Presentation given at the Sidney R Garfield Center for Health Care Innovation, with other colleagues, on the potential for integrating social media into an integrated care system.

1. What does Kaiser Permanente mean by “social media”?
Sidney R Garfield Center for Healthcare Innovation • July 24, 2012
Ted Eytan, MD MS MPH • The Permanente Federation • twitter: tedeytan
© 2012 The Permanente Federation, LLC
Photograph: Ted Eytan, MD, http://flic.kr/p/cxjxxj
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2. What does Kaiser Permanente mean by “Kaiser Permanente”?
Who is being ser ved, and by how many people?
§ Who and what
– A health system
– Trusted relationships
– Leadership excellence
9.0 million members
§ Total Health
– Not “100% Health”
0.18 million staff – Not “more health” - health equality
0.05 million nurses
0.017 million MDs
© 2012 The Permanente Federation, LLC
Wednesday, July 25, 12 2

3. What does Kaiser Permanente mean by “Kaiser Permanente”?
Source: http://www.kaiserpermanentecarestories.org/dale-
gordon’s-appointment-for-a-swollen-knee-leads-to-life-
saving-screening/
http://bit.ly/dalesstory
© 2012 The Permanente Federation, LLC
Wednesday, July 25, 12 3

4. The last time you had a health issue, did you get
information, care, or support from….?
Doctor/Health Professional Non-clinician source
All patients
60% 32% 30%
70%
8%
2002
2011
Source: Fox S. The Social Life of Health Information, 2011. Washington, DC; 2011. Available at: http://www.pewinternet.com/Reports/2011/Social-Life-of-Health-Info.aspx
© 2012 The Permanente Federation, LLC
Wednesday, July 25, 12 4

5. What caregivers want from us | each other
100% Health Professional Patients, Friends, Family
75%
50%
25%
0%
diagnosis, drug info, emotional support, quick
treatment info, referral info remedies, day to day advice
Source: Fox S, Brenner J. Family Caregivers Online. 2012. Available at: http://pewinternet.org/Reports/2012/Caregivers-online.aspx.
© 2012 The Permanente Federation, LLC
Wednesday, July 25, 12 5

6. 4 million members connected, via kp.org
4,000,000 members
In a typical quarter
3 million emails
9 million test results reviewed
2,000,000 members
34 % sign on 5 or more times
20032005
2007 2009
Source: Kaiser Permanente Web Analytics
2012 (1Q)
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7. More : The relationship
KP HealthConnect® – Enabling Patient-Centered Care
Deeper, with mobile
m.kp.org
16 % of visits to kp.org
Apps
91,000 iOS downloads
Source: Kaiser Permanente Web Analytics
© 2012 The Permanente Federation, LLC
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8. Leadership
#KPMM12
© 2012 The Permanente Federation, LLC
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9. The results : The most HEDIS #1’s
Effectiveness of Care Measures Kaiser Permanente #1’s
41 • Comprehensive diabetes • Weight assessment for
care — LDL control less than children — body mass
100 mg/dl (Hawaii Region) index percentile
• Osteoporosis management • Counseling for nutrition
in women who had a fracture for children
(Northern California Region) • Counseling for physical
31 • Breast cancer screening,
age 42–69 (Northwest
Region)
activity for children
• Chlamydia screening in
women (ages 16–20,
• Pharmacotherapy 21–24 and total)
Management of chronic • Appropriate testing for
obstructive pulmonary children with pharyngitis
disease (COPD) • Appropriate use of
exacerbation — medications for people
21 bronchodilator (Northwest
Region)
• Cholesterol management
with asthma (ages 12–
50, total)
• Comprehensive diabetes
(coronary artery disease), care — LDL control less
LDL level less than 100 mg/ than 100 mg/dl
dl (Colorado Region) • Comprehensive diabetes
• Follow-up after care — medical attention
10
hospitalization for mental
illness — 30 days (Colorado 11 for nephropathy
• Antidepressant
9 Region)
• Controlling high blood
pressure — cardiovascular
medication management
(effective acute phase)
• Antidepressant
(Hawaii Region) medication management
• Potentially harmful drug- (effective continuation
disease interaction — total phase)
(Hawaii Region) • Annual monitoring for
0 • Weight assessment for patients on persistent
adults — body mass index medications —
percentile (Georgia Region) anticonvulsants
Medicare Commercial
© 2012 The Permanente Federation, LLC
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10. Our ancestors opened doors, and minds
§ “We believe any
group of physicians
can easily duplicate
the Kaiser
Permanente
success.”
§ “Medical school
faculties should point
out the advantages
and disadvantages of
all methods of
practice to these
young men so that Nurse Elise Cook and Dr. Sandy MacColl
they can choose Group Health Cooperative
wisely.”
Sidney Garfield, MD
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11. Source: Lots to Lose: How Americaâ™™s Health and Obesity Crisis Threatens Our Economic Future. Washington, DC; 2012.
Available at: http://bipartisanpolicy.org/library/lotstolose.
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12. The results
Source: Ted Eytan, MD; http://tedeytan.com/tag/sdoh-tour
© 2012 The Permanente Federation, LLC
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13. Integration
§ “The scary part to me, when I do the
math, is 8.8 million members X
181,000 physicians/employees,
squared by an audience of 750
million on Facebook, divided by the
manpower we're prepared to commit
to it. You'd need Oppenheimer and a
Cray to figure that one out!”
– Vince Golla, Digital Media and
Syndication Director, Kaiser Permanente,
August 30, 2011
“Marcia Wellbyte, MD”
– Kaiser Permanente Northwest Family Physician Persona
– Piloting “Medical Home” model of care
– Innovative, Accomplished, Compassionate, Prevention and
Population Focused
– Stretched for time
13
#SMCareDelivery + @KPGarfield
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14. Audrey Crist, MD, Family Physician, Portland, Oregon
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15. The WHY for physicians - ( 4 ½ Reasons )
Medicine and Management Program, Session II, Colorado Springs, July 26, 2012
Ignite Format - 5 minutes, 15 seconds per slide • #KPMM12
© 2012 The Permanente Federation, LLC
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16. Challenges • Opportunities
§Extending, not duplicating services
§Supporting, not interfering with the relationship
§Total health, not just individual behavior
§Involving our members in our decisions
§Knowing that we’re not that smart, our ideas are
not that unique (sometimes)
© 2012 The Permanente Federation, LLC
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17. Help is here - #patientsincluded
§ “It is too easy IMHO to state :
"well we are all patients" , "it is
all about patients" or this one :
"we KNOW what our patients
want" well .....YOU DON'T. “
– Lucien Engelen -
– “No show patients on conferences: Patients Included”
- http://lucienengelen.posterous.com/no-show-
patients-on-conferences
© 2012 The Permanente Federation, LLC
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18. Manny Hernandez
@askmanny
© 2012 The Permanente Federation, LLC
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19. © 2012 The Permanente Federation, LLC
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20. Nikolai Kirienko
@ nikolaikirienko
© 2012 The Permanente Federation, LLC
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21. © 2012 The Permanente Federation, LLC
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22. The relationship, one more time.
Source: www.youtube.com/watch?v=iPxOcewBVrM
© 2012 The Permanente Federation, LLC
http://bit.ly/gennasstory
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