Using Kaiser Permanente HealthConnect™ to Transform Primary Care Delivery Ruth Brentari, MHA Director, 21 st Century Care Collaborative Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals Health Informatics New Zealand | 29-31 October 2007

About Kaiser Permanente Integrated health care delivery system 8.7 million members 156,000+ employees Serving 9 states and the District of Columbia 13,000+ physicians Nation’s largest nonprofit health plan * 2006revenues 32 hospitals and medical centers 416 medical offices $35* billion annual revenues

Integrated health care delivery system

8.7 million members

156,000+ employees

Serving 9 states and the District of Columbia

13,000+ physicians

Nation’s largest nonprofit health plan

32 hospitals and medical centers

416 medical offices

$35* billion annual revenues

Kaiser Permanente HealthConnect™ The world’s largest civilian deployment of an electronic health record Lab Radiology/ Imaging Others (immunizations, EKG, dictation) Outpatient Pharmacy Health Plan Claims Processing Membership/ Benefits Benefits Accumulation Pricing System Web Access Portal Data Warehouse / EDR Enterprise Data Repository Ancillaries Referral & Utilization Management Finance Capital Planning General Ledger Financial Reporting Care Delivery Core Outpatient Inpatient Scope of KP HealthConnect Suite Scheduling Registration Clinicals Billing Admission, Discharge and Transfer Health Information Management Clinicals Billing Pharmacy Emergency Department Operating Room Health Information Management

Regional Deployment Status  Launched Scheduled for Launch No Launch Date Identified K E Y         Member Access on kp.org Inpatient Practice Mgmt (hospital billing, ADT, chart tracking) Inpatient Clinicals (EMR, ED, OR, decision support) Ambulatory Practice Mgmt (scheduling, registration, billing) Ambulatory Clinicals (EMR, decision support tools)  Three sites live (complete Q2 2008)  (except scheduling w/chart pull Rolling out (complete Q4 2007) S. California  Two sites live (complete Q1 2010)  Rolling out (complete Q2 2008) N. California  2008   Northwest   Mid-Atlantic States   Ohio  2008   Hawaii   Georgia Complete one partner hospital Complete in one partner hospital   Colorado

Physician Ambulatory Charting

Nursing Inpatient Plan of Care Navigator

The Look of kp.org Direct access to KP HealthConnect Online features bundled under the header: “ My health manager” Launch: Nov 2007

21 St Century Care Innovation Project Background The primary drivers of this work: Primary Care Sustainability KP HealthConnect Value Realization This project is done in partnership with the Institute for Healthcare Improvement (IHI) and in full participation or our labor partners

The primary drivers of this work:

Primary Care Sustainability

KP HealthConnect Value Realization

This project is done in partnership with the Institute for Healthcare Improvement (IHI) and in full participation or our labor partners

Our Vision for the Future: “Blue Sky” Integrated & Leveraged Secure and seamless transitions Customized Home as the Hub

Primary Care Transformation: 21 st Century Care Innovation Project The Care Team’s work designed to needs of population Creating a patient-centered Relationship – Based Care Focus Supporting Total Panel Ownership Offering alternatives to 1:1 face-to-face office visits Collaborative care planning

The Care Team’s work designed to needs of population

Creating a patient-centered Relationship – Based Care Focus

Supporting Total Panel Ownership

Offering alternatives to 1:1 face-to-face office visits

Collaborative care planning

Offering Alternatives to Traditional Office Visits Telephone Visits Systematic offering Rely on the members’ preference and at their convenience Bridge to building secure messaging experience Builds capacity in the care team Other Alternatives Secure Messaging/eVisits Group Visits (woman, child)

Telephone Visits

Systematic offering

Rely on the members’ preference and at their convenience

Bridge to building secure messaging experience

Builds capacity in the care team

Other Alternatives

Secure Messaging/eVisits

Group Visits (woman, child)

Access – “Touches” – Member view Use of the phone creating capacity

Service Telephone Appointment Surveys (summer ’06) Key Findings: Satisfaction with the phone visit is high (77% rated 9 or 10 on 10 point scale). People like having this option. Preference for a phone visit or an office visit is situational for the member (and for the clinician). Satisfaction with the phone visit is driven by convenience and relationship factors not by the member’s demographics Source: TAV phone survey conducted by National Market Research, June – September, 2006. 150-250 surveys per team were completed. Overall Satisfaction with Phone Visit: All Facilities

Key Findings:

Satisfaction with the phone visit is high (77% rated 9 or 10 on 10 point scale). People like having this option.

Preference for a phone visit or an office visit is situational for the member (and for the clinician).

Satisfaction with the phone visit is driven by convenience and relationship factors not by the member’s demographics

Total Panel Ownership – with KP HealthConnect

Access – “Touches” Source: Clarity Warehouse. Report run by: National Analytical support. Note: Telephone includes TAVs and telephone encounters. Increasing capacity to touch more of patients on the panel

Collaborative Care Planning – with KP HealthConnect

Collaborative Care Planning Panel Survey conducted late Spring 2007 Denotes statistical significance above the control groups Teams that have worked in Collaborative Care planning are showing results in engagement, but not yet in member confidence/activation

Contact Information 21 st Century Care Innovation Collaborative Ruth Brentari [email_address] KP HealthConnect Communications Director Holly Potter [email_address]

21 st Century Care Innovation Collaborative

Ruth Brentari

[email_address]

KP HealthConnect Communications Director

Holly Potter

[email_address]