To keep all this stuff proximate, we also have to constrict the original view by limiting the number of rows it contains. Most people hate paging, so I gave her an array of options to consider. All Payments, All Payments This Month, All Payments this Quarter, and then of course, this year, last year, etc. I showed her how we can set the page limit and how we can dynamically filter the list to render things like All Payments for a specific vendor. Then, I gave her a homework assignment – go back and sketch out the perfect view. Next week, I’m going to help her build that perfect view. Maybe then I’ll have a better illustration.

Delete is a Form of Edit

imageIt’s summer, and despite the serious pile of work to be done and serious blog posts to be written, I’m finding more evenings filled with old movies, old songs, and old episodes of favorite shows. Unfortunately, due to that serious pile of work, the various threads get crossed. So, when I found myself in a meeting making the statement expressed in the title, I knew I was having an Office Space moment.

“I must have put a decimal point in the wrong place or something. I always do that. I always mess up some mundane detail.”

Oh! Well, this is not a mundane detail, Michael!”

If you say something like that, you’re either trying to avoid doing something that is difficult or you’re trying to avoid admitting having done something stupid. In my case, as of Friday afternoon, I was trying to avoid a difficult thing that might result in my doing something stupid.

I spent some time last week working on a series of workflows to delete entries in a payables process that we wired up in SharePoint. The problem with payables is that they have to be allocated and any one payable entry (invoice) can be allocated across several accounts. All of the allocations have to be deleted before the payable item can be deleted The inability to iterate over a list in SharePoint 2010 makes that impossible without a Rube Goldberg-type solution involving multiple shadow lists that allow you to work around the “a workflow can’t do anything that would cause itself to start” limitation. Fortunately, Nintex workflows can handle this limitation quite well.

In the case of ‘delete’ I have a simple workflow that checks to see that a payable item can be deleted (has been submitted but hasn’t been approved) and can delete payable items and the related allocation items. “Can” being the operative word – for now, the workflow is simply updating a text field with the string “this item would be deleted.” That’s a safe way to start, because I don’t have the luxury of a test environment with Nintex workflows running in it. I’m changing breakers with the power on, as it were. If I make a mistake, I could do some damage.

After I deploy the delete workflow, I have to modify it to create a delete workflow that the accountants can run even after a payable has been approved. After that, we need one final version that can delete an item even after the accountants have approved it. We are serious about not accidentally paying someone. Still, all forms of delete are just variations on a theme. The only differences are that some stop in the presence of a specific status flag and some don’t. After I get all the delete options working, I have to create an ‘edit payable’ option.

Deleting a payable is easy compared to preparing a payable for edit.

Preparing for editing requires making a payable entry, and its associated allocation entries look like they are at the point before they were submitted, or perhaps the point before they were approved or perhaps the point before they were cleared for payment. Since the approval process can involve multiple people, the items involved get quite messy. There are several workflows involved and they all set some value(s) and they all read some value(s) and they all work or don’t work based on those values. Get one value wrong and, if you’re lucky, something isn’t going to work. If you’re not lucky, you end up singing along with Jerry Lee Lewis “…she rolls but she don’t roll right.”

Michael Bolton (in Office Space, not the singer) and Jerry Lee hint at those mundane details causing problems, but John-Luc Picard encounters them directly. One of my favorite Star Trek Next Generation episodes is “Clues” and it’s based on the complexity of undoing the past to a point where you could start over. The episode involves a chance encounter with an alien race – a powerful alien race who would rather destroy the Enterprise than have the universe know that they exist.

As I crawl through the various workflows, looking for all the status indicators, I realize that resetting the status to a prior point is way harder than deleting it. I can see why those aliens would have been happy just deleting the Enterprise.

I decided to wait until Monday to wire up the delete option. In the meantime, I’ve been studying how to reset the items for editing and I think I’ll watch “Clues” this weekend.

I hope your summer is going well.

Time is Money – Or Something

imageOne day back in the mid-80s, I was sitting at my desk at one of the Big 8 (or was it 6) audit/consulting firms when my boss walked in. He looked at my desk and saw that I was drawing a diagram (we didn’t have much in the way of graphics capabilities in those days). He asked me what it was. I explained that I thought a diagram would help our client (Bob) understand the work we were doing.

“How long have you been working on that?”

“About an hour”

“When will you be done?”

“Maybe 15 minutes”

“OK, when you’re done, fax it to Bob and ask him for $280”

“Whaaaat?

“That’s how much it cost him for you to draw that. That’s assuming that what I’m looking at is the presentation copy. Or were you going to ask the people in the report department to make that pretty? In that case, ask Bob for more money”

The picture vs. the thousand words thing wasn’t going to work. My diagram was worth 50 or 60 words at best. My boss was adamant that we spend our client’s money as if it were our own. I’ve never forgotten that lesson. I’ve shared that story with almost everyone who has ever worked for me. The wisdom in that story is one of several pillars supporting the notion that “just because you can do something, doesn’t mean that you should do something.”

Since we decided to use SharePoint for content management in 2006, our goal had always been to expand SharePoint into the other areas where we could “make it work.” Our logic was simple – the more people used SharePoint, the more familiar they would be with its features. It was a good theory but expanding SharePoint requires effort if you want to maintain a quality user experience

Last year we decided to abandon our dreams of extending imageSharePoint via the Internet to work with our various business partners. We decided to reel our expectations for SharePoint back into the services that it provides out-of-the-box pretty – back into the SharePoint comfort zone. One of the things that SharePoint doesn’t do well is surveys, and although we have experience making the results of a SharePoint survey look good, a process that takes many hours, we don’t have the ability to make the survey itself look good…can you say WuFoo?

WuFoo gave us the opposite challenge that SharePoint does. We get a nice customer experience out of the box, but we don’t have the flexibility of wiring up some pretty Data View Web Parts to digest the results.

Here are a few things we were able to easily do with WuFoo that we couldn’t ever figure out with SharePoint:

  • Insert text comments into the survey to explain the upcoming questions
  • Add instructions to help people understand how to answer the questions (without making the question 10 miles long).
  • Make the survey pretty
  • Change the default text when it didn’t make sense
  • Exit the survey without completing required fields based on certain answers (without branching)

We had looked at online surveys before, but the price point that we needed to buy at, in order to get the features we needed, was too high. Also, there were a couple of features that we could make work in SharePoint that didn’t work with the online surveys. Fortunately, products evolve and WuFoo now offers all the features we need at a price that we would be silly to ignore.

By using WuFoo, we can give our customers a great user experience, and the woman in our office who is building the survey has figured out how to configure the web-based reports to give us all the information we need to manage the event. And, they look pretty good. Our coworker who is in charge of the event has already said that he thinks this year’s survey is the best that he has seen. You see, he’s the one who has to deal with the customers who fill out the survey.

WuFoo isn’t free. Well, it can be free, but the free version won’t do all the things we need. But, an employee’s time isn’t free either. When you do the math that my old boss taught me, WuFoo is, as he used to say, “A bargain at twice the price.

Information Stories

clip_image002That will soon be the title of this blog. I’ve registered the domain. I’ve mulled it around in my head and that’s the best I could come up with. Well, it’s not the best but technologyStories.com is a premium domain and GoDaddy wants $2,588.00 for it. Sorry. Not happening. Besides, it’s not about technology, it’s about information. Really, it’s about people, but this isn’t where I want to write about people. The fact of the matter is that it’s about inflection points.

SharePoint is at an inflection point. It went from being a hot new product to a must have product to, or at least it’s approaching being a legacy product. I should have known better when I named this blog. I’ve been in this industry for my entire career and technology is ongoing, but no single technology really has the staying power worthy of a domain name. It’s OK, the name had a good ride and if I manage the transition well enough, I’ll keep a few of you as readers. After all, you didn’t come here for my SharePoint knowledge. My favorite comment ever on this blog is “I like that you explore the ‘why’ behind the solutions.” The ‘why’ by the way is people.

I write about ECM and content a lot, but Content Management is at an inflection point. Some people say that it is past the inflection point. But, those are marketing types. Marketing types are always ahead of the curve with regard to change. Marketing types want to use terms at the moment of peak hype and then relegate them to the dustbin of ‘legacy’. Marketing types have had SharePoint and ECM in the rearview mirror for quite some time. I can tell ECM is in the mirror because ecmStories.com is available for 12 bucks.

I also write about process. People, process and technology are the things I’m told we need to focus on, and specifically in that order. I know that. I’ve always known that. OK, I haven’t always known that but I was told that when I asked:

“Why do I have to take The Psychology of Business when I’m studying Operations Research?” The answer was: “Because you’re going to be dealing with people.

Operations Research, by the way, was all about process. I love process but the instructor was right, it really is about people. ProcessStories.com is available, but is has those 3 s’s in a row and it sounds dumb. And really, who wants to read about process. Process is boring and belongs behind the scenes where it can’t hurt anybody.

So, Dan, why don’t you call it peopleStories.com? Well, there are two reasons: 1) peopleStories.com is not available. peopleStories.info is but, again, dumb. 2) I’m not qualified to write about people. 3) Wait, you said there were two reasons. I know, but 3) I write about people and my thoughts and ideas as they relate to people on No Facilities. See, I needed a third point to plug my other blog.

I write from my experience. My most recent experience is being collected at ANI. ANI is at an inflection point. We are planning for the retirement of a bunch of senior folks who have information in their heads. We are simultaneously planning to support a bunch of younger folks who want to be able to find that information without having to live in it. But, I can’t really talk that much about ANI.

So then, Information?

Yes, information. Because that’s what people need most, and that’s what I do. That’s what I’ve always done. I have spent over 35 years finding ways to put data into context in order to create information and then to give people access to that information in a way that helps them to perform their business process.

Technology will continue to morph itself from file shares to SharePoint to a different kind of file share (DropBox, Box, ShareFile, OneDrive, iCloud – I have one of each of these) and onto other things once people discover (again) that file shares don’t really work and that search (alone) doesn’t really work. Dropbox and all the Dropbox wanna-be’s of the world will add metadata to their product, and the marketing folks will give it a clever sounding name and some dumb kid will create a blog using that word. A few months later, the marketers will tag the word as passé and a few years later, the industry will be calling it legacy and the dumb kid will be searching GoDaddy.

Thanks for reading this blog for over 5 years. I’ll be making the turn soon, and I hope to keep you on board.

Will We Ever Get This Right

Almost every IT shop has an inventory of projects. imageSome have been on the shelf for a long time and curiously, some pop into inventory and immediately get addressed. What causes one project to leap ahead of 10 or 20 others? Well, it might be an executive sponsor. It might be a pressing regulatory need. It might be a staffing change. Sometimes, it’s not logical. We are reexamining our priorities this summer for all these reasons. I’ve been at this a long time so I take change in stride. So far, nothing has ever stopped the show from going on.

Ironically, I started thinking about what drives technology projects not from the perspective of a producer of technology, not even as a consumer, but as an innocent bystander.

I had to see a doctor this week. I hurt my shoulder and I needed the advice of an Orthopedic specialist. My primary care physician has recently added an Orthopedic PA (Physician’s Assistant) to his staff so that made scheduling easy. No referral required. Unfortunately, when I sustained a similar injury to my other shoulder several years ago, I was under the care of a different PA who was working with a different physician. Those records were “transmitted” verbally by me during my exam. Later, my wife quizzed me – “did you tell her about the…?” How nice it would have been for all of that information to have been available during my exam. “Oh, it’s in the works” I’m told, but it’s probably a long way off.

Fortunately, this PA did have access to my medical allergies and knew better than to prescribe any form of NSAID in the Propionic Acid class, to which I am allergic. She prescribed a topical gel from a class that those records indicated that I am not allergic to. Yay for accurate and complete, albeit isolated records!

An hour later, I was at the drug store trying to get that prescription filled. The ointment she wanted me to use is not an approved medication according to my medical insurance provider. The drug store has that information because they have access to my insurance provider’s database. They have access because having access allows them to charge me the right amount and get paid faster. My doctor, who might have prescribed something different had she known what was approved, has no such access.

I explained why my doctor had prescribed this medicine. I explained my allergies and how this stuff is in the Acetic Acid class rather than the Propionic class. They, the clerk and the pharmacist, both felt that that explanation would convince my insurance provider to agree to pay for it, but only if it came from my doctor. Not wanting to wait for the wheels of medical deliberation to turn, I agreed to pay the “retail” price instead.

Once the clerk confirmed the price and my willingness to pay the price, she handed the script to the pharmacist who had been at her side during the entire discussion. Before I got to the waiting area, the pharmacist called me back to the window.

Our records indicate that you are allergic to NSAIDs.

Without being snarky to the last human being standing between me and relief from pain, I recalled the conversation we had just finished. I explained again that I appear to tolerate a specific class of NSAIDs and that this gel was in that class. He apologized and then he explained.

I heard your explanation and it makes sense. Our system doesn’t differentiate by NSAID class; I wish it did because this is common. As for making you provide the information again, I am only following protocol. I have to check a box that says you provided this information to me in response to my question about your allergy.”

Oh, it’s a liability issue. If I were to end up in an Emergency Room, this drug store doesn’t want to be in court having their employee say “well, I overheard him say to our clerk that…” I get it.

I get all of this:

Having accurate and complete information helps people make better decisions.

Having access to information can sometimes save money.

Information is good but authoritative information is better.

Protocols are important and should be followed.

I also understand that the systems that exist and the connections that have been made are the ones that either save money or reduce liability. The ones that would merely benefit the people involved are still sitting in inventory. ROI, whether you prefer ‘return on investment’ or ‘risk of incarceration’ can’t be the only driver when deciding what system to build. Sooner or later, we have to find a way to place value on the information that would simply help people do a better job.