In 1910, President Theodore Roosevelt gave a rousing speech to an enthusiastic audience assembled at the Sorbonne in Paris; the speech has since been referred to as “The Man in the Arena”.  A slightly modifed version of its most famous passage is offered below:

“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena… who strives valiantly… who does actually strive to do the deeds… who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

Why, one might ask, would this passage be offered in a blog post about Health Information Exchange (“HIE”).  As a provider of comprehensive HIE technologies and services, I’ve been very fortunate; I’ve witnessed, first-hand, improved patient care through enhanced care coordination within and between communities facilitated by real, useful, intelligent health information exchange.

I do, however, find myself regularly frustrated at the press releases and pronouncements outlining grandiose HIE initiatives that ultimately never leave the paper on which the plans were drawn.  Yet dollars are spent, consultants are engaged, and industry ratings from various third-parties are offered.

Where, amidst all this activity and all this buzz about HIE, has the provider and patient landed?  For some, real value (measured by adoption, participation, use, transaction volumes, and effective clinical communications) underwrites improved patient care; the “doer of deeds… realizes the triumph of high achievement”, not because money is made but rather because care is improved through tangible, “rubber meets the road” clinical data distribution and integration – in other words, by “…the man who is actually in the arena”.

It has been my experience that all too often “could, should, and might” hide behind the veil of slick marketing and stories of what might be, could be, and should be as substantial resources in terms of dollars and time are spent; yet, those that spin such a yarn never actually enter the arena.  For if these “timid souls” entered the arena, their performance would be measured; the performer(s) would be held accountable.

So, I come to my conclusion. When choosing an HIE vendor, be sure to choose wisely.  Choose from those that have strived to deliver, those that have leapt into the arena and learned from experience, those that have stumbled but continue because a relentless pursuit of improved care is the objective.  Avoid those “…cold and timid souls who neither know victory nor defeat.”  Let them continue to sit on the sidelines and pontificate about the struggles and realities only a few of us truly know.