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The Sycamore Tree:
A Patient View Through the Leaves of a Life story


By Regina Holliday
In 1978, there was a little boy named Freddie who lived in Maryland
and a little girl in Oklahoma named Regina.
Patient Reported Data is very important.
14 years later,
Fred would meet Regina on stage in a scenic painting class atOklahoma State University.




                  We would talk of Stephen King’s Dark Tower.



                  We would fall in love.
The Holliday Family Christmas 2007
Everything we ever wanted…
  Resolutions January 2008:
1. Get Medical Insurance for the whole family
      2. Get little Freddie into a special needs school
       3. Fred gets a job in his field
        4. Spend more time together as a family
         5. Get a two bedroom apartment




 Freddie’s
 IEP Binder
Fred was happy with his new job.




But he was very tired,

He went to the doctor and was
diagnosed with hypertension.
During the months of
January, February and March of 2009,

Fred was in constant pain.
On Friday March 13th, We went to the ER because Fred was in so much pain .



We waited three hours before being sent home.
Fred was hospitalized on March 25th 2009
 for the administration of tests.




On March 27th, he was told while alone that
he had “tumors and growths.”

He was scared and confused and did not understand.

His oncologist left town for the next four days to a medical
conference and was not reachable by phone or email.
What was the diagnosis? What were the treatment options? Would he get a pain consult?
Systems Error:

More than one bad doctor
20 Ambulance Transports=
Minutes of Sunshine
A name tag defines us
This is my husband’s
medical record.

I was told it would cost


73 Cents
         per page

And we would have to
wait 21 days to get a copy.
“She must not have tried very hard to get the record….”
Comparing access to an unpublished book by
Stephen King
to accessing the

Electronic Medical Record
while hospitalized.
“Go After Them,
 Regina.”
  April 18, 2009
After waiting for   5 days for a transfer
to another hospital for a second opinion,

We were sent with an out of date
and incomplete medical record
and transfer summary.


The new staff spent     6   hours trying to
cobble together a current medical record
Using a telephone and a fax machine.
This is the
vital clinical information
from Fred’s electronic medical record.

Presented in the style of
the Nutrition Facts Label.

Then painted on the wall of
Pumpernickel’s Deli in
Washington, DC.
Why did we get more help and answers from

Social Media
                 than from our local hospital ?




               I got on Twitter on May 3rd to find Christine Kraft and e-Patient Dave
               to talk to them about kidney cancer.

                                     Within one day were in email contact and
                                     then spoke on the phone.

                                     By ten o’clock May 4th 2009, I was talking on
                                     the phone with Dave’s Oncologist about my
                                     husband’s cancer.
On May 27th, I met group of amazing folks at a small Health 2.0 meeting.

They asked, “ What was the worst thing that happened?”
I responded, “Lack    of access to the medical record.”
We fulfilled our final 2008 resolution on June 11th 2009.

We moved into a two bedroom apartment so I could care for Fred in home hospice.




                    He died six days later on June 17th, 2009
Painting Advocacy meets   Social Media
This is the painting 73                              cents.



 This is the vital patient story, the social history , the sacred heart of Fred’s




ELECTRONIC MEDICAL RECORD.
On Tuesday, October 20th 2009 we dedicated the mural,

“Where do we go
   from here?”
As e-patient Dave would say: “Give us our dammed data.”
A painting for my
Mother-in-law Joan Holliday:

“The Best of Us.”

Inside of everyone
there is a little child.

What would that child
Say about health care?
The Bakery Circa 1980




When was the last time you used a
Rotary Dial Phone?

Or was cashiered at a
hand crank cash register?
The Doctor’s Office circa 1980




How much has the picture changed at your local Doctor’s office?
Patients can complete the story of care

Nurses Progress Notes:
04.18.09 09:00

Look Dick.
See Sally and Tim.
Funny, funny Sally.
Funny, funny Tim.
The patient record
makes a lot more
sense if you include
the full picture.
When venders talk with Patients,
We realize we share the same vision.
Inside of every EMR there is a patient story,
And sometimes it is told by Betty of Bellin Health.
Inside Sharp Coronado Healthcare, there are open medical records reviewed by patients
With the ability for patients to amend…
Why not have CDS (clinical decision support) for patients?
                             If a child’s toy can figure any item in the world in 20 questions, why

Can’t we have CPOE and CDS in every hospital and family practice?
When Venders invite patients to play the game, Everybody WINS.
Change can be Scary.
What really scares us?
Standing out and looking different,

Can be uncomfortable or frightening.

But is often needed for advocacy.
Two years after painting 73 cents,
Freddie grows beyond peering through
adoor crack to walking in a Gallery.
Welcome to the Walking Gallery.




Telling the patient story one jacket at a time.
On July 13, 2010 I had the honor of
            speaking before the assembled at HHS.
            I presented the patient voice within

                            Meaningful Use.




There was another Regina there that day
Doctor Regina Benjamin, Surgeon General
presented her very gripping reason she supported
Electronic Medical Records adoption in the united States.
On September 13th 2011,
I met Regina once again. This was the launch of
the Consumer e-Health Program

The “I” in HIT
at the Department of Health and Human Services.
But here is the real meaning of
the “I” in HIT.

Isaac at his Doctor’s appointment
with his EHR in his hands.




                                    The   in HIT
Thank you for helping patients and families access their data.




        It means the world to us.

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The sycamore tree

  • 1. The Sycamore Tree: A Patient View Through the Leaves of a Life story By Regina Holliday
  • 2. In 1978, there was a little boy named Freddie who lived in Maryland and a little girl in Oklahoma named Regina.
  • 3. Patient Reported Data is very important.
  • 4. 14 years later, Fred would meet Regina on stage in a scenic painting class atOklahoma State University. We would talk of Stephen King’s Dark Tower. We would fall in love.
  • 5. The Holliday Family Christmas 2007
  • 6. Everything we ever wanted… Resolutions January 2008: 1. Get Medical Insurance for the whole family 2. Get little Freddie into a special needs school 3. Fred gets a job in his field 4. Spend more time together as a family 5. Get a two bedroom apartment Freddie’s IEP Binder
  • 7. Fred was happy with his new job. But he was very tired, He went to the doctor and was diagnosed with hypertension.
  • 8. During the months of January, February and March of 2009, Fred was in constant pain.
  • 9. On Friday March 13th, We went to the ER because Fred was in so much pain . We waited three hours before being sent home.
  • 10. Fred was hospitalized on March 25th 2009 for the administration of tests. On March 27th, he was told while alone that he had “tumors and growths.” He was scared and confused and did not understand. His oncologist left town for the next four days to a medical conference and was not reachable by phone or email.
  • 11. What was the diagnosis? What were the treatment options? Would he get a pain consult?
  • 12. Systems Error: More than one bad doctor
  • 14.
  • 15. A name tag defines us
  • 16.
  • 17. This is my husband’s medical record. I was told it would cost 73 Cents per page And we would have to wait 21 days to get a copy.
  • 18. “She must not have tried very hard to get the record….” Comparing access to an unpublished book by Stephen King to accessing the Electronic Medical Record while hospitalized.
  • 19. “Go After Them, Regina.” April 18, 2009
  • 20. After waiting for 5 days for a transfer to another hospital for a second opinion, We were sent with an out of date and incomplete medical record and transfer summary. The new staff spent 6 hours trying to cobble together a current medical record Using a telephone and a fax machine.
  • 21. This is the vital clinical information from Fred’s electronic medical record. Presented in the style of the Nutrition Facts Label. Then painted on the wall of Pumpernickel’s Deli in Washington, DC.
  • 22.
  • 23. Why did we get more help and answers from Social Media than from our local hospital ? I got on Twitter on May 3rd to find Christine Kraft and e-Patient Dave to talk to them about kidney cancer. Within one day were in email contact and then spoke on the phone. By ten o’clock May 4th 2009, I was talking on the phone with Dave’s Oncologist about my husband’s cancer.
  • 24. On May 27th, I met group of amazing folks at a small Health 2.0 meeting. They asked, “ What was the worst thing that happened?” I responded, “Lack of access to the medical record.”
  • 25. We fulfilled our final 2008 resolution on June 11th 2009. We moved into a two bedroom apartment so I could care for Fred in home hospice. He died six days later on June 17th, 2009
  • 26. Painting Advocacy meets Social Media
  • 27. This is the painting 73 cents. This is the vital patient story, the social history , the sacred heart of Fred’s ELECTRONIC MEDICAL RECORD.
  • 28. On Tuesday, October 20th 2009 we dedicated the mural, “Where do we go from here?”
  • 29. As e-patient Dave would say: “Give us our dammed data.”
  • 30. A painting for my Mother-in-law Joan Holliday: “The Best of Us.” Inside of everyone there is a little child. What would that child Say about health care?
  • 31. The Bakery Circa 1980 When was the last time you used a Rotary Dial Phone? Or was cashiered at a hand crank cash register?
  • 32. The Doctor’s Office circa 1980 How much has the picture changed at your local Doctor’s office?
  • 33. Patients can complete the story of care Nurses Progress Notes: 04.18.09 09:00 Look Dick. See Sally and Tim. Funny, funny Sally. Funny, funny Tim.
  • 34. The patient record makes a lot more sense if you include the full picture.
  • 35. When venders talk with Patients, We realize we share the same vision.
  • 36. Inside of every EMR there is a patient story, And sometimes it is told by Betty of Bellin Health.
  • 37. Inside Sharp Coronado Healthcare, there are open medical records reviewed by patients With the ability for patients to amend…
  • 38. Why not have CDS (clinical decision support) for patients? If a child’s toy can figure any item in the world in 20 questions, why Can’t we have CPOE and CDS in every hospital and family practice?
  • 39. When Venders invite patients to play the game, Everybody WINS.
  • 40. Change can be Scary.
  • 42. Standing out and looking different, Can be uncomfortable or frightening. But is often needed for advocacy.
  • 43. Two years after painting 73 cents, Freddie grows beyond peering through adoor crack to walking in a Gallery.
  • 44. Welcome to the Walking Gallery. Telling the patient story one jacket at a time.
  • 45. On July 13, 2010 I had the honor of speaking before the assembled at HHS. I presented the patient voice within Meaningful Use. There was another Regina there that day Doctor Regina Benjamin, Surgeon General presented her very gripping reason she supported Electronic Medical Records adoption in the united States.
  • 46. On September 13th 2011, I met Regina once again. This was the launch of the Consumer e-Health Program The “I” in HIT at the Department of Health and Human Services.
  • 47. But here is the real meaning of the “I” in HIT. Isaac at his Doctor’s appointment with his EHR in his hands. The in HIT
  • 48. Thank you for helping patients and families access their data. It means the world to us.