The Patitent as a Person - my lunch with Clay Patterson

The patient’s position in the HIT marketplace is that of data….that is a really strong statement but if you look at the Medical Record you know it’s actually a fact. The focused push to enable EMR in hospitals IS critical and has to occur. The mindset around it, to me, is often concerning.

Somehow the “data” has to evolve back into a “patient” who has to evolve back into a “person”.


As most of you know – my professional passion is the patient, the one who must take up residence within the walls of a hospital for a period of time. However, if we limit ourselves to seeing the “patient” only within those walls then we limit our view of the health continuum.

On Monday I enjoyed a wonderful lunch with Cerner’s Clay Patterson. I wasn’t sure what to expect – Cerner is an enigma – when people ask me about it I say “It’s shiny” meaning it’s very exciting, cool new innovations, amazing technology, thriving business, and flashy interactive gadgets. However, nothing I had seen to date gave me the feeling of heart – innovation, yes – incredible business, absolutely – heart, not so much. The heart I was missing was the patient – the person. Then I met Clay. His passion is getting medical data in a useable format so that a person can better interact with their health. This incredibly engaging and friendly man painted a picture of Cerner unlike any I had seen before – he shared a vision of people not products.

As he spoke, the picture that formed in my head was a giant sphere and inside of it there were stations of a person’s health journey. They include Hospital, Family Doctor, Medications, Tests, and even Diet & Exercise. (which I call DEA - which is a blog for another day) all surrounding the ability to research within the platform. The components within the sphere are interconnected and the data can ride freely between them.

The Sphere is taking information that is generally spaghetti and putting it into waffle format. When it’s in waffle format it can be searched, analyzed, cross referenced, and made into useable information. Think of it like managing your finances. Many of us keep our receipts in a box – or a wallet – or the center console of our car (or for some of us all of those places). You may have to dig them out if you need to return something, but the data of what you bought and when generally goes nowhere. However, if you use an online banking service then it automatically can analyze your spending habits and you can toss your little pieces of dispirit papers. The evaluation can lead to better planning, better habits, and overall better financial wellness. WHY? Because Data itself is not valuable – Data analyzed and applied into information is valuable.

But will adoption of this medium really occur. My prediction is yes – if you look at the slow recovery of our economy, you notice that people are spending less with credit cards and more with cash. Why because when you lose your home due to over spending you must take drastic measures to get things under control. People have had to learn to live within their means. Currently, the US is one of the most unhealthy nations in the world. Out of necessity a time is coming when we are going to have to reclaim our health. Sooner than later change will occur – not because there is some cool gadget but because consumers will realize that managing their health is the same as managing their finances.

The challenge will be education, access, and funding. How are we going to teach masses of people how to engage with their health while using a computer based tool?  Encouraging people to take control of their health is only part of the puzzle.  How are people going to get access to this portal?  This is a really layered portion of the equation including socioeconomic, locations, etc.  Who is going to provide access to this cool portal and who will “own” the data? Remember the data isn’t the value, the value is in the analysis….. when the data becomes information. As with everything else, it all comes back to who is going to pay for it? In a time when socialized healthcare is looming are we going to drive consumers to pay (not likely), employers, payers, ACOs?

If you believe that the patient is the heart of all we do then you must believe that the patient’s ability to interact with their health is critical to our success.

Stay Tuned for an exciting announcement from Cerner in the coming months.

The Walking Gallery

I always wanted to be one of those creative artsy people when I was younger – something about their free spirit draws you into their earthy lifestyle. As my friend Carrie can attest – I did attempt to be “cool like that” but I have settled for just enjoying art and music. So, when I started following @ReginaHolliday I was enamored with her artistic ability, and something about her draws you into her world of colors and words.

I will admit – I didn’t know what to expect traveling to the Walking Gallery. Let’s face it I met her on the internet….squares just don’t do this type of thing….I had no idea what I was in for, and let me say the experience was incredible.

When I arrived at the Kaiser Permanente Center for Total Health – I encountered fellow Walkers @MatthewBrowning and @FairCareMD we were all lost but soon we found our way to the “Gallery”. There were jackets all ready walking…I was challenged to find my own as I began to lose myself in the art. Soon I found myself standing at a table receiving my jacket, but strangely it wasn’t the jacket I sent – the jacket had become a window into my life for all to see. As I stared into the face of my sick baby it was incredible how she captured him – my Noah. I put on my jacket and found @ReginaHolliday. She recognized me immediately and threw her arms around me. It was like seeing an old friend.

As I wandered through the room I met @technicaljones and learned about his mothers fight for life. His jacket with a “SuperMom” who fought through illness to be there for her children. Across the room I spotted @epatientDave, he moved through the room like a rockstar with people reaching out and talking. David Hale incredible Matrix inspired jacket with a red pill representing all data and a blue pill representing us accepting what we are told to be truth from doctors. We marched together walked sharing the challenges of weeding through data with limited budgets. @MatthewBrownings jacket (one of my favorite paintings) showed the harrowing experience he had with his wife and their first child. @tmit beautiful jacket in support of the #caremom movement. The evening went on and my story repeated itself over and over sometimes without my mouth even opening – to people who understood. I didn’t have to prove myself as an expert in my field – I didn’t have to justify how I knew anything since I am not a clinician or doctor. I just got to be a mom with a story about healthcare.

My story – we were in the hospital and Noah vomited – I pressed my button and no one came….my company installed the button years ago – I thought it was broken……it wasn’t…..the difference between my story and most is when I went to the hospital they acted. They didn’t just act – they talked to me and made me part of the solution. I was able to meet other patients they call “frequent fliers” and their parents. I was able to work deeply with the technology team. I took my story and I created because that’s what I do. Talking only will get us so far – words are meaningless without action.

Look at Regina – she is a preschool teacher – she is an artist – who would listen to her? Most artist are seen by business people as creatives who can’t work so they paint….I laugh at the thought when I think of Regina. She uses her powerful medium as a tool to reach the masses – as a method to spread her gospel – as a leader to those of us who don’t know how to define our voice. Let me tell you, some of the most powerful people in healthcare listen to her. If you are in healthcare and you don’t – you are missing the boat.

I have shared with very few people recently how tired I am – fighting to build a startup, being challenged by healthcare to prove it, traveling every week, and night time kisses through video phone – after this event…..I am inspired…..I am energized…..and I know it’s all worth it.

If what I do impacts one life – it’s worth it. Let that be your thought today. Be inspired by the stories – not by your technology.

An Industry in Flux

It strikes me that there are some fascinating industry changes occurring in the “middleware” space and more are on the horizon. Interestingly, its not aggressive competitive behavior - it’s shuffles, buyouts, ReOrgs, partnerships, major players leaving major organizations, and simply surprising business decisions.
Dramatic human capital changes as opposed to dramatic technology change.
But what does it all mean – is it that alarm notification tools are not doing the job they set out to do, is it that the alarm notification tools promised too much and delivered too little, or is it that creativity and design ability was not balanced with well researched deployment on the cause and effect of the disruptive technology.

My thought is well intentioned creative individuals saw an opportunity in the marketplace that allowed the perception of faster communications. (If you haven’t figured it out – I believe most people are well intentioned.) The crux is more than 10 years after Michael McNeals press to market with the game changing Emergin platform – the cluttered market space is starting to relax and mature into a “what’s next” mentality.

Major platform changes are needed to meet the demands of a healthcare ecosystem that has a broader expectation of what information needs to go to which person. The new mantra is not about “alarm notification” it is more about “information distribution” and “decision support”. “Notification” brings with it the thought of disruption while information distribution and decision support bring the picture of well balanced and focused approach to patient care.

The problem is alarm notification has not reached maturity before the next change. What I mean by that is we have started to move to a new thinking without truly looking at the data associated with the “old thinking”. We have no base line comparison to clearly identify how information distribution will affect the ability of the clinicians to serve better. The industry has no clear baseline of information to compare the emerging decision support capabilities of the patient communications platforms (aka Nurse Call) with the old way.

Technologists, ask yourself:

Are we making things more flashy, exciting, techy because we can or because it’s right?

I challenge Nurse Call providers – Middleware developers – and even you EMR players who get in the game to prove it.

Show us how a change to status quo solves….if it doesn’t make the patient’s and caregiver’s lives better in documentable, data backed ways – then don’t waste your development dollars.

My prediction – major change is coming – large players will be motivated to change their focus and new players will be motivated to create better platforms.