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You’re going to need a bigger binder:What one late great film profes can teach us about care transit a presentation by @Regina Holli

You're going to need a bigger binder

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This presentation is a mash-up of film, social media and HIT policy.

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Page 1: You're going to need a bigger binder

“You’re going to need a

bigger binder:”

What one late great film professorcan teach us about care transitions.

a presentation by @Regina Holliday

Page 2: You're going to need a bigger binder

"That's part of your problem, you haven't seen enough movies. All of life's riddles are answered in the movies." —Davis (Steve Martin), Grand Canyon,

from Frederick Holliday's PhD e-mail signature

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What does 70s TV have to do with medicine?

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Fred met Regina on stage in a scenic painting class at Oklahoma State University.

They would talk of Stephen King’s Dark Tower

and fall in love.

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The reality of patient engagement

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Playing Doctor: Fall 2008

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During the months of

January, February and March of 2009,

Status Lines…

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

We waited three hours before being sent home.

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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.”

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

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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.

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“She must not have tried very hard to get the record….”Comparing access to an unpublished book by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.

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

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"This is your last chance.

After this, there is no turning back.

You take the blue pill -- the story ends, you wake up in your bed and believe whatever you want to believe.

You take the red pill -- you stay in Wonderland and I show you how deep the rabbit-hole goes.”

-The Matrix

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After waiting for 5 days for a transfer, 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 record using a phone and a fax machine.

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This is the

vital clinical informationfrom Fred’s electronic medical record.

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

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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 ?

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Going to Hospice.

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Terminal Restlessness.

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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.

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

“Where do we go from here?”

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What can we do by next Tuesday?

What will defeat the Big Bad?

The Final Boss?

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Meaningful Use in adiner

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The Cake is a Lie.

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Doctor Strangelove&Value Based Purchasing

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MIB

MedicalInformation Bureau

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My Halloween Decorations:

Portals are coming!

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What does data and device access advocate Dr. Eric Topol have in common with

the movie Alien?

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All over the world, patients are demanding their data.

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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.

87% of those patients enrolled in this study did check the notes.

80% Patients claimed greater adherence to medication protocols due to access to the notes.

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What if data donation improved organ donation?

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The Learning Health System and Chaordic Organization

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Blue Button: More than app for veterans.

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Who taught you how to be a patient?

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Involving Patients as a Path to Achieving the Triple Aim

How would pop-culture define the IHI Triple Aim?

Not as just another pyramid….Not as just another failed pictograph.

What does it make you think of ?

How about…

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The Temple of Gozer from Ghostbusters?

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I have a radical idea. The door swings both ways, we could reverse the particle flow through the gate.

How? [hesitates] We'll cross the streams.

'Scuse me Egon? You said crossing the streams was bad!

You're gonna endanger us, you're gonna endanger our client - the nice lady, who paid us in advance, before she became a dog...

Not necessarily. There's definitely a *very slim* chance we'll survive. [pause while they consider this]

[slaps Ray] I love this plan! I'm excited to be a part of it!

LET'S DO IT!

Cross the streams...

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IHI Triple Aim is not a triangle.

It is a focusing beam.

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HAI! The artists and designers are coming

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What happens to user experience when designers like

Michael Graves design wheelchairs?

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Why can’t we ask Hallmarkto make hospice cards?

Would that help us talk about end of life?

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You can take a negative and turnit into a

POSITVE.

Welcome to the Walking Gallery.

Telling the patient story one jacket at a time.

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206 unique Walkers have joined wearing 227 jackets.

The Walking Gallery is promoted heavily using the free tools of

social media.

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Fred’s last request is to remember him by watching a film on his birthday.

March 31,1970 – June 17, 2009

Thank You.