An Uncomfortable Truth: Screening for Colorectal Cancer Can Prevent a Deadly Disease

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March is coming to a close, and with it, Colorectal Cancer Awareness Month. But when the clock strikes midnight on the 31st, we shouldn’t lose sight of the devastation that colorectal cancer can cause. A new story from the Kaiser Permanente Institute for Health Policy explores Kaiser Permanente’s journey towards improving screening rates, and outlines what it will take for the nation to do the same.

Colorectal cancer is the third most common cancer in America and the second leading cause of cancer-related deaths, with an estimated 49,700 Americans who may lose their lives to the disease in 2015. The good news is that it is highly treatable if caught early; up to 80 percent of deaths can be prevented if everyone over 50 receives a recommended screening. The bad news is that many people — about a third of all Americans and even more in certain racial or ethnic groups, such as Latinos — still aren’t getting screened.

Over the past 10 years, Kaiser Permanente has been leading the charge to improve colorectal cancer screening rates and reduce deaths due to the disease. By reminding people to get screened at every point of care, improving access to the Fecal Immunochemical Test (an easy, home-based colorectal cancer test) and focusing on disparities, Kaiser Permanente has nearly doubled screening rates — from 43 percent in 2004 to 82 percent in 2013.

If you are over 50 or at risk of colorectal cancer, please remember to get screened. And check out the Institute for Health Policy story for more information.

Exercise is the New Vital Sign!

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Since the dawn of the doctor’s visit, taking vital signs has been a mainstay. Height, weight, temperature, heart rate, blood pressure. It’s a routine process that we participate in almost without thinking.

But at Kaiser Permanente, after the blood pressure cuff comes off, you’ll get questions that might surprise you: how many days a week do you exercise moderately or strenuously? How many minutes a day do you exercise at this level?

Come again? At first thought, asking about physical activity levels might seem unorthodox. Unlike other vital signs, it’s measuring a behavior, not a body part. But conventional thinking about health and health care has changed, and systems like Kaiser Permanente recognize that addressing personal behavior and lifestyle is just as important as addressing biology.

A new KP Policy Story from Benjamin Wheatley of the Kaiser Permanente Institute for Health Policy highlights our “Exercise as a Vital Sign” (EVS) initiative. Since 2009, Kaiser Permanente providers have asked patients about their exercise habits during routine office visits. Taking this “vital sign” encourages ongoing conversations between patients and providers about physical activity, and serves as a gateway for referring patients to activities such as yoga, Zumba classes or hiking clubs. Recent research shows positive results of the EVS initiative: in 2013, we found that asking about exercise habits is associated with modest weight loss in overweight patients and improved glucose control among diabetics.

You can read the story in its entirety at the Institute for Health Policy site.

What is a ‘wired’ hospital — and what does it mean for patients?

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Today’s post is authored by guest blogger Samantha DuPont, with the Kaiser Permanente Institute for Health Policy.

For the second year in a row, Kaiser Permanente’s California hospitals have been named “Health Care’s Most Wired” by Hospitals & Health Networks magazine. The honor recognizes our excellence in technology integration across the health care spectrum — infrastructure, procurement, human resources, security, clinical quality and safety, patient access, care continuum and health information exchange.

Kaiser Permanente has long been recognized as a leader in using technology to deliver high quality care. By 1970, we had implemented an electronic health record (EHR) for over 1 million patients. Today, our EHR, Kaiser Permanente HealthConnect®, connects 9.3 million members to their providers, and is one of the most advanced in the nation. By integrating comprehensive patient data, best practice research, treatment recommendations and other provider tools in one record, KP HealthConnect® ensures that patients receive the best care at every encounter.

We were also an early adopter of online health services for patients, as chronicled in an informative Kaiser Permanente Institute for Health Policy Story. In 1996 we began offering online prescription refills and appointment scheduling. Since then, our patient portal, My Health Manager, has grown a bevy of features, allowing patients to:

• view personal health information, including lab results, immunizations, past office visits,
• prescriptions, allergies, and health conditions;
• view, schedule, or cancel appointments;
• refill prescriptions;
• securely email doctors, pharmacists, and member services staff;
• take health assessments and programs that support healthy lifestyle changes and find information about health topics; and,
• manage health benefits, including viewing drug formularies and estimating the cost of treatments.

As of 2014, more than 4.4 million members are registered for My Health Manager on kp.org, nearly double the number in 2008. To learn more about how we’ve achieved success in getting patients online – and how that has improved health outcomes – read, “Engaging Patients Online with My Health Manager.”

Weighing in on the Impact of Obesity Interventions

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Measuring obesity in an individual person is relatively simple: get out the tape measure, step on the scale, calculate body mass index.

Measuring the impact of interventions that aim to reduce rates of obesity? Not so easy.

For all the attention directed toward combating the obesity epidemic in the United States, policymakers, researchers, advocates, and public health practitioners struggle to develop and agree upon measures that indicate whether a particular intervention is working, and even more, whether it is scalable and generalizable.

Compounding this issue is that different stakeholders have different evidence needs. Some are not convinced that an intervention is working unless they see rigorous data collected from a randomized controlled trial – considered to be the “gold standard.” Others may set the bar lower, knowing that we may never get perfect evidence, because obesity prevention involves a complex web of social, economic, environmental and behavioral factors.

These were some of the issues raised in a session at AcademyHealth’s 2014 National Health Policy Conference titled, “Obesity Prevention: How Much Evidence Do We Need to Act?”

In this session, a diverse set of stakeholders – Jeff Levi, Executive Director, Trust for America’s Health; Bill Hoagland, Senior Vice President, Bipartisan Policy Center; Linda Belheimer, Assistant Director of Health and Human Resources, Congressional Budget Office; and Shiriki Kumanyika, Professor, University of Pennsylvania Perelman School of Medicine –– discussed the myriad of issues surrounding obesity prevention measurement, and offered some clear steps for moving forward.

“There was strong agreement that the obesity epidemic is real and that we need to be thinking about how to address it,” said panel moderator Murray Ross, vice president, Kaiser Permanente, and director, Institute for Health Policy. “”It will have–and is already having–major implications for Americans’ health and America’s health care spending.”

In this short clip, Ross gives us the highlights of this important and timely conversation.

Note: Panelist Linda Bilheimer’s comments are not included in this video, but you can view her full presentation slides online.