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Kaiser Web-based Tool Enhances Patient Care

November 11, 2010
by John DeGaspari
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Report authors share the secrets to the tool's success

Kaiser Permanente this month released the first studies of its proprietary Panel Support Tool, a Web-based software that extracts information from Kaiser’s HealthConnect electronic medical record (EMR) to help physicians improve and manage their patients’ care. First rolled out in 2006, the Panel Support Tool is tightly integrated with HealthConnect, the organization’s comprehensive electronic health record (EHR). According to Permanente, the two studies are the first to examine the effectiveness of the Panel Support Tool in a large, diverse patient population.

According to Kaiser Permanente, the Panel Support Tool was developed in-house to help its primary care physicians manage the care for individual patients, groups of patients, or their entire panel. It works by comparing the care the patient is receiving to the care that is recommended by national guidelines. A physician can, for example, query the Panel Support Tool in advance of a patient visit, to find out if that patient needs a screening test or a vaccine. Physicians can also ask the Panel Support Tool to display a list of all of their patients who are overdue for a mammogram or colon cancer screening; or a list of their diabetic patients whose blood sugars are too high, or those who need a foot exam or an eye exam.

The retrospective, longitudinal study, “Effect of a Patient Panel-Support Tool on Care Delivery,” which was published in the October issue of The American Journal of Managed Care, followed 204 primary care teams who are using the Panel Support Tool to manage care of 48,344 patients with diabetes and/or heart disease. After three years, for patients with diabetes, the percentage of care recommendations met every month increased from 67.9 percent to 72.6 percent; for heart disease patients, the percentage rose from 63.5 percent to 70.6 percent.

The second study, “Improving Population Care with an Integrated Electronic Panel Support Tool,” which was published online in Population Health Management, involved 207 primary-care teams that were using the Panel Support Tool to manage the care of 263,509 adult patients, some of whom were relatively healthy and others who have chronic diseases. The study looked at 13 different care recommendations and found that, after 20 months, the Panel Support Tool improved performance from 72.9 percent to an average of 80 percent. The researchers also found that during the first year of tool use, performance in delivering the care recommendations improved by a statistically significant degree every four months.

The Panel Support Tool monitors recommendations pertaining to medical management and screening for co-morbidities in six chronic conditions: asthma, diabetes, coronary artery disease, heart failure, hypertension, and chronic kidney disease. The tool measures preventative care measure, such as administering adult immunizations and screening for breast, cervical, and colorectal cancer, hyperlipidemia, and osteoporosis. For each care recommendation, the Panel Support Tool indicates what action needs to be taken, if any.

Recently, HCI Managing Editor John DeGaspari interviewed Robert Unitan, M.D., Panel Support Tool Physician Leader, one of the authors of the first study, and Yvonne Zhou, Ph.D., director of analytics, evaluation and knowledge management, northwest permanente and lead author of the second study, about the events that led to the development of the Panel Support Tool and what it will mean for Kaiser Permanente’s primary care physicians.

In Part 1 of the interview Drs. Unitan and Zhou speak about the formation and early development of the Panel Support Tool, and the improvements in care that Kaiser Permanente’s physicians have seen with its use.

Healthcare Informatics: Explain the genesis of the Panel Support Tool. How did it develop?

Robert Unitan, M.D.: I am physician leader at Kaiser Permanente, the director of operations for medical specialties. And we are always looking for ways to take better care of our membership.


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