Exercise as a Vital Sign

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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

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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

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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

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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.

Q&A with Kaiser Permanente Chairman and CEO Bernard Tyson on Mental Health

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Kaiser Permanente Chairman and CEO Bernard J. Tyson discussed mental health, the social determinants of health and Kaiser Permanente’s always-active expansion strategy with Southern Bureau Chief Dave Barkholz in San Francisco. To read an edited transcript, click here.

Kaiser Permanente, the nation’s largest integrated health system, has made mental-health awareness a priority, as it seeks to promote the total health of the individuals and communities it serves. Even though depression and other mental health issues are common, they can be difficult to talk about. Kaiser Permanente’s “Find Your Words” public health awareness campaign focuses on TV, radio and online messages that talk about depression in an honest and inspiring way.

Kaiser Permanente Launches ‘Find Your Words’ Campaign to Fight Stigma Around Mental Health

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Kaiser Permanente’s “Find Your Words” public health awareness campaign focuses on TV, radio and online messages that talk about depression in an honest and inspiring way. Coinciding with the start of National Mental Health Month, the campaign launched Monday, May 1.

In addition to the “Find Your Words” campaign, Kaiser Permanente Colorado awarded grant funding to advance social and emotional wellness and mental health in school districts across the state. In August 2017, Kaiser Permanente will award five Colorado school districts a combined $1.5 million in Thriving Schools behavioral health grants.

The schools will use the grants to increase access to mental health and wellness programs to help teachers and staff learn how to identify and deal with mental health needs in students as well as themselves.

You can read more about the Find Your Words campaign and learn more about the grants KP Colorado awarded 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

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

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