Thursday, August 19, 2010

Kaiser Permanente Health IT - Here is a Good Discussion on A World Leader!

The following appeared a few days ago.

Electronic records keep pulse of patients

Kaiser system gives glimpse of future

Jim Steinberg, Staff Writer

Posted: 08/07/2010 07:10:48 AM PDT

The quest to put medical records on computers are a national priority set by President Barack Obama before he took office.

"This will cut waste, eliminate red tape and reduce the need to repeat expensive medical tests," then President-elect Obama said in early January 2009.

"...It will save lives by reducing the deadly but preventable medical errors that pervade our health care system," Obama said.

Late last month, the U.S. Department of Health and Human Services issued rules for hospitals and physicians to receive financial incentives to promote their use of electronic medical records.

Starting in 2015, there will be penalties for failure to meet the government's 19 guidelines for "meaningful use" of electronic health records.

Although 2015 may not mark the year emergency room teams in any Maine hospital will have access to the health records of a vacationing Southern Californian, "we will be a lot further along than we are now," said Dylan H. Roby, a research scientist with the UCLA Center for Health Policy Research.

Hospitals and doctors across much of Los Angeles County are beginning to exchange health information records in a pilot health information exchange program that is being echoed with similar ventures in various stages across the country.

While some facilities have had a great deal of information on computers for years, others are preparing to dive into the process.

Most health care providers will choose among more than six vendors for off-the-shelf software which they will then customize.

"We have narrowed it down to two software vendors and will make a decision very soon," said Dr. Rafael Amaro, medical director of Long Beach-based Molina Healthcare Group, which has 20 health care centers nationwide targeting the ethnically diverse low-income population.

Molina's Southern California locations include Ontario, Fontana and San Bernardino, Pomona and Long Beach.

Mark Amey, chief information officer of the University of Southern California's health units, said that from the perspective of "change of work flow and process," the computerization medical records is the largest project ever undertaken in the healthcare realm.

Once medical records go on the computer, the patient can be brought aboard the medical team in a way not possible previously.

Better compliance with medical instructions and a happier, healthier patient are the hoped for results.

Among the government's "meaningful use" criteria are provisions for the establishment of e-mail communication between doctor and patient.

Oakland-based Kaiser Permanente is generally recognized as a global leader in its use of electronic medical records and related technologies, including e-mail.

Although one might think patient to doctor e-mail might expose busy physicians to a barrage of questions, symptom updates and lengthy prattles from hypochondriac patients, that overall has not been the experience.

A Kaiser Permanente study found that 75 percent of all patient-physician e-mail encounters addressed ongoing medical problems or care plans.

Leading reasons patients contact physicians are to discuss changes in a health condition, lab test results, a new condition, drug dosage adjustments and the need for a new condition.

In a research project published in the July issue of "Health Affairs," a leading health policy journal, Kaiser Permanente's Southern California region showed e-mail messaging improves the effectiveness of care for patients with diabetes, high blood pressure or both.

The study, involving 35,423 patients, showed 2 percentage-points to 6.5 percentage-points improvements in glycemic, cholesterol and blood pressure screening and control.

"Putting patients and their data at the center of care, quality, access and cost," George Halvorson, Kaiser Permanente chairman and CEO, said in a statement.

"This data proves that health IT (information technology) can be a fundamental component of accomplishing those three critical goals," Halvorson said.

"I call it a revolution," says Kaiser Permanente patient Dan Bozick.

"I take a blood test in the morning and get results on the computer in the afternoon," the Redlands resident said.

"I like it (My Health Manager) because it gives us numbers," said Grace Wong of Hacienda Heights.

Test results give specifics and show normal ranges for those tests so patients can know their system is out of whack.

In cases where results are outside normal ranges, patients can query their doctor to find out if this change warrants a visit, a change in medications or just watching for the next test.

After a trip to the doctor, a summary of the visit will be in their hand at departure and on My Health Manager, for later view after the paper has long ago disappeared.

Something in the details a little fuzzy?

Just fire off an e-mail, Wong said.

Rusty Spencer, of West Covina, lost the use of his legs following a motorcycle accident and has since been plagued by frequent urinary tract infections.

He and his wife use a home test kit and frequent e-mails to their doctor to nip those infections earlier with antibiotics before it progresses into a life-threatening situation.

"I've reduced my emergency room trips 90 percent," he said.




Increased and speedy access to patient history and information. The network is most efficient by region, but a national network is in progress.

Improves patient compliance and overall health outcomes.

Gives Kaiser Permanente medical professionals faster access to new information, i.e., medication alerts and clinical libraries.

Provides Kaiser Permanente medical professionals a trusted network of information as all content is verified by the network's own physicians.


Functions are limited to what information/access the user needs to perform their specific job. Different levels of access based on level of employee.

Security level designations approved by manager and reviewed quarterly.

Every action leaves an electronic footprint, so questionable access/action can be traced back.

"Break the glass" function: Puts an automatic alert on certain patient records that asks the person seeking access "Do you really need to know?" (Example use: If someone famous is being treated at a particular hospital, this function prevents staff from attempting to snoop the patient's information on any level.) If the "glass" is broken, and the employee didn't have a legitimate reason for doing so, it is a fireable offense.

Lots more here:

Here is a little on what the patients think.

Kaiser Permanente notes gains in members online care management

By IFAwebnews Staff

Posted: August 11, 2010

Health insurer Kaiser Permanente says its members are embracing online communication methods in their medical care.

The company, reporting on its second-quarter earnings, said it has invested in developing the world’s largest private electronic health record system, Kaiser Permanente HealthConnect, which is now in use across Kaiser Permanente. The company operates in nine states and Washington, D.C.

Kaiser Permanente care teams routinely document patient care with an electronic chart in both inpatient and outpatient settings, according to the company.

For the first six months of 2010, members have exchanged 5.3 million emails with their Kaiser Permanente doctors and refilled 4 million prescriptions online. In addition, 12.7 million lab results have been delivered online in the first six months of the year.

More here:

And for proof it all seems to work (one of many papers)

Study: Doctor, patient e-mailing improves patient outcomes

August 10, 2010 | Molly Merrill, Associate Editor

OAKLAND, CA – E-mail use between patients with diabetes and hypertension and their doctors resulted in improved quality of care scores, according to a study of patients in Kaiser Permanente's Southern California region.

The study, which was published in the July issue of Health Affairs, observed 35,423 patients with diabetes, hypertension, or both. Researchers found that the use of secure patient-physician messaging in any two-month period was associated with statistically significant improvements in HEDIS (Healthcare Effectiveness Data and Information Set) care measurements. Results included 2 to 6.5 percentage point improvements in glycemic, cholesterol and blood pressure screening and control.

"Putting patients and their data at the center of care allows Kaiser Permanente to improve health care quality, access and cost," said George Halvorson, chairman and CEO, Kaiser Permanente. "This data proves that health IT can be a fundamental component of accomplishing those three critical goals."

More here:

If you want more here might help:

My Health Manager: The Story Behind Kaiser Permanente's Powerful PHR

Web Seminar Center, September 2, 2010, 11:00AM ET

As a trailblazer in Health IT, Kaiser Permanente continues to set standards with its personal health record initiative to engage patients online with Kaiser Permanente health teams to manage their health and wellbeing.

Anna-Lisa Silvestre, Kaiser Permanente’s vice president of online services, has developed and overseen the strategy for My Health Manager on The patient portal now has more than 3 million patients registered to access their PHRs, e-mail physicians and participate in health behavior programs.

This is really important in my view – as it shows what leadership and preparedness to actually invest can achieve.

You can assess what is on offer from our leaders after reading this. Remember the 8 million members of KP are not waiting a further decade this is fully implemented and operational today!


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