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

1. “You’re going to need a
bigger binder:”
What one late great film professor
can teach us about care transitions.
a presentation by @Regina Holliday

2. "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

3. What does 70s TV
have to do with medicine?

4. Fredmet Regina on stage in a scenic painting class at Oklahoma State University.
Theywould talk of Stephen King’s Dark Tower
and fall in love.

5. The reality of patient engagement

6. Playing Doctor: Fall 2008

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

8. On Friday March 13th, We went to the ER because Fred was in so much pain .
We waited three hours before being sent home.

9. 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.‖

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

11. 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.

12. ―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Comparing access to an unpublished book by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.

13. ―Go After Them,
Regina.‖
April 18, 2009

14. "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

15. 5
After waiting for 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sent with an out of date and incomplete medical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.

16. This is the
vital clinical information
from Fred’s electronic medical record.
Painted on the wall of
Pumpernickel’s Deli in
Washington, DC.

18. 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 ?

19. Going to Hospice.

20. Terminal Restlessness.

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

23. On Tuesday, October 20th 2009 we dedicated the mural,
―Where do we go
from here?‖

24. What can we do by next Tuesday?
What will defeat
the Big Bad?
The Final Boss?

25. Meaningful Use
in a
diner

26. The Cake is a Lie.

27. Doctor Strangelove
&
Value Based Purchasing

28. MIB
Medical
Information
Bureau

29. My Halloween Decorations:
Portals are coming!

30. What does data and device access
advocate Dr. Eric Topol
have in common with
the movie Alien?

31. All over the world, patients
are demanding their data.

32. 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.

33. What if data donation improved organ donation?

34. The Learning Health System and Chaordic Organization

35. Blue Button: More than app for veterans.

36. Who taught you how to be a patient?

37. 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…

38. The Temple of Gozer from Ghostbusters?

39. 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!
Cross the streams...
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!

40. IHI Triple Aim
is not a triangle.
It is a
focusing
beam.

41. HAI!
The artists and designers are coming

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

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

44. You can take a negative and turn
it into a POSITVE.
Welcome to the Walking Gallery.
Telling the patient story one jacket at a time.

45. 206 unique Walkers have joined
wearing 227 jackets.
The Walking Gallery is promoted heavily
using the free tools of
social media.

46. Fred’s last request is to remember him by watching a film on his birthday.
March 31,1970 – June 17, 2009
Thank You.