Upload
ted-eytan-md
View
990
Download
1
Tags:
Embed Size (px)
Citation preview
© 2010 The Permanente Federation, LLC
Using Technology to Achieve Total HealthTED EYTAN, MD, MS, MPH • ALIGNING FORCES FOR QUALITYKaiser Permanente: www.kp.org | twitter: tedeytan
Photo: M.V. Jantzen, Washington, DC : http://flic.kr/p/8TuUgj
1
Who’s a fan of the pedometer?
2
The first place to start is the starting point...
3
The first place to start is the starting point...
4
Who’s a fan of the patient?
Christine Abbott and Ted Eytan, 2008
5
The member experience attracts people
6
Even through harsh conditions….
7
Why Total Health? Why not?
Integrated Health CareEasy, Excellent, Comprehensive
Commitment to PreventionAddress issues before they become problems
Empowering of the whole personBeyond health care - mind, body, spiritWhat you eat, the air you breathe, the environment you live in
Photo: M.V. Jantzen, Washington, DC : http://flic.kr/p/8Ttx3g
8
In the words of a patient(and we will all be patients one day)
“Kaiser Permanente HealthConnect® at Home - Empowering People”
youtube.com/kaiserpermanenteorg
9
Technology does not replace us...
“Where do you go for help with health or medical issues?
0%
25%
50%
75%
100%
Health Professional Friend/Family internet books/print insurance provider other
Source: Pew Internet & American Life Project: The Social Life of Health Information, June 2009, http://pewinternet.org/Reports/2009/8-The-Social-Life-of-Health-Information.aspx
10
We use it to improve the care we provide
60%
68%
75%
83%
90%
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.)
Didn’t use E-mail Used E-mail Kaiser Permanente Southern California
% Members with high blood pressure under control
2005 - 2008
HEDIS 90th Percentile, 2008
70.3 %
11
And you will, too.
Jack Cochran, MD, Executive Director of The Permanente FederationNational Governor’s Association, Washington, DC
12
KP HealthConnect® – Enabling Patient-Centered Care
My Health Manager, part of a comprehensive electronic health record
Ambulatory deployment complete: 431 medical offices live
Inpatient deployment complete:36 hospitals live
24 HIMSS Stage 7 Hospitals
13
Kaiser Permanente physician : 2007
Victor Silvestre, MDOakland, CA
14
Kaiser Permanente Nurse : 2009
youtube.com/kaiserpermanenteorg
15
Kaiser Permanente Advice Nurses: 2010
Appointment and Advice Call Center, Vallejo, CA - KP HealthConnect enabled!
16
Kaiser Permanente members/caregivers : 2010
“Balancing Work and Family”Kaiser Permanente YouTube Channelhttp://www.youtube.com/kaiserpermanenteorg
17
We connect with over 3 million members...
0
875,000
1,750,000
2,625,000
3,500,000
Q3 ‘03 Q1 ‘05 Q1 ‘07 Q1 ‘08Q3 ‘10
Registered members
August, 2010946,273 e-mails sent by members • 9,600 physicians AND• 11,310 other providers
responded
2,216,326 test results reviewed by members• 435,906 members reviewed
test results
Source: Kaiser Permanente Internet Services Group Web Analytics
18
and, 275,000 caregivers
200,000
225,000
250,000
275,000
300,000
Jan, 2010
Aug 2010
Act for Child / Act for Adult
Source: Kaiser Permanente Internet Services Group Web Analytics
19
Who are experiencing significant job impacts
Source: Caregiving in the United States, 2009http://www.aarp.org/relationships/caregiving/info-12-2009/caregiving_09.html
2004 2009
62%
69%
Job impact while caregiving
20
We are involving members and families betternew My health manager pharmacy center - live in 2010-2011
Convenient dropdown box to refill prescriptions for “Act for a family member”
Option to refill a prescription for someone else (prescription number needed)
Add someone to your list
21
Helping families grownew My health manager Pregnancy center
New layout
Information and organization user -tested by pregnant women
Relevant health messages, linked to My health manager
kp.org/pregnancy
22
Moving people from information to actionnew My health manager Pregnancy center
Link members to prenatal education, facility services
and baby care classes
Link members to appointments, e-mail, labs, visit summaries
kp.org/pregnancy
23
Why this mattersvideo courtesy Regina Holliday & Health 2.0http://reginaholliday.blogspot.com | http://www.health2con.com
24
We use social media to participate as people
May 28th, 2009 by Ted Eytan | Popularity: 36% May 28th, 2009 by Ted Eytan | Popularity: 36% | | Edit this entryEdit this entry 20 comments | show/add 20 comments | show/add »»
Is it meaningful if patients can’t use it?
I attended a smallish get together yesterday organized by Christine Kraft to think about Health
2.0 / DC in the epicenter type things, where we thought about some of the trends in social
media use, social media use by physicians and medical groups (I got a lot of help on this one),
journalists, and finally, a real story about a patient’s experience, here in DC, that really brings to
light a problem with a meaningful use definition that doesn’t include “and the patients can see
the data.”
I’ve been thinking about the idea that meaningful use must include “patients can see everything”
since ARRA came out, and see my first mention of it in the Twittersphere around April 22. I have
noticed since then that the idea seems to be picking up steam – initially I was told by some that
this would be a “distraction” to the conversation. Now I’m sure that it’s not. Read on…
This is the story of Regina Holliday – it’s really worth a read, and I’ll quote some of it here:
We will fight the good fight. Regina’s USA medical advocacy 2009
Why do we have more transparency in special education law then in medical care? Why do
we have more access to information on a box of Cheerios then on a medical chart? Why isn’t
PHOTO
LATEST TWEETNo public Twitter messages.
Follow me on twitter
PREVIOUS ENTRYPhoto Friday: Jane and Bob at NCVHSTestimony
NEXT ENTRYFew are using HMSA’s OnlineCare | HonoluluAdvertiser.com |The Honolulu Advertiser
SIMILAR POSTS73 Cents : A New Monument to Patients, in Washington,DCMeaningful Meaningful UsePhoto Friday: Return Expectations to the Upright PositionModerating a Dream Panel at WHIT 5.0How would you counsel this patient?
Home ContentTed Eytan, MD e-Health. Patient empowerment. Washington, DC.
HomeHome AboutAbout PortfolioPortfolio ContactContact Subscribe to UpdatesSubscribe to Updates DiscussionDiscussion
25
“73 Cents”A National Monument to Patient Empowerment, in Washington, DC
http://reginaholliday.blogspot.com
26
Failure to Notify, “significant results”
Lab results studied in community practices - no improvement with EHR
Imaging results studied at the VA, with advanced EHR
11 times (out of 92), imaging results that were not relayed to patients after 4 weeks were of an abnormality that turned out to be cancer.
7.1%
92.9%
Lab
Sources: Singh H, Thomas EJ, Mani S, Sittig D, Arora H, Espadas D, Khan MM, Petersen LA. Timely Follow-up of Abnormal Diagnostic Imaging Test Results in an Outpatient Setting: Are Electronic Medical Records Achieving Their Potential? [Internet]. Arch Intern Med 2009 Sep;169(17):1578-1586.[cited 2009 Sep 29 ]; Casalino LP, Dunham D, Chin MH, Bielang R, Kistner EO, Karrison TG, Ong MK, Sarkar U, McLaughlin MA, Meltzer DO. Frequency of Failure to Inform Patients of Clinically Significant Outpatient Test Results [Internet]. Arch Intern Med 2009 Jun;169(12):1123-1129.[cited 2009 Jun 26 ]
7.7%
92.3%
Imaging
Failure to Notify Notification
27
OpenNotes
myopennotes.org
28
We use social media to tell our story about quality
50%
60%
70%
80%
90%
100%
2006 2007 2008 2009
Hawaii Region Georgia Region
Source: Kaiser Permanente Integrated Analytics; Data is for commercial enrollees only; When I Grow Up (Hawaii) - Kaiser Permanente YouTube Channel - http://www.youtube.com/kaiserpermanenteorg
NCQA 2010 90th Percentile
Breast Cancer Screening • HEDIS 2010
29
“When I Grow Up”
(125,075 total views)30
And our patients are telling it back to us
31
2005 was long ago in Internet time….
0%
25%
50%
75%
100%
AGE: < 3030-50
50-6465+
Social Networking Use Internet
Source: Pew Internet & American Life Project Tracking Survey, September, 2005; Pew Internet & American Life Project: Older Adults and Social Media, August 2010, http://pewinternet.org/Reports/2010/Older-Adults-and-Social-Media.aspxDenominator is all adults for both data points; data is for “ever have” done this activity
32
0%
25%
50%
75%
100%
AGE: < 3030-50
50-6465+
Social Networking Use Internet
Source: Pew Internet & American Life Project Tracking Survey, May, 2008; Pew Internet & American Life Project: Older Adults and Social Media, August 2010, http://pewinternet.org/Reports/2010/Older-Adults-and-Social-Media.aspxDenominator is all adults for both data points; data is for “ever have” done this activity
2008
33
0%
25%
50%
75%
100%
AGE: < 3030-50
50-6465+
Twitter/Status Update Social Networking Use Internet
2009
Source: Pew Internet & American Life Project Tracking Survey, April 2009; Pew Internet & American Life Project: Older Adults and Social Media, August 2010, http://pewinternet.org/Reports/2010/Older-Adults-and-Social-Media.aspxDenominator is all adults for both data points; data is for “ever have” done this activity
34
0%
25%
50%
75%
100%
AGE: < 3030-50
50-6465+
Twitter/Status Update Social Networking Use Internet
2010
Source: Pew Internet & American Life Project Tracking Survey, May 2010; Pew Internet & American Life Project: Older Adults and Social Media, August 2010, http://pewinternet.org/Reports/2010/Older-Adults-and-Social-Media.aspx
Half of internet users ages 50-64 and one in four users age 65 and older use social networking sites
35
Support Systems
“If there was one common theme I found in caring for my patients I would say it was the importance of support systems. Healthcare facilities don’t always provide optimal support systems. We don’t necessarily have to wait for facilities to revolutionize themselves; support systems can be developed in spite of the limitations of the healthcare industry itself. This is where social media becomes interesting.”-@PhilBaumann
“Why a Registered Nurse is Interested in Social Media,” http://philbaumann.com/2008/06/12/why-a-registered-nurse-is-interested-in-social-media/
36
“Direct Message”
Followers&Following@ = “Reply”
Monitoring
37
Ideabook: KP’s Social Network
38
Our Social Media Policy
• Employees must not represent KP views in social media channels, at work or not, without prior approval
• Aligns with Principles of Responsibility
• Covers all social media channels• Is a “living document” and will be
updated/revisited regularly• http://tinyurl.com/kpsocialmediapolicy
39
Home. Sort of.
40
Medical-Surgical Ward
41
Operating Room
42
Garfield Innovation Center
Opened in 2006 Sponsored by KP IT, National
Facilities Services, and Patient Care Services
37,000 square feet Full-scale medical-surgical ward;
Labor and Delivery; Operating Room; Emergency Department
Home environment Open prototyping space; IT lab;
conference rooms
43
1 PROTOTYPING SPACE 2 HOSPITAL
4 HOME 3 CLINIC
44
Garfield Center ActivitiesSpace Designs
Workflow Studies
Technology Demos
Training and Simulations
45
MedRite
“With our nurses as co-designers, we learned that the medication administration process is unclear, chaotic and full of interrupts. The evidence-based design is simple, elegant, and safe. We call this innovation KP MedRite.”
xnet.kp.org/innovationconsultancy
46
Growing a healthier health care system
47
Where were you when….?
48
Building, buying, eating green
Energizing our facilities with solar power
Eliminating unhealthy materials from our buildings
Zero exporting of e-wasteSourcing food locally;
creating hospital based farmer’s markets
Green Resource Center: http://xnet.kp.org/newscenter/aboutkp/green/index.html
Source: 2009 EPA Pacific Southwest Environmental Awards, http://www.epa.gov/region09/awards/09/index.html; “Healthy Health Care Leader - Kaiser Permanente,” http://blog.epa.gov/blog/2009/10/15/healthy-health-care-leader-kaiser-permanente/;
49
Greenhouse Gas reporting
Source: KP 2008 GHG inventory for the NCAL, SCAL and Northwest regions, Joe Bialowitz, Environmental Stewardship
Does not yet include all impacts of care delivery, including travel or procurement
66%
25%
4%3%2%Purchased electricityStationary combustion (incl. boilers emergency power generators)Medical gases (N2O CO2 SF6)RefrigerantsMobile combustion (fleet vehicles landscaping equipment)
Estimated Total: 0.621 Megatons of CO2eCalifornia, Oregon, Washington Operations, 2008
50
What people want
Sidney Garfield, MD summed things up …
“The people of this country ... donʼt want to get sick.”
kaiserpermanentehistory.org
51
How we are delivering it today
youtube.com/kaiserpermanenteorg
52
© 2010 The Permanente Federation, LLC
“Keep Caring”
-Mike Linton, Coalition of Wisconsin Aging Groups
53