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a presentation by @Regina Holliday Knowing the Score: Truth is truth to the end of reckoning. Photo By Ted Eytan

Knowing the Score: Truth is Truth

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Presentation covering our family story and an overview of what is happening in health policy.

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Page 1: Knowing the Score: Truth is Truth

a presentation by @Regina Holliday

Knowing the Score:Truth is truth to the end of reckoning.Photo

By T

ed E

yta

n

Page 2: Knowing the Score: Truth is Truth

Thinkingoutside the text boxand focusingon the border

Page 3: Knowing the Score: Truth is Truth

Art, balance, hot spotting and the IEP

Page 4: Knowing the Score: Truth is Truth

Patient Reported Data is very important.

Page 5: Knowing the Score: Truth is Truth

Even a child can understandand appreciate health Information.

Both Quantitativeand Qualitative.

Page 6: Knowing the Score: Truth is Truth

When the abuse becomes too bad call this number.

Page 7: Knowing the Score: Truth is Truth

1990 Reporting to results of The Sapulpa High School

Wellness Check

(I visit the principal’s office again)

Page 8: Knowing the Score: Truth is Truth

14 years later, Fred would meet Regina on stage in a scenic painting class at Oklahoma State University.

We would talk of Stephen King’s Dark Tower.

We would fall in love.

Page 9: Knowing the Score: Truth is Truth

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 studiesand 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.

Page 10: Knowing the Score: Truth is Truth

I would paint

neighborhood murals. I would also

teach art at a local preschool.

I would work in a toy store.

Page 11: Knowing the Score: Truth is Truth

The Holliday Family Christmas 2007

Page 12: Knowing the Score: Truth is Truth

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’sIEP Binder

Page 13: Knowing the Score: Truth is Truth

Fred was happy with his new job.

But he was very tired,

He went to the doctor and was diagnosed with hypertension.

Page 14: Knowing the Score: Truth is Truth

During the months of

January, February and March of 2009,

Status Lines…

Page 15: Knowing the Score: Truth is Truth

On Friday March 13th, We went to the ER because Fred was in so much pain .

We waited three hours before being sent home.

Page 16: Knowing the Score: Truth is Truth

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 medical conference and was not reachable by phone or email.

Page 17: Knowing the Score: Truth is Truth

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

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Systems Error:More than one bad doctor

Page 19: Knowing the Score: Truth is Truth

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.

Page 20: Knowing the Score: Truth is Truth

“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.

Page 21: Knowing the Score: Truth is Truth

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

Page 22: Knowing the Score: Truth is Truth

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.

Page 23: Knowing the Score: Truth is Truth

This is the

vital clinical informationfrom Fred’s electronic medical record.

Presented in the style of the Nutrition Facts Label.

Then painted on the wall ofPumpernickel’s Deli in Washington, DC.

Page 24: Knowing the Score: Truth is Truth

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 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

Page 25: Knowing the Score: Truth is Truth
Page 26: Knowing the Score: Truth is Truth

I am trying to talk with Christine Kraft and epatient Dave.

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.

Why did we get more help and answers from

Social Media than from our local hospital ?

Page 27: Knowing the Score: Truth is Truth

Going to Hospice.

Page 28: Knowing the Score: Truth is Truth

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

Page 29: Knowing the Score: Truth is Truth

Painting Advocacy meets Social Media

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This is the painting 73 cents.

This is the vital patient story, the social history , the sacred heart of Fred’s

ELECTRONIC MEDICAL RECORD.

Page 31: Knowing the Score: Truth is Truth

On Tuesday, October 20th 2009 we dedicated the mural,

“Where do we go from here?”

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Change can be Scary.

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How about a report card for Hospitals?

Page 34: Knowing the Score: Truth is Truth

The HCAHPSScores of two local hospitals.

If this Patient Hospital Experiencewas depicted using a child’s report card,

we would see

C’s, D’s,

and F’s.

Page 35: Knowing the Score: Truth is Truth

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 from

B+ to A+

Page 36: Knowing the Score: Truth is Truth

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.

Page 37: Knowing the Score: Truth is Truth

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.

Page 38: Knowing the Score: Truth is Truth

The in HIT

Here is the real meaning ofthe “I” in HIT.

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There may be set backs on Our way to patient data access.,

but we will prevail.

Page 40: Knowing the Score: Truth is Truth

All over the world, patients Are demanding their data.

They are demanding accessto the data from their doctors,from their hospitals,and from the devicesinside of their bodies.

Page 41: Knowing the Score: Truth is Truth

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

Page 42: Knowing the Score: Truth is Truth

Blue Button: More than app for veterans.

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The Learning Health System and Chaordic Organization

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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.

Page 45: Knowing the Score: Truth is Truth

Consumer Reporting System for Patient Safety, May 2013

When the abuse becomes too bad call this number.

Page 46: Knowing the Score: Truth is Truth

What happens to user experience when designers like

Michael Graves design wheelchairs?

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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?

Page 48: Knowing the Score: Truth is Truth

Who taught you how to be a patient?

Page 49: Knowing the Score: Truth is Truth

Welcome to the Walking Gallery.

Telling the patient story one jacket at a time.

Page 50: Knowing the Score: Truth is Truth

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

Page 51: Knowing the Score: Truth is Truth

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.

Page 52: Knowing the Score: Truth is Truth

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.

Page 53: Knowing the Score: Truth is Truth

As of December 2012, 198 unique Walkers have joined wearing 218 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.

Page 54: Knowing the Score: Truth is Truth

We each walk inspired by our core mission centered on the patient story.

Page 55: Knowing the Score: Truth is Truth

Welcome to the Gallery. Welcome to the future.

- @ReginaHolliday, #TheWalkingGallery