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

"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

What does 70s TV have to do with medicine?

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.

The reality of patient engagement

Playing Doctor: Fall 2008

During the months of

January, February and March of 2009,

Status Lines…

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

We waited three hours before being sent home.

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.”

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

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.

“She must not have tried very hard to get the record….”Comparing access to an unpublished book by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

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

"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

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sent with an out of date and incomplete medical record and transfer summary.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.

This is the

vital clinical informationfrom Fred’s electronic medical record.

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

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 ?

Going to Hospice.

Terminal Restlessness.

This is the painting 73 cents.

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

ELECTRONIC MEDICAL RECORD.

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

“Where do we go from here?”

What can we do by next Tuesday?

What will defeat the Big Bad?

The Final Boss?

Meaningful Use in adiner

The Cake is a Lie.

Doctor Strangelove&Value Based Purchasing

MIB

MedicalInformation Bureau

My Halloween Decorations:

Portals are coming!

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

the movie Alien?

All over the world, patients are demanding their data.

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.

What if data donation improved organ donation?

The Learning Health System and Chaordic Organization

Blue Button: More than app for veterans.

Who taught you how to be a patient?

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…

The Temple of Gozer from Ghostbusters?

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...

IHI Triple Aim is not a triangle.

It is a focusing beam.

HAI! The artists and designers are coming

What happens to user experience when designers like

Michael Graves design wheelchairs?

Why can’t we ask Hallmarkto make hospice cards?

Would that help us talk about end of life?

You can take a negative and turnit into a

POSITVE.

Welcome to the Walking Gallery.

Telling the patient story one jacket at a time.

206 unique Walkers have joined wearing 227 jackets.

The Walking Gallery is promoted heavily using the free tools of

social media.

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

March 31,1970 – June 17, 2009

Thank You.