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Tuesday, May 3, 2011

Painting at Microsoft

If you were to enter my small kitchen, you would see paint, brushes, and a canvas upon my counter leaning ever so slightly onto the cabinets above. If you opened one of those cabinet doors, you would see a birthday card taped inside.  My husband Fred gave me that card almost 2 years ago on May 10, 2009.  My mother-in-law Joan picked it out, as Fred could no longer leave his bed.  And being well-meaning and an always dedicated mother, she even signed it for him.  In her lovely penmanship, she wrote his name upon this card as she had on scores of childhood Golden Books and pile upon pile of school photos.  She wrote it here as she had done many times before, but this would be one of the very last times she would write for him: “Love, Fred.”  But my Fred was not represented well within his mother’s elegant cursive signature. So, scrawled in Fred’s uneven hand was his added comment, “Love, (Forever), Fred…" And beside that were three symbols: Alpha Omega Infinity. 

For that is what I was to Fred.  I was his Alpha and Omega, his everything.  He signed cards to me this way during our 16 years together.  I look at this card every day when I open up my cabinet.  Taped beside it is the last hospice nurse instruction from 6-16-09.  I can give Fred Atropine every four hours… until he dies 12 hours later.  Both the card and the note await my glance in silence.  I have never taken them down, and daily they remind me of why I paint and why I speak.

Last week I had the honor of painting at the Microsoft Connected Health Conference 2011 in Chicago.  The experience was a little unusual for a conference painting, because I was not in the main hall where I could hear the speeches.  Instead my easel was placed in the very back of the exhibition hall.  This was as close as I could get to the speakers.  And it would have to do.
Garrett Clarke & Luisa Monge from Microsoft view "The Menu Set"
I was at this event because Mathew Holt introduced me to Luisa Monge, Director, Business Development and Strategy Health Solutions Group, Microsoft HealthVault , prior to Health 2.0 in San Francisco.  Luisa is a kind and charming woman.  She and Garrett G. Clarke, Business Development Manager, Health Solutions Group, even came to DC and saw the December show of my work in Politics and Prose Bookstore.  We had a lovely evening together, and they asked me if I would like to attend a Health Partner Summit in February and speak at the Connected Health event in April (full disclosure: they would pay me an honorarium for my speaking at this event.)

In February, I listened to some amazing folks say some amazing things about what is possible in a PHR.  After two days of listening, I was able to tell the staff at HealthVault my takeaways.  I was very concerned about their use of faceless avatars.  I was disturbed that one of the only graphics representing HealthVault in the many slide sets was a closed lock.  I remarked, “When I hear HealthVault I do not want to see locks.  I want to see the vaulted ceilings of sacred spaces.  I want to be uplifted.”  Finally, I wondered at the meaning of the purple, blue and green ribbons that scrolled across each frame.  What did they represent?  Well, they meant nothing really, just branding, just …decoration. 
The Canvas in the Back of the Room
I told Luisa I would love to come and paint at Connected Health.   And it really did not matter all that much that I would not get to be within the conference hall, because I had come to paint what HealthVault could mean to the people who would use it.  

Prior to attending Microsoft Connected Health, I had a few conversations with Chuck Denham, MD from TMIT.  I talked with him about his new program CareMoms on  According to the site,  “More than 70% of healthcare decisions are made by women in our communities. One in four Americans is a caregiver of someone else, and 80% of the caregivers are women.”   Inspired by this information, I decided to depict HealthVault with an empowered female image.
Alpha and Omega:  The A to Z of me
This is Alpha and Omega: The A to Z of Me.  It is a powerful piece.  The woman here is dynamic.  Her head is thrown backward; her eyes stare at the expanse above.  Her chest is thrust forward and she is positioned like Clark Kent changing into Superman.  The Clark Kent/Superman image applies mostly to the left side of her body, and this is in direct reference to the one speech I listened to that morning.  Craig Mundie, Chief Research and Strategy Officer, Microsoft, talked about the need some patients have for an avatar.   These patients desperately want to use the Internet for research and support, but only if they can have a secret identity or an avatar to protect their privacy.  The right side of her body represents the patients who have “come out” online; they use their own name and are metaphorically bearing their naked self before the world.  Both types of patients would like to access and share data, but their paths toward a health exchange are slightly different. 

The right and left arms of this woman appear to be pulling open the vault of her chest.  As I was painting this part of the picture, many of the men who walked by seemed a bit perturbed by this graphic imagery.  One gentleman even asked me if I was painting the chest-bursting alien from the film Aliens.  I said no.  I am painting a living healthvault.   This is the vault of her chest--here the major organs should reside.  Within this vault, the ribs curve round behind to reveal the vaulted ceiling of a church.  Upon this ceiling is a modified image from the Sistine Chapel.  This is unfinished depiction of a doctor sending the spark of life through the computer to a patient.  It mimics the positioning of God and Adam in The Creation of Adam.  The doctor is God, and the patient is Adam, and both are faceless avatars.  Other than this vignette. the vaulted ceiling is empty; the composition is unfinished.
The Health Vault
Soon after I was painting this element, Archie Galbraith from Calance Corporation walked over to talked to me.  As we looked at the painting of a woman craning her neck, Archie shared a tale of his evening at the Sistine Chapel a few years ago.  The company he was working with at the time had a private viewing for two hours (I have never personally seen the Sistine Chapel, but I was speaking about it with a fellow pre-k teacher/artist Courtney Mazza a few days ago.  She bemoaned how much there was to see and how little time she could stop and stare when the crowds of people poured through the space.).  Archie got two hours to look up, and that sparked an idea that it really should be viewed while being pushed on a lying upon a gurney.   As his neck began to ache more and more from the strain, he thought of a better way.  I think Archie is right.  We need to support people as they try to stare upwards.

Below the empowered woman stand two daughters.  They represent the future generations.  They are the reason to work toward better health.  Each of the girls stares out at us with a serious expression as if asking, ”What are you doing to create a better world?”.  Each of the girls and the woman hold a gymnastic ribbon.  These are the Microsoft HealthVault ribbons, and they mean something.   Each awareness ribbon represents various diseases, treatments, or problems. 
The Green Ribbon
Green is labeled: with terms like Childhood depression, open records, and kidney cancer.  Light blue is childhood cancer, prostrate cancer, and Trisomy 18. Purple is pancreatic Cancer, testicular cancer, ADD, and domestic violence.  Have you ever played with a gymnastic ribbon?  They are fun, and you want to play with them.  The key to people utilizing a PHR is to make it fun yet meaningful.  I am glad I got a chance to paint this vision of a PHR, and I am glad Microsoft purchased this painting via a charitable donation to the Society for Participatory Medicine
The Blue Ribbon
As the conference wrapped up,  Liza Sisler came over to speak with me as she had many times throughout the day.  She is a friend of mine on Twitter and is Microsoft National Sales director at Perficient.
Liza Sisler

She is an amazing lady whose accent rambles back and forth from an Irish lilt to an American flat nasal tone.  She works at a company that tries to help providers use the Microsoft technologies already at their disposal to create a better working environment.

As I stood before the painting, I said, “Do you see it?  Do you see how her body forms the Alpha and Omega?  See how her hair is blown back to form the omega sign.  See how her shoulders, arms and chin form the Alpha?”  This patient stands before us reminding us, “I am the first and I am the last.”  That is a vital lesson as we look at the PHR within the scope of a health information exchange.  And coupled with that other saying, “Nothing about with me, without me.”  It makes quite a powerful point. 

1 comment:

  1. Reginda it was a pleasure meeting you. Your passion for a patient centered care model was inspiring. At the conference they all spoke about a need to put the patient at the center of the care model, and yet all the speeches were from politicians and clinicians. I attend a NEHTA meeting in Australia a few months ago where we sat at round tables to discuss the type of information to be stored in a personally controlled electronic health record (PCEHR). At my table were seated 2 clinicians, 1 policy maker, 2 IT implementers and 2 consumer advocates. It was great to see the consumer’s voice providing the requirement, the clinician highlighting clinical risk, the policy maker guiding our thinking and the IT specialist advising on solution options. It was warm, engaging and transparent...... and it worked!

    The conversation went something like this
    Consumer - I need a place in my PHR where I can record how I am feeling or why I stopped taking medicine that day. And I need the doctor to read it.
    Clinician - I am concerned it would take me all day to read your notes. How can I sift through the information to find the info I need and still treat patients?.
    IT - we could provide a template which would guide the patient on how to structure the information.
    Policy - and we could develop policy to allow the clinician to be paid to read the patients notes as though it were a face to face consultation.
    Consumer - how will I know a doctor has read my notes?
    IT - we could get them to 'sign' the record
    Clinician - that works for me
    Policy - I think we could develop policy for that
    Consumer - that is much better than we have know and will save me a trip to the doctor.

    That's how I believe we need to develop eHealth.