I spied bike sharing in Rome earlier this summer. Now DC is getting national attention as the first American city to start a program. Interesting comment/issue at the end in this movie about bike helmets. They are not provided, and they can’t be mandated

• Urban competitiveness | Washington, DC is #5 Globally | Economist.com - Go BosWash. Place Matters.

I admit, that maybe, once or twice in my past, I may have used convening and convener in less than flattering terms, much like I used to use “process” in unflattering terms. I learned through LEAN, though, that process isn’t bad, bad process is bad. And so I have learned the same thing about convening, now that I have done it a couple times this summer, with the California Healthcare Foundation.

The most recent time was yesterday, when Veenu Aulakh, MPH, and I brought together Safety Net health care organizations, and national experts in patient online access and social impact of the Internet to talk about (you can guess…) “Patient Online Access in the Safety Net.”

These being the first convenings I have co-led, rather than participated in, I have learned a ton, and have gotten a good understanding of doing this for a purpose, which both situations have had. In the event we hosted yesterday, in Oakland, I put together an A3 document before we invited anyone, which included the background, the goals, and most importantly, the “why?” we were doing this in the first place. It was really helpful to have created agreement around the “why?” - I referred to this many times in the planning.

At the event itself, I got a new perspective that I had not had as a participant previously. It was one of listener/observer - even when I was doing the talking, I was interested to see reactions and learn what people and organizations are capable of. It made me think that when I have been a participant in convenings in the past, this is what my hosts were doing - learning what myself or my organization was capable of doing to solve a problem, as much as they might have tapped me as an expert. Interesting to have this happening in my brain.

Sharing information happened, too, courtesy of some of the most innovative organizations in the U.S., including Cambridge Health Alliance, University of California, San Francisco’s Positive Health Program , New York’s Primary Care Information Project, Institute for Family Health, and Kaiser Permanente.

In addition to all of this, there were a few nice moments of recognition for people’s work, such as when Jim Kahn, MD, thanked Kate Christensen, MD, and her team at Kaiser Permanente for their support and assistance in the launch of the myHERO patient portal for HIV patients cared for at San Francisco General Hospital.

…and a little something for me, a follow-up conversation with Hilary Worthen, MD, from Cambridge Health Alliance, about his study and pathway to discover and implement LEAN in primary care at CHA. He told me that for him, this is a transition from thinking about exam rooms and staff to “work that you need to get done, defined by doctor and patient.” I love hearing about how people apply their creativity and copy the thinking of LEAN to do exceptional things for their patients.

This being the second time I have done this, I don’t know if it was perfect. We tried a lot of things I’ve not done in meetings before, and I am still working to integrate social media before, during, and after. I am definitely sold on my philosophy of supporting any and all technology use (”if you need or want to use your device, use it”) - I have not, in my conveningness, come around to the “turn your devices off” philosophy, as I have written about previously.

Oh, and I learned that a 60″ table seats 8 people.

Here are a few images from yesterday. I’ll follow up with my slides in a separate post. Click on any to see larger size.

This week’s photograph was taken on the National Mall, where the movie “The Apartment” was being shown as part of HBO’s Screen on the Green Series.

There was an interesting dialogue between Jack Lemmon (who works in a large insurance company) and Shirley McLaine (who’s an elevator operator in said company) in this 1960 film:

BUD
They got a great little band at El
Chico, in the Village — it’s
practically around the corner from
where you live.

FRAN
Sounds good.
(a sudden thought)
How do you know where I live?

BUD
Oh, I even know who you live
with — your sister and brother-in-
law — I know when you were born –
and where — I know all sorts of
things about you.

FRAN
How come?

BUD
A couple of months ago I looked up
your card in the group insurance
file.

FRAN
Oh.

BUD
I know your height, your weight and
your Social Security number — you
had mumps, you had measles, and you
had your appendix out.

They have now reached the corner, and Fran stops.

FRAN
Well, don’t tell the fellows in the
office about the appendix. They may
get the wrong idea how you found
out.
(turning the corner)
‘Bye.

Many people in the audience were laughing during this part (and I assume many in this crowd probably are very engaged in these issues), and it made me think about how we got from there to here, and a thought provoking question: Did HIPAA solve a problem or is it a band-aid on a bigger, deeper one?

Lastly, on this gorgeous summer evening, I also encountered a curiosity of this series, the HBO Dance, which is choreographed to the opening theme many in my generation remember before the days of cable. It’s always good to dance, and laugh, every day - and that does happen in Washington!

Video posted below, along with a bonus image of the crowd.

Free Movie, originally uploaded by M.V. Jantzen.

• Checking out at the D.C. Public Library - This is not the District's finest moment. The libraries are a vital future link to patient empowerment, and data shows that GenY is flocking to them. As I integrate into this community more, I am interested in working on this problem. Any ideas, let me know. (Update: Mayor Fenty announced that the libraries are staying open full time after all.)

This week’s photograph confirms Richard Florida’s research (just a little) about extroverted types being closer to the Atlantic than the Pacific Ocean.

Frozen yogurt is back. In a big way. As a Generation Y customer in line told me, “(large ice cream chain) is doomed.” I really enjoy a place where people are easy to engage, and they walk to get places. In this case it’s to one where the product sold is only 25 calories per ounce. Not bad! (More pictures of the atmosphere are here, this place is Web2.0 enabled)

click on the image to see it full size

I took this photograph as I was walking to Georgetown and noticed the Ghost Bike placed in Dupont Circle by the Washington Area Bicycling Association. The ghost bike was placed in a ceremony on July 10 (more information here) following the death of 22-year old Alice Swanson, who was killed by a garbage truck while riding her bike to work on July 9, 2008, in Dupont Circle.

As I walked by, I noticed the words written on the tire by Alice’s mother. They had an impact on me. They will on you too. Click on the image to see them for yourself.

The world is not flat; place matters.

I couldn’t agree more with the latest work by Richard Florida. This book looks at the importance of place not only in the global economy but in a person’s life. I personally had a good idea that this made a huge difference some time ago, despite living and working in a world where colleagues work for organizations for which home base is irrelevant.

On this, my 300-day DCVersary, I can confirm that my experience bears this out. Moving from one of the smaller “mega-regions” (Cascadia, Portland, Seattle, Vancouver, 9 million people, $260 billion light-based regional product) to the second largest one in the world (Bos-Wash, Boston-Washington, DC, 54 million people, $2.2 trillion LRP) has undeniably made a significant difference in everything I do, even in a technology-related occupation. As Florida describes, people cluster:

(There is) the tendency of creative people to seek out and thrive in like-minded groups, and (there is the) self-perpetuating economic edge that comes from doing so.

Florida does a good job of reviewing the evidence that place matters, and the idea that its impact on personal and professional happiness has been underemphasized. He combines original research as well as data currently available to create a compelling picture of both the importance of place and the factors about it that matter. One of the interesting explorations in the book is about the personality of cities - extroverted people and agreeable people tend to be localized east of the Mississippi, where “open to experience” people tend to be localized to the coasts, with dominance in California and Bos-Wash (okay, maybe the extroversion doesn’t stretch as far east as DC, and maybe the “open to experience” doesn’t stretch as far South, but I’m pretending they do - you always see the best in something you like).

Throughout, It’s nice to imagine where you might “fit” but also how your own experience stacks up, because an important criteria of a place its aesthetic.

I have been using a curious measure for the past few years to judge aesthetic, the “touch-down” measure. It is, “In what city do you say to yourself, ‘I’m home,’ when the plane touches down on the runway.” I think you can’t fake that. Alternately, it’s the city that when the plane touches down, you say to yourself, “I can’t believe I don’t live here.”

I give strong kudos to Florida for acknowledging the role of diversity and tolerance in a place, not just for minorities, but for all people. He says:

It’s not about tolerance for tolerance’s sake. As my previous research has shown, places that are intolerant simply do not grow. And, as the Place and Happiness Survey confirms, people in intolerant places are less happy and less fulfilled than those in tolerant an open-minded ones.

This finding is similar to research that shows the same thing about organizations. As a patient said to me a very long time ago, “We don’t tolerate diversity (within the organization I work for). We LIVE diversity.” That describes a place that has a better chance of thriving, and one that most people (including me) want to be involved with.

A book by an author that writes a blog is a better read

It is worth mentioning that as I read the book, the positive impact of Florida having experience writing a blog came across, because (a) he brought his personal experiences and those of his colleagues into the story and (b) he crowd sourced several of his ideas, bringing in commentary from blog entries. This made for a much more engaging read, and I can’t help thinking that without this experience, the work might feel less connected to the experience of real people. I think this is an interesting way that blogging is changing traditional publishing because those who blog are forced to become more personal in their communication to be successful. I like it. A lot.

And the winner is…

I have experience living in three mega-regions described in the book: Bos-Wash, Nor-Cal, Cascadia and it was interesting for me to compare the decisions I’ve made with the characteristics of each. All of them offer so much. My recent experience with Bos-Wash has been, well, fantastic, both in terms of livability, ability to be extroverted, and exposure to diverse populations and cultures. Nor-Cal scores high in my book as well as it shares many of the livability and diversity attributes, as well as strong dominance in technology and innovation. Cascadia was definitely enjoyable for the time I spent there.

Who’s Your City? Feel free to post your experiences…

• Maintaining Metro - washingtonpost.com - For those who live in Washington, more information about what's happening during those 30-45 minute delays on weekends when they are replacing switches. Things related to place matter even to those working to change the world. The world is not flat.

JAY PARKINSON + MD + MPH

How long before HelloHealth comes to Washington, DC, with the most regional-serving walkable urban places per capita in the country?

Note: There’s been some buzz about walkability for other cities as well, also fine choices for those who love living in places that support walking.