Social Media’s Role in Outreach for Studies and Surveys

Social media is now playing a role in population health research.

Social media is no longer an option, it is an expectation on the part of many people.

One of the goals of the affordable care act is commendable, that of developing the “Medical Home”. The concept of the "medical home" has evolved since introduction of the terminology by the American Academy of Pediatrics in 1967, which was envisioned at the time as a central source for all the medical information about a child, especially those with special needs.  Prior to the era of over specialization the family physician and general practitioner served in this role.  A gradual disintegration of  their role due to  a number of factors, including the increasing shortage of primary care physicians has led to a breakdown in the established referral patterns.

Patient advocacy groups also describe a “Patient Centered System”, one in which participatory medicine plays a great role.

Dr. Victor Montori, Lead Investigator from the Knowledge and Encounter Research Unit at Mayo Clinic, explores patient compliance issues at Transform 2009, a symposium sponsored by the Mayo Clinic Center for Innovation.

 

Person-Centered HealthCare- HealthCare Innovations Exchange: Short-Cut to Health Innovations News

Some physicians are aware of patient centered health care as part and parcel of ‘treating the whole patient, and not the disease. The person centered health care is nothing more than this concept.

Patients however are not that familiar with the new model for diagnosis and treatment.  They however are hungry for better patient More information needs to be offered to patients both in popular lay press, and especially social media. Social is a prime necessity for human existence, witness how isolation and social deprivation effect emotional health and interaction.

Social media offers a private, laid back approach to ideas, shared much like that at a coffee shop or around the ‘water cooler’ of life.

Person-Centered Health Care is a healthcare innovation. The Innovation Exchange provides support for not only patients and caregivers, it also provides support for physicians. With the Health Care Innovations Exchange,   AHRQ (Agency for Healthcare Research and Quality)  has vetted and collated new and better ways of delivering health care in the hopes of speeding up the implementation of these tools. It offers busy health professionals and researchers a variety of opportunities to share, learn about, and ultimately adopt evidence-based innovations and tools suitable for a range of health care settings and populations.

Attributions:  Health Works Collective (exclusive post by) Amelia Burke-Garcia.

 

Technorati Tags: medical home,patient centric model,participatory medicine,victor montori,mayo clinic,innovation exchange,social media,amelia burke-garcia,ahrq,agency for healthcare research and quality

Medicare Costs Contained?

 

For the first time in 4 decades the cost of health care’s growth has slowed. This is not bad news however caution must prevail.

“This is understandable given the fact that health care spending represents nearly 18 percent of the overall economy and the Medicare and Medicaid programs combined account for nearly a quarter of the federal budget.”

What factors affect the medical cost trend?

Read more:  The Hill

However, despite this good news, or perhaps because of it, it is important that we make a point to emphasize the real and continued need for Medicare reform.
The Hill on Facebook

Much of the slow-down in spending growth can be attributed to the recession, which inevitably slows spending patterns across the board.  In addition, the imminent implementation of Affordable Care Act subsidies and Medicaid expansions will further boost spending.

Medicare is projected to add 30 million new beneficiaries in the next 20 years – which will place significant added cost pressure on the program.  This trend cannot be altered, nor avoided nor wished away.  Adding 30 million people to the program will raise the cost of program and must be dealt with.

As important as program solvency and financial health are, finances are not the only reason to fix the Medicare program.  Medicare was developed in the 1960s and, as such, no longer meets the needs of the Medicare patient today.  Today’s beneficiaries have different demands; they are living longer with more chronic conditions, and are receiving care in a variety of settings.  Medicare must be updated to adapt to these changing demands so that patients can receive the best, most effective care.”

Physicians no longer practice 1964 medicine and in the 21st Century there will be further advances. The business and payment models and governance also must change.  Currently we have 2013 autos running on 1940s roads.  It is no wonder health costs have escalated. The old system has been inadequate.

In addition to reforming the  SGR (sustainable growth rate for physician fees),

Policymakers should look past the narrow reforms and short-term cost trends to deliver to beneficiaries a program that better meets their needs.

The Future for Medicare:

What You Need to Know

There are four proposals currently before Congress to reform aspects of Medicare. The Medicare Board of Trustees' 2013 report projects the Hospital Insurance Fund would become insolvent after 2026. 

This process is inextricably interwoven with current reforms including the Affordable Care Act, the formation of Accountable Care Organizations and major reimbursement reform (including conversion from ICD-9 to ICD-10 as well as health information technology, including electronic medical records, health information exchanges and health benefit exchanges come on line in 2014.

The challenges for health care professionals is enormous.

 

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Congress Has A Duty To Delay IRS Funding To Block ObamaCare's Implementation

 

In the midst of serious IRS ethical, moral and legal confusion, there is an inability to obtain accurate accountability for decision making.

Until these matters are successfully addressed expansion of IRS accounting and enforcement of Accountable Care Act monitoring and penalties for non-compliance with the mandate for obtaining health insurance coverage would be ill-advised.

The Galen Institute reports:

Americans already are fearful and confused about the sweeping changes that ObamaCare will inflict, and the widening IRS scandal deepens concerns about the agency’s major role in implementing and enforcing the health overhaul law.

Based upon Government Accountability Office data, we count 46 new responsibilities assigned to the IRS.

The Affordable Care Act assigns to the IRS  46 new responsibilities.

IRS officials have acknowledged the huge problems these major new responsibilities will create for the agency.

It is unprecedented in recent history, the amount of responsibility the IRS is being given in an area that most people don’t think of as an IRS function,” George said. Americans, he added, will have more questions about their taxes because of health care penalties or credits, flooding already busy call-in and walk-in tax help centers. “This is going to lead to problems, sir,” he testified.

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The Shortcomings of the Affordable Care Act

No law is perfect and often fails to attain it’s mission.  The ACA is like that, however it does many things counter to common sense and reduces the reality of purchasing insurance other than a mandated program that is unaffordable, and/or punitive.

For some workers, health reform brings no coverage, fewer hours

A common story is unfolding such as that of McCoy Faulkner who collects $81 a day as a substitute teacher in the Wake County (N.C.) Public School System. A mere sub, he has no benefits.

The 62-year-old former Raleigh, N.C., police officer shells out $580 a month for an individual insurance policy, more than half his monthly pay. The full-time teachers for whom Faulkner fills in, however, are eligible for free health insurance, with no monthly premiums, through their employer.

That’s why Faulkner was looking forward to the Patient Protection and Affordable Care Act, figuring he was the kind of person that the health care reform law was designed to help. Under the new law, anyone who works 30 hours or more a week for a large business will be eligible for employer-sponsored health care.

But instead of adding subs like Faulkner to its health care plan, the school system is looking for ways to avoid doing so. Wake is considering restricting its 3,300-plus substitutes to working less than 30 hours a week, effective July 1.

The reason: If just a third of the system’s subs were to qualify for employer-sponsored insurance, it would cost Wake schools about $5.2 million.

Some businesses will restructure themselves to employ mostly, or only, part-timers.

It’s expected that some will opt for the fines. Nancy Adams, owner of two Piggly Wiggly grocery stores in North Carolina, said that’s one option under consideration for her business. The $2,000-per-worker fine would apply to just five full-time employees at the two stores, amounting to $10,000 a year, she said, because the law exempts the first 30 workers from the fine.

Adams said the company would save considerably and likely give workers a $2-an-hour pay raise to help them buy individual policies on a health care exchange. Such exchanges, created by the Affordable Care Act, are designed for those who buy coverage on their own.

Adams’ grocery business has 86 employees and currently provides insurance to 31 of them at a cost of about $120,000 a year. Insuring all those who work at least 30 hours would raise the cost to about $165,000, she said.

“We don’t have the pockets to pay an extra $45,000 for health insurance,” Adams said. “It’s huge.”.  And should opt in these costs will be passed along to consumers.

It becomes obvious that the results of Obamacare will have both direct and indirect increases for health insurance.

 

Technorati Tags: affordable care act,aca,health reform law

Mobile Health and the FCC

FCC Names New Director of Healthcare Initiatives

At a time when mobile health initiatives and mobile apps are flooding the market, the Federal Communications Commission has shown enough interest to appoint Matthew Quinn as Director of Healthcare Initiatives.  “In this role, Quinn leads the agency’s efforts in facilitating and promoting communications technologies and services that improve the quality of health care for all citizens and help reduce health care costs; facilitating the availability of medical devices that use spectrum; and ensuring hospitals and other health care facilities have required connectivity. In addition, Quinn advises the FCC on health issues, working closely with the team overhauling the $400 million Rural Health Care program, and coordinating with federal partners including the NIH and the FDA, and with the private health care sector to develop effective FCC programs related to healthcare technology.”

Mr. Quinn will have expanding responsibilities at his new position. FCC is currently working on health initiatives to improve and enhance wireless communications and broadband connectivity nationwide. Projects include the Healthcare Connect Fund to expand telemedicine and revising its experimental licensing program to open more pathways for mobile healthcare app development.

This quiet appointment which occurred in April comes at a time when wireless technology is critical, because both  wifi and cellular systems will be essential for health information technology. It becomes one more step for FCC oversight of it’s authority over the radio-frequency spectrum.

“The incumbent will lead the agency’s efforts in facilitating and promoting communications technologies and services that improve the quality of health care for all citizens and help reduce health care costs; facilitating the availability of medical devices that use spectrum; and ensuring hospitals and other health care facilities have required connectivity,” the posting read.

The job description includes advising the FCC on health issues, providing guidance to the team overhauling the $400 million Rural Health Care program, working with other government bodies like the NIH and the FDA, and working with the private health care sector to develop effective FCC programs.

The job description includes advising the FCC on health issues, providing guidance to the team overhauling the $400 million Rural Health Care program, working with other government bodies like the NIH and the FDA, and working with the private health care sector to develop effective FCC programs.

The West Health Institute’s director of public policy Kerry McDermott was the last person to head up health care initiatives for the FCC.  McDermott previously led the FCC’s healthcare efforts and helped Mo Kaushal and Spencer Hutchins write the healthcare chapter in the FCC’s National Broadband Plan. Following the National Broadband Plan’s publication all three of them left the FCC to join the then-named West Wireless Health Institute. In 2011 the American Telemedicine Association published an open letter to the FCC criticizing the agency for going “silent” on healthcare since the publication of its National Broadband Plan in early 2010. In its letter the ATA also noted “the departure of every key professional staff from the Commission involved in healthcare policy.”

Last September the FCC held a public briefing this week with its mHealth Task Force, which formed in June 2012 to gather input from healthcare professionals and technologists to create a report full of “concrete” next steps that the FCC (and other agencies) can take to facilitate the adoption and acceleration of mHealth in the United States. One of the task force’s key suggestions was that the FCC hire a new healthcare director immediately.

My impression is that this is a low level appointment designed to give the appearance of FCC engagement in health.  It seems to be a redundant position one which is less necessary than FDA guidance for mobile health apps.

 

Technorati Tags: fda,fcc,mobile health,mhealth,telehealth,telemedicine,hit,broadband,rural health program,wifi,rural broadband initiative

Obama+Superman+The Man of Steel

 

 

It looks like the man of steel has Obama’s back. Although The Affordable Care is due to come online a short less than 6 months and experts predict it will create chaos and not have the effect of significantly reducing the number of insured.

It is certain to increase overhead and operating expenses to develop accountable care organizations which are supposed to be the backbone of saving cost, improving outcomes and producing “big data”, which is now named “meta-data”.

Recent missteps by the Democratic administration and Mr. Obama have triggered Congressional Hearings on National Security, the IRS, and Benghazi to name a few. There is also the observation that this may be just the ‘tip’ of the iceberg.  Who knows what hidden secrets and agreements lurk in the making of the Affordable Care Act.

       

As a matter of political expediency the Democratic majority passed it unilaterally, not caring enough to even read the  ACA.

Popular demand does not seem to sway HHS or the President to review or consider modifications to the Act.  It appears they will push forward until the cracks widen, chaos ensuing and insolvency occur.

Let’s call for a Congressional Inquiry  into the Department of HHS, and it’s divisions such as Medicaid. 

Full Committee Hearing - Hearing for Secretary of Health and Human Services-Designate, Governor Kathleen Sebelius

The Cabinet members in the Department of Justice, the Internal Revenue Service (Treasury) and State Department all refused to ‘fall on their swords’ during their appearance before Congress.

Apparently raising your right hand and swearing to be truthful and not commit perjury do not hold sway with these Cabinet heads.

                                        

Not quite taking the fifth amendment option of not incriminating themselves, they developed ‘selective amnesia’ .  By admitting to ‘nothing’ or claiming mental inadequacy’ saves them from perjury.

                

I’d like to see Secretary K. Sebilius on the witness stand to answer many questions Congress will have for  her about the Affordable Care Act.

               

1. How did big Pharma play a role?

2 What role did insurance companies play?

3. What is her plan to follow the mandate of the ACA?

 

The passage and enactment of the  Patient Protection and Affordability Act seems to be an oxymoron, it will not be affordable for the country, and patients are not protected.

Only when these and more questions bring into the light of day how the ACA was formed.

 

del.icio.us Tags: obama,aca,affordable care,sebelius,ppaca,health,health insurance,doj,hhs,treasury,irs,congressional hearing

Health Information Exchange and Accountable Care

 

 

 

Are HIEs Ready for Accountable Care?

This is a very interesting question.  HIEs were originally proposed long before the Affordable Care Act was law.  Their concept was to allow for  interoperability by harmonization and standardization of disparate EMR vendors.

The Accountable Care Organization is conceived to improve reimbursement paradigms, improve outcomes and to coordinate care among providers.

EMR and HIE came along long before the ACO was a concept.  The ACO in fact is not a reality in many places. Development costs, organization and implementation are a complex process.

I have not seen a concept of how HIEs would interact with ACOs. Technically all things are possible.

One of the centerpieces of the effort was support for the development of Health Information Exchanges. The government threw $564 million into the effort to create statewide HIEs, and some states followed suit with their own financial support.

But the big question facing the industry is what role, if any, HIEs can and will play in supporting the newest federal idea: accountable care organizations. As of February 2013, there were more than 250 Medicare ACOs, according to the Centers for Medicare and Medicaid Services; in a Health Affairs article published in February, David Muhlestein, an analyst at research/consulting firm Leavitt Partners, pegged the total number of ACOs at 428.

ACOs are credited as booming, and as of right now, there seems to be enough HIEs to support them. However, the future of HIEs is extremely murky due to the problem that has plagued the information exchanges since their conception-financial sustainability.

Most of the ACO effort has not been in terms of management, but the complexity of formation.   There are few operating Accountable Care Organizations working. Some that have been formed and operating are large health systems already operating as a single business entity.

The vast majority of medical practitioners and small hospitals function independently and have no contractual agreements with each other, a fundamental requirement for operating an ACO, to manage reimbursement, measure outcomes, and plan.

Stakeholder advocacy group eHealth Initiative assessed the state of HIEs in the United States in 2012 and identified 222 public and private HIEs, down from 255 in 2011.

A total of 161 HIEs responded to the organization's annual survey, the results of which highlight a big problem: Only 29 HIEs reported themselves as being financially self-sustaining. Ninety-three HIEs in 2012 said they were "highly likely" to be in business in three years, and 64 of those believe they will be financially sustainable within the next three years.

However, nearly half of those optimists currently depend on federal funds as their primary revenue source. And the $564 million in federal funding awarded to state HIEs under the HITECH Act stops in October 2013, with currently budgeted state funding sources expected to dry up by March 2014.

Very few HIEs are ready. The  eHealth Initiative survey also indicates that ACOs likely won't find the kind of data networks they could pay to piggyback on: Only 24 HIEs in 2012 reported being able to offer value-added services such as advanced data analytics, quality reporting, clinical decision support, and PACS reporting, all of which are services needed just as much by value-based programs as the actual exchange of data.

But too many HIEs are little more than a fax machine, sending a PDF-based Continuity of Care Document or medical image to a fax or into an EHR, and a surgeon can't operate the clinical decision support functionality of an EHR on information in a PDF.

Health Data Management also discusses further unknowns regarding the relationshiop between an ACO and a HIE.

Smoke and mirrors, cannot substitute for building ACOs on top of already inadequate Health Information Exchanges.

 

Technorati Tags: hie,aco,health informaiton exchange,accountable care,emr,interoperable,data,data analytics,affordable care act,aca,ehealth,hitech,outcomes

Reversal of HHS policy has Positive Outcome

 

Dying child was on life support when new lungs became available

Ten-year-old Sarah Murnaghan, who has cystic fibrosis, is receiving a lung transplant, at this moment.

The previous policy regarding the prohibition of children less than 12 years old with cystic fibrosis  receiving an adult lung transplant was reversed several weeks ago by the Dept of HHS in response to a public outcry  regarding the policy.  The policy was the result of obsolete statistics regarding survival statistics of children with the fatal genetic disease, cystic fibrosis which affect the lungs.  Previously adult lungs were also avoided due to size discrepancy between adult lungs and those of children.  The availability of adult lungs is much greater than children.

HHS Secretary Sibelius approves recommendations for lung transplant in child.

 

The criteria for lung transplantation in children with cystic fibrosis has been expanded .

 

 

Technorati Tags: lung transplants,cystic fibrosis foundation,children,rejection,survival rates,sarah murnaghan,life support

Health Train Express on Pause

 

Health Train Express will not publish for the remainder of June 2013

We are focused on publishing important status reports on the topic of Accountable Care Organizations in an effort to educate those assigned to develop these new entities.

Numerous topics will be addressed, including:

What health IT is necessary to support accountable care?

The CCHIT ACO HIT Framework is a guide
to developing a technology roadmap   HIT framework is an essential enabler for ACO’s.

The market for these products will be considerable, and it is still in the development phase.  As yet the role of health information exchanges is not clear, however some are looking to HIE’s as a component for their ACO HIT infrastructure.

Follow the links to Digital Health Space for daily updates.

 

Technorati Tags: aco,accountable care organization,cchit,healthtrain express,digitall health

The Achilles Heel(s) of The Affordable Care Act

 

Some Youths Unlikely to pay for Obama Care

President Obama had focused his long term objective as being the President that brought universal health care to America. Despite it’s passage unilaterally with only Democratic votes the law is unpopular and each day new challenges arise as to the fiscal integrity of the law, as much of it appears to be wishful thinking based on  the desire to see every citizen have health insurance without concern for affordability, it’s impact on businesses, and rough autocratic mandates the law gives to the Head of the Department of Health and Human Services, Kathleen Sebelius.

 

Health Train will continue to bring to you thoughts, observations and opinions from many respected health consultant and experts:

*********************************************************************************

By Grace-Marie Turner
Orange County Register, June 5, 2013

Virtually all Americans will be required to have health insurance under the Affordable Care Act (caution---this document is about 900 pages-- starting in 2014, and President Barack Obama especially wants young, healthy people to sign up.

About two-thirds of the uninsured are younger than 40. They use fewer health services, and their premiums are needed to help keep insurance costs down for everyone else.

Yet the incentive structures in the law work at cross-purposes with this goal and could well undermine its success. It will all come down to costs.

Four out of 5 people younger than 30 will face higher premiums than without the Affordable Care Act even with the subsidies many can receive.

The law requires young people to pay more for their health coverage so older people can pay less. A study published this year by the American Academy of Actuaries’ Contingencies magazine found that because of this provision, “premiums for younger, healthier individuals could increase by more than 40 percent.” Young men will pay even more than young women.

A former director of the Congressional Budget Office, Douglas Holtz-Eakin, conducted a survey that showed fewer than half of young people will sign up for insurance if premiums rise by 30 percent.

Young people also face a daunting approval process in applying for coverage. Applicants must divulge their income, family status and information about their employers, details on any insurance offered at work and their health habits — just to find out if they are eligible for subsidies.

Ezekiel Emanuel, a key architect of the president’s health plan, says he is worried that young people will be “bewildered,” and they may “forgo purchasing health insurance and opt to pay a penalty instead.”

That certainly will be an attractive option for many since the penalty starts at just $95 the first year.

And there is yet another disincentive for young people to enroll in coverage: They can wait to sign up for coverage until after they get sick or injured. The law requires health insurance companies to sell insurance to anyone who applies.

         

But if young people don’t sign up, the insurance pools are likely to be composed primarily of people who have high health costs. This could cause a “death spiral” where many more older — and sicker — people are enrolled, causing health insurance premiums to rise to cover their medical costs, thereby driving even more young people out of the market.

The White House believes that it will be able to persuade young people, who overwhelmingly supported the president, to enroll out of loyalty.

“The president connects with young people, too, so he needs to use that bond and get out there to convince them to sign up for health insurance to help this central part of his legacy,” said Emanuel, a health care expert at the University of Pennsylvania.

But young people may find that zeal may be severely tested when it comes down to paying thousands of dollars for health insurance that they may not want or need.

Consider, for example, a 27-year-old earning about $34,000 a year. He now could buy health insurance for about $200 a month. However, the new rules and more generous benefits required under the health law mean he would have to pay about $300 a month instead. He could get a subsidy of about $20 a month but, even with that, he still would be paying nearly $1,000 a year more for health insurance than without the law.

The White House is expected to mount a massive advertising campaign this summer to encourage people to enroll.

This will severely test his young supporters, who are having the hardest time finding jobs in our economy. Forcing them to also purchase health insurance — and pay more for it — may cool their enthusiasm to help the president fulfill his legacy.

http://www.galen.org/topics/some-youths-unlikely-to-pay-for-obamacare-coverage/

 

Technorati Tags: ezekiel emanuel,aca,obamacare,white house,university of pennsylvania,elderlly,young people,hhs,sebelius

Obamacare in California: Health Benefit Exchange

 

Executive Director:  Peter Lee

 

Health Train Express did some deep dyving into the Covered California Plan. California is the first State to embark on the Affordable Care Acts option for states to plan their own Insurance Exchange.

This information is taken from the Covered California web site. Readers must realize that this plan will not be operational until January 2014, and that most figures are subject to revision.

On the surface it appears reasonable to assure all are covered.  If your income is below the 400 % of the Federal Poverty Level (subject to the size of your family) you will be eligible for the subsidized tax credit.  The Covered California web site provides a simple calculator to get an estimate of your premiums.  The web site also provides a benefit table, co-pays, deductibles, maximum out of pocket expenses and a range of plans, Bronze,Gold, Silver, Platinum.

The ACA  Changes that occur in January 2014

Calculating Potential Insurance Cost in 2014

Coverage Basics

For Individuals and Families

Getting Financial Help

Calculating Potential Insurance Cost in 2014

Frequently Asked Questions

If you need coverage before 2014

The Fine Details (Not for the faint of heart)---written by attornies and passed into law by the California State Legislature and signed by Governor Jerry Brown

Legislative Bills

AB 792

AB 1766

AB 1926

SB 961

 

Technorati Tags: PPACA,AB 792,AB1766,AB1926,AB 961,AFFORDABLE care act,health insurance exchange,health benefits exchange,federal poverty level

A Blogger’s Paradise

 

If you are an avid blogger your presence is most likely known to the Department of Homeland Security.

I came upon this little tidbit of information released as a result of a FOIA (Freedom of Information Act) query

Analyst Desktop Binder_REDACTED by Andrea Stone

It professes to know what ‘keywords” the D.H.S. searches for when scanning social media for ‘suspicious’ material.

Judging from the list there is little to fear….this has to be some kind of joke, sort of like the Affordable Care Act.  It would be funny but it is not…these are the people we elect to run our lives.

So here goes my test:

This material has been released under the Freedom of Information Act and is in the public domain.

Technorati Tags: terror,homeland security,keywords,social media,blogger,foia,freedom of information

THE WALKING GALLERY A SOCIAL EVENT

 

Just a reminder,  today is another episode of The Walking Gallery, a regularly occuring event, which thus far has only been held in Washington, D.C.  This unique event was founded by Regina Holliday. This year it will be held:

The Walking Gallery 3 will be held in St. Paul’s Lutheran Church in Northwest DC one block from the Mural 73 Cents.

The event has been quite successful growing in numbers each year. For the past two years The Walking Gallery gathered in the Kaiser Permanente Center for Total Health.  It was a great venue for the first two years.  Thank you Kaiser Permanente for your gracious support!  The first year we had 54 Walkers wearing their jackets.  The second year we had over 80.  

The “glue” that is the centerpiece for the event is the creative paintings which Regina Holliday has painted on the back of jackets which the attendees wear. These are pictorials of people in medical situations depicting different events.  Regina travels the country visiting many medical conferences and is inspired by these events. Many of the attendees are well known in social media and are prominent thought leaders.

Regina Holliday also blogs at “Regina Holliday’s Advocacy Blog”  this week’s edition is entitled “Stair Steps”

Accompanying each of these paintings Regina also utilizes her amazing story telling talent as a postscript for the artwork. The stories themselve are an art form and a novelette. They are also based upon real life situations. The stories always grab me, there is humor, happiness, sadness and tragedies….many of which are precipitated by our broken health care system.

If you are a provider, patient or an advocate it gives you much thought and should stimulate thought and illuminate just where things have gone “wrong’ Regina along with other prominent patient advocates, such as ePatientDave are already making a difference.

The event came to my attention rather late. So if you miss it plan for next year.

My only complaint is that the event has not taken place on the West Coast or in the midwest.

Regina, you have many fans here on the ‘Left Coast”.  How about a Walking Gallery in Los Angeles, San Diego, or in San Francisco ?

 

San Diego Convention Center                   San Francisco Cable Car Turnaround

One other suggestion is to also carry the event as a live stream on Google Hangouts on Air, to share it with the rest of the world.

 

del.icio.us Tags: regina holliday,walking gallery,st paul's lutheran church,washington d.c.