eHealth Equity, Tim Kieschnick
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Transcript of eHealth Equity, Tim Kieschnick
HIT Transformation / Analytics – National Quality & Care Delivery ExcellenceHARVESTING VALUE
Kaiser PermanenteKP HealthConnect
Terhilda GarridoVP Health IT Transformation/AnalyticsMarch 7, 2011
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About Kaiser Permanente
Integrated health care delivery3 Organizations in one: Health insurer, hospital system, physician partnerships
8.6 million members
165,000 employees
Serving 9 states and DC
14,000 physicians
Nation’s largest nonprofit health plan
36 hospitals and medical centers
430+ medical offices
$40.3 billion annual revenues (2008)
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Data Warehouse / EDR Enterprise Data Repository
Membership/Benefits
Claims Processing
Benefits Accumulation
Pricing System
OutpatientPharmacy
Lab
Radiology/Imaging
Others(EKG, dictation)
GeneralLedger
Capital Planning
Financial Reporting
Ancillaries
Outpatient
Scheduling
Registration
Clinicals
Billing
Health Information
Management
Inpatient
Admission,
Discharge & Transfer
Health Information
Management
Clinicals
Pharmacy
Emergency
Department
Operating Room
Billing
Scope of Kaiser Permanente HealthConnect®
Web Access Portal / kp.org
Health PlanCare Delivery Core Finance
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KP HealthConnect
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The After Visit Summary – an example of consistent, reliable care services
What were my vital signs? What instructions did the
doctor give? Heat or ice? How long will it take to
recover? What tests were ordered? What medications were
ordered?
Past Visit Information
55 © Copyright Kaiser Permanente
Patient portal – Successful with patients!
•3.4 million registered users
•52 million sign-ons
•10 million secure emails
•25 million tests viewed
•6.8 million Rx refills orders
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Patient portal – Effectiveness
Efficiency /conveniencePatients who use secure e-mail:
Are 7% to 10% less likely to schedule routine office visit1
Make about 14% fewer phone contacts Those who book appointments online are up to
50% more likely to keep them Quality of Care
In a matched-control analysis published in Health Affairs, secure email was associated with a 2.0 to 6.5% improvement in performance on HEDIS measures, such as glycemic (HbA1c), cholesterol, and blood pressure screening and control2
Patient Satisfaction 85% rated encounters 8 or 9 on a 1-9 scale3
1 Zhou, Yi Yvonne; Garrido, Terhilda; Chin, Homer; Wiesenthal, Andrew; Liang, Louise, “Patient access to an electronic health record with secure messaging: impact on primary care utilization,” The American Journal of Managed Care, Vol 13:418-424, July 2007.
2Zhou, Yi Yvonne; Kanter, Michael H; Wang, Jian J; Garrido, Terhilda, “Improved Quality at Kaiser Permanente Through E-Mail Between Physicians and Patients,” Health Affairs, Vol 29, No 7 (2010); 1370-1375.3 Internal KP study, “Harvesting Value: Early Findings from Kaiser Permanente HealthConnect™” presented to Center for Information Therapy by T Garrido, C Serrato, J Oldenburg (1/15/2008)
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Patient Empowerment
Consumers and Health Information Technology:A National Survey©2010 California HealthCare Foundation
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PHR Registration by Age
KP MyHealth Manager registration by ageThe online population is made up of older members
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White/ non-
Hispanic42%
Hispanic31%
Asian/PI12%
Black12%
Other3%
Not Registered for PHR Registered for PHR
Black8%
Asian/PI14%
Hispanic16%
White/ non-
Hispanic59%
Other3%
KP MyHealth Manager Registration by Race / Ethnicity
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Patient Empowerment
• Populations with less education benefit more from a PHR
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Increased operational efficiencies & cost-savings
A nationwide survey conducted in 2010 by the California HealthCare Foundation found that people with a household income of less than $50K and also people with an education that is lower than a college degree feel more connected to their MD with the use of personal health records when compared to all users of PHR.1 These groups also reported that they asked more questions than they would before the use of PHR to a greater extent than all the users of PHR.
This has large potential benefits because HIT seems to offer more to these traditionally underserved populations, which could potentially equalize health outcomes. This, coupled with the survey finding that Latinos, African American men, and Asian Americans show more interest in health applications than all adults in the United States, could mean that there is much opportunity in HIT.
1Undem, Tresa. Consumers and Health Information Technology: A National Survey. Publication. California HealthCare Foundation, Apr. 2010. Web. http://www.chcf.org/~/media/Files/PDF/C/ConsumersHealthInfoTechnologyNationalSurvey.pdf
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Beginning of KP journey….
We are beginning work to:• understand the nature of the ‘eDisparities’• understand how to bridge and diminish those gaps• understand how populations at risk can best be
served by HIT