E-health systems have led to significant improvements in clinical outcomes at the Oakland, Calif.-based Kaiser Permanente, as healthcare continues to be driven by new technology, according to the chairman of Kaiser, George Halvorson, who delivered a keynote speech at the New York eHealth Collaborative's annual Digital Health Conference on Thursday morning at the New York Hilton.
Halvorson stressed that Kaiser has committed itself to care delivery that is grounded in continuous improvement strategies based on the study of data. "You have to have the team, mission, commitment, and continuous improvement to address health disparities. Disparities today are due to three factors—biology, bias, and behavior. It took eHealth data to help us change the system to reduce racial and ethnic disparities in health," Halvorson said.
The Kaiser organization, which combines a nonprofit insurance plan with its own hospitals and clinics, serving more than 9 million members, has been investing heavily in electronic health records (EHRs) and physician support systems. Kaiser's care improvement programs have dramatically diminished rates of sepsis and pressure ulcers, cut HIV death rates to half the national average, improved heart-disease survival, and significantly reduced the number of broken bones for Kaiser members, said Halvorson, who added that, "Electronic data lets us uncover all kinds of linkages and causalities in healthcare. Without the data, we couldn't have even begun the research," he said. "As a result of eHealth systems, our outcomes our twice as good as any in the country."
Paper records are a huge impediment, and at best, are inert, continued Halvorson. "Patient data needs to be in real-time, interactive, and shared amongst all care providers." Halvorson specifically emphasized the sharing of data, urging caregivers who share patients to also share health information about those patients. But tools are needed—connectivity tools, process tools, and enhancement tools are critical components to delivering better care, he said.
Halvorson attributed reduced death rates in the Kaiser system to these tools, providing an example related to stroke mortality rate. Data and technology helped Kaiser identify that patients who suffered a stroke were twice as likely to live if they were given a statin. If the statin was given then discontinued, the mortality rate increased even more.
Going forward, Halvorson sees healthcare as an industry that is going home, predicting that for many patients, home will be the primary site for their care, while also believing that the internet will also be a key deliverer of care. At Kaiser, patients can stay electronically connected to care teams through e-visits instead of face-to-face clinical visits, and receive lab reports, test results, and updates electronically, he said. '"We need internal and external connectivity inside and outside our healthcare organization."