Kaiser Permanente: Leader in Integrated Health Care and Information Systems

An Overview of Kaiser Permanente
Integration and Information Systems in Health Care
July 2014
Molly Porter, Director, Kaiser Permanente International
Molly.porter@kp.org, kp.org/international
Copyright © 2014 Kaiser Permanente

What is Kaiser Permanente?
Kaiser Permanente is committed to helping shape the future of health
care. We are recognized as the largest integrated delivery system in the
U.S. and one of the leading health care providers and not-for-profit
health plans.
Our strategy is to excel in providing high-quality, affordable health care
through our integrated delivery system, our investment in technology,
and our vision of supporting Total Health.
Copyright © 2014 Kaiser Permanente, Slide 2

Our Mission and Vision
Mission: to provide high-quality, affordable
health care services and to improve the
health of our members and the communities
we serve.
Vision: To be a leader in Total Health by
making lives better.

Kaiser Permanente is recognized nationally
Kaiser Permanente
Hospitals are the safest in
the nation
10 Kaiser Permanente Hospitals
listed among the nation’s elite in
annual “Best Hospitals” rankings
All Kaiser Permanente regions
received 5-Star ratings, the
highest possible rating
Kaiser Permanente is the only
health plan in California to earn
the highest rating for overall
quality of care in the Healthcare
Quality Report Card
Kaiser Permanente has received
36 Stage 7 Hospital Awards for
successful electronic health
record implementation
Leads the nation in the most
No. 1’s in Effectiveness of Care
Measures
The KP flagship and Every Body
Walk! apps have received Silver
Web Health Web Awards
recognizing high-quality digital
resources for consumers
KP won five 2013 eHealthcare
Leadership awards, including
the highest honor for
Organizational Commitment,
and the 2013 Hospital Website
Transparency Award with
Distinction
KP’s California health plans
receive top rating -- 4 Stars --
for quality and service
27 Kaiser Permanente
facilities honored as ‘Top
Performer’ for Quality and
Safety by The Joint
Commission

KP by the Numbers
ƒ 7 regions serving 8 states and the District of
Columbia
ƒ More than 9.3 million members
ƒ More than 17,000 physicians and 174,000
employees (including 48,000 nurses)
ƒ 38 hospitals (co-located with medical
offices)
ƒ 608 medical offices and other outpatient
facilities
ƒ 70 years of providing care (opened in 1945)

Our Markets and Membership: 12/31/2013
Mid-Atlantic
States
502,176
members
Georgia
251,827
members
Colorado
572,748
members
Northwest
501,547
members
California
7,252,462
members
Hawaii
229,304
members

External Validation of our Overall Quality
ƒ In the National Committee for Quality Assurance’s 2013
Health Insurance Plan Rankings, all 8 Kaiser
Permanente commercial plans were rated in the top 6%
of the 484 ranked national plans.
ƒ According to the 2014 Medicare star quality ratings: all
7 of Kaiser Permanente’s regions received 5 stars,
based on 55 measures of quality and service, such as
staying healthy, managing chronic conditions, member
satisfaction, customer service, and pharmacy services.

External Validation of our Inpatient Care
ƒ On four sets of Joint Commission inpatient
process measures (related to heart attack,
heart failure, pneumonia, and surgical care
improvement), almost all Kaiser
Permanente hospitals score in the top 10th
percentile.
ƒ We had the highest scores of any hospital
system from The Leapfrog Group, which
rates 2,618 hospitals on safety.

And our members like us!

Driving Performance through Incentives
ƒ Permanente physicians are all
salaried, based on competitive salaries
in their specialties and geographic
areas, and receive generous benefit
packages.
ƒ A small incentive bonus (usually less
than 10%) is awarded if both the
facility (practice site) and the individual
physician achieve some specific
quality measures

Driving Performance through Incentives
Physicians have goals related to:
ƒ Quality
ƒ Access
ƒ Service
at the individual, department, and facility
levels.
Their performance in these areas compared
to local and regional averages affects their
bonus as well as their annual pay raise.

Sample Quality Goals
ƒ Childhood immunizations
ƒ Breast cancer screening
ƒ Chlamydia screening
ƒ Tobacco counseling
ƒ Diabetes glycemic control
ƒ LDL control
ƒ Blood pressure control

Kaiser + Permanente
Kaiser
Foundation
Health Plan,
Inc.
Permanente
Medical
Groups
Regions
The
Permanente
Federation,
LLC
Articles of Federation
Kaiser
Permanente
Program Group
Medical Service
Agreements/
Memorandums of
Understanding
Our Structure
13 Copyright © 2013 Kaiser Permanente, Slide 13

KP Operating Model (since 1955) KP Operating Model (since 1955)
POPULATION
Kaiser
Foundation
Health Plan
Kaiser Foundation
Hospitals
Permanente
Medical Group
Health Plan
Members
Medical Service
Agreement
Hospital Service
Agreement
Group/Individual Contracts:
Prospective Payment
Operating Budgets Capitation to the Group
REVENUE
EXPENSE
---------------------------------------------------------------------------------------------------------------------

One-Stop Shopping for Most Services
ƒAmbulatory/outpatient care
ƒAudiology and optometry (hearing and seeing)
ƒBehavioral/mental health
ƒDiagnostic imaging, laboratory, and pharmacy
ƒEmergency care and hospitalization*
ƒHealth education and preventive care
ƒHome health care
ƒLabor and delivery
ƒOccupational health (workers’ compensation)
ƒPhysical therapy
ƒPrimary care working closely with specialty care, surgeons, hospitalists*
* Special note: In our smaller regions, we may contract with community hospitals
as well as for some medical care.

KP leads the world with 100% adoption of
Multifunctional Electronic Health Records
Doctors with EHRs and Multifunctional Health IT Capacity
97% 92%
98%
69%
56%
82%
98%
68%
60%
33%
27%
10% 7% 4%
120%
100%
80%
60%
40%
20%
0%
UK AUS NETH USA CAN GER NOR
Source: Commonwealth Fund 2012 International Health Policy Survey
Percentage of Primary Care Doctors
Using EHRs
with Multifunctional Health IT Capacity

External Validation of our IT Leadership
ƒ The Healthcare Information and Management Systems
Society (HIMSS) — the largest health care IT
association in the world — gave us their top award, the
Davies Award for health care IT excellence.
ƒ Their top award for hospital IT achievement is to be a
Stage 7 hospital. All Kaiser Permanente hospitals are
Stage 7.
ƒ Implemented between 2004 and 2010, KP
HealthConnect is one of the largest and most advanced
civilian deployments of an electronic health record.

Hospital w/ hospital
based specialty care
Specialty Hub
w/ primary care
Primary care
/ ancillaries
Mobile
Services
Employer
Clinics
Web
Care
Anywhere
Tele-medicine
Micro-Hospital
Home
as the
Hub
Mobile
Health
Health Care Transformation
:: ::
Care
Anytime
Micro-Clinics

Kaiser Permanente HealthConnect
Kaiser Permanente typically spends about 6% of our total revenue on information
technology. KP HealthConnect (our integrated system for care delivery) is:
ƒ More than just an electronic medical record
ƒ A Program-wide system that integrates the clinical record with appointments,
ancillary and specialty services, registration, and billing
ƒ A complete health care business and management system that enhances the
quality of patient care
ƒ A personal health record for more than 4 million Kaiser Permanente members
(67% of members over 13 with Internet access)
Note: Return on investment was estimated at 8.5 years (but this was a
strategic investment, not based on ROI)

Integrated Clinical Information Systems
At Kaiser Permanente, patient care is highly coordinated through state-of-the-art
technology and multispecialty physician group practice.
Disease registries
Risk stratification
Identification of
subgroups needing care
Patient management tools
Targeted panel lists
Inreach- prompts, reminders
for clinicians
Outreach- Letters and
automated telephone
outreach to members
Monitoring and process
improvement measures and
reports
KP Health Connect enables member
engagement, which produces
superior medical outcomes.
KP
Health Connect
Secure Web-Based
Universal Access
Real Time
Linked to Delivery System
Electronic Ordering
Digital Imaging
Secure Messaging
CarePoint
Population
Management Tool
Labs
Inpatient
Outpatient
Emergency
Pharmacy
Imaging
Immunization
Membership
Financial &
Benefits KP.org and
My Health Manager

Instant Access to Medical Records for
Providers and Patients
ƒ Review medical records
ƒ Check lab results
ƒ Immunization records
ƒ History of medical visits
ƒ Direct ordering of
prescriptions, labs, and
referrals
ƒ Best practice alerts

Anytime, Anywhere Access
56% of U.S. adult cell phone
owners have smartphones.
Of the KP members registered
on kp.org, a quarter of them are
accessing our online features
via mobile devices.
KP app:
ƒ locate facilities
ƒ access medical records
ƒ refill prescriptions
ƒ make appointments
ƒ email caregivers
ƒ view test

Transforming Primary Care Encounters
Care is not just delivered in face-to-face visits now. It is now done on the phone and through secure emails. In 2003,
there were essentially 0% secure emails – Now it represents 32% of the primary care patient encounters.
95% 66% 60% 57% 55% 54% 51%
5%
18%
23% 26% 28% 30% 33%
16% 17% 17% 17% 16% 16%
100%
80%
60%
40%
20%
0%
2003 … 2008 2009 2010 2011 2012 1H2013
— KP Program Wide —
Office Visits
Secure email
Telephone
Source: UCDA Core Value Metrics
24

Seniors are some of our highest online users!
% of KP members registered for kp.org at end of 2012
Internet use not considered in this calculation
Kaiser Permanente Web Insights National Market Research
49%
66%
62% 63% 66%
53%
18-29 30-39 40-49 50-59 60-69 70+

As a result, malpractice cases are down
Professional Liability Claims Per 100,000 Members
KP HC
implementation
began 2004
1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Preserving the Environment
Online requests contribute to an estimated annual 7,000
tons of avoided carbon dioxide emissions.
Health Affairs, 30, no. 5, 2011

“Ordering
prescriptions online
has made my life a lot
easier no more
driving 22 miles and
waiting in long lines.”

Better Adherence
Patients (who used online prescription service) had higher
rates of medication adherence as compared with nonusers.*
American Journal of Managed Care, 2012
*45% of all KP pharmacy refills are ordered online.

“The test result
feature helps me to
be aware of my
responsibility in taking
care of myself.”

More Loyal Members
Patients with online access to key components of the
electronic health record’s patient portal, My Health
Manager, are 2.6 times more likely than nonusers to
remain Kaiser Permanente members.
The American Journal of Managed Care, July 2012
.

“Kp.org is an excellent
way to communicate with
my doctor and children’s
pediatrician. It saves me
a lot of time.”

Panel Support Tools

Why Data is Critical to Health Care…All About the Outcomes
Convenience / Service Affordability Quality
14.8
secure physician &
million
clinician emails
131
million
visits to KP.org &
KP Mobile
3.6 online
appointments
reduction
in office visits
per member
8%
reduction
in follow-up visits per
member
11% in emergency
room visits
26%
reduction
in medication
errors
50%
fewer
hospitalizations for
diabetics
73% in cardiac
mortality
57%
million reduction reduction

KP International Offerings (see
kp.org/international)
April 14-17 : Three-day program in San Francisco
Three-day programs at Kaiser Permanente (currently planning for April 2015)
Two-day customized programs (for a minimum group size of 10)
Kaiser Permanente workshops or presentations in your country
Presentations or seminars in your country
Videoconferences or Skype presentations
Care Management

Kaiser Permanente: Leader in Integrated Health Care and Information Systems

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to Kaiser Permanente: Leader in Integrated Health Care and Information Systems

Similar to Kaiser Permanente: Leader in Integrated Health Care and Information Systems (20)

More from Empreender Saúde

More from Empreender Saúde (20)

Recently uploaded

Recently uploaded (20)

Kaiser Permanente: Leader in Integrated Health Care and Information Systems