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Kaiser's Care Model

April 22, 2010
by Kate Gamble
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By leveraging IT systems and focusing on disease prevention, Kaiser is looking to redefine the way care is practiced.

Kaiser Permanente is in a class by itself.

The Oakland, Calif.-based, integrated managed care organization, which includes Kaiser Foundation Hospitals and their subsidiaries and The Permanente Medical Groups, along with the nation’s largest not-for-profit health plan, serves more than 8.6 million members in several states. With a unique closed-system model, Kaiser is able to allocate funds for initiatives geared toward prevention and chronic care management — programs that have yield significant benefits, both in cost savings and improved patient outcomes.

“We’re a preventive care organization at our core, so we already do quite a lot of chronic care management as part of our core systems across our organization,” said Phil Fasano, senior vice president and CIO, in a recent interview with Healthcare Informatics.

The results have been quite impressive, and Kaiser has the numbers to prove it. “Our predictive analytic tools help us leverage all the information about our members and patients to proactively engage members in their health, and help them understand their risks and the benefits they will see from various preventive care programs,” says Amanda Higgins, executive director of communications & stakeholder management for Kaiser Permanente Information Technology.

According to Higgins, Kaiser’s IT-enabled care approach and focus on disease prevention have been able to achieve the following outcomes:

  • When barcode scanning was linked with Kaiser Permanente HealthConnect CPOE and eMAR, there was a 57 percent reduction in the rate of medication errors.
  • A program in Kaiser’s Ohio region providing proactive outreach to diabetic patients resulted in a 50 percent reduction in hospitalizations. The number of diabetics with poor hemoglobin A1C control decreased from 40.9 percent to 21.1 percent, the number of diabetics receiving eye exams increased from 51.9 percent to 75 percent, and the number of patients who successfully controlled their low-density cholesterol levels went from 40.2 percent to 58.7 percent
  • In the Colorado region, the risk of cardiac mortality within 90 days of a heart attack was reduced by 88 percent (the number of patients meeting their cholesterol goal went from 26 to 73 percent, and the number of patients screened for cholesterol rose from 55 to 97 percent)
  • With the introduction of KP HealthConnect EMR (Epic Systems), office visits per member decreased by 26.2 percent
  • After Kaiser introduced MyHealthManager, a feature on the portal where members can access their health information, the organization saw an 8 percent decrease in follow-up office visits, a 14 percent reduction in unscheduled phone calls, and an 11 percent reduction in emergency room visits.

While it is understood that most organizations have nowhere near the resources Kaiser has (not to mention the luxury of being a closed system), it’s still notable what the system has been able to accomplish. As healthcare reform initiatives start to take shape, hopefully more healthcare systems will be able to roll-out programs focused on the prevention of chronic diseases. As Kaiser’s results have shown, these programs could be just what the doctor ordered to help curb the growing cost of chronic care management.