Every Body Walk! and Make Roads Safe – hyper-Ignite at American Medical Student Association Annual Convention 2013

Help this Muppet

Below in timed version and self-advanced version, given at the 2013 American Medical Student Association Annual Convention (@AMSANational), in Washington, DC.

I decided to stray a bit from the Ignite format and instead do what I’m calling a hyper-ignite. 9.5 seconds per slide instead of 15. It’s 33% more efficient! Enjoy, and links to relevant web sites are below the script. Thank you, AMSA students, Make Roads Safe (@Make_Roads_Safe)

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The Script


  1. Hi. I’m Ted. I’m here on behalf of 17,000 physicians and 9 million members who are supporting the American Medical Student Association this year.
  2. I work in the super awesome Center for Total Health, just down the street, on Capitol Hill, which you are most welcome to visit 
  3. Here, we demonstrate what it’s like to train in and practice the best health care, 
  4. And talk about health, too – check out that 80 foot video touch wall.
  5. You’ve probably seen this sign and wondered what the heck it is all about, I’m going to tell you, starting with my story.
  6. When I was in medical school, hoping to become a family doctor, I was taught that the only way to listen to patients was in here – the medical office/hospital
  7. This is the image of being a doctor that I was taught, and the one that still exists in most of health care – only one way to be there for patients
  8. A few public health degrees later, I worked in Health IT, and now, we can listen and learn wherever our patients are
  9. After years of doing this, a discovery, based on listening to our patients when they weren’t in the medical office or hospital – where they live work learn pray and play. 
  10. Which is that health doesn’t happen here. 
  11. It happens here – notice the walking meeting
  12. It happens here
  13. It happens here. Those are solar panels – on the top of this medical office
  14. After learning about our patients outside of the health care system, I learned about the ways we can make sure all the work we do in our hospitals is not wasted – this is our carbon footprint. We’re the first US Health System to have a verified greenhouse gas emission inventory. And we’re to going to reduce it. By 30%, by 2020.
  15. But we’re all doctors, and I’m one, too, proudly a specialist in Family Medicine. So what should you do? We thought of that.
  16. That’s where walking comes in, and here are 3 things I’d like you to do.
  17. FIRST: WALK. Walk with your friends. Walk with your enemies. Walk using this app. When you have a difficult problem to solve with someone, walk with them. FIND the person in this room who you are least interested in spending time with and walk with them.
  18. Trust me, it works. And biology is on your side. When you move, you can manage yourself better, pay attention, and your brain actually grows new cells.
  19. SECOND: Partner with this doctor. Regina Benjamin, MD, MBA is the US Surgeon General. On April 1, she will start a process to create a new call to action around walking.
  20. She was with us 2 days ago telling us how important this is. Look for it, and participate, in the Federal Register, starting April 1, 2013. Why?
  21. It doesn’t matter if you become an endocrinologist or or an otolayngologist, walking helps EVERYTHING. It’s easy to recommend, and easy to do. There are a zillion benefits that will make your job as a doctor easier and more rewarding
  22. THIRD: Partner with this muppet to MAKE ROADS SAFE around the world
  23. Worldwide traffic fatalities will exceed diabetes and HIV in our generation. If we do nothing, 5 million fatalities, and 50 million serious injuries will result. Every 6 seconds, a person is killed or seriously injured on roads.
  24. May 6-12 is Global Road Safety Week. Take a long short walk, register it at mylongshortwalk.org and tweet using the hashtag #walksafe
  25. And by the way, it’s better for your health, too. Do it for that reason alone.
  26. We took a long short walk. We celebrated that we’re fortunate to be able to walk safely. 
  27. If you think this is an international problem, think again. even in the United States, a walk to school can end a child’s life.
  28. Be aware, be a leader, and you can save lives inside the health care system and outside of it, too.
  29. The last thing I want to say is Thank you, good luck, we support you, and we’ll see you next year, if not sooner!
  30. Thrive.


Presentation: 4 ½ Reasons WHY : Social Media for Physicians in Integrated Care Delivery – Ignite format

This is the second presentation I gave on social media last week. The first audience was interested in the “how,” this audience is interested in the “why”. (see: What does social media mean, in an integrated care system? A conversation at @KPGarfield | Ted Eytan, MD)

This audience is 42 physicians, in their leadership journey, from 6 Permanente Medical Groups (Hawaii Permanente Medical Group, Northwest Permanente Medical Group, Group Health Physicians, Colorado Permanente Medical Group, The Southeast Permanente Medical Group, and Ohio Permanente Medical Group). I’ll post on this leadership program separately.

And….I can’t believe it but I actually decided to do this in Ignite format. The disbelief is because I recall how challenging the Ignite format was for me when I first did it (see: Slides, Script, References, Photos, from my #ONCmeeting Ignite Talk – Acceleration and Tipping points – Consumer E-Health | Ted Eytan, MD). This time it was easier….and it was right for this discussion. Following the presentation I was asked more about the format, which none of the physicians had heard of. A little diffusion of innovation on top of diffusion of innovation.

My attempt to record a video of me giving the talk didn’t work out, so I’ve closed captioned the YouTube video of the slides above (just hit the “cc” button), and/or you can access the slideshare + the script as well as sources of the data (for an Ignite, you typically want the source information separate, to keep the slides clean). Let me know what you think.

The YouTube is timed at 5 seconds per slide instead of 15 seconds, to accommodate the attention-deficit web/mobile viewer of the content.


Washington, DC, is the most social city in the United States. It’s the most walkable city in the US, it’s compact, and it’s a place with shared challenges and leadership in society. We can’t vote like residents of other states; however, we’ve had marriage equality since 2010. It’s a great place to understand the “why” of social networking, with information that I’d like to share with you about why it’s important to us as physicians in an integrated, non-profit, care delivery system.

This is where my “why” started, in 2005, when I was helping to lead a statewide EHR/PHR project. I needed to use social media because it was the only way to communicate authentically, honestly, and frequently during a time of immense change.

Reason 1. We value communication. The ways people are communicating is changing.

Look at 2005: Just 7 years ago, very few people were using social networking sites, even among people aged less than 30 years old.

Now, look at the generation after Generation Y. If you ask teens how they communicate with their friends, they cite text as most common way they communicate with friends. Social networks are #2, in person is #3.

At the same time, their FAVORITE way of communication is in person, followed by text, followed by social networks. In person will always be valuable. Think about social networking as an ADDITIONAL method to all of the ways you will need to communicate as a colleague and as a physician with the people you serve.

This is what I hear from our patients today, like Mackenzie Marsh, who’s pictured here. She told me, “social networking does not replace the way I communicate. I talk with people in person, on the phone, in text, over facebook, all at the same time.”

This brings us to reason #2. We want to be there for our patients (and they want to be there for us).

If you look at the data from 2002 to 2011, health professionals are still the #1 place that people go to get health information. Notice, this percentage hasn’t gotten lower since 2002.

The data is even more significant for caregivers, 78% of them cite health professionals as the most common place they go to get health information.

Reason #3: We came here to change the world. I took this photograph at the AIDS Quilt display in Washington, DC, the first time the quilt has been shown there since 1992.

There are so many stories like this, during a time when the medical profession was not as compassionate as it could have been – causing people to ask “why?” about the death of their loved one.

Our ancestors, at Kaiser Permanente and Group Health Cooperative, wanted our organizations to demonstrate a replicable model, that gave people the choice to practice medicine in a higher quality, more compassionate way. We want to continue this tradition.

At Kaiser Permanente, this is not the case. We made an announcement in 2012 with the White House that we have eliminated disparities in care for HIV/AIDS patients. You don’t have to be white, Black, Latino, straight, gay, female or male, to achieve comparable outcomes at Kaiser Permanente. We have posted the HIV challenge online because other care providers and health systems should have this option (and really, a requirement) to eliminate disparities, too.

This is my blog post about that announcement. I blog because I want people to know that there is a voice for change, that we don’t have to do things the same way they have always been done. When I was in training, there was NO voice that I could turn to to understand that what was going on in my environment was not right, that the profession was not behaving professionally. I use social media to hopefully be that voice for others.

This is reason #4. Play at http://youtu.be/_vwxL59tWhc

Our ancestors led the way before anyone else did in thinking about environmental causes of good or poor health. Sidney Garfield recognized the benefit of sunlight for healing (the photograph on the right is called “sun bath”). Today, we are still thinking about the determinants of health beyond health care. We want physicians’ work to not be defeated by the environment, at Kaiser Permanente and beyond.

We have an amazing culture here, that allows us to innovate, and tell the world about it. People know that I’m passionate about walking meetings, and I can use social media to talk about the benefits and get feedback on what this means for others.

The ½ reason is that our leaders want us to. Bill Marsh, MD, is interested in exploring the lives of our patients beyond their health care through social media. We recently hosted the Permanente Executive Leadership Summit, with its own social network. This allowed 300 of leaders at Kaiser Permanente and the top health systems in the United States (and world) to engage in frequent, informal, small bits of communication + LISTENING, which is what social media ultimately is – listening.

With those why’s, it’s easy to see why you can find me here, here, here, here, here, and here. Glad you’re going to join me.

Sources of the data used above

Slides, Script, References, Photos, from my #ONCmeeting Ignite Talk – Acceleration and Tipping points – Consumer E-Health

Here’s the script, the slides, and the reference used in my presentation today at the 2011 ONC Annual Meeting, in Washington, DC. This format is definitely challenging, still it’s a great experience to create a message using this format, and really fun to do it for the first time with three other people.

Most of the photographs in the presentation were taken by myself, I’ve included links to them in the list below. You are welcome to use any per Flickr community guidelines.

Enjoy, let me know if there are any questions, comments and feedback welcome.

And now I get to say, Ignite – check that box 🙂 .

Hi. I’m Ted. I entered medical school hoping to be a family practitioner, I left medical school hoping to be one, too (and I became one). However, when I realized that primary care was hallway of blinking lights, my vision for medicine was changed forever.

I didn’t understand why this was the only way to listen in primary care, going from room to room, providing the same information that only I had, again and again, to people who physically came in to be seen.

Where did the hallway come from? It came from where health care used to be – where the only way to listen was in person, occasionally on the telephone.

A colleague recently told me that her first experience with a personal health record made everything else feel antiquated/past life. Here’s what she was talking about.

In 1999, patients were interrupted by physicians 23 seconds after they began speaking. This was up from 18 seconds in 1984. 72 % of the time, they never got to finish their opening statements.

Thanks to health information technology, we can listen better. This is what you’ll find at a Kaiser Permanente medical office, like this one in Portland – options to be heard. Because of the interest in listening better, adoption is huge, hockey-stick like.

3.7 million patients are now registered to use our personal health record, 61% of all eligible members, 50% of medicare members, are logged on, and 27% logged on more than 11 times in the last 6 months.

Same goes for caregivers, because we realized through technology that the patient in front of us was not the only person that needed information. It’s the child/parent/loved one of the patient, too.

You shouldn’t think of this as one big personal health record – think of this of multiple connections to individual practices in a system.

And this is what listening looks like in 2011. Add another million e-mails send to physicians and another 2 million test results viewed online by members to those numbers to be accurate through Q3 2011. Also 4.4 million after visit summaries.

The cool thing is, I don’t have to tell you why this is important, your patients will. They’ll say things like “health care used to happen in a hospital”, and “I’d be up a creek” without the connectivity my caregivers have to my health care.

Oh, and the care is better. Here’s just one example. Blood pressure control in the era of the electronic health record was already showing huge gains, way beyond what was thought possible.

When we examined the impact of patient-physician e-mail, the control was significantly better than that. The same is true for diabetic and lipid control. Not bad!

Notice that e-mail makes everything BETTER, so regardless of your abilities, you can improve your performance with the connectivity to patient and family.

Let’s talk about the threat of information overload. It’s real. You will have to pay attention to your workflow and you can make it work. Again, the goal is to listen better, because the threat of not listening is even greater.

Even in organizations with advanced electronic health records, it is still critical for patients and families to be involved. This is not just a burden, it can be devastating. This PIE should be whole, which equals an accurate, safe, health system.

So what will happen next, after electronic health records and personal health records are the norm, rather than exception? Let me float some ideas…let’s start with the practice of medicine. Family physicians will be able to lead teams with more tools and time to listen to patients.

They will return to practicing the full spectrum of family medicine, in medical homes, supported by great specialists, all with more time, and more flexibility in their work schedules.

When the front door to your electronic health record is a computer screen or a cell phone screen, you will start listening to what your patients are doing when they are not in the medical office, and it will change the way we think about our roles in the medical system and their lives.

We’ll see signs like this, because we’ll invite patients to participate outside of the exam room, in patient advisory councils, and we’ll listen to them as strategic partners in the design of a better health system that will improve faster.

We’ll build a health care system that blends into the environment better, with more efficient buildings and less parking lots. Parking lots are the most toxic structure you can build in terms of environmental impact. US Health care activities account for 8% of total Greenhouse Gas emissions, by the way.

And then, health care will be healthier, and your patients will be too, because you’ll contribute to total health. Total Health includes mind, body, spirit, individual, family, community, society. The health care system will function as highly here as it does in the hospital.

And that’s what you’ll get from being able to listen better. Thank you.

Links to facts/data/photographs:

Speaking at #ONCmeeting tomorrow , my images, references and wardrobe

Tomorrow I’m doing something very “exciting” which is trying out a new presentation format at the 2011 Office of the National Coordinator Annual Meeting. You can access the meeting live, tomorrow, Thursday, via webcast at this link:

2011 ONC Annual Meeting | Healthit.gov

The presentation format is the Ignite format, which is 20 slides, 5 minutes, 15 second per slide on a timer. I’m always game for something new and you can tell me if it worked out or not. The topic is “Acceleration and Tipping Points,” and my talk is on Consumer E-Health, where I’ll be joined by 3 other innovators in the 9:45 am – 10:15 am EST time slot. We just did our first joint rehearsal this evening. This promises to be fun. I think.

Because this format reinforces brevity and constraint, I’m publishing the links to the studies and data cited in my slides below. I’m also publishing images of the slides as a teaser. The format really requires storytelling to go along with the images so having these in advance won’t spoil the content, or the fun (or terror).

No complaints, I chose this path in life, and thanks to Claudia Williams (@ClaudiaWilliams) and Lauree Ostrofsky (@SimplyLeap) for the interest in trying something new, and supporting myself and fellow presenters (storytellers?) in learning how to do this. I will definitely be wearing the lucky wardrobe for this one.

See you in person or online tomorrow.

Links to facts/data behind the images below: