Rosa Parks in Health Care

Honoring Mrs. Rosa Parks
Originally uploaded by Shavar Ross

In December 2008 and January 2009 there was quite a bit of controversy brewing over the implementation of an electronic transfer record in Washington, DC. A lot of the arguments used to decry or promote the new system would sound familiar in our current medical community. The paper transfer has been used for years. The poor, the illiterate and elderly were comfortable with the current system and would not be able to understand a new electronic version. Those favoring change pointed out the favorable outcome of less wait time, faster processing and ability to aggregate data. All these argument fluttered around us, as we said goodbye to the paper version of the National Capital Metrobus transfer and hello to the Metro Smartrip Card.

Within medicine, we are living in our time of controversy. People are taking sides: supporting some types of reform and not others. On January 28th 2010, I attended a meeting of a Health 2.0 group. This was the "8th month" check up. Most of us had met before, on May 27th 2009. At that meeting, we decided real-time patient access to the medical record was a first priority in attaining better medical outcomes for the patient and family. We spent the next eight months working feverishly toward that goal. We painted, spoke at medical conferences, gave interviews and wrote numerous blog posts on the subject. It was now time to work on strategy for the next year.

The definition of "Meaningful Use" and implementation of HITECH policy was being decided upon while we spoke. If patient access to the EMR/EHR was going to be a reality, we would need to do everything we could in the coming weeks to draw attention to the need for a patient's right to access his own data. We decided to speak to our congressmen and try to meet with staffers on the Hill. But we also decided we needed a symbol. We needed our own ribbon or armband. We decided the perfect symbol for our current lack of access is an empty USB on a Lanyard.

After proposing this idea, we heard of several companies who are encouraging patients to wear necklaces or lanyards with enclosed personal health records. These systems would function like med-alert bracelets. They allow you to fill in fields of data and create a stop-gap solution in a world without data transfer. Our Health 2.0 group decided to promote a symbolic use of an empty USB. We are encouraging patients to go to their doctor and request a medical record down-load onto the USB device. Our hope is twofold. We want doctors to view the patient's information as belonging to the patient and to consider the adoption of an electronic medical record that is patient accessible.

We may be asking a lot of a little USB, but symbols are very powerful.

That brings me back to the bus. I often compare the patients' rights struggle with the civil rights era. Imagine the civil rights era without Rosa Parks. Imagine a world where she gave up her seat and moved along quietly. Would that world be the world we live in today? I am going to ask you to do a very scary thing. I am going to ask you to take a USB to every medical appointment and ask to get a copy of your record. I am asking you to do this even if the answer will be no. This may impact your life and friendships. This may effect your work and standing within society. Sometimes we need to stand against oppression. Sometimes we need to sit in our seat until the authorities take us away.

I like to ride the bus. I like all the wonderful people I meet. I know that a lot of us are broken and sad. I see the elderly stumble and I see the homeless man reach out a helping hand. I see the young urban college student and the working poor. I see all of us as the patients were are in the end, deserving of respect and compassion. Seeing this, I ask of you, do not give up your seat at the table. Demand access to your electronic medical record.