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KP in American Healthcare System
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KP in American Healthcare System

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Given by Murray Ross,Vice President and Director Kaiser Permanente Institute for Health Policy,

Given by Murray Ross,Vice President and Director Kaiser Permanente Institute for Health Policy,

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  • The potential impact of a connected community for healthcare delivery seemed intuitive but remained largely unproven.

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  • 1. Murray N. Ross, Ph.D. VP, Kaiser Foundation Health Plan Director, Kaiser Permanente Institute for Health Policy Kaiser Permanente: Transforming Care Through Technology Netherlands/Cisco San Jose February 15, 2011
  • 2. Discussion outline
    • U.S. health care “non-system”
    • Kaiser Permanente
      • By the numbers
      • What integration means
    • Using health IT to transform care
      • Engaging our members
      • Supporting our clinicians
    • Expanding knowledge along three dimensions
      • Person, panel, population
  • 3. The U.S. health care environment
    • We mix all possible ways to:
    • Provide coverage
    • Finance coverage
    • Pay providers
    • Deliver care
    • Govern insurance and delivery
    • Regulate insurance, delivery
    Health reform changes and builds on this non-system!
  • 4.
      • Organization
      • 8.8 million members
      • 14,000+ physicians
      • 166,000+ employees
      • 35 hospitals
      • 431 medical offices
      • $44b revenue (2010)
    Kaiser Permanente: who we are
      • Services (2008)
      • 36.7 million DOVs
      • 129 million Rx filled
      • 550,000 surgeries
      • 1.1 million mammograms
      • 1.6 million CRC screens
    Kaiser Permanente Medical Program Kaiser Foundation Health Plan* Kaiser Foundation Hospitals* Permanente Medical Groups
  • 5. What does integration mean?
    • Shared responsibility for program success
      • KP “owned” jointly by physicians, health plan, and labor
      • The “MEMO” relationship
    • Integration along multiple dimensions
      • Between financing and medical care
      • Along the health/illness continuum
      • Across health care providers
      • Over time (Kaiser babies become Medicare members)
    • Functional specialization
      • Physicians practice medicine, nurses care for patients
      • KFHP execs manage finance, administration, marketing
  • 6. Knowledge key to successful integration
    • Invested $3+ billion in electronic medical record
      • Real-time, continuous access to information on visits, lab and radiology reports, immunizations, medications, allergies
      • All caregivers directly connected for decision support
    • Data and evidence support performance
      • Focus on individual care AND population health
      • Systems orientation drives performance improvement
      • Technology assessment, comparative effectiveness research, clinical guidelines
      • Evidence gathering: clinical trials, registries, best practices
  • 7. Caring for the whole member
    • Caring for the whole member proactively addresses needs for:
      • Chronic conditions care
      • Lifestyle, behavior change
      • Prevention
     Diabetes  Coronary Artery Disease  Dyslipidemia  Hypertension  Tobacco Use  Diet Chronic Conditions Prevention   Colorectal cancer screening  Immunizations  Diabetes  Coronary Artery Disease  Dyslipidemia  Hypertension  Tobacco  Chronic Conditions Chronic Conditions Prevention Prevention  Breast & Cervical cancer screening  Colorectal cancer screening  Immunizations Lifestyle / Behavior Lifestyle / Behavior Lifestyle / Behavior Exercise 
  • 8. KP’s e-care evolution
    • E-Health Management: including blood pressure, blood glucose, respiratory peak flow, weight measurement, “virtual care” using video and audio cast, and online health assessments
    • E-mail your doctor
    • View lab test results online
    • Refill prescriptions online
    • Schedule/cancel appointment online
    • Select a physician online
    • View your health record
    • Drug/health encyclopedia
    • Healthwise Handbook
    • Facility/staff directory
    • Link to other Web sites
    Impact on Quality and Care Experience General Information Personalized Information Care
  • 9. Engaging patients: My Health Manager
    • Secure view of EHR:
      • View lab results, immunizations, allergies, past office visits
    • Interact with care team:
      • E-mail my doctor, complete a HRA
    • Convenient transactions:
      • Refill prescriptions, manage appointments, act for a family member
    • Educational opportunities:
      • Links to health & drug encyclopedias, online behavior change programs
  • 10. Patient engagement in online care
    • Over 3 million registered users in 2009
            • 61.7 million site visits
            • 21.7 million My Test Results viewed
            • 8.6 million E-mail My Doctor messages
            • 6.8 million prescription refills ordered
            • 185,000 submissions to online behavior health programs
            • 1.8 million online appointment requests
  • 11. Screen shot of KP HealthConnect
  • 12. Panel support with KP HealthConnect TM
  • 13. Screen shot of panel support tool
  • 14. HEDIS Measures 2009
    • NCAL SCAL HI NW CO GA MAS OH
    • Breast Cancer Screening
    • Childhood Immunization Status
    • Chlamydia Screening in Women
    • Antidepressant Medication Management, Acute Phase
    • Antidepressant Medication
    • Management, Continuation
    • Diabete--BPControl – 130
    • Diabetes--Neuropathy
    MARKET RANKING WITHIN REGION 1 1 1 1 1 1 1 1 2 2 1 1 1 1 2 3 1 1 1 1 1 1 1 1 1 1 1 1 1 2 6 1 1 1 2 1 2 1 1 1 1 1 1 3 4 1 1 1 1 1 1 1 6 7 1 1 1 Based on HEDIS 2009 Commercial results and NMR Competitors. Leading in preventive and clinical measures
  • 15. For more information
    • Murray N. Ross, Ph.D.
    • Vice President, Kaiser Foundation Health Plan, Inc.
    • Director, Kaiser Permanente Institute for Health Policy
    • One Kaiser Plaza, 22nd Floor
    • Oakland CA 94612
    • Office: 510-271-5691
    • Email: [email_address]
    • IHP Website: http://www.kpihp.org/