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NASA Event Blasts Off from the Center for Total Health

imageToday, the Center for Total Health is hosting the “Accelerating Innovation” event, presented by the NASA Human Health and Performance Center.  The NASA Human Health and Performance Center is a virtual center that brings organizations together to advance human health and performance applications related to space and life on Earth. Member organizations address global issues and spaceflight challenges, share best practices, and post collaborative projects that accelerate innovation.

This is the second event NASA has held at the Center for Total Health, and this year’s program features speakers from Harvard Business School, Jump Associates, Inc., the Conrad Foundation, and NASA.  A panel of executives from industry, government, academia and non-profit organizations will discuss models for accelerating innovation across sectors, and interactive breakout sessions addressing successful business models for advancing innovation in various types of organizations will be conducted in the afternoon.

Follow the event on Twitter via hash tag #nasahealth, or follow us at @kptotalhealth for updates.  And check back here for other event coverage.

KP’s Member Mobile App Gets a Makeover, Inside and Out

Mobile apps that support health continue to be wildly popular among consumers looking for ways to access and track health information and resources.  Today, one health organization — Kaiser Permanente — unveiled a new and improved mobile app for its members that promises improved ease of use and functionality.

KP’s original member app was launched in 2012 and so far has been downloaded 600,000 times.  The app made it possible for users to securely email their doctors, refill prescriptions and check lab results from anywhere with a smartphone.  All of those features continue to be available in the refreshed version.

kp-mobile-app-refresh-340x243-4But this app has definitely had a face lift — most noticeable is the colorful and streamlined interface.  According to Brian Gardner, executive director of KP’s mobility center of excellence — it was purposely designed so that users can find what they are looking for in “the first few swipes” of the app.

According to the press release, the new design works with smartphone technology, greatly improving functionality.  Now when KP members schedule an appointment using the mobile app, that can be saved right to the device’s own calendar.  And on the appointment screen, a map with driving directions is included.  The upgraded interface is also ADA-compliant for the vision and hearing impaired.

The app is available to the 4 million registered users of Kaiser Permanente’s PHR, My Health Manager, on kp.org, and it can be downloaded for free at the Apple App Store.

 

Google Glass: It’s a Wrap (Up)

By all accounts, the second-ever Center for Total Health tech focus was a great success. We were pleased to welcome a small in-person audience along with more than 80 guests via webcast to discuss the potential of wearable computers to change and improve health care — as well as check out Google Glass in action. (Kaiser Permanente and the Center for Total Health host these conversations to explore ideas and the potential of new technology; there is no implied endorsement by KP or CTH of any participating product or company.)

Center for Total Health Medical Director Ted Eytan, MD, and Executive Director Keith Montgomery kick off the live broadcast.

Center for Total Health Medical Director Ted Eytan, MD, and Executive Director Keith Montgomery kick off the live broadcast.

We had lively audience participation and interaction during the Tech Focus event (see the full chat here), and wanted to highlight a few of the most common and most interesting questions raised.

 

Availability
Google Glass is not yet widely available to consumers, and we aren’t sure when they will be. For those who are lucky enough to snag a pair (mostly developers), the price tag today is $1,500.

 

Privacy and Security
Information gathered by this device is not currently encrypted or HIPAA compliant, though this would certainly have to be addressed before Glass could be used in a clinical setting (just like any other device). A few folks asked about privacy – specifically if there’s any way for bystanders to know that Glass is taking photo or video. Such a feature does not exist in the current design, but members of our smart audience suggested that a recording light (not unlike those on video cameras) would do the trick.

 

Ideas for Use

Antonio Zugaldia and CTH Operations Manager Yen Greene rehearse before the broadcast.

Antonio Zugaldia and CTH Operations Manager Yen Greene rehearse before the broadcast.

Folks tuning into the webcast were not short on ideas for how wearable computers might someday be used to promote health and facilitate care delivery in a clinical setting:

  • Closed captioning or hearing aid for the hearing impaired;
  • Capturing the patient perspective of an office visit;
  • Visualizing veins for blood draws;
  • Promoting healthy behavior and choices by helping the wearer locate nearby farmers markets, parks, and health food stores;
  • Real-time communication between pre-hospital providers, transferring facilities and accepting teams; and
  • Improving safety for cyclists by warning them about cars and pedestrians.

If you have other questions or ideas, we’d love to hear from you in the comments below (or via Twitter – we are @kptotalhealth).

Innovator Spotlight: Caremerge’s Asif Khan on the need for Coordinated Care

Caremerge Founder and CEO Asif Khan

Caremerge Founder and CEO Asif Khan

This week in our spotlight series on innovators, we interviewed Asif Khan, Founder and CEO of Caremerge (www.caremerge.com).

After a personal experience showed Khan how fragmented health care can be, he set out to design a complete set of web-based and mobile apps to improve coordination, specifically for senior citizens and their care providers, both clinical and family. Care merge apps track everything from medications to patient activity and clinical assessments. According to its website, Caremerge was selected to be part of the GE Health Growth Acceleration Program (a partnership with StartUp Health), and was named one of the five coolest apps of 2013 by HealthBeat Magazine. Our interview with Khan is below.

 

CTH Blog:
First, please tell us a little about yourself and why you became interested in health and technology.

AK:
I have been in the health and technology industry for the past 12 years. I have been in various global leadership roles at GE IT before launching Caremerge. Health care has many opportunities for improvement, not only in the U.S., but also around the world.

CTH Blog:
Being an entrepreneur must be very rewarding and exciting, but also quite challenging. What is the passion that drives you?

AK:
I strongly believe in wellness and that better health care is a fundamental right (just like food and shelter) for everyone.  Effective health care should not be considered a privilege. The question is, how do we provide health care more efficiently and affordably at a global level? Caremerge is set out to solve this problem by bringing patient into the middle and allowing all the care providers (irrespective of their physical location) around that patient to see what each one is doing, sharing information, documents, images, and most importantly to be able to include the patient and engage with each other in a HIPAA compliant real-time chat within a patient centric context.

CTH Blog:
How did you get into your current field? How long have you been working on this project or company?

AK:
My parents volunteer building orphanages, schools, hospitals, etc. in remote areas in a developing country. In 2010, my mother got terribly ill and was put on ventilators, once I got there I realized that my father didn’t have all her medical information organized to share with the physicians. I was very upset with my father that he didn’t have this information together, but then he asked me “Asif, do you know which medications you took three months ago or which physicians your wife goes to and sees?” I was speechless!

I realized that as advanced as we are in the United States with the advancements in medicine, we are as backward as a developing country when it comes to accessing and sharing critical information about patients. That’s when I launched Caremerge, focusing initially on the most vulnerable demographic, our elderly, which by the way, also costs the most to our health care system and us.

CTH Blog:
What do you think is the most exciting innovation or trend happening health care right now?

caremerge appsAK:
It is exciting that care coordination is at the core of health care reform, driving value-based reimbursements through provider collaboration as compared to traditional volume based reimbursements. That’s where Caremerge sits through its super simple mobile/web based platform – simplifying communication and care coordination among providers through automated alerts, notifications, and reminders. Finally we have come full circle to have our health care organizations focus on wellness.  This will contribute immeasurably to the quality of life for millions. That is exciting and worthwhile.

CTH Blog:
Describe your vision of the future of health or health care.

AK:
At Caremerge, we have identified the FIVE RIGHTS TO EFFICIENT CARE™: The RIGHT Information, about the RIGHT Patient, at the RIGHT Time, to the RIGHT Provider so they can make the RIGHT Decision.

With an additional 30 million people requiring insurance next year and then another 10,000 people reaching age 65 every day for the next 17 years, the demand on health care providers is increasing exponentially; whereas the supply of those providers (physicians, nurses, etc.) is not increasing at the same magnitude. Unless providers are using a solution like Caremerge that pushes information to them so they can make the right decision immediately (no need to be in front of a computer), we are in for an unpleasant surprise. We may experience significant bottleneck situations in our health care systems. The cost in quality of life and in dollars is staggering. On the flip side, imagine what a healthy, engaged population could do for personal and economic growth.

CTH Blog:
At Kaiser Permanente, we think of “total health” as a combination of mind, body and spirit. What does total health mean to you?

AK:
Kaiser Permanente’s view of “total health” is right on! Our health is defined by our lifestyle choices. Just treating medical conditions in health care is not going to help us get healthier. We need to better understand and track our lifestyle choices (that are impacting our mind, body and spirit) that ultimately drive our health.

That’s why at Caremerge, we are allowing senior care providers to not just focus on clinical information but also on the many other dimensions of a person’s overall well-being (including, physical, emotional, environmental, spiritual, vocational, social, intellectual, nutritional, etc.). Our technology allows these care providers to understand each individual’s needs across many dimensions to truly provide a holistic and individualized plan for them. This understanding is then put to statistical significance tests along with other clinical data to drive better outcomes that are quantifiable and not subjective.

Please note that Kaiser Permanente does not endorse the products featured in these discussions.

Unhealthy Foods & Beverages Brought to School Outnumber Healthy Alternatives: Talking with Researcher Karen Coleman

Karen J. Coleman, PhD

Karen J. Coleman, PhD

In a recent report, the Institute of Medicine described schools as the “heart of health” and identified school-based interventions – policies that change food environments in schools – as one of the most promising ways to prevent childhood obesity. Inspired by these recommendations, Karen J. Coleman, PhD, a researcher from the Kaiser Permanente Southern California Department of Research & Evaluation, led the Healthy Options for Nutrition Environments in Schools (Healthy ONES) project. This program worked to change nutrition environments and policies at eight elementary and middle schools in Southern California over a three-year period. The project led to a study last year that found involving teachers, parents, and school staff to promote healthy school nutrition environments helped to reduce unhealthy foods and beverages in schools by 30 percent.

This week another study was published from this initiative in the journal Public Health Nutrition that reveals nearly 80 percent of all food and beverages brought to elementary and middle schools by students, parents, and teachers are unhealthy — including high-sugar snacks, beverages with added sugar, and chips or crackers. We caught up with Dr. Coleman to discuss the findings of her latest study and the importance of healthy foods and beverages in schools.

CTH Blog:
This is not your first time reporting on food options in schools. Tell us a bit about your work in this area.

Karen Coleman:
The Healthy ONES program was the result of a national research initiative from the U.S. Department of Agriculture concerning nutrition and policy. From 2007 to 2010 we studied a low-income school district in San Diego. We worked with schools in the district to remove unhealthy foods and beverages that were brought to campus for celebrations, fundraisers, and school meals. We also tried to encourage students to eat healthier food options, such as fruits and vegetables. We discovered that schools were throwing away perfectly good fruit after each lunch period, so we convinced cafeteria staff to serve the fruit as snacks for morning recess. We also worked with teachers in the school district to change their habits of using unhealthy foods and beverages as rewards. Now, instead of candy bars and soda, students are rewarded with stickers, pens, or certificates for quality time with the teacher. These are just a few examples of the types of things we have done to encourage healthier nutrition habits among schoolchildren.

CTH Blog:
What did you find in this latest study?

KC:
We set out to develop a system to monitor the junk food brought to eight school campuses in the Healthy ONES schools. We wanted this method to be as objective as possible since much of the research in this area was based on self-reporting, which is not always accurate. We observed and recorded the types of foods and beverages that students, parents, and teachers brought to school campuses over a period of one year before we started the Healthy ONES program and found that nearly 80 percent of all food and beverage items were unhealthy such as high-sugar snacks, baked goods, energy and snack bars, beverages with added sugar, and chips or crackers. We also found that only 14 percent of all items were healthy such as fruits, vegetables, and 100 percent water. This was the trend across all school environments observed including the playground, gym, classroom, and cafeteria. None of the schools studied had outside food vendors or vending machines on premises, so the only sources of this unhealthy food were students, parents, teachers, and other school staff.

CTH Blog:
Were you surprised by these findings?

KC:
Based on my experience I was not surprised by the lack of healthy nutrition options in schools, but I was surprised by the frequency in which children are exposed to junk food. I think that people greatly underestimate the amount of junk food present on school campuses and at special occasions, like end-of-the-month celebrations, birthday parties, and holiday festivities. There are also school-wide assemblies and fundraisers, parent and teacher nights, and many other events where organizers serve junk food. All of the unhealthy foods and beverages served at these events adds up over time. People often think about this as happening every once in a while but in reality, it happens a lot more often.

CTH Blog:
This study is unique in that it uses direct observation by non-school staff to report findings. Why is this important?

KC:
I think that if people really want to assess the environment or the impact of a policy accurately, objectively observing the outcomes is important. Studies that ask people about what is happening in their environment, especially when it comes to healthy behaviors, can sometimes be unreliable, because there may be pressure to report they are doing better than they actually are. Another issue with self-reporting is that staff are often limited to certain areas of the school, such as the classroom or cafeteria, and may not be able to tell us what is happening at school-wide events or fundraisers. As independent researchers, we were able to visit every environment within each school, at any time, and objectively assess the types of foods and beverages present in a methodical way. Conducting a study this way provides us with a better understanding of the extent of the problem.

CTH Blog:
Why focus healthy eating initiatives on the school environment?

KC:
The school environment is important because most kids spend the majority of their day there. We have the opportunity to control these settings and make them as healthy and safe for kids as possible. In addition, public schools have mandates to ensure the well-being and health of their students. The work we are doing here is intended to help school districts realize these goals.

CTH Blog:
What do you hope people take away from this study?

KC:
Up to now, the majority of the work done to change nutrition environments in school settings has focused on the quality of school meals or reducing unhealthy competitive foods sold or in vending machines on campuses. I really hope that as a result of this study, people are more aware that students, parents, teachers, and school staff are a major source of unhealthy items on campuses and that this problem is more prevalent than we think. Although regulating food and beverage items brought to school campuses is a time-intensive task, it engages and educates parents and staff about nutrition while improving what is available during the school day. These efforts may also influence what parents and children eat at home.

CTH Blog:
Tell us a little bit about the other work that Kaiser Permanente is doing in this area.

KC:
One way Kaiser Permanente is working with schools to improve overall health is through an initiative called Thriving Schools.  The program promotes workforce health and student-focused initiatives like improving school lunches and increasing opportunities for physical activity. Kaiser Permanente also recently worked with the San Diego Unified School District to develop a “Breakfast in the Classroom” program. As part of the program, the school sets aside 10 – 15 minutes at the beginning of each day to allow the students to eat their meals. The program also assigns students with various mealtime roles, such as retrieving food from the cafeteria, distributing placemats and food items for the class, and cleaning up.

 

This Week at the CTH: Walking Takes Center Stage

U.S. Surgeon General Regina Benjamin and Deputy U.S. Surgeon General Boris Lushnia speak to people attending the meeting on the Surgeon General's walking initative.  The meeting was held Tuesday at the Center for Total Health in Washington, D.C.

U.S. Surgeon General Regina Benjamin and Deputy U.S. Surgeon General Boris Lushniak speak to people attending the meeting on the Surgeon General’s walking initiative. The meeting was held Tuesday at the Center for Total Health in Washington, D.C.

Deputy Surgeon General Lushniak, Surgeon General Benjamin, and Kaiser Permanente's Bob Sallis, MD, lead the meeting attendees in a midday walk around the center's Every Body Walk! wall.

Deputy Surgeon General Lushniak, Surgeon General Benjamin, and Kaiser Permanente’s Bob Sallis, MD, lead the meeting attendees in a midday walk around the center’s Every Body Walk! wall.

What Research is Telling Us About the State of HIV/AIDS in the United States: Interview with Expert Michael Horberg, MD

Michael Horberg, MD

Michael Horberg, MD

Kaiser Permanente recently hosted the 8th Annual HIV/AIDS, Hepatitis, and STI Conference. The event brought together physicians, advanced practice providers, research scientists, and other care providers, offering a constructive atmosphere for exchanging ideas, learning from national experts, and networking with colleagues from across the nation. For insight into the conference, we spoke with Michael Horberg, MD, national director for HIV/AIDS at Kaiser Permanente and member of the Presidential Advisory Council on HIV/AIDS.

 

CTH Blog:
Tell us about the 8th Annual HIV/AIDS, Hepatitis, and STI Conference you recently hosted.

Michael Horberg:
The goal of the conference has always been to bring together physicians, nurses, pharmacists, allied health professionals, and researchers to determine the latest knowledge and best practices in HIV/AIDS and hepatitis. We want to gather all of the people involved in HIV/AIDS care and share our best knowledge and practices.

The idea is to promote the key areas of learning in these fields: new knowledge and new medications for hepatitis; how to care for lesbian, gay, bisexual, and transgender patients; and new aspects of quality HIV, hepatitis, and sexually transmitted diseases care. Most importantly, we wanted to continue developing the Kaiser Permanente community of committed HIV and hepatitis care teams and community providers.

CTH Blog:
You presented a research study at the conference on the “HIV Engagement Cascade,” with participation of many of the HIV clinical and research leaders in Kaiser Permanente.  I understand this was presented earlier this year at the very important Conference on Retroviruses and Opportunistic Infections.  Can you give us some background for those unfamiliar with that concept?

MH:

For a while now, we’ve known that antiretroviral therapy (ART) can significantly improve health outcomes for people living with HIV. We consider ART to be successful when it reduces the viral load of a person living with HIV to undetectable levels. For years, clinical research has shown that people who have undetectable viral load in their blood are more likely to live long and healthy lives and are less likely to pass the virus on to others.

The CDC developed a standardized care order for how HIV care proceeds from diagnosis to ART success. It’s a series of steps or an engagement “cascade”:

1)    HIV diagnosis
2)    Linkage to HIV care
3)    Retention in care after diagnosis
4)    Prescription of ART
5)    Reaching an undetectable viral load

Each of these steps presents a challenge to an HIV-positive person and to the health workers who try to guide them through consistent care. One particular challenge for HIV-positive individuals is Read More

Talking Code-A-Thons with Kaiser Permanente’s Madhu Nutakki

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At the Code-A-Thon this week, we spent a few minutes with Madhu Nutakki, vice president for digital presence technologies at Kaiser Permanente.  Nutakki shared insight about the event and what KP’s new open API, Interchange, means in the short and long term.

CTH Blog:
So tell us about this Code-A-Thon event.  What is it about?

Madhu Nutakki:
Today at the Center for Total Health in beautiful Washington, D.C., we’re holding a Code-A-Thon built around Interchange – an API that Kaiser Permanente EVP and CIO Phil Fasano announced Monday at Health Datapalooza.  Interchange is going to start enabling innovation not just within KP, but also outside of our four walls.  We feel that’s the way to expand our footprint and applications for our consumers, and we can do it in a way that’s secure and private.  With it, our consumers can get much better user experiences built for them.

CTH Blog:
So who are the people participating in this Code-A-Thon, and what will they be doing over the 36 hour-long event?

MN:
We’re fortunate to host about 80 people here, both internal and external to KP.  We have about 10 physicians that are going to help us out, we have 20 people we refer to as catalysts, and we have 40 developers here.

The physicians are going to be focused on something called iThrive, which is about wellness and how we as consumers at Kaiser Permanente can better manage our total health.  The physicians will help us think through what those options are.

The catalysts serve as product managers, in a way.  They’ll enable us to build out these applications, think about what functionality we should have in them, and invigorate the teams.

The developers are the most important people in this room.  They’ll be working on this for 36 hours, and they’ll be building out these applications.

It’s a fun-filled event, and many of these people will work through the night.  We have Thrive breaks scheduled throughout the 36 hours to keep people feeling good.  We also have a midnight “Zombie’s Run,” for two miles, so anybody that’s interested can join us.  We’ll have a judging session at the end of the event where we’ll pick the top applications in eight different categories.

CTH Blog:
What do you find so valuable about Code-A-Thons?

MN:
Code-A-Thons are an extreme way to trigger innovation.  Typically, software development is a long, drawn-out process, taking months to a year.  A Code-A-Thon brings everybody who is interested in a concept together.  When you have people together, ideas flow much more freely.  And because they are co-located with the developers, any changes they want to make can happen that much more quickly.  So the product that comes out of a Code-A-Thon is that much more thought through and that much more reliable.

CTH Blog:
What do you see as the future for Interchange – beyond just apps benefitting Kaiser Permanente?

MN:
When we thought about Interchange, we thought about it very much as Kaiser Permanente’s contribution to the community.  API is a new concept for health care.  If you look at the retail market, Netflix and others have done it very well.  Our foray into this space will hopefully trigger innovation in general in health IT.

At the end of the day, Interchange has three purposes:  One is for consumers or KP members – hopefully they’ll get a better user experience by apps that are developed both internally and externally.  Second is for developers – developers now get access to our public data, and hopefully they can build interfaces from that.  And third is for Kaiser Permanente – we can expand our app portfolio that much more quickly.

 

Code-A-Thon Now Underway at the Center for Total Health

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For the next 36 hours straight, about 80 designers, programmers, and health care professionals will be working — pretty much non-stop — at the Center for Total Health. It’s a Code-A-Thon, and this time, participants will be focused on using Kaiser Permanente’s just-announced open API, Interchange. Currently, Interchange includes information on Kaiser Permanente’s public facility information and locations.

We snapped a few photos as the event got underway. More to come! And to follow the code-a-thon happenings on Twitter, check out hash tag #kpinterchange, or follow @kpdigitalhealth.

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