From Blue Button to GOLD (Getting Older with Love and Dignity) Card

As I say on here with regularity, I am not that smart and my ideas are not that unique. I was speaking with Warren Wong, MD, a colleague of mine in the Hawaii Permanente Medical Group, about an idea of his that I thought was worth sharing here, and with his support….

Take a look and think about it. What are the applications? I thought of the blue button, which allows one to download and transport clinical documents. GOLD represents social documents, could there/should there be a button for that? I thought of Engage With Grace (@engagewithgrace) as well.

Comments welcome. Warren’s background is at the bottom of this post.

GOLD (Getting Older with Love and Dignity)


  • Every older adult will have the opportunity to have a gold card. An always event
  • The GOLD card allows every older adult to store, share and update as much or as little information as a person desires regarding a person’s values, goals, accomplishments, daily life, challenges, contact info, medical contacts, preferences
  • The information could be securely maintained in the web.

Gold card information content: What matters to me, the things that I want to share

  • The things I enjoy most
  • The primary language I speak
  • Beliefs that are important to me
  • Things that are important for me to do regularly
  • I’m most proud of …
  • Things I wish were different
  • Things that are the biggest stress for me
  • What I want my next several years to be like
  • If I get sick, please contact…
  • When it comes to my health, the person who knows me best is
  • Things about my body that don’t work right
  • If I ever get very sick, I want
  • I have an advance directive which says:
  • Places that I might live in the future:
  • What else matters to me:

Potential Uses of the GOLD card

  • Reframes older adults in society
  • In a secure and confidential environment, encourages a person to express identity/sense of self. Even as I grow older, I matter, the pain that I feel, the disappointment, the pride that I have, the thoughts I have, it matters. Let me speak with my own voice. I am no less important than anyone else. My feelings are alive. I choose, therefore I am.
  • Allows a person to “share” connect his own reality with society…connect.
  • Encourages person centered health. What I think matters.
  • Available to sites of care, anywhere.
  • Encourages a happy last chapter in life.
  • Provides guidance to families, caregivers and health care providers when health care issues come up. Potential for audiofeed.
  • Encourages a person to develop clarity re goals.
  • If GOLD cards become widely used, can create a collective voice for older adults in society. “Older adults health care bill of rights.”
  • Links to the “Conversation”, education and community activity sites
  • Could potentially identify patterns in communities, ie densities of loneliness or conversely, communities are recognized as “supportive”
  • Organizations, such as health care organizations, can assert: “we honor the GOLD card”. You are at the center of what we do. “The care you want is the care you get”
  • Could eventually lead to “GOLD card certified care center”. A change in health care culture that is person centered.
  • Could provide links for people to discounts and connections for things “they love to do” ie sports events, “coffee” days in the neighborhood
  • Potential for a web community, shared and supportive, ? tie in with “Facebook”

About Warren Wong, MD

Warren F. Wong has been a geriatrician with Kaiser Permanente in Hawaii for over twenty years. In that role, he established the Geriatrics consultation service and also developed the nursing home program, home visit program and played an instrumental role in developing palliative care. Dr. Wong has also been a physician lead for the Kaiser Permanente Aging Network.

Dr. Wong spent a year at the Institute for Healthcare Improvement (IHI) as a Merck Fellow. While at IHI, his primary work was focused on health care system design for older adults who are frail and have complex needs. System redesign includes many elements that are currently lacking in most health care systems and requires a much stronger integration with community based services. Dr. Wong will be continuing work in this area with IHI.

Dr. Wong is a clinical professor of Geriatric Medicine at the John A. Burns University of Hawaii School of Medicine.


These are things all of use want. The context of our lives might provide the most important and material information to the success of our care. Providing context to stakeholders from the person with the most at stake: the patient. To quote the other GOLD card, “My life. My card.”

lesliekellyhall Well said, Leslie – as we begin to understand what technology can do for us, I think it’s natural that we’re moving from clinical to social. it’s the dream of so many people who have been in the field for a long time, Ted

Ted Eytan, MD