Care Innovation Summit 2012: a conference report in three paintings

 It is the function of art to renew our perception. What we are familiar with we cease to see.

- Anais Nin

On Thursday January 26^th, I attended the Care Innovation Summit in Washington DC. 1,000 registration slots for this event were filled within 24 hours. I was able to attend this event as a member of the media. I would report on the event live via my twitter feed, and paint about it.

I set up in the back of the room next to the tech team. The light was so low in the space that I could not tell the differences in purple, black and blue within my palette.  One member of the lighting team came over concerned about the lack of light. He said he would do what he could to make it easier to see.

The room was grand. The stage was so far away that I could see few details. As the light dimmed even farther, I began to paint on patient advocate Katherine Arbanasin’s jacket. She could not be there that day. Nor was any patient speaker.  As I painted this, 40 speakers came and went upon the stage. 17 were doctors, at least 8 were CEO’s, another 8 worked at CMS or HHS and two were nurses. In panel after panel, ideas were considered and feedback sought, but not from any patient.  The closest this summit came to providing the patient voice was Amy Berman, a nurse who has revealed publicly that she has cancer.

The summit was peppered with high energy moments from Todd Park, Aneesh Chopra and Atul Gawande. But the saving grace for patient participation was social media. The event was live streamed and the twitter feed was actively promoted. The hastag #cisummit was listed on every page of the program. I think that was one of the most innovative elements of the conference.

I painted Katherine’s jacket: “Welcome to Change Mountain!”

I am a big proponent of determining the meanings of the words, and when I read the conference title I saw it in word pictures.  Innovation is: to change.  Summit is either a meeting of great leaders or the heights of a mountain. Since patients were not invited, and they are the most involved participants in care, I decided this summit must refer to a mountain…

So high upon the risen stage one figure stands with his innovative light bulb of thought in hand. He appears in silhouette, too far away to make out any details. The bulb in hand is a classic incandescent bulb, the type that has been in existence for over 100 years.

Below the stage a crowd of patients stare upon the viewer. Front and center an old man holds up the Medicare donut hole while other patients try to staunch the flow of funds. This image referred to acting administrator for CMS, Marilyn’s Tavenner’s speech in which she recited a litany of accomplishments of CMS and HHS in the past three years. To the old man’s right hand a woman stands with a Health Reform banner in hand. She fought to support health reform legislation that will go into effect in 2014. She waits stoically for her chance at care as the blood pools at her feet and a small band-aid covers her wound.
 

Marilyn Tavenner went on to speak about a truly innovative use of data capture. To the left stands a man with an open laptop. The screen reads hospital compare.hhs.gov. Here is a site where clinical data is used side by side with patient satisfaction scores to determine where patients can get care.

That is innovative thinking.

Patients can make informed choices using easy to access aggregated national data sets.

To the far left is Katherine herself. She is reaching for the tools of technology so she can participate in this conversation. This is the only way that Katherine can be part of this. She is sick within a system that forces the sick into financial ruin.

Behind the triptych of Health Reform, Medicare and Hospital Compare, is a crowd of patients staring at the viewer. They are listening and using the tools of social media. In a far back row of the crowd, a patient raises one arm with an apple in hand as the other hand clutches a ruler to his chest. He represents the power for positive change if we combine amassed knowledge with proper measurement guidelines. He also represents the many United States teachers who have seen wage increases slip away in ever-spiraling healthcare costs.  

Later in the morning, there was a panel discussion with four doctors and a CEO. One speaker caught my attention when he stated he learned all he needed to know about treating patients from his clients under the age of five.

What wisdom to impart before this crowd!

Unfortunately this inspiring statement was followed by many speeches bemoaning the demands of non-compliant patients. I wonder how different that panel would have been if they had included an actual five year old. I could see a little boy dressed in a small suit upon the stage, requiring speakers to use plain language that anyone could follow. The child would ask the frank and powerful questions that come from a mind pure of thought and free of doubt.

During a break a member of the tech crew tried to refocus an emergency light and point it toward my easel so I could finish the detail on this piece of art. But it was too dim to see clearly within the summit space. 

So, I began work on another jacket. This is EBM (evidence based medicine) a jacket for Trenor Williams, MD.  Trenor is a founder of Clinovations in DC.  He is a kind doctor, who cares deeply about the intersection of technology and medical practice. When I began this painting, I painted a patient holding a light bulb of innovation within the piece, but I re-worked the image to be a dissection T-pin.  An adult male patient, a young girl patient and a doctor hold this T-pin. Whist the patients look at the tool of medicine within their hands, the doctor stares upon the viewer with worried candor. He knows that shortened appointments and little follow-through have replaced the great science that the patients believe is used within their lives.

 Many a doctor spoke upon the stage this day. I heard a deep yearning within them.  They were not demanding another new innovation but instead wanted best practices upheld. How could they implement a scientific method of care if not given time for appropriate charting and repetition of tasks? How can they tell if a care procedure results in good or ill if there are no double checks? In rush to embrace technology, tried and true methods of research using dissection and autopsy have been tossed to the side and we are all the poorer for this lack of knowledge.

Then it was time to break. I went into the hall and grabbed a box lunch. Small groups of like-minded individuals congregated throughout the hall and tweet-ups were staged within moments. I went back to my easel and ate with lighting tech crew from the hotel. We each sat beside our labors. They wore the back garb of any tech team and I ware the black dress of an artist who paints about medicine. I spent my lunch answering their health policy questions based upon the speeches they had heard that day. Then we talked of how it applied to the citizens of DC.

I could think of no better lunch companions.

After Lunch I began my final jacket.  This is Jason Bhan’s jacket: “Not Lovin It.“ Jason is a co-founder of Ozmosis and currently is Medical Director of Medivo. He told me his tale in those last moments of lunch. 

He had always wanted to be a doctor since he was a small child. He went to school and dedicated his education and life path to this goal. He was very interested in public health and was determined to help people. 

Then he began to practice medicine. 

It felt more like McMedicine then the kind of medicine he had hoped to practice. It was bundled and packaged for speedy delivery. The CPOE or CDS model could mimic a fast food register, if used by rote. It was sad how many patients wanted to super-size their prescription with unneeded antibiotics. So I painted Jason thus. He is a young doctor in a fast food uniform. His face is crestfallen, head bowed. The happy meal, once a joyous promise of childhood, now revealed as a vacant box with only heartbreak left inside.

So Jason joined the world of health technology, determined to create a future where patients could be treated while doctors would have a meaningful and fulfilling professional lives.

Those are the messages I heard at the Care Innovation Summit. 

What was the most innovative takeaway of the day? Practice medicine as a child would have you do it.  Be open and honest in the bright light of day, and don’t you dare break those children’s hearts.  Whether patient or doctor, CEO or nurse, we once all played in the same sandbox. If any true innovation is to come of events like this one, it will not come from thinking out side of one box, but instead playing together in this one.