Saturday, August 15, 2015

Flow - a spoken-word piece about health information exchange

Cross-posted from my personal blog.

On Monday, August 17th, 2015 I begin a new chapter as Program Director for the new Integrated Care Network initiative at CRISP, Maryland's health information exchange. We will be providing data to healthcare providers to enhance their care coordination efforts and providing additional care coordination tools to some of those providers who don't already have these capabilities in place.

To mark the transition, I decided to make a video of this spoken word piece I wrote in 2012 (originally entitled "A Man among Millions") for my last day consulting for the Office of the National Coordinator for Health IT while I was working at Deloitte Consulting. This piece explains why I am so passionate about making health information exchange work for all of us.

I am grateful for the opportunity to make a difference with an amazing team of collaborators and look forward to providing updates on our progress over the coming months and years.


tick tock
check the clock
it's moving faster
relentless in its quest
to stop us in our tracks

tick tock
can you hear it?
faster than my beating heart
thumping with anxiety
checking over my shoulder
for the reaper
he's on a bender
hell-bent on the hunt
to sniff down and snuff out
those I love

tick tock
time won't stop
or take a break or hesitate
to cut us off at the knees
yet here we stand
for what we believe
can make a difference
if we only make it flow

today we stand for flow --
for what we know is essential to the health
of this thing we call a healthcare system

we stand for flow
for overcoming the inertia of standing still
pushing information out
transforming it from solid state to liquid gold
letting it go where it needs to go
flowing into the chasm that separates us
from the quality we pay for but don't receive
flowing so that the liquid data
cascade and echo
creating ripples of insight
that concatenate to engulf us
in tsunamis of knowledge

and so we implement electronic health records
organizing into exchanges
to make flow a reality
in local circumstances
taking chances with taxpayer dollars
that we could never afford
on our own accord
trying to fix on a massive scale
the brokenness of our system
that we in our confessed complacency
have grown to see as normal

millions --
nameless, faceless
suffering under the burden
of a system uninspired
to go the extra mile --
are saying enough
I have a name
I have a voice
I have a face
I take a stand

here I stand
just one example
of a man among millions
with a family lost in this maze
with a father who died
from cancer of his phantom prostate
that had been removed twenty years before
no PSAs for twenty years
why test for something long removed?
maybe because there's a chance it's not all gone
maybe the answer is there
hidden among the data
to know the answer to the question
of whether it would have made a difference
a life or death difference
this one simple test

here I stand
just one example
of a man among millions
with a family lost in this maze
with a mother slowly losing her way
keeping the memories of her youth
but misplacing those formed an hour ago
her children
long away from their hometown
trying to connect the dots of her care
by remote control
"help! I've fallen and I can't get up"
doesn't traverse time zones
so we rely on old technology of phone and fax
which isn't up to the task
as she rides
from assisted living
to hospital
to rehab
and back again
while her medical records struggle
to keep up the pace

here I stand
just one example
of a man among millions
with a family lost in this maze
with a son who enjoys good health
but has already faced the surgeon's scalpel
at an age too young for his memory to recall
exactly why he has that scar on his back
or how his kidneys lack the full capacity
others take for granted
how will he know
when he comes of age
what this means for him
his records passed down
from his elders
like an oral history
told around a campfire
after a hunt for mastodons

here I stand
just one example
of a man among millions
with a family lost in this maze
with a wife who bravely faces
cancer number four
in thirty-two years
who alone carries the burden
of coordinating care
among the dozens and dozens
of providers who focus on
the particular part of her they understand
who alone carries the records
from place to place
from year to year
from diagnosis to diagnosis
hoping she can keep it all straight
so at the very least they do no harm

here I stand
one of the lucky ones
with coverage
with knowledge
with friends
who stands helpless
to make the system work
for those who are the world to him

here I stand
speaking to my heroes
who possess amazing superpowers
to bend maze corners
into straight corridors
and transform the flow
from a trickle
to a torrent

I don't presume to know what drives you
what compels you to forego
another fifteen minutes sleep
and return to the battle
to do the heavy lifting
to add another line of code
to write another line of policy
to create another decision support rule
to make one more connection
to solve one more problem
to make it flow

but if you need a story to motivate
to steel your resolve to press on
mine is here and free for the taking

better still
forget my story
and tell your own
shout it from the rooftops
or whisper it only to yourself
but keep that image
sharply focused in your mind
to give you the inspiration
to do the work
so we all can be
one among the millions
who survive
no, who thrive
who sail

in the flow
(c)2015 Ross D. Martin, MD, MHA