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Using Technology to Achieve Total Health      The Office of Health Information Technology and Quality • HRSA      December...
Using Technology to Achieve Total Health      The Office of Health Information Technology and Quality • HRSA      December...
Why Total Health? Why not?       A state of complete       physical, mental and       social well-being for       individu...
Why Total Health? Why not?       A state of complete       physical, mental and       social well-being for       individu...
Why Total Health? Why not?        We are committed to helping our        members, our workforce, their        families, an...
We’re on a mission….        © 2012 The Permanente Federation, LLCWednesday, December 19, 12                      5
Technology does not replace us...   “The last time you sought help with health or medical issues, it was from…”           ...
We use it to improve the care we provide                                                                                  ...
We use it to improve the care we provide                              Significant? How                                    ...
Here’s how we’re doing it                                                                                9       Source: K...
KP Health Manager, part of a   My HealthConnect® – Enabling Patient-Centered Care            comprehensive electronic     ...
KP Health Manager, part of a   My HealthConnect® – Enabling Patient-Centered Care            comprehensive electronic     ...
More : The relationship   KP HealthConnect® – Enabling Patient-Centered Care     Deeper, with mobile      m.kp.org        ...
More : The relationship       § Nine million Kaiser Permanente          members have 24/7 access to their          medica...
4 million members connected, via kp.org                                                                         5,000,000 ...
4 million members connected, via kp.org                                                                  5,000,000 members...
The most HEDIS #1’s                                                                                2011                   ...
The most HEDIS #1’s                                                                                                       ...
The most HEDIS #1’s                                                                                2012                   ...
The most HEDIS #1’s                                                                                                       ...
Highly meaningful use                                                     Nonuser, kp.org                                 ...
Highly meaningful use                                                          Nonuser, kp.org                            ...
Highly meaningful use                                                                                                     ...
Health doesn’t happen here        © 2012 The Permanente Federation, LLCWednesday, December 19, 12                      19
It happens here        © 2012 The Permanente Federation, LLCWednesday, December 19, 12                      20
Back to Opower...Wednesday, December 19, 12   21
Back to Opower...Wednesday, December 19, 12   21
Back to Opower...Wednesday, December 19, 12   21
To heal, you have to not harm                                                                                             ...
Why.                                                        “Dream Grounds for a Dream Hospital”    Source: http://kasierp...
Why.                                            “Showcases of modern, green hospital design”    Source: http://xnet.kp.org...
Building, buying, eating green      §Energizing our facilities        with solar power      §Eliminating unhealthy      ...
Health Affairs, May 2011: “Kaiser                                         Permanente Study Finds Use of                   ...
Our ancestors opened doors, and mindsWednesday, December 19, 12                   27
Our ancestors opened doors, and minds  § “We believe any     group of physicians     can easily duplicate     the Kaiser ...
kp.org/hivchallengeWednesday, December 19, 12   28
believe in ELIMINATION of disparitiesWednesday, December 19, 12                                           29
Wednesday, December 19, 12   30
© 2012 The Permanente Federation, LLCWednesday, December 19, 12                31
kp.org/thrive  © 2012 The Permanente Federation, LLCWednesday, December 19, 12                                32
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Technology to Achieve Total Health - Office of Health Information Technology and Quality • HRSA

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Presentation, hosted by Yael Harris, PhD, to monthly HRSA Office of Health Information Technology and Quality, Rockville, MD, USA

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Technology to Achieve Total Health - Office of Health Information Technology and Quality • HRSA

  1. 1. Using Technology to Achieve Total Health The Office of Health Information Technology and Quality • HRSA December 18, 2012 Ted Eytan, MD MS MPH • The Permanente Federation • twitter: tedeytan © 2012 The Permanente Federation, LLC Photograph: Ted Eytan, MD, http://flic.kr/p/dqEMVHWednesday, December 19, 12 1
  2. 2. Using Technology to Achieve Total Health The Office of Health Information Technology and Quality • HRSA December 18, 2012 Ted Eytan, MD MS MPH • The Permanente Federation • twitter: tedeytan © 2012 The Permanente Federation, LLC Photograph: Ted Eytan, MD, http://flic.kr/p/dqEMVHWednesday, December 19, 12 2
  3. 3. Why Total Health? Why not? A state of complete physical, mental and social well-being for individuals, families, communities, society. © 2012 The Permanente Federation, LLCWednesday, December 19, 12 3
  4. 4. Why Total Health? Why not? A state of complete physical, mental and social well-being for individuals, families, communities, society. Leonora Brogan - Kaiser Permanente Center for Total Health http://kp.org/centerfortotalhealth © 2012 The Permanente Federation, LLCWednesday, December 19, 12 3
  5. 5. Why Total Health? Why not? We are committed to helping our members, our workforce, their families, and our communities achieve Total Health through the services we provide and by promoting clinical, educational, environmental, and social actions that improve the health of all people. Kaiser Permanente Center for Total Health, Washington, DC http://kp.org/centerfortotalhealth © 2012 The Permanente Federation, LLCWednesday, December 19, 12 4
  6. 6. We’re on a mission…. © 2012 The Permanente Federation, LLCWednesday, December 19, 12 5
  7. 7. Technology does not replace us... “The last time you sought help with health or medical issues, it was from…” 100% 75% 50% 25% 0% Others with condition Friend/Family Health Professional 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, LLCWednesday, December 19, 12 6
  8. 8. We use it to improve the care we provide 85% KP member 73% US 90th % 60% 2005 2006 2007 2008 Source: Zhou YY, Kanter MH, Wang JJ, Garrido T. Improved Quality At Kaiser Permanente Through E-Mail Between Physicians And Patients. Health Affairs. 2010;29(7):1370-1375. Available at: http://content.healthaffairs.org/cgi/content/abstract/29/7/1370 [Accessed July 7, 2010].Wednesday, December 19, 12 7
  9. 9. We use it to improve the care we provide Significant? How 85% about p<0.0001 + email 73% US 90th % 60%2005 2006 2007 2008 Source: Zhou YY, Kanter MH, Wang JJ, Garrido T. Improved Quality At Kaiser Permanente Through E-Mail Between Physicians And Patients. Health Affairs. 2010;29(7):1370-1375. Available at: http://content.healthaffairs.org/cgi/content/abstract/29/7/1370 [Accessed July 7, 2010].Wednesday, December 19, 12 8
  10. 10. Here’s how we’re doing it 9 Source: Kaiser Permanente Care Stories Blog: http://kp.org/carestories © 2012 The Permanente Federation, LLCWednesday, December 19, 12 9
  11. 11. KP Health Manager, part of a My HealthConnect® – Enabling Patient-Centered Care comprehensive electronic health record Ambulatory deployment complete all medical offices live Inpatient deployment complete 37 hospitals live 36 HIMSS Stage 7 © 2012 The Permanente Federation, LLCWednesday, December 19, 12 10
  12. 12. KP Health Manager, part of a My HealthConnect® – Enabling Patient-Centered Care comprehensive electronic health record Ambulatory deployment complete all medical offices live Inpatient deployment complete 37 hospitals live 36 HIMSS Stage 7 © 2012 The Permanente Federation, LLCWednesday, December 19, 12 11
  13. 13. More : The relationship KP HealthConnect® – Enabling Patient-Centered Care Deeper, with mobile m.kp.org 20 % of visits to kp.org App downloads (Dec 2012) 203,195 - iOS 168,450 - Android Source: Kaiser Permanente Web Analytics, updated 09/24/12 © 2012 The Permanente Federation, LLCWednesday, December 19, 12 12
  14. 14. More : The relationship § Nine million Kaiser Permanente members have 24/7 access to their medical information anywhere in the world from their mobile devices § Patients can – email their providers – check lab test results – order prescription refills – manage appointments © 2012 The Permanente Federation, LLCWednesday, December 19, 12 13
  15. 15. 4 million members connected, via kp.org 5,000,000 members 2,500,000 members 20032005 2007 2009 Source: Kaiser Permanente Web Analytics, updated 12/18/2012 2012 (3Q) © 2012 The Permanente Federation, LLCWednesday, December 19, 12 14
  16. 16. 4 million members connected, via kp.org 5,000,000 members In the 3rd Quarter 2012 3.3 million emails 8 million test results reviewed 2,500,000 members 2.4 million appointments made 34 % signed on 5 or more times 20032005 2007 2009 2012 (3Q) Source: Kaiser Permanente Web Analytics, updated 12/18/2012 © 2012 The Permanente Federation, LLCWednesday, December 19, 12 14
  17. 17. The most HEDIS #1’s 2011 Effectiveness of Care Measures Kaiser Permanente #1’s 41 31 21 10 11 9 0 Medicare Commercial © 2012 The Permanente Federation, LLCWednesday, December 19, 12 15
  18. 18. The most HEDIS #1’s 2011 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, LLCWednesday, December 19, 12 15
  19. 19. The most HEDIS #1’s 2012 Effectiveness of Care Measures Kaiser Permanente #1’s 41 31 21 16 13 10 0 Medicare Commercial Source: Kaiser Permanente Newe Center, http://xnet.kp.org/ newscenter/pressreleases/nat/ 2012/101012_ncqa_care_measures.html ; http://xnet.kp.org/ newscenter/pressreleases/nat/2012/112812-ncqa-medicare- measures.html © 2012 The Permanente Federation, LLCWednesday, December 19, 12 16
  20. 20. The most HEDIS #1’s 2012 • Breast cancer screening • Comprehensive diabetes Effectiveness of Care Measures Kaiser Permanente #1’s care — blood pressure control (<140/80) • Breast cancer screening, • Comprehensive diabetes 41 age 42–69 (Southern California) • Use of Spirometry Testing in care — blood pressure control (<140/90) • Comprehensive diabetes care — medical attention the Assessment of COPD for nephropathy (Hawaii Region) • Pharmacotherapy • Antidepressant medication management Management of COPD (effective acute phase) Exacerbation — 31 Bronchodilator (Southern • Antidepressant medication management California) (effective continuation • Cholesterol management phase) (coronary artery disease), LDL Screening (Hawaii) • Weight assessment for children — body mass • Cholesterol management index percentile (coronary artery disease), LDL level less than 100 mg/ • Counseling for nutrition 21 for children dl (Colorado) • Controlling high blood • Counseling for physical activity for children pressure — cardiovascular (Ohio) • Comprehensive diabetes 16 • Chlamydia screening in women (ages 16–20, 13 21–24 and total) care — HbA1c Testing (Hawaii) • Appropriate treatment for children with upper • Comprehensive diabetes respiratory infection 10 care — LDL level less than 100 mg/dl (Northern California) • Avoidance of antibiotic treatment in adults with acute bronchitis • Comprehensive diabetes • Use of spirometry testing care — Medical Attention for in assessment & Nephropathy (Colorado) diagnosis of chronic • Comprehensive diabetes obstructive pulmonary care — blood pressure disease 0 control (<140/80) (Georgia) • Comprehensive diabetes • Annual monitoring for patients on persistent care — blood pressure medications — control (<140/90) (Colorado) anticonvulsants • Osteoporosis management Medicare in women who had a fracture (Southern California) • Potentially harmful drug- Commercial • Medical assistance with smoking cessation — advising smokers to quit Source: Kaiser Permanente Newe Center, http://xnet.kp.org/ disease interaction — • Medical assistance with smoking cessation — newscenter/pressreleases/nat/ Dementia (Hawaii) discussing strategies 2012/101012_ncqa_care_measures.html ; http://xnet.kp.org/ newscenter/pressreleases/nat/2012/112812-ncqa-medicare- measures.html © 2012 The Permanente Federation, LLCWednesday, December 19, 12 16
  21. 21. Highly meaningful use Nonuser, kp.org User, kp.org 100% All p < 0.001 Voluntary retention 90% 80% 70% < 1 year 1 -3 years > 3-10 years > 10 years Time as Kaiser Permanente member Source: Turley M, Garrido T, Lowenthal A, Zhou YY. Association between personal health record enrollment and patient loyalty. The American journal of managed care. 2012;18(7):e248–53. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22823553. © 2012 The Permanente Federation, LLCWednesday, December 19, 12 17
  22. 22. Highly meaningful use Nonuser, kp.org User, kp.org All p < 0.001 100% Voluntary retention 90% 80% 70% < 1 year 1 -3 years > 3-10 years > 10 years Time as Kaiser Permanente member Source: Turley M, Garrido T, Lowenthal A, Zhou YY. Association between personal health record enrollment and patient loyalty. The American journal of managed care. 2012;18(7):e248–53. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22823553. © 2012 The Permanente Federation, LLCWednesday, December 19, 12 17
  23. 23. Highly meaningful use 2.578 times 100% Voluntary retention 90% The greater likelihood that a 80% member who uses kp.org will continue their care relationship, compared to a 70% < 1 year 1 -3 years > 3-10 years > 10 years member who does not use kp.org. Time as Kaiser Permanente member Source: Turley M, Garrido T, Lowenthal A, Zhou YY. Association between personal health record enrollment and patient loyalty. The American journal of managed care. 2012;18(7):e248–53. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22823553. © 2012 The Permanente Federation, LLCWednesday, December 19, 12 18
  24. 24. Health doesn’t happen here © 2012 The Permanente Federation, LLCWednesday, December 19, 12 19
  25. 25. It happens here © 2012 The Permanente Federation, LLCWednesday, December 19, 12 20
  26. 26. Back to Opower...Wednesday, December 19, 12 21
  27. 27. Back to Opower...Wednesday, December 19, 12 21
  28. 28. Back to Opower...Wednesday, December 19, 12 21
  29. 29. To heal, you have to not harm 52  million  people 9  million  members 178,000  employees 37  hospitals 611  medical  office  buildings   607  other  faciliGes NHS England KP 0.8675  MtCO2e 5.04  MtCO2e   (energy  only) MtCO2e : Metric Tonne (ton) Carbon Dioxide Equivalent, 2010 Reporting Year Source: http://www.theclimateregistry.org/ ; http://www.sdu.nhs.uk/sd_and_the_nhs/Wednesday, December 19, 12 22
  30. 30. Why. “Dream Grounds for a Dream Hospital” Source: http://kasierpermanentehistory.org ; Joe Bialowitz, MS, HEM, Senior Environmental Stewardship Consultant, Kaiser PermanenteWednesday, December 19, 12 23
  31. 31. Why. “Showcases of modern, green hospital design” Source: http://xnet.kp.org/centralvalley/pages/green_features/green_features.html ; http://xnet.kp.org/newscenter/pressreleases/scal/ 2012/011712sandiegosolar.htmlWednesday, December 19, 12 24
  32. 32. Building, buying, eating green §Energizing our facilities with solar power §Eliminating unhealthy materials from our buildings §Zero exporting of e- waste §Sourcing food locally; creating hospital based Source: 2009 EPA Pacific Southwest Environmental Awards, http://www.epa.gov/region09/awards/09/ farmer’s markets index.html; “Healthy Health Care Leader - Kaiser Permanente,” http://blog.epa.gov/blog/2009/10/15/ healthy-health-care-leader-kaiser-permanente/; § Green Resource Center: http://xnet.kp.org/newscenter/ aboutkp/green/index.html © 2012 The Permanente Federation, LLCWednesday, December 19, 12 25
  33. 33. Health Affairs, May 2011: “Kaiser Permanente Study Finds Use of Electronic Health Records Reduces Carbon Emissions, Waste and Water Consumption” PotenGal  CO2  emissions  reducGons  as   much  as  1.7  million  tons  across  the  enGre   U.S.  populaGon   Source: Turley M, Porter C, Garrido T, et al. Use of electronic health records can improve the health care industry’s environmental footprint. Health affairs (Project Hope). 2011;30(5):938-46. Available at: http://content.healthaffairs.org/cgi/content/abstract/30/5/938 [Accessed January 3, 2012].Wednesday, December 19, 12 26
  34. 34. Our ancestors opened doors, and mindsWednesday, December 19, 12 27
  35. 35. 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 they can choose Nurse Elise Cook and Dr. Sandy MacColl Group Health Cooperative wisely.” *(this was 1970) Sidney Garfield, MDWednesday, December 19, 12 27
  36. 36. kp.org/hivchallengeWednesday, December 19, 12 28
  37. 37. believe in ELIMINATION of disparitiesWednesday, December 19, 12 29
  38. 38. Wednesday, December 19, 12 30
  39. 39. © 2012 The Permanente Federation, LLCWednesday, December 19, 12 31
  40. 40. kp.org/thrive © 2012 The Permanente Federation, LLCWednesday, December 19, 12 32

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