Working Ideas

Reach-Role-Measure-Capture test

The Reach-Role-Measure-Capture test weighs any capability your EHR vendor promises against build, buy, and partner on four questions: does it reach the people and settings that matter, what role it plays (table stakes, operating advantage, or differentiation), can you measure its contribution including the cost of waiting, and can your organization capture the value.

Michael Alden · First published October 21, 2026 · Revised November 6, 2026

Question it answers

Our EHR vendor says this capability is coming. Should we wait for it?

As EHR vendors ship faster, leaders often defer a build, pause a vendor search, or shelve a partnership to wait for the EHR's version, without pricing the delay. The test treats waiting as one of five options, alongside building on the EHR's platform, building your own, buying, and partnering, and puts the same four questions to each.

How to use it

For each option, ask:

  1. Reach. Which practices, sites, and clinicians need it to deliver on your promises, and which would go without it?
  2. Role. Is it table stakes, an operating advantage, or part of why patients, physicians, payers, or employers choose you?
  3. Measure. Can you prove its contribution in the terms a CFO or payer uses, and what does operating as you do today cost while you wait?
  4. Capture. Can your organization redesign the work, secure adoption, and sustain the improvement?

The role answer sets the bar. For table stakes, the EHR's default is usually sufficient. For an operating advantage, another option earns its cost through better economics or faster value. For differentiation, own the capability, or accept parity, win on something else, and tell the market.

Run it with strategy, IT, clinical operations, finance, and contracting in one room, write down what would have to be true for each option, and test the shakiest condition first. Judge the EHR's option on what has shipped.

In practice

In a clinically integrated network, the EHR's version often reaches only part of the network: independent practices on their own EHRs, hosted affiliates that license fewer modules, and acquired groups awaiting conversion. An accepted gap names who is affected, what it costs them, and when it closes.

On role, a neighborhood restaurant can take online orders through the same point-of-sale platform as the place across the street and win on its food and service, provided the neighborhood knows it. As AI tools standardize inside EHRs, more health systems will be in that position.

Where it breaks

Teams rate their own capabilities generously.
A capability differentiates when a patient, physician, or employer would notice it and choose you for it.
Waiting has value of its own.
Early adopters absorb costs and risks that later adopters avoid, and a lead built on technology alone closes as the technology spreads. The cost-of-waiting figure nets out both.
Building on the EHR's platform is still a build.
It carries the full capture question, and a workflow co-developed with the vendor may become every customer's default.
Reach gaps make weak control groups.
Practices on and off the platform differ in size, ownership, and patient mix, so a comparison holds only when designed on purpose.

What it borrows

  • What would have to be true, the question A.G. Lafley and Roger L. Martin ask of every option in Playing to Win (2013), first set out in "Bringing Science to the Art of Strategy," Harvard Business Review, 2012.
  • Cost of delay, from Donald Reinertsen's The Principles of Product Development Flow (2009). The measure question applies it to an EHR roadmap.
  • Pace layering, Gartner's method for sorting applications into systems of record, differentiation, and innovation. The role question sorts capabilities by what they do for the organization's position.