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Writing on the wall


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Updated Writing on the Wall

Published in: Health & Medicine

Writing on the wall

  1. 1. The Writing on the WallA presentation by Regina Holliday
  2. 2. Thinkingoutsidethe text boxfocusingon the border
  3. 3. Art, balance and the IEP
  4. 4. In 1978, there was a little boy named Freddie who lived in Marylandand a little girl in Oklahoma named Regina.
  5. 5. Patient Reported Data is very important.
  6. 6. Even a childcan understandand appreciatehealthInformation.Both QuantitativeandQualitative.
  7. 7. When the abuse becomes too bad call this number.
  8. 8. 1990Reporting to resultsofThe Sapulpa High SchoolWellness Check(I visit the principal’s office again)
  9. 9. 14 years later,Fred would meet Regina on stage in a scenic painting class atOklahoma State University. We would talk of Stephen King’s Dark Tower. We would fall in love.
  10. 10. Fred and I married, worked and played together for many years.Fred continued his schooling and worked as video store clerk. In 2005, Fred would get a PhD in film studies and would write his dissertation About “Buffy the Vampire Slayer.” In 1998, Freddie III joined the family game followed by the littlest player Isaac in 2006.
  11. 11. From 1994onward,I was working full time in retail sales,but I would try to find time to paint.
  12. 12. I would paintneighborhood murals.I would alsoteach art at a local preschool.I would work in a toy store.
  13. 13. The Holliday Family Christmas 2007
  14. 14. Everything we ever wanted… Resolutions January 2008:1. Get Medical Insurance for the whole family 2. Get little Freddie into a special needs school 3. Fred gets a job in his field 4. Spend more time together as a family 5. Get a two bedroom apartment Freddie’s IEP Binder
  15. 15. Fred was happy with his new job.But he was very tired,He went to the doctor and wasdiagnosed with hypertension.
  16. 16. During the months ofJanuary, February andMarch of 2009,Status Lines…
  17. 17. On Friday March 13th, We went to the ER because Fred was in so much pain .We waited three hours before being sent home.
  18. 18. Fred was hospitalized on March 25th 2009 for the administration of tests.On March 27th, he was told while alone thathe had “tumors and growths.”He was scared and confused and did not understand.His oncologist left town for the next four days to a medicalconference and was not reachable by phone or email.
  19. 19. What was the diagnosis? What were the treatment options? Would he get a pain consult?
  20. 20. Systems Error:More than one bad doctor
  21. 21. This is my husband’smedical record.I was told it would cost73 Cents per pageAnd we would have towait 21 days to get a copy.
  22. 22. “She must not have tried very hard to get the record….”Comparing access to an unpublished book byStephen Kingto accessing theElectronic Medical Recordwhile hospitalized.
  23. 23. “Go After Them, Regina.” April 18, 2009
  24. 24. After waiting for 5 days for a transferto another hospital for a second opinion,We were sent with an out of dateand incomplete medical recordand transfer summary.The new staff spent 6 hours trying tocobble together a current medical recordUsing a telephone and a fax machine.
  25. 25. This is thevital clinical informationfrom Fred’s electronic medical record.Presented in the style ofthe Nutrition Facts Label.Then painted on the wall ofPumpernickel’s Deli inWashington, DC.
  26. 26. What about the chemotherapy?We were told an order for Sutent had been placed.It did not come. The hospital pharmacy kicked out the orderas it was too expensive.I would have to order it from a specialty pharmacy and havedelivered to our apartment.This painting is “Sutent in a Shadow Box.”It is a mixed media piece of pills & paper.It is priced at cost in homage of theretail price of the pills alone.17 pills $24,285.71
  27. 27. I am trying to talk with Christine Kraft and epatient Dave. Why did we get more help and answers from Social Media than from our local hospital ? Within one day were in email contact and then spoke on the phone. By ten o’clock May 4th 2009, I was talking on the phone with Dave’s Oncologist about my husband’s cancer.
  28. 28. Going to Hospice.
  29. 29. We fulfilled our final 2008 resolution on June 11th 2009.We moved into a two bedroom apartment so I could care for Fred in home hospice. He died six days later on June 17th, 2009
  30. 30. Painting Advocacy meets Social Media
  31. 31. This is the painting 73 cents. This is the vital patient story, the social history , the sacred heart of Fred’sELECTRONIC MEDICAL RECORD.
  32. 32. On Tuesday, October 20th 2009 we dedicated the mural,“Where do we go from here?”
  33. 33. Change can be Scary.
  34. 34. How about a report card for Hospitals?
  35. 35. The HCAHPS If this Patient Hospital Experience was depicted using a child’s report card,Scores of twolocal hospitals. we would see C’s, D’s, andF’s.
  36. 36. This is a comparison of the same hospitals,but now presented from the clinical viewusing process of care measures.In this Report Card,we see the scores vary fromB+ to A+
  37. 37. On July 13, 2010 I had the honor of speaking before the assembled at HHS. I presented the patient voice within Meaningful Use.There was another Regina there that dayDoctor Regina Benjamin, Surgeon Generalpresented her very gripping reason she supportedElectronic Medical Records adoption in the united States.
  38. 38. How would youdefineMeaningful Use?
  39. 39. On September 13th 2011,I met Regina once again. This was the launch ofthe Consumer e-Health ProgramThe “I” in HITat the Department of Health and Human Services.
  40. 40. Here is the real meaning ofthe “I” in HIT. The in HIT
  41. 41. There may be set backs onOur way to patient data access.,butwewillprevail.
  42. 42. All over the world, patientsAre demanding their data.They are demanding accessto the data from their doctors,from their hospitals,and from the devicesinside of their bodies.
  43. 43. Inside of every EMR there is a patient story,And sometimes it is told by Betty of Bellin Health.
  44. 44. Blue Button: More than app for veterans.
  45. 45. The Learning Health Systemand Chaordic Organization The Patient-Centered Outcomes Research Institute
  46. 46. 2 year study at Primary care settings of BethIsrael Deaconess Medical Center, Geisingerand Harborview90% patients responded they understoodwhat they had read & were not bothered by it.1-2% were concerned/offended by thecontents of the notes87% of those patients enrolled in this studydid check the notes.Doctors said the study either only added amodest increase in work or that it wasnegligible.80% Patients claimed greater adherence tomedication protocols due to access to thenotes.
  47. 47. Consumer Reporting System for Patient Safety, May 2013 When the abuse becomes too bad call this number.
  48. 48. What happens to user experience when designers likeMichael Graves design wheelchairs?
  49. 49. Why not have CDS (clinical decision support) for patients? If a child’s toy can figure any item in the world in 20 questions, whyCan’t we have CPOE and CDS in every hospital and family practice?
  50. 50. Who taught you how to be a patient?
  51. 51. Welcome to the Walking Gallery.Telling the patient story one jacket at a time.
  52. 52. Freddie grows beyond peering througha door crack to walking in a Gallery.
  53. 53. Isaac grows up.He joins the gallery as an artist.His jacket is named “Feelings.”He is marching in a rally supportingpatient data access.
  54. 54. Standing out and looking different,Can be uncomfortable or frightening.But is often needed for advocacy.You can take a negative and turnit into a POSITVE.
  55. 55. 207unique Walkers have joined the Walking Gallery wearing 228 jackets.The Gallery has representatives on five continents, but the majority of Walkersreside in the US. One artist creates the majority of the art, but new artists arejoining and currently make up 14% of content creation.The Gallery is promoted heavily on twitter, facebook and personal blogs.
  56. 56. Why can’t we ask Hallmarkto make hospice cards?Would that help us talkabout end of life?
  57. 57. Welcome to the Gallery. Welcome to the future. - @ReginaHolliday, #TheWalkingGallery