Updated Writing on the Wall

1. The Writing on the Wall
A presentation by Regina Holliday

2. Thinking
outside
the text box
focusing
on the border

3. Art, balance and the IEP

4. In 1978, there was a little boy named Freddie who lived in Maryland
and a little girl in Oklahoma named Regina.

5. Patient Reported Data is very important.

6. Even a child
can understand
and appreciate
health
Information.
Both Quantitative
and
Qualitative.

7. When the abuse becomes too bad call this number.

8. 1990
Reporting to results
of
The Sapulpa High School
Wellness Check
(I visit the principal’s office again)

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. 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. From 1994onward,
I was working full time in retail sales,
but I would try to find time to paint.

12. I would paint
neighborhood murals.
I would also
teach art at a local preschool.
I would work in a toy store.

13. The Holliday Family Christmas 2007

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. Fred was happy with his new job.
But he was very tired,
He went to the doctor and was
diagnosed with hypertension.

16. During the months of
January, February and
March of 2009,
Status Lines…

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. Fred was hospitalized on March 25th 2009
for the administration of tests.
On March 27th, he was told while alone that
he had “tumors and growths.”
He was scared and confused and did not understand.
His oncologist left town for the next four days to a medical
conference and was not reachable by phone or email.

19. What was the diagnosis? What were the treatment options? Would he get a pain consult?

20. Systems Error:
More than one bad doctor

21. This is my husband’s
medical record.
I was told it would cost
73 Cents
per page
And we would have to
wait 21 days to get a copy.

22. “She must not have tried very hard to get the record….”
Comparing access to an unpublished book by
Stephen King
to accessing the
Electronic Medical Record
while hospitalized.

23. “Go After Them,
Regina.”
April 18, 2009

24. After waiting for 5 days for a transfer
to another hospital for a second opinion,
We were sent with an out of date
and incomplete medical record
and transfer summary.
The new staff spent 6 hours trying to
cobble together a current medical record
Using a telephone and a fax machine.

25. This is the
vital clinical information
from Fred’s electronic medical record.
Presented in the style of
the Nutrition Facts Label.
Then painted on the wall of
Pumpernickel’s Deli in
Washington, DC.

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 order
as it was too expensive.
I would have to order it from a specialty pharmacy and have
delivered 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 the
retail price of the pills alone.
17 pills $24,285.71

28. 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.

29. Going to Hospice.

30. 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

31. Painting Advocacy meets Social Media

32. This is the painting 73 cents.
This is the vital patient story, the social history , the sacred heart of Fred’s
ELECTRONIC MEDICAL RECORD.

33. On Tuesday, October 20th 2009 we dedicated the mural,
“Where do we go
from here?”

34. Change can be Scary.

35. How about a report card for Hospitals?

36. The HCAHPS If this Patient Hospital Experience
was depicted using a child’s report card,
Scores of two
local hospitals. we would see
C’s, D’s,
andF’s.

37. This is a comparison of the same hospitals,
but now presented from the clinical view
using process of care measures.
In this Report Card,
we see the scores vary from
B+ to A+

38. 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 day
Doctor Regina Benjamin, Surgeon General
presented her very gripping reason she supported
Electronic Medical Records adoption in the united States.

39. How would you
define
Meaningful Use?

40. On September 13th 2011,
I met Regina once again. This was the launch of
the Consumer e-Health Program
The “I” in HIT
at the Department of Health and Human Services.

41. Here is the real meaning of
the “I” in HIT.
The in HIT

42. There may be set backs on
Our way to patient data access.,
but
we
will
prevail.

43. All over the world, patients
Are demanding their data.
They are demanding access
to the data from their doctors,
from their hospitals,
and from the devices
inside of their bodies.

44. Inside of every EMR there is a patient story,
And sometimes it is told by Betty of Bellin Health.

45. Blue Button: More than app for veterans.

46. The Learning Health System
and Chaordic Organization
The Patient-Centered
Outcomes Research Institute

47. 2 year study at Primary care settings of Beth
Israel Deaconess Medical Center, Geisinger
and Harborview
90% patients responded they understood
what they had read & were not bothered by it.
1-2% were concerned/offended by the
contents of the notes
87% of those patients enrolled in this study
did check the notes.
Doctors said the study either only added a
modest increase in work or that it was
negligible.
80% Patients claimed greater adherence to
medication protocols due to access to the
notes.

48. Consumer Reporting System for Patient Safety, May 2013
When the abuse becomes too bad call this number.

49. What happens to user experience when designers like
Michael Graves design wheelchairs?

50. Why not have CDS (clinical decision support) for patients?
If a child’s toy can figure any item in the world in 20 questions, why
Can’t we have CPOE and CDS in every hospital and family practice?

51. Who taught you how to be a patient?

52. Welcome to the Walking Gallery.
Telling the patient story one jacket at a time.

54. Freddie grows beyond peering through
a door crack to walking in a Gallery.

55. Isaac grows up.
He joins the gallery as an artist.
His jacket is named “Feelings.”
He is marching in a rally supporting
patient data access.

56. Standing out and looking different,
Can be uncomfortable or frightening.
But is often needed for advocacy.
You can take a negative and turn
it into a POSITVE.

57. 207unique Walkers have joined the Walking Gallery wearing 228 jackets.
The Gallery has representatives on five continents, but the majority of Walkers
reside in the US. One artist creates the majority of the art, but new artists are
joining and currently make up 14% of content creation.
The Gallery is promoted heavily on twitter, facebook and personal blogs.

58. Why can’t we ask Hallmark
to make hospice cards?
Would that help us talk
about end of life?

59. Welcome to the Gallery. Welcome to the future.
- @ReginaHolliday, #TheWalkingGallery