Tapping the Power and Potential of Technology Together

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Digital technology is revolutionizing our world in ways we are only beginning to realize. Recently Kaiser Permanente Chairman and CEO Bernard J. Tyson joined other CEOs and global leaders to welcome the World Economic Forum’s Center for the Fourth Industrial Revolution to San Francisco — a fitting location for a global center committed to ensuring that advances in technology, science and medicine serve humanity and foster the universally held values of equality, connectedness and peace.

World-Economic-Forum-feature-274x168As a founding partner of the center, Kaiser Permanente will actively use this platform to collaborate with policymakers, technology leaders, influencers and others to tap the power and potential of technology to transform health care. Specifically, we will explore opportunities related to such things as artificial intelligence, the internet of things, precision medicine, data sharing and ownership, etc., while also working to resolve the ethical and practical concerns these advances in science and technology create.

Watch the video introducing the Center for the Fourth Industrial Revolution.

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Taking Bids on Hospital of the Future

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garfieldAs Silicon Valley’s main hospital system and insurer, KP has been working with tech companies to respond to patient demands, and supply what the organization envisions it may need in the near future. Much of the testing is happening at the Garfield Innovation Center in San Leandro, California.

Kaiser Permanente Chairman and CEO Bernard J. Tyson sat down with Bloomberg Businessweek writer Caroline Chen to talk about the hospital of the future.

Read the Bloomberg story here. 

Virtual Care Lets Physicians Provide Care Anytime, Anywhere

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The world of health care is changing. Telehealth options such as video visits, phone visits, and email consultations are growing in popularity. Today, out of more than 100 million encounters with Kaiser Permanente members, more than 50 percent occur over phone, email or video.

Video visits in particular are quickly becoming a popular method among members for handling routine, nonurgent care.

Kaiser Permanente introduced video visit technology in 2014. Today, our members and their care providers have the ability to complete appointments from anywhere, at any time. (Appointment types and availability, and how they can be scheduled, currently vary by region — but we are improving our virtual offerings every day).

videovisitBecause doctors have access to members’ electronic medical record, they are connected to a complete picture of their health. The video visit details are then documented in the patients’ medical records for future reference.

According to a recent study by Kaiser Permanente’s market research team, members:

  • like video visits and see convenience and time-savings as key benefits
  • prefer video visits over telephone visits
  • believe video visits are most appropriate for minor ailments
  • expect discussions with doctors to be more limited in scope compared to an office visit

Snapshot: Colorado

For Jan Ground, director of virtual care for Kaiser Permanente in Colorado, the mission is clear: “We have to meet members where they want to consume services.”

The goal in Colorado, Ground says, is to provide Kaiser Permanente members with video visits with their own doctor, no matter the department or specialty. Depending on demand and schedules, it can sometimes take few days to schedule an in-person appointment that works for the member and care provider, but with video visits, appointments are available within 24 hours — and sometimes as soon as one hour from scheduling.

This flexibility benefits all concerned: Video visitors receive more immediate attention, and physicians can see those who prefer in-person appointments much sooner. Plus, care providers are generally able to see a patient’s home environment and take that into account when creating a care plan.

Of course, video visits aren’t the only way KP physicians in Colorado provide care virtually — they offer phone visits, online chat consultations, and e-visits, in which patients with common and minor ailments, such as sinus issues or stomach problems, can fill out a questionnaire and receive advice based on their answers.

Without doubt, the trend toward virtual care will continue. And with the ongoing improvements Kaiser Permanente is making to kp.org and our mobile app, it will be even easier for our members to access care, when, where, and how they want it.

The Future of Care Delivery

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You walk in, verify at a kiosk that you’ve already checked in and paid, plug in your laptop at the charging station, and soon get a text that it’s your turn. No — you’re not at Starbucks — you’re at Kaiser Permanente’s new Signal Hill Medical Office in Southern California for your medical appointment.

Signal HillSignal Hill exemplifies Kaiser Permanente’s most recent effort of evolving its care model to better integrate into members’ lives.

“Granddad’s medical office building doesn’t cut it anymore,” said Don Orndoff, senior vice president, National Facilities Services.  “We’ve all now become accustomed to the Amazon and Uber experience and that’s our new expectation.”

The medical office of the future at Kaiser Permanente means harnessing design, technology and workflow to create an intuitive and convenient experience for members and care teams. It also means developing a much more agile and flexible environment that meets the evolving technology and service needs of those increasingly tech-savvy members and care teams.

Convenience and care under one roof

Signal Hill opened to Kaiser Permanente members on June 29, 2016, and its sleek architectural design doesn’t disappoint. But it’s the convenient technology features and efficient spaces inside that really impress. When you walk inside the building, you enter into the “public square.”

Since members have the option of checking in and handling their copayments at home, a quick visit to the kiosk allows them to take advantage of a number of options available to them in the public square. They can engage with others at the community table or use computers at the docking station. Or, they can decompress in a quiet spot on the upstairs “porch.” In fact, members can use their time wherever they wish because once the provider is ready, the member will receive a text message.

At the pharmacy, there is also no need to wait around. You’ll receive a text when your medication is ready.

signalhill2The exam rooms don’t look traditional either. Instead of the long, awkward exam table and steel chairs, there’s a comfortable reclining chair and a couch for family seating. The care team also uses hand-held tablets, which is not only easier for them, but avoids having the member stare at the back of a big computer monitor. On the wall, there’s a large monitor for virtual visits or patient education programs.

Read more of this story here. 

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.

michael kanter md

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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nirav shah

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.