“I will not stop until we have the right to see our own information” – Part 2 -2015

This is the scene in which I encountered @ReginaHolliday yesterday

Regina Holliday Paint In 55551
Regina Holliday Paint In 55551 (View on Flickr.com)
That’s her with others, in front of the imposing low-rise brutalistic structure of the Hubert H Humphrey Building which is the headquarters of the United States Department of Health and Human Services (@HHSgov).

This is the scene in which I encountered Regina on July 13, 2010, the day Meaningful Use regulations were announced:

(from this blog post: “I will not stop until we have the right to see our own information” | Ted Eytan, MD)

Then, Regina stood next to Kathleen Sibelius as she unveiled Meaningful Use to the world.

The difference in images is striking – from filling the scene to being just a small part of it.

Brutalist architecture is so fascinating to me. It was considered beautiful for its time (see: Continuing my Sustainability Tour: Royal College of Physicians, London – A Brutalist Modern Masterpiece | Ted Eytan, MD), and yet … it feels like something is missing.

I looked up the history of the Humphrey building, and I found that it was the second government building commissioned during President Kennedy’s call for “the finest contemporary American thought.” Indeed, from the 1962 Guiding Principles for Federal Architecture:

The policy shall be to provide requisite and adequate facilities in an architectural style and form which is distinguished and which will reflect the dignity, enterprise, vigor, and stability of the American National Government. Major emphasis should be placed on the choice of designs that embody the finest contemporary American architectural thought. Specific attention should be paid to the possibilities of incorporating into such designs qualities which reflect the regional architectural traditions of that part of the Nation in which buildings are located. _Where appropriate, fine art should be incorporated in the designs, with emphasis on the work of living American artists._ (emphasis added by me)

Interestingly, the policy doesn’t say anything about buildings being human scale or connected to the community, other than they should be “accessible to the handicapped.”

About the plaza with which Regina and others were standing, architect Marcel Breuer said:

This gives us a sizeable plaza opposite the Mall where we least need one. Nor can it be landscaped because trees won’t grow over the freeway tunnel. Bereur’s solution is to turn it into a kind of urban landscape with granite paved depressions and pyramids to give it some interest and perhaps – I am keeping my fingers crossed – delight. – By Wolf, V. E. (1972, May 13). Breuer’s new HEW: Fine designs, dollar signs. The Washington Post, Times Herald (1959-1973)

I’m not sure if people would characterize the plaza today as a place of delight, you be the judge!

Regina was visited by folks including Mark Scrimshire (@ekivemark), Lana Moriarty (@Lmoriarty1), and Erin Siminerio (@epoetter), so it’s not as if there is a lack of communication. However, it feels like there’s a lack of accessibility. The building architecture doesn’t help.

In other wackiness in the 1970s, by the way, plans for a gym in the building were scrapped as executives were told they “would be expected to get their exercise by running upstairs and chasing welfare fathers.” (HEW drops plan for gym, to stay trim chasing welfare cheaters. (1973, Aug 31). The Sun (1837-1989))

Now of course, we realize that lack of active design in a building causes the people in them to live shorter lives and be less innovative in solving problems at their root cause….

In terms of what this is about, Regina Holliday wrote a blog post about it Regina Holliday’s Medical Advocacy Blog: Let Freedom Ring.

My opinion is that this is less about a number in a regulation than it is about an interest in being accessible to the people we serve. There are so many different ways to do that. For example, you can measure response time to messages – a health professional that doesn’t respond to a patient query in less than a business day on average, is not accessible. Easily measured and tracked across providers. Other measure is access to physician progress notes and lab results – if a high percentage of patients are accessing their test results online (in the 40-50% range) it’s easy to understand that there are structural factors in place making this happen. Again, easily measured and comparable across providers and sites.

I’m convinced after almost 50 million patient-years of experience connecting with patients online at Kaiser Permanente that doctors and nurses want to do this. What health professional wakes up hoping to not be there for the people they take care of? What they need is a system that enables and prioritizes this type of care – patients want them to have this too. We’re all in agreement, no groupthink involved 🙂 .

As with so many things, this is about communication, not technology. As my profile says, I am glass 3/4 full, and I am not a huge fan of seeing patients on the outside of the health care system.

At least on this day, the Humphrey building emphasized the work of living American artists. I think President Kennedy would be proud.

More photos from yesterday below (click to enlarge), and one additional one, where this all started. Comments always welcomed.

73 cents the first day 6-23-09


Ted Eytan, MD