8. Why Total Health? Why not?
Integrated Health Care
Easy, Excellent, Comprehensive
Commitment to Prevention
Address issues before they become
problems
Empowering of the whole person
Beyond health care - mind, body, spirit
What you eat, the air you breathe, the
environment you live in Photo: M.V. Jantzen, Washington, DC : http://flic.kr/p/8Ttx3g
8
9. In the words of a patient
(and we will all be patients one day)
“Kaiser Permanente HealthConnect® at Home - Empowering People”
youtube.com/kaiserpermanenteorg
9
10. Technology does not replace us...
“Where do you go for help with health or medical issues?
0%
25%
50%
75%
100%
Health Professional Friend/Family internet books/print insurance provider other
Source: Pew Internet & American Life Project: The Social Life of Health Information, June 2009, http://pewinternet.org/Reports/2009/8-
The-Social-Life-of-Health-Information.aspx
10
11. We use it to improve the care we provide
60%
68%
75%
83%
90%
2005 2006 2007 2008
Source: (Zhou YY, Kanter MH, Wang JJ, Garrido T. Improved Quality At Kaiser Permanente Through E-Mail Between Physicians And
Patients. Health Affairs. 2010 ;29(7):1370-1375.)
Didn’t use E-mail Used E-mail Kaiser
Permanente
Southern
California
% Members
with high
blood
pressure
under control
2005 - 2008
HEDIS 90th
Percentile, 2008
70.3 %
11
12. And you will, too.
Jack Cochran, MD, Executive Director of The Permanente Federation
National Governor’s Association, Washington, DC
12
13. KP HealthConnect® – Enabling Patient-Centered Care
My Health Manager, part of a
comprehensive electronic health
record
Ambulatory deployment
complete: 431 medical
offices live
Inpatient deployment complete:
36 hospitals live
24 HIMSS Stage 7 Hospitals
13
16. Kaiser Permanente Advice Nurses: 2010
Appointment and Advice Call Center, Vallejo, CA - KP HealthConnect enabled!
16
17. Kaiser Permanente members/caregivers : 2010
“Balancing Work and Family”
Kaiser Permanente YouTube Channel
http://www.youtube.com/kaiserpermanenteorg
17
18. We connect with over 3 million members...
0
875,000
1,750,000
2,625,000
3,500,000
Q3 ‘03 Q1 ‘05
Q1 ‘07 Q1 ‘08
Q3 ‘10
Registered members
August, 2010
946,273 e-mails sent
by members
• 9,600 physicians AND
• 11,310 other providers
responded
2,216,326 test results
reviewed by
members
• 435,906 members reviewed
test results
Source: Kaiser Permanente Internet Services Group Web Analytics
18
20. Who are experiencing significant job impacts
Source: Caregiving in the United States, 2009
http://www.aarp.org/relationships/caregiving/info-12-2009/caregiving_09.html
2004 2009
62%
69%
Job impact while caregiving
20
21. We are involving members and families better
new My health manager pharmacy center - live in 2010-2011
Convenient dropdown
box to refill
prescriptions for “Act
for a family member”
Option to refill a
prescription for
someone else
(prescription number
needed)
Add someone
to your list
21
22. Helping families grow
new My health manager Pregnancy center
New layout
Information and
organization
user -tested by
pregnant
women
Relevant health
messages,
linked to My
health manager
kp.org/pregnancy
22
23. Moving people from information to action
new My health manager Pregnancy center
Link members to prenatal
education, facility services
and baby care classes
Link members to appointments,
e-mail, labs, visit summaries
kp.org/pregnancy
23
24. Why this matters
video courtesy Regina Holliday & Health 2.0
http://reginaholliday.blogspot.com | http://www.health2con.com
24
25. We use social media to participate as people
May 28th, 2009 by Ted Eytan | Popularity: 36%May 28th, 2009 by Ted Eytan | Popularity: 36% || Edit this entryEdit this entry 20 comments | show/add20 comments | show/add »»
Is it meaningful if patients can’t use it?
I attended a smallish get together yesterday organized by Christine Kraft to think about Health
2.0 / DC in the epicenter type things, where we thought about some of the trends in social
media use, social media use by physicians and medical groups (I got a lot of help on this one),
journalists, and finally, a real story about a patient’s experience, here in DC, that really brings to
light a problem with a meaningful use definition that doesn’t include “and the patients can see
the data.”
I’ve been thinking about the idea that meaningful use must include “patients can see everything”
since ARRA came out, and see my first mention of it in the Twittersphere around April 22. I have
noticed since then that the idea seems to be picking up steam – initially I was told by some that
this would be a “distraction” to the conversation. Now I’m sure that it’s not. Read on…
This is the story of Regina Holliday – it’s really worth a read, and I’ll quote some of it here:
We will fight the good fight. Regina’s USA medical advocacy 2009
Why do we have more transparency in special education law then in medical care? Why do
we have more access to information on a box of Cheerios then on a medical chart? Why isn’t
PHOTO
LATEST TWEET
No public Twitter messages.
Follow me on twitter
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Testimony
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SIMILAR POSTS
73 Cents : A New Monument to Patients, in Washington,
DC
Meaningful Meaningful Use
Photo Friday: Return Expectations to the Upright Position
Moderating a Dream Panel at WHIT 5.0
How would you counsel this patient?
Home ContentTed Eytan, MD e-Health. Patient empowerment. Washington, DC.
HomeHome AboutAbout PortfolioPortfolio ContactContact Subscribe to UpdatesSubscribe to Updates DiscussionDiscussion
25
26. “73 Cents”
A National Monument to Patient Empowerment, in Washington, DC
http://reginaholliday.blogspot.com
26
27. Failure to Notify, “significant results”
Lab results studied in community
practices - no improvement
with EHR
Imaging results studied at the VA,
with advanced EHR
11 times (out of 92), imaging
results that were not relayed to
patients after 4 weeks were of
an abnormality that turned out
to be cancer.
7.1%
92.9%
Lab
Sources: Singh H, Thomas EJ, Mani S, Sittig D, Arora H, Espadas D, Khan MM, Petersen LA. Timely Follow-up of Abnormal Diagnostic Imaging Test Results in an
Outpatient Setting: Are Electronic Medical Records Achieving Their Potential? [Internet]. Arch Intern Med 2009 Sep;169(17):1578-1586.[cited 2009 Sep 29 ]; Casalino LP,
Dunham D, Chin MH, Bielang R, Kistner EO, Karrison TG, Ong MK, Sarkar U, McLaughlin MA, Meltzer DO. Frequency of Failure to Inform Patients of Clinically Significant
Outpatient Test Results [Internet]. Arch Intern Med 2009 Jun;169(12):1123-1129.[cited 2009 Jun 26 ]
7.7%
92.3%
Imaging
Failure to Notify Notification
27
29. We use social media to tell our story about quality
50%
60%
70%
80%
90%
100%
2006 2007 2008 2009
Hawaii Region Georgia Region
Source: Kaiser Permanente Integrated Analytics; Data
is for commercial enrollees only; When I Grow Up
(Hawaii) - Kaiser Permanente YouTube Channel - http://
www.youtube.com/kaiserpermanenteorg
NCQA 2010
90th Percentile
Breast Cancer Screening • HEDIS 2010
29
32. 2005 was long ago in Internet time….
0%
25%
50%
75%
100%
AGE: < 30
30-50
50-64
65+
Social Networking Use Internet
Source: Pew Internet & American Life Project Tracking Survey, September, 2005; Pew Internet & American Life Project: Older Adults
and Social Media, August 2010, http://pewinternet.org/Reports/2010/Older-Adults-and-Social-Media.aspx
Denominator is all adults for both data points; data is for “ever have” done this activity
32
33. 0%
25%
50%
75%
100%
AGE: < 30
30-50
50-64
65+
Social Networking Use Internet
Source: Pew Internet & American Life Project Tracking Survey, May, 2008; Pew Internet & American Life Project: Older Adults and
Social Media, August 2010, http://pewinternet.org/Reports/2010/Older-Adults-and-Social-Media.aspx
Denominator is all adults for both data points; data is for “ever have” done this activity
2008
33
34. 0%
25%
50%
75%
100%
AGE: < 30
30-50
50-64
65+
Twitter/Status Update Social Networking Use Internet
2009
Source: Pew Internet & American Life Project Tracking Survey, April 2009; Pew Internet & American Life Project: Older Adults and
Social Media, August 2010, http://pewinternet.org/Reports/2010/Older-Adults-and-Social-Media.aspx
Denominator is all adults for both data points; data is for “ever have” done this activity
34
35. 0%
25%
50%
75%
100%
AGE: < 30
30-50
50-64
65+
Twitter/Status Update Social Networking Use Internet
2010
Source: Pew Internet & American Life Project Tracking Survey, May 2010; Pew Internet & American Life Project: Older Adults and
Social Media, August 2010, http://pewinternet.org/Reports/2010/Older-Adults-and-Social-Media.aspx
Half of internet users ages
50-64 and one in four users
age 65 and older use social
networking sites
35
36. Support Systems
“If there was one common theme I
found in caring for my patients I
would say it was the importance of
support systems. Healthcare
facilities don’t always provide
optimal support systems. We don’t
necessarily have to wait for
facilities to revolutionize
themselves; support systems can
be developed in spite of the
limitations of the healthcare
industry itself. This is where social
media becomes interesting.”
-@PhilBaumann
“Why a Registered Nurse is Interested in
Social Media,”
http://philbaumann.com/2008/06/12/why-a-registered-nurse-is-interested-in-
social-media/
36
39. Our Social Media Policy
• Employees must not represent KP
views in social media channels,
at work or not, without prior
approval
• Aligns with Principles of
Responsibility
• Covers all social media channels
• Is a “living document” and will be
updated/revisited regularly
• http://tinyurl.com/kpsocialmediapolicy
39
43. Garfield Innovation Center
Opened in 2006
Sponsored by KP IT, National
Facilities Services, and Patient
Care Services
37,000 square feet
Full-scale medical-surgical ward;
Labor and Delivery; Operating
Room; Emergency Department
Home environment
Open prototyping space; IT lab;
conference rooms
43
46. MedRite
“With our nurses as co-
designers, we learned
that the medication
administration process
is unclear, chaotic and
full of interrupts. The
evidence-based design
is simple, elegant, and
safe. We call this
innovation KP
MedRite.”
xnet.kp.org/innovationconsultancy
46
49. Building, buying, eating green
Energizing our facilities
with solar power
Eliminating unhealthy
materials from our
buildings
Zero exporting of e-waste
Sourcing food locally;
creating hospital based
farmer’s markets
Green Resource Center: http://xnet.kp.org/newscenter/
aboutkp/green/index.html
Source: 2009 EPA Pacific Southwest
Environmental Awards, http://www.epa.gov/
region09/awards/09/index.html; “Healthy
Health Care Leader - Kaiser Permanente,”
http://blog.epa.gov/blog/2009/10/15/healthy-
health-care-leader-kaiser-permanente/;
49
50. Greenhouse Gas reporting
Source: KP 2008 GHG inventory for the NCAL, SCAL and Northwest regions, Joe Bialowitz, Environmental Stewardship
Does not yet include all
impacts of care delivery,
including travel or
procurement
66%
25%
4%
3%2%
Purchased electricity
Stationary combustion (incl. boilers emergency power generators)
Medical gases (N2O CO2 SF6)
Refrigerants
Mobile combustion (fleet vehicles landscaping equipment)
Estimated Total: 0.621 Megatons of CO2e
California, Oregon, Washington Operations, 2008
50
51. What people want
Sidney Garfield, MD
summed things up …
“The people of this
country ... donʼt want to
get sick.”
kaiserpermanentehistory.org
51
52. How we are delivering it today
youtube.com/kaiserpermanenteorg
52
