Kaiser Permanente: A leader in Health I.T.

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2 Kaiser Permanente: A leader in Health I.T. Frank Genova, MD, Associate Medical Director, Technology Integration Mid-Atlantic Permanente Medical Group Highest Member Satisfaction among Commercial Health Plans in the Virginia-Maryland-D.C. Region, Three Years in a Row. * *Kaiser Foundation Health Plan, Inc., received the highest numerical score among commercial health plans in the Virginia-Maryland region in the proprietary J.D. Power and Associates 2011 U.S. Member Health Insurance Plan Studies.SM 2011 study based on 33,039 total member responses, measuring 6 plans in the Virginia-Maryland-DC region (excludes Medicare and Medicaid). Proprietary study results are based on experiences and perceptions of members surveyed December 2010 January Your experiences may vary. Visit jdpower.com. March 27, Kaiser Foundation Health Plan, Inc.

3 About Kaiser Permanente of the Mid-Atlantic States 18 March 27, Kaiser Foundation Health Plan, Inc.

4 Kaiser Permanente Mid-Atlantic Who we are With the largest multi-specialty physician group practice in the region, supported by state-of-the-art technology, Kaiser Permanente offers members superior quality, market-leading convenience & the most highly coordinated care in the Mid-Atlantic Facts Located in the D.C., MD & VA Approximately 500,000 members 28 medical centers 2 full-service facilities; over 30 specialties under one roof 10 urgent care, after-hours medical centers Almost 1,000 Mid-Atlantic Permanente physicians 6,000 health plan employees Almost 215,000 members* registered for My Health Manager on kp.org Over 1.7 lab test results viewed online More than 806,000 secure s sent to doctors 462,000 online prescription refills *Data as of December March 27, Kaiser Foundation Health Plan, Inc.

5 Kaiser Permanente Our model Kaiser Permanente is an integrated health care delivery system with a unique partnership among three entities Kaiser Permanente medical centers offer a wide array of services, all under one roof: Pharmacy, radiology & laboratory Primary care: ob/gyn, adult medicine & pediatrics Specialty care: allergy, ambulatory surgery, dermatology & more Health education & preventive care Primary care physicians working closely with specialists Kaiser Foundation Health Plan Permanente Medical Groups Kaiser Permanente Health Plan Members Kaiser Foundation Hospitals (only in Ca.) Social purpose Quality driven Shared accountability for program success Integration among multiple dimensions Prevention and care management focus 20 March 27, Kaiser Foundation Health Plan, Inc.

6 Health I.T.: What keeps me up at night? 21 March 27, Kaiser Foundation Health Plan, Inc.

7 Health I.T. Systems Architecture 22 March 27, Kaiser Foundation Health Plan, Inc.

8 Upgrades and Enhancements Every enhancement has to be built and tested Tight integration of all the components means that improving one part of the system may alter something in another part of system Therefore changes take more time than in a stand alone system Every upgrade causes the potential for numerous systems to fail Therefore a lot of time and energy is spent on reviewing impact of upgrades About 10,000 hours of work last year for the Epic 2010 upgrade 23 March 27, Kaiser Foundation Health Plan, Inc.

9 Specialization and Training Every application has its experts A high level of skill is required to maintain and develop applications Talent does not come cheap Every enhancement or change can alter multiple workflows Some enhancements don t get implemented or delayed because the work of one group will be too heavily impacted (particularly relevant in ED, OR etc.) 24 March 27, Kaiser Foundation Health Plan, Inc.

10 Privacy and Data Flow Health care providers understand the inherent value in sharing relevant medical information across care settings and organizations Federal and state mandates and initiatives around sharing information are in flux Privacy laws conflict with each other and create cost and complexity The system hasn t decided where to price data sharing Some state level HIE s don t have sustainable models Vendors can lock into standards wars Delivery systems need size to achieve relevance 25 March 27, Kaiser Foundation Health Plan, Inc.

11 26 March 27, Kaiser Foundation Health Plan, Inc. Health I.T.: What do I dream of?

12 Data Modeling At the enterprise a common model for all data is established Any user interface can send its data to the model by way of its application The model stores data in a persistence layer Other applications talk to the persistence layer in the language of the model Significant reduction in maintenance and development of interfaces Data analysis becomes standardized Data experts learn the model Reporting can be transplanted to different parts of the organization 27 March 27, Kaiser Foundation Health Plan, Inc.

13 Data Modeling, cont d Decision support tools can be driven off a model Any delivery system can deploy and test a decision support tool The best performing tools are propagated across organizations User interfaces become more customizable and more useable If the GUI sends data on through to a model, the model is agnostic to the interface Design centered work can focus on the ideal interface 28 March 27, Kaiser Foundation Health Plan, Inc.