Photo Friday: Story of incredible innovation – at Hitsville, USA

I took this photograph right at the moment that my colleague Kristin ( @krisitnjuel ) realized that she had arrived. Soon after, I realized I had arrived, too. What an amazing lesson in innovation there is at the Motown museum ( @motown_museum ).

What happened was that we had just returned from a tour of the Ford Rouge Plant, in Dearborn, Michigan. This plant is a multibillion modern marvel, complete with green room, LEAN production techniques, showcasing the best in American ingenuity on a grand scale.

On our way back to the host venue, after passing the museum multiple times, I agreed to take a quick detour to the Motown Museum. It showed me so much about how incredible innovation, much more than I expected. We learned about how a 30 year-old Berry Gordy connected with the social network of people in their early teens and 20′s, who packed into a small room known as the snake pit, with no air conditioning (it created too much noise), lots of cigarette smoke, and a two track recorder, meaning that each take had to be executed perfectly. Detroit was put on the world map in an era where it shouldn’t have been. When he learned that a DJ would only play 3 songs from a single record label in an hour, he just created new record labels, and moved songs between artists for maximum exposure.

We were standing in the room with photographs like this, where Diana Ross and Smokey Robinson created the greatest hits of their time (and I’ll say of all time). If you know Kristin, you know how much music is a part of her life, and that it’s no surprise she had a tear in her eye as we walked through the space. I may have had a little one, too. Innovation and creativity in a time and place of constraint is emotionally powerful – it’s the triumph of the human spirit.

So that’s the story behind the photograph. My photos of the Ford plant are below. Unfortunately neither Ford nor the Motown museum allow taking pictures inside their production areas. 

I wanted to share what we experienced because it will shape dialogues I have about innovation for a long time to come. All of this is available in a little house a block away from the Henry Ford Health System in Detroit, Michigan, USA.

Oh, PS, see that green line in the parking lot at Ford? We were told that workers that drive Ford vehicles to work are allowed to park their cars on the side of the line that is closer to the plant so they don’t have to walk as far. It made me think, what if the drivers of the Ford vehicles were rewarded with parking farther away from the plant instead :) .

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Also in DC June 4-6, 2012: International Conference on Patient- and Family-Centered Care

From the place where I learned that it wasn’t just “patient centered care” ( @ipfcc )….

Wherever I go in health care, I have gotten in the habit of asking these questions:

  1. Do you have ‘visiting hours’ or can family be present 24/7 in this hospital?
  2. Does this hospital/health care system have member/patient/family advisory councils?

In fact, I asked these very questions earlier this week at the beautiful Henry Ford West Bloomfield Hospital ( @HenryFordWBH ) (pictures coming soon).

The answers are not always “yes” and getting to “yes” is both (a) possible and (b) dependent on learning about the experiences of others who have done this. If you can make it to Washington, DC (and why wouldn’t you want to), you’ll get to touch base with the who’s who of health care systems who have done this. 

That’s one important piece of knowledge to gain.

The other important piece of knowledge to gain is “what happens when an organization committed to patient and family involvement also walks the walk when it comes to planning its meetings?” I blogged about previously when I noticed that every abstract submission required proof of patient/family involvement (See: Promoting patient and family involvement – image from abstract submission form, Institute for Patient and Family Centered Care @IPFCC | Ted Eytan, MD.

And…one more thing…the conference is not just the conference, it includes an opportunity to learn where health care is delivered. The Institute for Patient and Family Centered Care has also set up hospital tours, of Fort Belvoir Community Hospital and Children’s National Medical Center:

Fort Belvoir Community Hospital, the newest military hospital in the nation, serves as a model for military hospitals around the world. Patient and family advisors participated in the planning for this new facility that opened in 2011. The guiding principles to achieve the hospital’s mission, pursue its vision, and maintain the highest level of quality and service are the Culture of Excellence, Patient- and Family-Centered Care, and Evidence Based Design.

This is also an interest of mine – that when you go somewhere to learn about health care being delivered, that you leave the conference room and learn about it where it is being delivered.

The sad part for me is that I cannot go, only because I have assigned duties at DC Health Data and Innovation Week – however I have no qualms about encouraging people to come to Washington, DC to attend this conference. I will be at Health Data and Innovation Week bringing the lessons that I’ve learned from IPFCC, and in the end, innovation and health data are insignificant without the involvement of patients, people, and their families. There’s going to be crossover, specifically with The Walking Gallery, so it’s possible to do both. See you in Washington!

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Exploring the Weight of the Nation, and Washington, DC, and Detroit

I got to speak to Jim Marks, MD, the Senior Vice President and Director of the Health Group for Robert Wood Johnson Foundation (@JamesSMarks48) because I won the monthly RWJF Alumni Social Network profile contest (it feels good to win at these times…), and I asked him about social determinants of health. He said to me (and I’m paraphrasing): “social determinants will not take the place of what people do for themselves and their families. We structure choices so that the right thing to do is the easy thing to do.”

With that in mind, and with the series Weight of the Nation on last night, I did some exploration, partly based on this, and partly based on a question my colleague Jan Ground ( @janground ) asked, which was, “Is obesity correlated with poverty?”

Because our friends at Community Commons have set up a special Weight of the Nation page with information , data kits, and the like, I ran some queries on Washington, DC:

As I’ve pointed out on this blog before (See: Do national numbers inaccurately represent Washington, DC’s obesity condition? ), any state or county-wide obesity % for Washington, DC, is going to be wrong, because we have wards with the lowest obesity rates in the United States ( 12 percent! ) and the highest, higher than Mississippi ( 42 percent! ). I’ve just pointed those out rather than putting the data on the maps.

You tell me if there’s a correlation.

Since I’m in Detroit right now for the Innovation Learning Network ( @HealthcareILN ) in person meeting, I decided to look at similar data for the Detroit area. I added the obesity % layer to the map because I believe that this region doesn’t have the same issue as DC (but I just did it this morning, you tell me).

We thought the first two segments of the show are important and educational for the American population. And now, in the era of open data, we don’t have to stop at admiring (or being afraid of) the pictures on the screen. One thing that came up was the image of the man with the “ARMY” T-shirt during the segment. We take for granted that this logo is commonly worn by people who have served, however, two of our colleagues watching the show with us serve as leaders in our military and spoke to us about how it made them feel to see that. How would it make me feel to see our health system logo being worn by a person who is struggling to stay healthy in their environment?

Because the viewing party was for this show, I made sure to pick up healthy snacks. Notice what I noticed – those bags of carrots and celery are resealable, which allows for portion control and re-use. Potato chip bags are typically not. Food for thought.

The 3rd and 4th parts are on tonight, with a reminder that this is “open signal,” no HBO subscription is required to watch. The shows are also available on YouTube, to keep them accessible to all Americans and their loved ones.

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HBO’s “The Weight of the Nation” begins tonight – all cable subscribers invited

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This groundbreaking series begins tonight. Note that it is being broadcast as an open signal, which means that an HBO subscription is not required to watch.

You can learn more about Kaiser Permanente’s involvement in this project here: Kaiser Permanente and Weight of the Nation.

I’ll be watching with colleagues from the Innovation Learning Network ( @HealthcareILN ) and will post some thoughts on the first film tomorrow.

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Capital Bikeshare’s Twitter defender? Mayor Vince Gray

Capital Bikeshare’s Twitter defender? Mayor Vince Gray.

An interesting debate had over twitter by our city’s Mayor ( @mayorvincegray ) about the utility and funding of the wildly successful Capital Bikeshare ( @bikeshare ) bicycle sharing program.

I actually found this because my photograph of the Mayor is used in the piece ( thank you! ). It directly relates to this recent post about the visualization of Capital Bikeshare data (see: “Quantified Community“).

I think the art piece in the blog post referred to above settles the question visually about whether Capital Bikeshare is being used by commuters or not. Another great use of art + open data to help people and communities make the best decisions.

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Photo Friday: Isaac Holliday, Bubbles….and Milo

I chose this photograph of Isaac Holliday, wearing his jacket entitled “Feelings,” which he designed himself, with a little help from a famous local artist and also his mother, Regina Holliday ( @ReginaHolliday ).

In the photo, Isaac is playing with the bubble machine that Regina Holliday brought to the corner of Connecticut and T Street, Northwest, this past Sunday. I came to officially present the blank canvas of my next gallery piece and request Regina’s talent in turning it into a piece in The Walking Gallery. She said yes!

Oh, and she was also there to bring awareness to the American Hospital Association’s stance on providing patients and families with their medical record information.

I brought my favorite dog in Washington, DC, Milo, and Isaac really took to him (and why wouldn’t he, who doesn’t love Milo) – they are both 6 years old, I found out. What the heck, let’s include a photo of Milo today as well:

Milo looks a little pensive. He’s in a strange surrounding (a little farther away from his normal dog park), and he’s also a very attached kind of dog. He gets very nervous when his dad or his dogfather (that’s me) are not close by. If I were to put a thought bubble over his head, it wouldn’t be that he’s angry or upset or sad or disapproving of what the humans around him are fussing over. It would just be, “I hope everyone here is working together to make sure that my dad is around for a long time.”

Isn’t it interesting how the most complex things are really simple from the perspective of our children and our dogs. It was great to see Isaac enjoying life again – he asked about Milo last night at Regina’s birthday party – I am glad he remembered him!

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Walking Podcast! Janet Wright, MD, for Million Hearts: “systematic care, put in place, works like a charm”

Not walking, our brains have quit working. View ‘Ted Eytan MD and Janet Wright MD’ on Flickr.com

Play

(click here to download directly into iTunes)

I’ll try anything if it involves walking (my first walking podcast!), and luckily so will Janet Wright, MD, FACC, who’s the Executive Director of Million Hearts ( @MillionHeartsUS ):

a U.S. Department of Health and Human Services initiative with the explicit goal to prevent a million heart attacks and strokes in five years.

Maybe I have more than a passing interest in hypertension (if you read all the linked posts about it on this blog, you’ll see), and that’s what brought myself and Janet together, on foot.

The podcast shows that DC can be a noisy (and stunningly beautiful) place – I did my best to shape the audio to be more understandable, but in reality I think more than 5 minutes with this background wouldn’t be as fun, so I edited accordingly.

As Janet points out, DNA is not destiny, and it is the science of creating systems and teams that are going to allow us to manage a condition that affects 1/3 of the United States population.

You’re also get a peek inside the relationship between the primary care (family practice) and specialist (cardiology) point of view. Janet reminds me, correctly, that blood pressure is not easy to treat in every person, which is another reminder that we’re all necessary.

In our talk, she refers to an event in Washington, DC, that brought four innovative programs together to talk about their scale and spread across health care. In 2012, there are many more programs that harness the science of systems. Our friends at the AHRQ Innovations Exchange ( @AHRQIX ) have a whole resource of the people, methods, victories and challenges of each. From my work with AHRQIX, I believe that just about any idea to innovate in health care should start with a search on that resource. Here are the links to the four programs featured recently just as a (great) example.

Since we were walking and talking I needed to ask about walking meetings at the end and…Janet’s a fan! Keep this in mind if you are fortunate to work with her during this effort. She added yet another important reason to walk, talk, and think at the very end of our conversation – our brains quit working when we stand still. And you know, she’s right.

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Now Reading: Causes of death mapped to social factors instead of individual characteristics

I referred to this paper in a previous blog post but decided to give it its own, based on recent interest.

A lot of people are familiar with the often-cited breakthrough analysis, “Actual Causes of Death in the United States,” by McGinnis and Foege in 1993, which was followed by another, impactful analysis in 2002. Both changed ideas about what could be done to promote health and wellness, from looking at “heart disease,” to instead looking at “smoking,” (1993), to instead looking at “behavioral patterns,” (2002).

In the 2002 analysis, “social circumstances,” is listed as being responsible for 15 percent of deaths, with an accompanying editorial that said:

the data are still not crisp enough to quantify the contributions [of social circumstances] in the same fashion as many other factors. (reference)

Well, it’s almost 10 years later, and there is more crisp data, and greater awareness of the “causes of the causes” of poor health. I created a pie chart from that data:

And below are the three studies laid out the same way, 1993, 2002, 2011. We have come a long way in understanding what we can do to improve health. What do we believe the balance is now compared to 2002, and where should we act, and in what proportion, at the level of the individual, family, community, society? Quantified self and/or quantified community? An app for improved social health or one for individual behavior change?

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