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Thursday, January 16, 2014

What I know about Charles Denham

What I know about Charles Denham

In 2010 I wrote a post entitled: “Praying with Chuck Denham.” Yesterday evening before bedtime I began receiving emails from various leaders in the patient safety movement who read that post and knew of my work with Chuck.  They had questions about a January 9, 2014 article by Jonathan Stempel in Reuters stating: 

“CareFusion Corp agreed to pay $40.1 million to settle a federal government lawsuit accusing it of paying kickbacks to boost sales of a pre-surgical skin treatment, and marketing the product for unapproved uses.

The accord announced on Thursday by the U.S. Department of Justice
resolves allegations that CareFusion violated the federal False Claims Act by paying $11.6 million to a doctor to promote its ChloraPrep product to healthcare providers.

That doctor, Charles Denham, received the kickbacks while serving as co-chair of the safe practices committee of the nonprofit National Quality Forum, which makes recommendations on healthcare practices, the Justice Department said.

"Corrupting the standard-setting process through kickbacks can affect the healthcare treatment choices that doctors and hospitals may make for patients," Stuart Delery, assistant attorney general for the Justice Department's civil division, said in a statement.

The lawsuit also claimed that CareFusion promoted ChloraPrep from September 2009 through August 2011 for unapproved uses.
The U.S. Food and Drug Administration had approved ChloraPrep to prepare patients' skin for surgery or injections. CareFusion said on Thursday that it set aside funds for the settlement in the first quarter of 2013.

Chief Executive Officer Kieran Gallahue said the San Diego-based company is pleased to settle, and has made "significant investments" to improve its quality and compliance practices, including in sales and marketing.

Denham could not immediately be reached for comment.”

I spoke to Chuck a few minutes ago and he is working on a response statement based on the original legal document.  The document is quite large so he will address each point carefully and with complete respect.  That is all I can say right now about the article in Reuters.

I can tell you what I know about Charles Denham.  He is a tireless advocate for patient safety.  He hosts regular patient safety calls on Saturday mornings with patients and has done so for years.  He films hour upon hour of patient safety video for his Discovery Channel documentaries in the hope that those films will reach the general public and alert them to the dangers of infection.  He drives his creative team team at TMIT (Texas Medical Institute of Technology) ever forward to more and more campaigns that address patient safety.  He helped create so patients would have some kind of platform to spread awareness of the power of patient speakers.

I was honored to work with the TMIT group as a paid fellow in 2011-2012.  That helped me pay my rent, support my family and my advocacy mission.  In the years hence I have participated in numerous unpaid webinars and conference calls in my support of the valid patient safety work of Chuck and his team at TMIT.

In the fall of 2012, I organized a conference called Partnership with Patients in Kansas City.  It was a great meeting of patients and partners from around the country focused on patient safety and data access.  I paid for that event through crowdfunding and my own personal income.

So to all of my dear patients friends and fellow advocates who attended that event and received travel scholarships, were we taking ‘kickbacks’ from Carefusion for our noble work?  I ask everyone in the patient safety movement to pause and consider Chuck’s stellar work within the movement. 

In the meantime, I will be praying for Chuck Denham.

Tuesday, January 7, 2014

Time to Spin

Today is January 7 and this day is known as Distaff day.  Other than my friend Julia Cooper, I doubt very many of you will celebrate this day in its traditional way.  Today is the day we leave the Christmas holiday behind us and pick up our work tasks again.

Imagine a world where people carry devices wherever they go.  Whether you are a pauper or princess, this is a world where people rarely go out socially without their technology close at hand.   The line between work and personal life is hopelessly blurred. You cannot even take your kids to the park without pulling out your device and following the most recent thread.  Does this sound like our wired society?

I thought so last January when I first wrote about Distaff Day. Well, I am actually describing the world of the average woman in the Middle Ages.  Back then every woman, regardless of age or rank, was expected to fill their day with meaningful work.  So each woman would carry their spindle and distaff  (also called a rock) with them to social occasions.  Sometimes they would even gather for this purpose and it was called “a rocking” I guess the modern equivalent of that would be a “tweet-up.” It was a constant frenzy of thread creation. 

But there were times that it was considered appropriate to put down the spindle and focus on friends, family and spirituality.  People would “unplug” (Or would that be unlace?) during the 12 days of Christmas. I see a pronounced absence of social media voices during the holidays.  After the “Engage in Grace” blogroll of late November our thought leaders in medicine pause and focus their thoughts on home and family.  During the holidays we set down our “spindles.”

Last Distaff Day I was working on a large painting for the great folks at ElizaAlexDrane had asked me to paint my vision of the company and its mission.  I painted a large triptych entitled “Eliza.”

In this painting the sky is blue and the ground consists of an overwhelming mass of green cables and threads.  Blue and Green are the corporate colors of health care and they provide the foundation to the piece.  Like the ever-changing technology of our times, this foundation seems to writhe and pulse; almost washing away the characters within the painting.

To the far left, I painted a mother at her spinning wheel.  Here thread leaves the distaff and flows to a large loom at the center of the painting.  The large wooden loom is braced above with a vintage phone receiver.  To the lower left a telephone switchboard operator moves cable after cable connecting calls.  This represents the work Eliza does to connect with patients on the telephone. 

A row of patients and their caregivers stand within the flowing cables.  They stand as though on the assembly line, they are placing their needed medication in pillboxes.  The system at Eliza is trying to help them remember this process in health.

To the right and left of the large loom stand two versions of Eliza Doolittle from “My Fair Lady.”  This character is the namesake of the company.  The Eliza on the left is a beautiful maiden holding the coiled phone line in her hands as though spinning at the distaff.  The Eliza on the right is the crone. Her face is haggard and her basket empty.  At the center of the loom a mother figure weaves.  A mother is supposed to run the loom and control the weft and warp of time and technology.  So deeply meshed within this painting is the role of women in care giving that the symbols of this role take up 80% of the painting.

To the lower right a male technician hauls a circuit board across the frame.  Upon its circuits the word Eliza is written in Morse code.   

Beside him and behind him a film reel unspools representing the media Eliza creates to help patient populations. The word Eliza is also written in a swirling font among the cables in the lower center panel.  In this area of the painting, children stare upon the viewer.  

The youngest holds out a smart phone with the word "Eliza." 

These are children are the future beneficiaries of the great work of this company.

In the center behind the loom, the mother figure is time and space itself.  This was not always the case.  In my original attempt at completing this masterpiece, I painted Alex Drane into the composition.   I knew that she was a strong mother in her own family but she was also the public face of Eliza.  She taught me the importance of their work.  She showed me their data sets and thoughtful campaigns to help people attain better health outcomes.

When Alex saw my center panel she felt that I definitely had been inspired by Distaff day.  That would be pronounced Dis-the–Staff.  She was troubled that she took such a prominent place as Eliza Corporation was a team environment.  So I did something a rarely do, I repainted the center figure.

This time I painted Demeter as a mother goddess.  Painting over your own work can be a painful thing, but I said good-bye to Alex.  The new figure was fuller of face with a quiet countenance.  Her hair was the color of straw and bedecked with grains of wheat.  I finished the painting and mailed it to Eliza in May of 2013.

In June at Health Datapalooza, Alex took me quietly aside and told me the she still had trouble with the painting.  She thought the Goddess looked too much like her.  I think I blinked then.  The Goddess was a good 50 pounds heavier than Alex with a completely different nose.       

Alex asked if I would fly to Boston and fix the painting one last time.  On August 2, 2013 I did exactly that.  I walked into the offices of Eliza.  I began to paint while my face felt flushed like that of a child asked to redo a math problem in front of the entire class.  Throughout the day people would stop and talk to me and their energy and warmth came to be the center of the painting. 

The lady in black is crowned with the time the staff of Eliza gave me.  The sun and all the planets of our solar system make her face.  Her hair swirls into a symbolic yin and yang and the mythos of the painting changes.  Both male and female must be in balance to do great work in care giving.  Both leaders and staff must feel part of the whole.

I am glad I was able to fly to Boston and complete the painting.  I was able to present it before Alex and the staff and acknowledge their concerns.  I told them Alex was the public face of Eliza.  So she greatly inspired the piece.  But nothing should stop them from being part of the worldwide conversation in health care.  They should blog, facebook and tweet.  They should become a public face of this amazing organization.  

They should join the Walking Gallery and tell the world their stories.

Last week Suzanne Carter, data analyst from Eliza, did exactly that.  Her jacket addresses the need for affordable hearing aids and is entitled: “Analyzing Whispers.”  

Thank you Suzanne, Alex and all the staff of Eliza for being part of my celebration of Distaff Day.   I look forward to seeing the new threads we create in 2014.

Friday, January 3, 2014

Dying with a Time Stamp: a story in status lines

My dear friend Ted Eytan once asked me,  “When are you going to name names? When are you going to tell people the names of the hospitals?”  I responded that I already did that as it was happening.  Everything was posted in real time with a timestamp. 

I was very thankful when Facebook came out with its timeline; now you could see everything that happened without endlessly scrolling through page after page.  Today I compiled the most pertinent status lines of the last year of Frederick Holliday’s life. 

You can see interesting patterns when you scroll the days of a life.

The first person Fred ever spoke to on Facebook was Christofer.
The last person Fred ever spoke to on Facebook was Christofer.
They were the best of friends, but so were the many other friends that graced Fred’s comment field.  

You can see Fred and I loved our boys; you can see we loved each other.   You can see what death looks like in the world of social media.