New resource to help identify and address social and non-medical needs

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Today marks the launch of the Social Interventions Research & Evaluation Network (SIREN) website, a new resource for health services researchers, clinicians, health system leaders, and others looking for evidence on what works to identify and address patients’ social and economic needs as a part of high quality health care.

Use the SIREN website to:

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On the site you’ll also see they are accepting applications for SIREN’s Innovation Grants. The Robert Wood Johnson Foundation and Kaiser Permanente have teamed up with SIREN to support a small number of research projects to advance our understanding of the health care costs and utilization impacts of addressing patients’ social determinants of health. Grants will provide up to $150,000 total funding over two years.

Letters of Intent are due May 15, 2017 and full applications are due June 15, 2017.

SIREN’s mission is to catalyze and disseminate high quality research that advances efforts to address patients’ social and economic needs in health care settings. Learn more here.

 

What’s the Outdoor Industry’s Role in Healthcare Reform?

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What’s the Outdoor Industry’s Role in Healthcare Reform?

An article recently published by RootRated.com, explores what efforts have been made to define the outdoor industry’s role in health care reform.

The article highlights how Kaiser Permanente is a leader in integrating health care with outdoor activity:

“We believe being outdoors is critically important for good health,” says Dr. Jennifer Bass, a pediatrician with Kaiser in Portland, Oregon. She says Kaiser Permanente’s practitioners treat “exercise as a vital sign.”

But it’s not just about numbers: the physical setting for exercise is key. “There are benefits of outdoor [activities] versus indoor,” says Bass, noting that outdoor runners enjoy health benefits that treadmill users do not, and the former are more likely to continue with the activity in the longer term.

Launched in 2011, Kaiser’s Rx Play program in Portland is “a partnership between the healthcare system and the recreation department,” says Bass. The doctor writes a prescription for activity, and the patient gets a copy, as does the appropriate rec center, and an advocate places an outreach call to foster participation.

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“They’ve had great success getting people in,” says Bass. “Having a navigator to help families through the system is a critical part of the program.”

Messaging and marketing are also important. “Raising awareness is the first step,” says Bass. “Kaiser is in definitely in that phase.”

Now focused on kids in the city, Rx Play is being revised to focus on outdoor activities in a broader geographic region, with an all-ages goal. There’s a solid business case for the expansion. “We know there are cost savings,” says Bass. “It’s really about preventing and delaying chronic illnesses.”

Read more of this article here.

Germ-free flying

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It’s Spring Break and you’re about to board a metal tube flying 40,000 feet above the ground at 575 mph, and you’re feeling a bit nervous. The good news is that you can stop worrying — flying remains one of the safest forms of travel out there.

The bad news: Disease-causing germs love aircraft.

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For more information and tips on how to fly germ-free, read the full article here.

You can also download an infographic to share with others:

Infographic Text: Germ-Free Flying

When Conventional Wisdom Becomes Outdated: How new perioperative guidelines can save time, pain, and cost

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Maurice Cates, MD, is an Orthopedic Surgeon at Kaiser Permanente’s Fredrick Medical Center. He is the chief of orthopedic surgery for the District of Columbia and Suburban Maryland as well as the regional medical director for musculoskeletal service.

Surgery has been around for thousands of years. The advances in technique, pain management, and outcomes have been remarkable. Since the advent of modern anesthesia, one thing has stayed pretty consistent; those dreaded pre-operative instructions not eat or drink anything after midnight the day of your surgery. Here is to hoping you’re scheduled in the morning, right?

qem2The thing about those instructions is that they may not be helping – especially in several types of cases, one of which is total joint replacement. While improvements in minimally invasive techniques have helped reduce length of stay for something like a knee replacement from well over a week to about 3.4 days in the past couple of decades, our work at the Mid-Atlantic Permanente Medical Group (MAPMG) is validating that it could be as short as 1-2 days in most cases. Several cases are achieving “same day discharge” and we have even completed a total knee replacement in our free standing ambulatory surgery center where the patient had no need to be admitted to a hospital at all.

One in 25 adults over 50 in America lives with a knee replacement. With that kind of volume, cutting length of stay by some 2 days per case, and potentially moving cases from hospitals to ambulatory surgery centers, could deliver a tremendous cost savings for American health care with no detriment to quality. To get there, more physician practices and hospitals need to embrace the mantra of evidence-based medicine and examine how to safely apply ERAS®, as MAPMG does, to its joint cases.

ERAS stands for Enhanced Recovery After Surgery. It represents a shift in care involving all aspects of the patient’s journey through the surgical process, from preoperative care through recovery. The whole idea is to reduce surgical stress and disruption to a patient’s baseline physiology. ERAS protocols, in brief, focus on: (1) allowing the patient to have liquids prior to surgery, (2) narcotic pain medicines are minimized (we use intravenous acetaminophen instead), and (3) eating and walking/ambulation as soon as possible after surgery. Implementation requires thoughtful development of end-to-end care pathways, decision trees, and detailed post-operative outcome measurements. Doctors, support staff, and administrators must be invested in patient-centric care, and having a cadre of talented surgeons helps too – just the ingredients we have at Kaiser Permanente.

Medical evidence in the modern world of health care is an ever-growing body of knowledge. The more organizations continuously look to new studies and those producing the best outcomes (even if it comes from outside the United States, as ERAS initially did), the more people can receive the best care possible. After all, who wants to lie in a hospital bed for 3-plus days when there is the possibility of going home the same or next day? Our patient satisfaction data bump for those having surgery with ERAS and getting early discharge versus the traditional approach suggests the answer is nearly no one.

Taking Predictive Analytics to the Next Level

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Using Predictive Analytics in health care holds huge promise for improving care quality and outcomes for patients.

This type of data science can help care teams and hospital systems manage population care for chronic conditions, proactively identify patients at risk for disease, infection or hospital readmission, and observe trends in quality and outcomes. There is no shortage of information; the tough part is making the information actionable and knowing in advance what you are going to do with it, such as having a care management team in place to receive and take action on the data.

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Kaiser Permanente has been using predictive analytics for years, leveraging our robust electronic health record, integrated systems and coordinated care teams. Two articles, Taking Predictive Analytics to the Next Level and How Predictive Analytics Can Help Prevent Infection describe the challenges and opportunities for working with this type of data, and ways it is currently used at Kaiser Permanente and other institutions to identify and target patients at risk for preventable events such as hospital readmissions and central line infections.

(Photo:Michael Kanter, M.D)

The tough part of predictive analytics is making the information actionable, says Michael Kanter, M.D., executive vice president of quality and chief quality officer of the Oakland, Calif.-based Permanente Federation.

To learn more about predictive analytics, check out the following links:

Taking Predictive Analytics to the Next Leveland How Predictive Analytics Can Help Prevent Infection

Hospitals target nutrition, other social needs to boost health

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Kaiser Permanente’s Nirav Shah, MD, MPH, spoke with USA Today about the social determinants of health, and shared some of Kaiser Permanente’s efforts to improve the health of its members most in need.

Dr. Shah, a former New York state commissioner of health, is senior vice president and chief operating officer for clinical operations for Kaiser Permanente Southern California.

In Southern California, Dr. Shah is working with the non-profit Health Leads to “fundamentally redefine what counts as health care” by helping to coordinate social needs hospitals don’t typically focus upon.

To read the full story, click here.

Healthy Meeting’s Tip – Red Wine & Chocolate Bites

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According to The Heart Foundation, February has been designated at Heart Health Month. Heart disease is the leading cause of death for both ment and women in the United States.  The good news?  It is also one of the most preventable.  Making heart-healthy choices, knowing your family health history and the risk factors for heart disease, having regular check-ups and working with your physician to manage your health are all integral aspect of saving lives for this silent killer. Reinforcing healthy behaviors is possible when organizing important business meetings and events.

At the Center for Total Health, we work with groups think about every aspect of their meetings and how to incorporate more positive choices in their planning.  For example, at dinner events, people often expect heavy desserts loaded with fats and sugars. A simple way to satisfy the taste buds is to add a red wine and dark chocolate dessert bar.  For our guests, a sommilier from our caterer can prepare matching red wines with varying degrees of dark cocoa bites.  One ounce tastings of various wines are offered and small bites of chocolate are paired.  Guests leave informed with not only the facts about new wines or chocolates but are reminded that — in moderation – red wine and chocolate is healthy for your heart.  For more information on suggested healthy food menus, check out our healthy meetings page on this website.  For a sample menu, check out this information card provided to guests: KP CTH Red Wine Chocolate Menu

 

What Women Need to Know About Heart Disease

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A stomach ache, jaw pain, fatigue.

Each symptom on its own may not prompt a woman to call her doctor. But combined, they could signal that a woman is having a heart attack.

There’s a myth that heart disease is a “man’s disease,” but the statistics tell a different story. The American Heart Association reports 44 million women in the United States are affected by heart disease, and heart disease and stroke kill approximately one woman every 80 seconds.

Peter Miles, MD, regional chair of the chiefs of cardiology for Kaiser Permanente Northern California, answers questions about what women need to know about heart disease and the steps everyone can take to maintain a healthy heart.

Peter Miles, MD

Peter Miles, MD

How serious is heart disease for women?

Heart disease is the leading cause of death among American women. In fact, heart disease kills more women than men, but 4 out of 5 women don’t know that.

How do heart attack symptoms differ between men and women?

Chest pain is the most common heart attack symptom, but it is not the only one. Women often experience different symptoms than men, and it’s not always the dramatic, crushing chest pain you may see on TV.

Women may feel a burning or numbness that can radiate to the back or shoulders. Because women’s symptoms can differ from men’s, it can be easy for women to think their symptoms aren’t serious. The more symptoms a woman experiences, the more likely it is that she is having a heart attack.

If pain or discomfort lasts more than 5 minutes, isn’t relieved by lying down, and travels through the back, shoulder, neck, or jaw, it’s important to get medical treatment right away. Getting treatment quickly can lower the amount of heart muscle that’s damaged.

Women who are busy with family and work responsibilities may ignore the first signs of a heart attack. They may be preoccupied with taking care of others and may ignore their own health needs. But it’s important to change that trend. We can do that with education and information.

How can women and men reduce their risk of heart attack and heart disease?

To take care of your heart, you need to take care of the whole you. Eat heart-healthy foods like fruits, vegetables, healthy proteins (such as fish, beans, chicken, nuts, and low-fat dairy), and whole grains to help keep your heart and blood vessels in good shape.

If you drink alcohol, drink it in moderation. Women should limit alcohol to no more than one drink a day.

We recommend 150 minutes of moderate exercise a week or at least 30 minutes of exercise on most days. If you can’t do all 30 minutes at once, do 10 minutes at a time. Brisk walking, swimming, or cycling are all good for the heart.

Lowering your weight by just 10 percent can also make a significant difference in reducing your risk for heart disease, and so can lowering your stress. Anger, anxiety, and depression may keep your blood pressure high and increase your risk for heart attack, stroke, and other illnesses. Try meditation, yoga, and breathing exercises to help control the stress in your life.

Finally, if you smoke, it’s time to quit. Talk to your doctor about resources such as medication and classes to help you kick the habit.

Visit www.kp.org/heart for more about the signs and symptoms of heart attacks and heart disease. To learn more about KP’s efforts to eliminate disparities in care, visit the Center for Total Health by scheduling a tour and submit a tour request form.

Consumer Driven Models can Transform Care

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Healthcare IT News interviewed Kaiser Permanente CIO Dick Daniels and he shared his perspective on Kaiser Permanente’s holistic model and the value of the consumer in the care equation.

“Consumer expectations and needs are a primary consideration for everything we do,” Daniels said. “We believe that individuals need to have access to information and services in ways that are welcoming and convenient to them in order to manage their health effectively. We consider all aspects, including how patients experience the selection of the health plan that best meets their needs, the care they receive when they come to one of our facilities, and the access they have to care from wherever they may be.”

Daniels will present “Transforming Care Through a Consumer-Driven Model” at HIMSS 17, running from February 19-23, 2017.

To read the full story, click here.

Defining Success In Resolving Health-Related Social Needs

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A recent Health Affairs blog offers a perspective on the challenges of addressing the social needs of patients – particularly when the health care system at large doesn’t have common language to describe what a successful intervention might look like. Programs such as Kaiser Permanente’s Total Health initiative and CMS’ Accountable Health Community model screen participants for unmet social needs, yet there is lack of clear definition as to how the community – or delivery system – should be accountable for resolving these needs. This will continue to be a complex area for exploration as health care increasingly moves outside of the exam room into the community, and as we continue to look at how factors such as where our patients live, work, play and pray impact their overall health.

Read the blog here