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 |

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:

Video – My Tednote from Social Media in Care Delivery Tech Demo Day @KPGarfield

I gave this keynote on September 15, 2011, at the Sidney R. Garfield Center for Healtcare Innovation (@KPGarfield) Technology Demonstration Day, with the theme “Social Media in Care Delivery.”

Even though the event was internal, we invited several special guests ( @drane, @seattlemamadoc, @susannahfox , @rzeiger , @rawegd ) to help us think about how social media could make a difference in integrated care delivery. Regina Holliday ( @ReginaHolliday ) was also there in spirit through her art, at the beginning and at the end of this presentation (along with a KP member in the audience, of course!).

The key concept is, “in integrated care delivery,” meaning, when care is already coordinated and incentives line up in the patient’s favor. For that reason, this was filmed for internal use, however, I received requests to make it more available, and here it is. See what you think, comments welcome.

With thanks to the multimedia expertise of Larry Kless ( @klessblog ), and the general innovation expertise of Aaron Hardisty ( @aaronhardisty ) and Jan Ground ( @janground ).

Oh, and you can access the slides and a written debrief of the day here: “The future is integrated” – Social Media in Care Delivery.”

Presentation (with the patients): Beyond the PHR to engage patients – WHIT 5.0

I wrote about moderating this panel previously, and today it happened. Here are my introductory slides, including the very first tweet of each panelist!

I asked every member of the audience to write a question or comment down on a notecard. I’m going to scan those in and allow panelists to answer them online, to continue the conversation.

Here’s where you can find everyone, and thanks for bringing your perspective today:

Holly PotterePatient DaveRegina Holliday

Presentation: Prevention and Screening – Informatics for Consumer Health

Below are high quality images of the slides I presented at the Informatics for Consumer Health Summit, at the Bolger Center for Leadership, in Potomac, MD. I didn’t know the U.S. Postal Service had such a nice facility, I guess that is a part of the fun of discovering new parts of this part of the country.

Below the slides is a list of links of sources used in my slides. I’m reposting here because the videocast did not include the actual videos.

This presentation will probably look familiar; there are new slides that show the very impressive breast cancer screening rates achieved in Kaiser Permanente regions, and most notably, Hawaii, which achieved a rate of 85 %, which ranks it as the number one health plan in the U.S.

Oh, one note, slide 2 is the title slide I “wanted” to use, instead of slide 1 – it’s not too informal is it? I want to highlight health instead of technology….

Enjoy, comments and questions welcome.

Links to Source Information

Moderating a Dream Panel at WHIT 5.0

The 5th Annual World Health Care Innovation and Technology Congress (WHIT v.5.0)

A few years ago, I was asked to prepare a presentation for leaders with two simple directives: “Ted, no powerpoint slides, and no talking heads, please.”

My response to that was equally simple: “Okay, then you’ll get to listen to the real boss/CEO/Board, the member.” (recall that Group Health Cooperative is member-governed)

Ever since then I have kept trying to include the patient perspective, and noticing that when it’s included, how compelling it is (see this photograph for proof).

Sometimes, I’ve been told, “Ted, a patient wouldn’t be appropriate for this setting.” But I still kept asking….

This time I wasn’t told that, and so I get to bring that perspective in the form of great people. They are Dave deBronkart, Regina Holliday, and Holly Potter.

Our session is in the section entitled “Consumer Connectivity: Engagement Through Social Networking,” and the title of our discussion is, “Beyond the PHR: Promoting participation at all levels: internal and external; patient, family, community.”

Holly is representing the health system perspective, though her work as Vice President of Public Relations and National Stakeholder Management for Kaiser Permanente.

What they have in common, is that they show how sometimes, your life can change, literally overnight, and social media tools are means to teach and learn from people “just like me,” to make a lasting difference.

Beyond the title, I’ve been asked to summarize what this panel will be about, which I’ll do here, with main points:

  • How does a health system foster broader participation after connecting 3.3 million patients online to their health care teams?
  • What are patients’ expectations for participation in health and health care using social media?
  • How are patients and families leveraging social media to participate in reshaping the system itself?

I haven’t yet run these by Holly, Dave, and Regina, they are to help potential attendees know what the session is about, so there may be edits. Or if you have suggestions, post them in the comments, please.

What I see happen when this perspective is brought in is that people in the audience become less afraid/more confident in taking risks to do what they can to help people. That’s what I want to promote.

The dream part is that I engage organizers of a respected event like this to bring these exceptional experiences directly to their audiences. So, thank you WHIT 5.0, I will do my best not to let you down!

Speaking of exceptional experiences. Here is Regina’s. We’re on at 10:55 am, on Day 2, please come and join us.

Disclosure of material connection: I have not received any compensation for writing this content or moderating this panel; I am an employee of one of the organizations represented on the panel (Kaiser Permanente); I am receiving admission to the event sessions as a speaker.

Presentation (and a conversation) about telehealth at Broadband Breakfast

I was delighted today to spend time learning about the possibilities of telehealth and application at leading edge care systems at the Broadband Breakfast, in Washington, DC, including Department of Veteran’s Affairs, and The Army.

The room we were in was not really conducive to showing audiovisuals (however, I was able to play one of Kaiser Permanente’s new radio spots about the Internet…), so I am posting the slides I would have shown here for the audience, and any other interested parties.

A few a ha’s from this very accomplished panel included Ron Poropatich, MD’s experience that the people he serves often have full e-mail boxes these days. They tell him, “text me.” Jay Sanders, MD from the Global Telemedicine Group continues to inspire with his optimism that telehealth is achievable, and not just for the sick, but the well, also.

If you’ve seen my recent presentations, these slides will look familiar; however, I have added a few pieces on Kaiser Permanente’s commitment to eliminating health disparities, and to reducing the carbon footprint of health care. The image of the award is one that Kaiser Permanente owns,given to it by the Environmental Protection Agency in April, 2009.

Finally, I have to say that it’s still impressive, in 2009, that you can ask a room of professionals supporting next generation technology if they have broadband at home (all of them raise their hand), and then you ask if they can e-mail their doctor, all of the hands go down.

Actually, all the hands went down except for the two people in this room who are Kaiser Permanente members … and I am one of them.

See what you think, and enjoy.

Presentation: Telling our Story: Using Web2.0 Tools to Maximize Health

It has been a busy week to say the least. One of the highlights, though, was giving this presentation with Holly Potter, Vice President of Public Relations and Stakeholder Management for Kaiser Permanente, at the Health Care Public Relations, Marketing & Internal Communications: A Social Media Summit, put on by Ragan Communications.

We talked about how we met, through similar communication-type experiences, and the work we are doing now, including promoting an internal social network at Kaiser Permanente, and promoting participation of physicians and staff online with members and potential members.

It’s been really great to work with Holly and her team, who are coaching us to participate, rather than to not participate, and who we can turn to when we want to know just how high the expectations our communities of us are. The expectations are pretty high, and they’re willing to help us meet them.

See what you think and enjoy.

“What are PHRs Good For?” : Presentation at AHRQ Annual Conference September 14, 2009

Attached below are the slides from the presentation I gave yesterday at the Agency for Healthcare Quality and Research Annual Conference, entitled “PHR’s What Are They Good For?

An important thing I learned about yesterday’s session is that it was the first ever annual conference session in AHRQ’s history that was not moderated by an AHRQ staff member or grantee. This speaks to the openness with which AHRQ is approaching this content.

Slides (click on any to see full size and go backward and forward):

The room was full but not packed; however, some of the most important and influential people in my growth and development as a supporter of patient empowerment were present, including Pat Sodomka, from the Medical College of Georgia, Josh Seidman, from the Center for Information Therapy, and fellow panelists John Moore and James Hereford, from Chilmark Research and Group Health Cooperative, respectively. In addition, new influencers Regina Holliday and Christine Kraft were also present, taking time from their busy schedules to be there for patients everywhere. I was allowed to tell Regina Holliday’s story to this audience, a great honor.

In any event, the packed-ness of a room doesn’t matter to me anymore; the conversation and learning now happens socially after the event. So, any presentation I prepare is designed to start a conversation in the room and far beyond it.

If you’re read my writings, I think PHRs are good for a lot of things, and with great thanks to the following organizations, I was able to present actual data showing how personal health records change care for the better, reactively and proactively:

  • Kaiser Permanente Internet Services Group
  • Kaiser Permanente Internet Services Group – Web Analytics
  • Kaiser Permanente Utility for Care Data Analysis
  • Kaiser Permanente HealthConnect and SmartBook for Value Realization and Optimization (and related data from the Colorado, Southern California, and Northwest regions)
  • Pew Internet and American Life Project , with on-the-spot-help from the informative Susannah Fox

Also, the videos show in this presentation are available on demand, on the Kaiser Permanente YouTube channel. Feel free to view at your leisure.

To support the request to produce a 508-compliant presentation, I have uploaded one to slideshare (link below). Of course, all comments and questions are welcome.

PHR's : What are they good for (508 COMPLIANT VERSION)