The Healthcare Anchor Network adds new members

by

This week, the Healthcare Anchor Network officially launched and expanded its membership to include: Adventist Health, Christiana Care Health System, Cleveland Clinic, Fairview Health Services, Presbyterian Healthcare Services, and VCU Health. The meeting represents the typical kind of convenings that take place at the center every day. At the center, we are dedicated to sharing, developing and accelerating ideas that improve total health around the world. If you are looking for an innovative space to hold your next convening, simply complete an event request form on our website.

For more information on the Healthcare Anchor Network meetings, click here. For more information on how to join the network, contact the Democracy Collaborative.

Here’s What Happened in May at the Center

by


If you haven’t visited the Center for Total Health recently, May was a busy month with events covering a wide range of topics and initiatives. In addition to hosting robust discussions about preventing violence, preventing and treating cancer, and creating innovative, healthy workplaces, we also had the opportunity to celebrate National Nurses Week (May 6-12) with leaders from the American Nurses Foundation. We not only welcomed this organization to the Center, but also showcased onsite displays that bring to life nursing leadership and communicate our appreciation for the difference nurses make in patients’ lives.

  • We welcomed the National Health Collaborative on Violence and Abuse (NHCVA) – including representatives from more than 30 health professional organizations – to discuss ways to reduce and address the health consequences of intimate partner violence (IPV) and abuse. Our very own Brigid McCaw, MD, represented Kaiser Permanente’s Family Violence Prevention Program, highlighting the crucial role health care play in caring for victims.
  • DC’s Colorectal Cancer Roundtable Summit brought local and national providers, advocates and educators to the Center to discuss the prevention and early detection of colorectal cancer and ways to improve screening rates to 80% by 2018 – a lifesaving goal set by the National Colorectal Cancer Roundtable. Joseph Territo, MD, of the Mid-Atlantic Permanente Medical Group, shared how Kaiser Permanente consistently ranks in the top 10% of the National Committee for Quality Assurance (NCQA) HEDIS Measures, which assess the number of adults who have had appropriate screening for colorectal cancer. NCQA data is also featured throughout the Center’s onsite displays.
  • The Center hosted the third annual Better Together event, All Systems Go! Closing the Gaps in Cancer Care, with the American Cancer Society and the Council for Accountable Physician Practices. The event highlighted patient stories, representing how coverage and accountable healthcare systems can improve survival and reduce morbidity for people living with complex conditions like cancer.
  • We hosted the Network for Excellence in Health Innovation (NEHI) and challenged attendees to think about Health Care Without Walls, a mind-shift to caring for patients outside of conventional institutional settings. To help get the conversation started, the center’s staff presented “Imaging Care Anywhere,” an example of our own provocation used with staff to think about the next generation of care for Kaiser Permanente members.
  • CoreNet Global’s Mid-Atlantic Chapter turned to Center to host an educational event focused on The Healthy Workplace, highlighting the subtle nudges that can be built into our work environments to drive healthier behaviors. Architects, designers, facility managers and other professionals learned how improving the health and wellbeing of employees through facility design can improve an organization’s bottom line, and also toured the Center’s interactive space to see the learnings come to life.

During the month, the Center also hosted meetings on improving prenatal conversations, credentialing of community health workers, and increasing the quality of ambulatory services, and welcomed a wide range of students, health care leaders, government employees and medical professionals for tours of our interactive and educational facility.

Supporting Healthy Communities through Collaboration: The Healthcare Anchor Network

by and

Supporting Healthy Communities through Collaboration: The Healthcare Anchor Network

Last December, 40 health systems gathered at the Kaiser Permanente Center for Total Health in Washington DC, to explore together how we can advance thriving, inclusive economies in the communities we serve across the country. This week, we’ll gather again to officially launch the Healthcare Anchor Network.

This collaboration represents a critical milestone in mobilizing our sector towards action and collaboration, and we are so proud to be a founding member.

Other founders include Advocate Health Care, Catholic Health Initiatives, Dignity Health, Henry Ford Health System, ProMedica, Providence St. Joseph Health, RWJBarnabas Health, UMass Memorial Health Care, Rush University Medical Center and Trinity Health.

And the Network continues to grow – new members include Adventist Health System, Bon Secours Health System, Children’s Hospital of Philadelphia, Christiana Care Health System, Cleveland Clinic, Dartmouth-Hitchcock, Gundersen Health System, HealthEast Care System, Mercy Health, Northwell Health, Our Lady of the Lake Regional Medical Center, Partners Healthcare (Massachusetts General Hospital and Brigham and Women’s), Presbyterian Healthcare Services, Presence Health, Seattle Children’s Hospital, UC San Francisco and VCU Health.

The lessons from the December meeting, and the vision of the Healthcare Anchor Network are presented in a report produced in partnership with the Democracy Collaborative and the founding members of the Network. The report reflects our collective voice calling our sector to action. It also provides useful examples and tools, to help health systems across the country become familiar with the policies and practices they might adopt to more intentionally support inclusive economic development in their communities. The examples and tools (produced with support from the Robert Wood Johnson Foundation) focus in particular on how healthcare providers can hire, buy goods and services, and invest capital in ways which benefit communities and residents most effectively.

These efforts are not easy—at Kaiser Permanente, we are working day-by-day to overcome the obstacles to adopting an anchor approach cross-functionally across our organization. We believe that our individual and collective journey in this important work will be greatly improved and our positive impacts amplified, if we work together.

The new Healthcare Anchor Network will convene health systems in order to share best practices, address common challenges, and identify areas where collaborative efforts may be possible. Our initial efforts will focus around:

1.     Making the case for adopting an anchor strategy;

2.     Effective collaboration with community stakeholders in these efforts;

3.     Shifting incentives to reward upstream health investments;

4.     Aligning approaches for scale;

5.     Building evidence of impact; and,

6.     Developing a shared policy agenda around addressing upstream determinants of health.

The Center for Total Health—an interactive learning destination committed to supporting innovation in how healthcare is delivered and experienced—provides the perfect venue for these conversations. We’re looking forward to gathering again at the Center this week to continue advancing healthcare sector innovation and collaboration for inclusive, thriving communities. We hope you and your health system will join us!

To learn more about the Healthcare Anchor Network, including how to join, contact David Zuckerman at the Democracy Collaborative, dave@democracycollaborative.org.

The Center for Total Health hosts third-annual Better Together Health

by

From left to right: Jayne O’Donnell (Moderator), Laura Seeff, MD, Alan Balch, PhD, John Bulger, DO, Michael Kanter, MD

 

On May 24, the Kaiser Permanente Center for Total Health hosted All Systems Go! Closing the Gaps in Cancer Care, the third-annual Better Together Health event, led by the American Cancer Society (ACS) and the Council for Accountable Physician Practices (CAPP). The event highlighted patient stories, representing how coverage and accountable healthcare systems can improve survival and reduce morbidity for people living with complex conditions like cancer.

Laura Fegraus, Executive Director of CAPP led opening remarks with an overview of the state of cancer care in America. She presented research on what physicians and patients value, with evidence-based medicine, doctor-patient relationships, and care coordination topping each list. “Patients aren’t getting what they need,” she says, stressing the importance of coordinated care. “We are not there yet, and that’s why we’re here today.”

Robert Pearl, MD, Chair of CAPP (@RobertPearlMD), provided contextual framework for the event’s discussion of gaps in American health care, citing his recently published book, Mistreated: Why We Think We’re Getting Good Health Care—and Why We’re Usually Wrong. “If we cannot lower the cost increase [in health care] and do it through better quality, coordination, technology and leadership, the system will get disrupted. This is the time to change.”

Danielle Carnival, PhD, Deputy Director of the Biden Foundation’s Cancer Initiative provided a sense of hope, urgency, and change in the approach to cancer care by encouraging partnerships. Discussing racial and socioeconomic disparities, she stated: “Culturally appropriate cancer outreach efforts are needed to reach people where they are.” Dr. Carnival alluded to Cancer Moonshot in the goals of The Biden Foundation’s Cancer Initiative, which she says will “break down silos that stand as barriers for patients.”

After viewing two patient stories: Hunter’s of Geisinger Health System and Daria’s of Kaiser Permanente, Jayne O’Donnell of USA Today moderated a panel discussion featuring Alan Balch, PhD, CEO of the Patient Advocate Foundation, John Bulger, MD, Chief Medical Officer for Population Health, Geisinger Health System, Michael Kanter, MD, Medical Director of Quality and Clinical Analysis, Southern California Permanente Medical Group, and Laura Seeff, MD, Director of the Office of Health Systems Collaboration, CDC.

Dr. Kanter said the detection of residual cancer in Daria’s case and so many others is “the obligation of every [PMG] physician to look at the whole patient.” In the case of barriers for change in the current health care system, he said, “There’s issues of will and physician leadership.” Dr. Bulger agreed that “physicians need to coordinate care, rather than work against each other.”

Addressing a lack of data use, Dr. Balch called on physicians to harness data. “Data creates evidence to drive action, linking science to prevention,” Dr. Seeff said. Referring to the researchable data on preventable cancer deaths, Richard Wender, MD, Chief Cancer Control Officer, ACS, stated an increase in survival rates requires “a need to invest in a disproportionate way what is proven to work.”

Dr. Seeff reminded that in “cancer survivorship, it’s key to remember the human element.” There are several factors blocking patients’ access to cancer, outside of treatment, such as logistics, transportation, and food security, among others, Dr. Balch warned.

Office of the National Coordinator Deputy Assistant Secretary for Health Technology Reform John Fleming, MD, gave a keynote address on policy. His suggestion that “Every American should have a single, unified electronic head record available in the cloud,” from anywhere, at all times, for all involved physicians to access was met with approval from event audience.

While the outlook on American healthcare is uncertain, the panel and speakers are hopeful. They agreed with Dr. Kanter that for now, “Nothing is more important than the issue of health care access and coverage.” For more information on Better Together Health, click here.

Violence and Your Health

by

The National Health Collaborative on Violence and Abuse (NHCVA), comprised of more than 30 national health professional organizations dedicated to addressing the health consequences of violence and abuse, held its annual meeting this month at the Center for Total Health. Brigid McCaw, MD, of Kaiser Permanente’s Family Violence Prevention Program participated in the meeting. “What I love about hosting meetings here at the center is the connections that you make. The center allows conversations to happen that are bigger than the building itself, bigger than what’s just included in its four walls. Diverse groups gather here and tackle issues bigger than themselves and implement real solutions to problems that impact everyone’s health.”

Two focus areas emerged during the meeting: 1) education of health care professionals from all disciplines and 2) understanding current/potential legislative policy on issues related to adult, child and elder abuse. All forms of violence were discussed. Speakers from medical societies, advocacy orgs and the federal government shared best practices so everyone could learn from one another.

“The relationship between violence and health is becoming more well-known. We know that exposure to violence as a child can impact your long-term health, said Paula Amato, MD, immediate past chair of NHCVA. “We need to promote the science of violence to the next generation of health care leaders.  Partners such as Kaiser Permanente, as well as other member organizations, are helping shape that progress.”

Moving forward, NHCVA members would like to see greater access to resources for victims of violence.  Health care providers and health systems are starting to share best practices in caring for victims of violence. Longer-term and, perhaps more pro-actively, health care systems can play a bigger role in the prevention, the intervention and the promotion of healthier relationships.

Futures without Violence is a member of NHCVA. Futures offers numerous resources for trauma-informed care. Through the collaborative work facilitated through NHCVA, we can expect to see promotion of tools for clinics and health professionals as well as discussions on what models of care are available to be better integrate care for victims of violence wherever they enter the health care system.

Ultimately, violence is just as much a part of someone’s health as are other social and behavioral determinants of health (e.g., race, ethnicity, food insecurity, depression, substance misuse, etc.)  Thankfully, the work of NHVCA are starting to raise the visibility of this issue and bringing forth the opportunity for real change.

Just Breathe….Smoking Cessation Support

by

While it is difficult to overcome the addiction of smoking and completely kick the habit, different strategies and tactics can help control the desire to smoke in certain situations. To help, Kaiser Permanente established an online program called “Breathe,” free for Kaiser Permanente members 18 years or older. The program gives you a closer look as to why it’s so hard to quit smoking and ongoing support based on your unique needs. Components of this program include:

  • Tools to track and monitor your everyday process
  • A personalized plan to quit smoking
  • Relaxation and guided imagery podcast
  • Finding ways to cope with stress and deal with the urge to smoke

Nurse Practitioner Louis Casa encourages members to “try the program that has successfully helped 58 percent of its participants stop smoking”. She also expresses if you aren’t able to finish the program all at once, you can save your spot, then pick up where you left off when you return. That way, you can to finish at your own pace. You could also be confident that your privacy is protected and that the security of your own personal information will be maintained.

Another supportive resource Kaiser Permanente has is personal Wellness Coaching. These convenient phone sessions provide personal support to help members achieve their goals. Kaiser Permanente’s Wellness Coaching is available for five topics; tobacco cessation, stress management, physical activity, weight management, and healthy eating.

How Wellness Coaching works?

  • Patients are assigned a coach. During their first appointment, a coach helps assess your readiness and motivation. Are you prepared to make changes at this time?
  • After your first session, your and your coach will work together on how often you should meet by phone.
  • To make an appointment, call 1-800-862-4295, Monday through Friday, 7 a.m. to 8 p.m. (no referral needed, members are encouraged to call if needed)

 

For more information, the following resources are available online:

Always remember the four D’s:

  • Deep breathing
  • Drinking water
  • Delaying gratification- 2 minute delay helps
  • Doing something else

 

Exercise as a Vital Sign

by

Since May is National Physical Fitness and Sports Month, we were reflecting on a meeting at the Center for Total Health a couple years ago with the American College of Sports Medicine (ACSM) to address key issues related to establishing a physical activity prescription at every visit as a medical standard of care. Kaiser Permanante’s own Robert Sallis, MD, was in attendance and helped lead a walking break to visit the Supreme Court.

A lot has happened since that meeting. A white paper was published summarizing the call to action and an article was published in the American Journal of Medicine on June 3, 2016. Vital signs such as blood pressure, heart rate and other metrics are used to understand the potential root of health issues. They can inform clinicians about the likelihood of future diseases and your potential health status. Smoking, tobacco use and other metrics have been used as predictors of health for years.

Several large health systems are now monitoring physical activity as a vital sign, including Kaiser Permanente, Intermountain Healthcare (UT), and Greenville Health System (SC). The process is simple. A health care team member asks two questions: 1) On average, how many days per week do you engage in moderate-to-vigorous physical activity? And, 2) On average, how many minutes do you engage in physical activity at this level?Rx pad 1

“As a physician, we know simple steps can have a huge impact on someone’s health,” Sallis said. “You don’t have to join a gym or commit significant amounts of time to exercising. Physical activity is about movement and that movement can make all the difference on your long-term health.”

This more proactive approach offers patients a chance to partner with their care provider on more personalized interventions to improve their health, Sallis said.

Kaiser Permanente of Southern California recorded and 85 percent capture rate for 2.1 million members during the first year. The experience at Kaiser Permanente and other health care systems shows that physical activity can be captured by any medical assistant or member of the care team as part of the routine vital signs process.

“We are currently working with the ACSM and Exercise is Medicine initiative to establish exercise as a vital sign (EVS) around the world. At Kaiser Permanente, we’re proud to be a leader in this space,” Sallis said. “Currently, more and more health care organizations are adopting EVS and we are working on establishing a HEDIS measure around assessing exercise in adults.”

 

New Perinatal Depression Display

by

mother-child-iconPerinatal depression occurs in 12-20% of all pregnancies and can include premature delivery, decreased maternal-child interactions, child behavior problems and, in severe cases, suicide or infanticide.  Through Kaiser Permanente of Northern California’s Universal Perinatal Depression Screening Program, all women are screened with a nine-question survey called the PHQ-9 three times during the prenatal period. Each woman’s obstetrician reviews the results and, when depressive symptoms are present, offers treatment and referrals for classes, support groups, individual counseling or prescription medication.

Results:

  • Screened 98% of pregnant and postpartum women at least once during and after pregnancy, compared to less than 1% prior to implementation
  • Increased rate of new depression diagnoses to 12%, compared to 8% prior to implementation
  • Provided treatement to 82% of women with severe depression, compared to 5% prior to implementation.

For more information on the program, visit the center to see other displays on innovative programs or read the full story on KP Share.

A Future of Health Care Without Walls

by

Today, May 10, at the Kaiser Permanente Center for Total Health, the Network for Excellence in Health Innovation (NEHI) convened experts and launched a project to frame a plan for advancing “Health Care Without Walls” — the type of 21st century health care system that technology now makes possible.

Drawing on existing and future innovations, new modes of care delivery, and an augmented health care work force, much of health care can now be shifted out of conventional institutional settings through modalities that transcend time and distance. Health care can be brought closer to individuals in their homes, communities, or workplaces, dramatically expanding access for the underserved, frail, or elderly, and increasing convenience for everyone. Under the right circumstances, the efficiency and effectiveness of care could be increased, and costs sharply lowered.

At the NEHI convening, Keith Montgomery, executive director of the Center for Total Health, presented one of Kaiser Permanente’s own “Imagining Care Anywhere” visions for the future: a scenario involving a fictional dementia patient, Leo. A panel of executives from health systems, health information technology and health services companies – along with Aneesh Chopra, the former chief technology officer of the Obama administration — built on that vision, discussing where health care could be by 2025 if rebuilt and reconfigured on new technology platforms.

nehi pic 2Yet a system of “health care without walls” won’t come about without dismantling many obstacles, and a second panel of experts will address these barriers at the convening. The legal and regulatory environment, particularly at the state level, has not adapted quickly enough to technologies like telehealth and remote monitoring. Longstanding state scope-of-practice battles already lead to an inflexible health care work force and could further impede a shift to more distributed care. Many insurers are reluctant to pay for telehealth when some evidence suggests that, to date, it has added to the costs of care already provided, rather than displacing them. And a range of human factors – including how humans behave in relation to technology — may also stand in the way.

NEHI’s year-long project will examine these forces through a series of “work streams,” and identify policies and other initiatives that can help to overcome these barriers. Only by toppling them can we achieve the sort of health care system that Dave and other Americans should rightly expect to have in place today.

NEHI is a nonprofit, non-partisan think tank and membership organization focused on enabling innovations that lead to better health care, smarter spending, and healthier people. In partnership with members from across the spectrum of health care, NEHI conducts research and produces thought leadership designed to stimulate that innovation and change. For more information, visit www.nehi.net.

Nurses Week 2017

by

National Nurses Week is May 6 to 12. It’s a time to honor, celebrate and thank America’s 4 million nurses for the countless ways they make us healthier in mind, body and spirit. At Kaiser Permanente, more than 54,000 nurses serve our members across multiple settings and care specialties. Whether they’re working on the front line or as managers, executives, researchers, and policy specialists, Kaiser Permanente nurses are enhancing patient care experiences. Read more about Nurses Week and take time to celebrate and thank our nurses here.