On Sunday, March 25 after spotting some blue sky, I rushed Jeff and Jane out of the house and we drove up to the Cal Campus to explore. I found a great little walking map (pdf) that provided a one-hour loop tour of some of the major spots on campus. I figured we could get a good walk in before the next downpour.

Since I had recently explored Cambridge and the Harvard campus, I figured it was worth spending some time to check out the campus in my backyard. It was a very pleasant walk and I’m always surprised by what can be found. As far as highlights go, I was excited that the Life Sciences Building was open and I got to show Jeff and Jane the T-Rex (picture below).

So, on Sunday, March 11, the family got in the car, picked up sandwiches and headed out to El Sobrante to check out Kennedy Grove. We had a great picnic at the park and then embarked on our hike. Off we went onto the Laurel Loop trail, took a wrong turn, and managed to reach a dead end. Once we turned around and found the trail we had actually planned to take, we started up a beautifully wooded trail.

By that time we had reached that moment that all parents know too well. Both kids were as distracted as a cats playing with a ball of yarn. There was nothing we could do to get them focused on actually making it up the hill, so we gave up. Headed back to the picnic area and let them play on the playground. The kids were happy and our sanity restored.

Once again, this Thanksgiving we are grateful to all the people who keep this mission alive day after day: to ensure that each and every one of us understands, communicates, and has honored their end of life wishes.

Seems almost more fitting than usual this year, the year of making change happen. 2011 gave us the Arab Spring, people on the ground using social media to organize a real political revolution. And now, love it or hate it – it’s the Occupy Wall Street movement that’s got people talking.

Smart people (like our good friend Susannah Fox have made the point that unlike those political and economic movements, our mission isn’t an issue we need to raise our fists about – it’s an issue we have the luxury of being able to hold hands about.

It’s a mission that’s driven by all the personal stories we’ve heard of people who’ve seen their loved ones suffer unnecessarily at the end of their lives.

It’s driven by that ripping-off-the-band-aid feeling of relief you get when you’ve finally broached the subject of end of life wishes with your family, free from the burden of just not knowing what they’d want for themselves, and knowing you could advocate for these wishes if your loved one weren’t able to speak up for themselves.

And it’s driven by knowing that this is a conversation that needs to happen early, and often. One of the greatest gifts you can give the ones you love is making sure you’re all on the same page. In the words of the amazing Atul Gawande, you only die once! Die the way you want. Make sure your loved ones get that same gift. And there is a way to engage in this topic with grace!

Here are the five questions, read them, consider them, answer them (you can securely save your answers at the Engage with Grace, share your answers with your loved ones. It doesn’t matter what your answers are, it just matters that you know them for yourself, and for your loved ones. And they for you.

We all know the power of a group that decides to assemble. In fact, we recently spent an amazing couple days with the members of the Coalition to Transform Advanced Care or C-TAC, working together to channel so much of the extraordinary work that organizations are already doing to improve the quality of care for our country’s sickest and most vulnerable.

Noted journalist Eleanor Clift gave an amazing talk, finding a way to weave humor and joy into her telling of the story she shared in this Health Affairs. She elegantly sums up (as only she can) the reason that we have this blog rally every year:

For too many physicians, that conversation is hard to have, and families, too, are reluctant to initiate a discussion about what Mom or Dad might want until they’re in a crisis, which isn’t the best time to make these kinds of decisions. Ideally, that conversation should begin at the kitchen table with family members, rather than in a doctor’s office.

It’s a conversation you need to have wherever and whenever you can, and the more people you can rope into it, the better! Make this conversation a part of your Thanksgiving weekend, there will be a right moment, you just might not realize how right it was until you begin the conversation.

This is a time to be inspired, informed – to tackle our challenges in real, substantive, and scalable ways. Participating in this blog rally is just one small, yet huge, way that we can each keep that fire burning in our bellies, long after the turkey dinner is gone.

Wishing you and yours a happy and healthy holiday season. Let’s Engage with Grace together.

To learn more please go to www.engagewithgrace.org. This post was developed by Alexandra Drane and the Engage With Grace team.

I personally completed my Advance Directive as a direct result of the Engage with Grace project. Do you need an Advance Directive to share with your family? You can find them here on kp.org.

My latest post on Ragan’s Health Care Communications News:

Kaiser Permanente asks: How are you educating patients about your quality reports? Consumers aren’t paying attention to your quality reports or awards. How can health care communicators change that?

Originally posted July 20, 2011 on the Ragan’s Health Care Communications News

Kaiser Permanente asks: How do you ‘let patients help’? Inspired by the e-patient movement, this health care organization is determined to share patient voices.

Last week I had the honor of speaking at WHIT 5.0 with Ted Eytan, MD, MPH, e-Patient Dave and Regina Holliday. Together we addressed the topic “Is a Personal Health Record enough in 2009?: Engaging staff, patients and communities through social media.”

In hosting the session, Ted did a great job soliciting audience comments and questions. He has posted the full collection of questions and comments in his blog post Voice of the Audeince: WHIT 5.0 “Beyond the PHR.”

Below, I will begin tackling some of the audience questions that I felt qualified to answer.

1. Social Media Policies (question #5): One member of the audience requested existing policies that balanced transparency and patient privacy. I am happy to share Kaiser Permanente’s policy. It is available at: http://tinyurl.com/kpsocialmediapolicy

2. International NGO’s (question #9): There was a question about whether Kaiser Permanente works with international NGO’s and the answer is YES! Check out kp.org/international for more information.

3. Patient-Friendly Presentation: A member of the audience asks “How could medical information be presented in a patient -friendly format to assure added value to patients?” While I admit I am biased, I think kp.org does a great job linking directly from actual clinical information (e.g., a lab test result) within the PHR to a health encyclopedia with easy-to-read information about what that information means to a non-clinical reader. To see what I mean, check out this demo of My Health Manager.

More answers to come . . . .

So I was lucky enough to get a quick tour of Kaiser Permanente’s new mobile health vehicle during it’s brief visit to Oakland before it’s put on a boat to serve people on the Big Island of Hawaii. Simply put, this thing is cool. With just 500 square feet, they have squeezed in an exam room, restroom, a digital mammography unit and a rather cozy little waiting room. Fully computerized, the vehicle runs off cellular technology and the team in Hawaii has identified hot-spots that will ensure that providers will have full access to KP HealthConnnect — an electronic health record — whenever they care for patients.

Truly a great solution for improving access to high-quality care for people in rural areas.