The Future of Care Delivery

By | Care Delivery, Community Health Initiatives, Health Innovation, Health IT | No Comments

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. 

Consumer Driven Models can Transform Care

By | Health IT, Mobility / Mobile Health, Uncategorized | One Comment

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.

Empowering Patients to Drive Their Own Care: A Conversation with Kaiser Permanente’s Terhilda Garrido

By | Guest Blogger, Health IT | No Comments

Health information technology (IT) is revolutionizing how patients and physicians interact. Electronic health records (EHRs), such as Kaiser Permanente’s KP HealthConnect, allow physicians to have a more complete view of patient health information. EHRs also enable patients to have more access to their physicians through secure emails, phone calls, and video visits. To learn more about the ways KP HealthConnect impacts members and providers across Kaiser Permanente, the Institute for Health Policy spoke with Terhilda Garrido, vce president for health information technology transformation & analytics at Kaiser Permanente.

Health information technology is changing the practice of medicine across the nation. What are the most profound changes KP HealthConnect has brought to Kaiser Permanente?

Terhilda Garrido, Kaiser Permanente

Terhilda Garrido, Kaiser Permanente

Physicians now go to the computer as opposed to paper records for checking medical history, taking notes, and ordering prescriptions. Providers are alerted about patient issues and in some locations can bring in added expertise through a function called eConsult. Increasingly, our patients drive care. Patients have the ability to access their health information through kp.org. They have extremely high satisfaction with the patient portal, and those who use kp.org are 2.6 times more likely to remain Kaiser Permanente members than are non-users. Once people experience the convenience of accessing care online, they tend to stay with Kaiser Permanente.

As a result of these capabilities, outpatient primary care has changed. Half of primary care visits are now virtual. Secure emails and phone calls represent about 30 percent and 20 percent, respectively, of primary care contacts. In absolute terms, face-to-face visits per member per year are slightly decreasing, but our secure email visits per member are substantially increasing. Primary care access has improved because technology allows more contact with patients. Virtual visits replace some face-to-face visits, but primarily virtual visits occur after a face-to-face encounter has already taken place.

Have clinicians in Kaiser Permanente embraced KP HealthConnect and the changes that have come with it?

The organization has embraced the changes, but the impact on physicians is mixed. Some physicians embrace the technology because they feel it improves care for their patients, while some are still reconciling this new workflow with their already busy calendars. We are such a huge organization, so it’s not out of the ordinary to have such varying reactions. We are still trying to understand and support the best use of our providers’ time.

You have been involved with research exploring the unintentional health care disparities that can emerge with Health IT. Can you explain why these disparities occur?

We’ve conducted a few studies on eHealth disparities. After controlling for various factors, including age, sex, comorbidities, distance to a medical center, income, and education levels, researchers found that Asians, African Americans, and Latinos have lower levels of use of the patient portal. This finding shows us that there are underlying biases between non-Hispanic whites and other ethnic groups.

Recently, we’ve done focus groups with African Americans and Latinos to explore the reasons for their lower levels of enrollment. One reason for not using MyChart is the belief that the site is not secure. Other explanations include login difficulties and language issues, which Southern California has attempted to address by turning on Spanish MyChart. Fewer people cite lack of access to the technology as their reason for not using MyChart.

Are there any policies that could be implemented to help reduce eHealth disparities?

General education campaigns showing that virtual care augments rather than substitutes for in-person care would be beneficial. There are people who think virtual care is cheaper care used to keep patients out of physicians’ offices. There should be broader understanding that many of people are benefiting from virtual care, and it is still high quality care.

Also, the Centers for Medicare and Medicaid Services (CMS) could help to support appropriate funding for virtual care to help it become more mainstream. Despite the fact that the Office of the National Coordinator for Health IT (ONC) is encouraging organizations to adopt virtual care, CMS still only pays for face-to-face visits. This is contrary to the direction in which ONC is pushing healthcare. Acknowledging that virtual care is beneficial and reimbursing for it could make it more widely available and help reduce eHealth disparities.

What is the next frontier in health IT and care transformation, and how are we preparing for it?

The next improvements will encourage self-service for patients and help them be more engaged in their care. Social networking and apps, such as glucose measurers, weight monitors, and fitness trackers, will help patients be more involved. Apple’s Health Kit is an app that combines health information from various health apps. Video visits will also become more common as we move forward. Finally, we will see more machine learning in healthcare. Technology like IBM’s Watson – a machine that can observe, interpret, evaluate, and decide – may be used to help support clinical care.

What Is Blue Button? Why Do I Care?

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RevisedBlueButtonlogowithmarkEditor’s Note: This post is authored by guest blogger Mary Anne Sterling. Mary Anne has been a thought leader in health information technology and health policy for over a decade. She serves on several healthcare advisory panels, a Federal Advisory Committee, and recently served as Executive in Residence for the Healthcare Information Management and Systems Society (HIMSS) Foundation, Institute for e-Health Policy.

  • Are you caring for an elderly parent? Are you trying to keep your child’s vaccination records up-to-date?
  • Do you have a health issue? Do you want to feel more in control of your personal health information?
  • Do you need to share your health information among several doctors? Are you changing doctors?
  • Do you need to find the results of a medical test? Do you need a current list of your medications?

If you answered “yes” to any of these questions, you need access to your health information or the health information of someone you care for. You may not be aware that you have the right to access it and healthcare providers must allow you to do so. When you have access to your health information, you can partner with care providers on improving the quality and safety of care that you or a family member receives.

To help you better understand why this should be important to you, I’ve asked Aaron Seib of the National Association for Trusted Exchange (NATE) to help me break down what this means and what you can do to help.

MA: Why would someone want access to their own health information?
AS: You have a legal right to receive your personal health information. Many people are not aware of this. When you have your health information, you can:

  • Share it with your doctors or trusted family members or caregivers
  • Check to make sure the information, such as your medication list, is accurate and complete
  • Keep track of when your child had his/her last vaccination
  • Have your medical history available in case of emergency, when traveling, seeking a second opinion, or switching health insurance companies
  • Plug your health information into apps and tools that help you set and reach personalized health goals.

These things are just too important to leave to others to manage for you. It’s time to take command of your health information. After all, it belongs to YOU.

MAS: It’s one thing to have access, but will the information be in an understandable format?  Will medical jargon be translated?  How will someone know what to do with the information?
AS: Our medical information is often difficult to understand and we don’t always have easy access to people who can explain it to us. Right now, it is imperative that people have access to their health information first and then we can work with patients, family caregivers, and app developers to ensure this information is presented to them in a way that they can better understand and use. The good news: we see multiple services already emerging that assist in translating complicated health data into accessible information for patients and family caregivers.

MAS: If I want to share my health information, can I choose what parts of my information I allow to be shared?  For example, will my mental health notes from my psychiatrist or therapist be made available to my primary care doctor?  Is it all or nothing as far as what is made available?
AS: Working in partnership with your doctors, you can decide what information is shared and for what purpose. But you must be actively engaged in managing your health information in order to do that. You may decide to share some information, all of your information, or nothing at all.

BlueButton-Logo-withtextandmarkv2 (2)MAS: How is my information protected? With all the hacking of retail, credit cards and even insurance accounts, how can I be sure my information is being kept safe, especially when I download it?
AS: Using ‘Blue Button” is one good way you can access your health records electronically. Millions of Americans can get easy, secure online access to their health records thanks to Blue Button. Health information about you may be stored in many places, such as doctors’ offices, hospitals, drug stores and health insurance companies. Ask your health care providers or health insurance company if they offer you the ability to view online, download, and share your health records via Blue Button and look for the Blue Button logo.

MAS: How do I talk to my doctor about getting access to my health information?
A: NATE has a letter that you can download from our website to make that conversation easier. The hardest part is getting the conversation started! But you will be glad you did when you have the peace of mind of knowing your health information is at your fingertips.

MAS: If someone is interested in knowing more about this topic, what are the best resources for more information?  
AS: NATE is not the only organization working to get patients and family caregivers access to their health information. Additional sources of information are:

Blue Button:

Other initiatives that you may be interested in learning more about:

Overall, having access to your personal health information, or the health information of someone you care for, is an important step in maximizing your health and the health of others. Now is the time to get involved in the discussion and request access to your own health information. Being a more informed healthcare consumer could save your life!

Domestic Violence: It’s a Health Issue

By | Audio, Experts, Healthy Living, Mobility / Mobile Health, Podcast | No Comments

October is Domestic Violence Awareness Month — a good time to pause and consider just how many people are affected by domestic violence and sexual assault. The numbers are astounding. According to the National Coalition Against Domestic Violence, an estimated 1.3 million women are victims of physical assault by a domestic partner each year. And one in every four women will experience domestic violence in her lifetime.

Adults aren’t the only ones affected. Every year, nearly 1.5 million high school students experience physical abuse from a dating partner. One in three adolescents is a victim of physical, sexual or emotional abuse.

This episode of Total Health Radio talks about what teen dating violence looks like and some of the warning signs parents and friends should be watchful for. Guest Nancy Schwartzman, the inventor of the Circle of 6 mobile app, shares ways that young women can both prevent and cope with sexual assault.

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.”

Care Delivery Beyond the Walls of the Doctor’s Office — Celebrated at This Year’s IHI Summit

By | Care Delivery, Health, Health Innovation, Healthy Communities, Mobility / Mobile Health | One Comment

MAS Mobile Health VehicleWhat if, instead of going to a doctor’s appointment, the clinic actually came to you?

That’s right.  Not just the doctor. The clinic.

This isn’t your grandfather’s version of a house call.  What we’re talking about here is a whole new animal.  Mobile health clinics that offer individuals and communities accessible, quality care.

For the past three days, the Institute for Healthcare Improvement held its 15th Annual International Summit on Improving Patient Care in the Office Practice and the Community here in Washington, DC.  And in the days leading up to the Summit, IHI recognized the growing relevance of mobile health clinics to the transformation of health care with events in Boston, New York City, and Washington, DC – with discussions on the local impact some 2,000 mobile clinics in the US are having in the context of health reform.

Kaiser Permanente has its own mobile health vehicle on site for Summit attendees to visit. Designed to mirror a small medical center on wheels, the state-of-the-art vehicle has two exam rooms, areas for patient intake and health education, and computers wired with Kaiser Permanente HealthConnect® (the organization’s system-wide electronic health record). This mobile health vehicle can provide access to health care, as well as preventive services and screenings, to thousands of Kaiser Permanente members – as well as the uninsured – within the Mid-Atlantic region.

Read more about IHI’s summit on its official website.  And for more on Kaiser Permanente’s Mid-Atlantic mobile health vehicle, visit this page.

The Buzz from SXSW Interactive, Health Track Edition!

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SXSWSunInfographicWe’ve captured the buzz and analysis of yesterday’s health track sessions at South by Southwest in this info graphic, one of five we’ve published from SXSW Interactive so far. We’ve shared each digital newsroom info graphic through social media channels such as Twitter and Facebook. You also can see each infographic here: http://w.cg/sxswkp.

On the Ground from SXSW Interactive

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sxsw_541wideTens of thousands of people have converged at SXSW Interactive for five days of compelling presentations and panels, networking events, and opportunities to share startup ideas and technologies.  Kaiser Permanente is on the ground and will be publishing a digital newsroom highlighting social content and the Twitter conversation from SXSW.  See a larger version of the above image here.

Presenting at SXSW from Kaiser Permanente is vice president Madhu Nutakki and dermatologist Jeffrey Benabio, MD, who will be leading a talk about how technology and meaningful data are enabling health care and wellness.  The pair will be highlighting digital trends such as wearable devices, mobile health and biometrics — as well as what’s on the health horizon.

Can’t be in Austin but interested in following along?  The hash tag for the event is #sxswhealth, or you can follow updates on Twitter from @kpshare and @kpdigitalhealth.  Our Facebook page will also post highlights from Austin.

 

Delivering Care Anywhere: Imagining it at HIMSS14

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Much of the conversation taking place in Kaiser Permanente’s booth at HIMSS is about the concept of imagining care anywhere. At the conference today, Wendy Lee, senior vice president of digital health technologies and strategic services with Kaiser Permanente, and Danielle Cass, innovation evangelist of innovation and advanced technology, also with Kaiser Permanente, led a session called, “How Technology Can Enable Care Anywhere, Anytime.” Their talk generated serious interest — and energy! — among audience members as well as later with visitors to the booth.

This video, shared with us by Cass, demonstrates what the Imagining Care Anywhere concept is like when experienced in person at Kaiser Permanente’s Garfield Innovation Center in San Leandro, Calif.

If you are as interested in this concept as the countless visitors to our booth at HIMSS today, we encourage you to check out the Imagining Care Anywhere microsite at kpcareanywhere.org.