Kaiser Permanente Ecosystem
Born from Dr. Sydney Garfield's failing 12-bed Contractor's General Hospital in the Mojave Dessert during the height of the Great Depression, Kaiser Permanente is now one of the largest, not for profit hospital organizations in America. Through a sequence of unforeseen events and the development of the prepaid health plan system, it grew from a simple 12-bed facility in the Mojave Desert to 38 hospitals and 622 medical offices stretching from Hawaii and the Pacific Northwest to Colorado, Georgia and Washington, D.C. and its suburbs. (Press Release, 2015)
World War II is the historic event that really impacted the growth of Kaiser Permanente. As the Grand Coulee Dam Project was coming to an end in 1941, America was entering World War II. This meant that ships and other steel products had to be built and would require tens of thousand of workers. Henry J. Kaiser would employ these workers but also had the obligation to provide healthcare for them and their families. Knowing Dr. Sidney Garfield from previous projects, including the Grand Coulee Dam Project, Mr. Kaiser called Dr. Garfield to implement the prepayment healthcare model that was very successful in the past. Upon calling, Mr. Kaiser discovered that Dr. Garfield was entering active duty with an Army Reserve unit and would be leaving in a few weeks. In a plea made to President Franklin Roosevelt from Henry J. Kaiser, Dr. Garfield was released from the military and begin to plan and lead a prepaid group practice for the workers at the shipyards. This is how the innovative healthcare system got to the San Francisco Bay area and formed an association with Kaiser that continues today. (Kaiser Permanente Share, 2015)
At the end of the war, the 90,000 employees became 13,000 employees in just a few months and the practice got smaller. Dr. Sidney Garfield and Henry J. Kaiser did not want the new prepayment plan of healthcare delivery to end. On July 21, 1945, the Permanente Health Plan officially opened to the public. Enrollment surpassed 300,000 members in Northern California within 10 years largely due to the support of the unions. In 1953, the name of the Health Plan and the Hospitals was changed from Permanente, which some felt had little meaning outside the organization, to Kaiser, which had high recognition nationally because of Kaiser Industries and Henry J. Kaiser himself. The medical group chose to keep the Permanente name, in part to clarify that they were not employees of Henry J. Kaiser. (Kaiser Permanente Share, 2015)
Kaiser Permanente's vision is that “We are trusted partners in total health, collaborating with people to help them thrive and creating communities that are among the healthiest in the nation.” (About Kaiser Permanente, n.d.)
In 2005, Hurricane Katrina ravaged the Gulf Coast. One of the hardest hit areas was New Orleans, Louisiana. For the past 10 years, as a service provided to the community, Kaiser Permanente employees and physicians have been involved with rebuilding the community through projects to improve the health and well being of its citizens by volunteering to help. With the hard work being directed by HandsOn New Orleans, Kaiser Permanente volunteers are helping the community thrive once again. (Kaiser Permanente Share, 2014).
For two full days the Einstein Charter School was the focus of the Kaiser Permanente volunteer team. The team renovated the Welcome Trailer, created an edible school yard, a teaching garden and a teaching kitchen with the aim of getting students involved in growing their own food and learning about healthy eating. The teaching garden now includes kale, herbs and citrus trees, with more produce to come. All of the Kaiser Permanente projects associated with the Einstein Charter School are part of the continued improvement to provide opportunities for the school to encourage healthy eating and physical activity among the students. (Brozina, 2014)
Kaiser Permanente Thriving Schools is a collaboration between Kaiser Permanente, schools in the community, school staff, teachers and students in kindergarten through 12th grade. One quality improvement initiative that they are involved with is providing safe walking and bike paths. (Kaiser Permanente Thriving Schools, [PDF], n.d.)
When walking or biking to school, there are areas that are not safe to do either activity. Kaiser Permanente is involved in the Safe Route to School National Sponsorship and the Fire Up Your Feet Challenge which is open to any elementary and middle school in grades K – 8th. This challenge is used to increase physical activity before, during and after school for students, parents, school staff and teachers. (Venturino, 2015)
This partnership between Kaiser Permanente and the communities is a great example of the vision statement. This shows that Kaiser Permanente is involved and working with local schools to encourage a healthier way of life for the students and staff which in return will make an overall healthier community.
Kaiser Permanente has been conducting research for deploying an electronic health record, or EHR, and the impact that it has on the doctor and patient relationship. The EHR system is known as KP Health Connect. Using its clinical diabetes registry, an electronic database containing health information for diabetic patients, they began the study by using a partial deployment. The study consisted of facilities that implemented the EHR and ones that didn't.
In the study, it was found that the facilities using the electronic health record for the diabetic patients were more likely to monitor the patients low-density lipoprotein cholesterol level and increase treatment as needed. Implementing the EHR and using it to monitor the cholesterol level of the patient led to the reduction of bad cholesterol in the patient.
As the study moved in to the second phase it was found that emergency room visits and hospitalization among the diabetic patients was lower when the physician used the electronic health record. (Kish, 2015)
The clinical diabetes registry database and the creation of an electronic health record has impacted the healthcare delivery for Kaiser Permanente. It has reduced costs for both the facilities and the patient. It has created an environment for a better diagnosis for the patient.
Radio Frequency Identification, or RFID, enables IT departments and other medical staff to track and locate non-stationary equipment and devices. This emerging technology tracks assets for a facility, such as Kaiser Permanente San Jose, and enables staff to find movable equipment and devices using wireless technology and a web based application site. RFID tags can take the place of a bar code system used to track assets. The tags are battery operated and use wireless access points to transfers location and other asset information to a server that can be used to locate and monitor inventory.
Kaiser Permanente San Jose installed this technology across 10 buildings, 35 floors and is tracking more than 4,200 items. Some of the valuable items tagged would often be misplaced such as wheelchairs, EKG machines, ventilators, aspirators and dialysis machines. RFID tags can track smaller items as well. Terri Simpson-Tucker, the assistant administrator of Kaiser Permanente San Jose Medical Center and who also has a background in nursing, also tagged keys, phones and other items that nurses might misplace, but that were of high value and significance to the tasks they perform. Nurses now spend less time searching for missing assets or their own tools, and can thus use that time to care for patients (Swedberg, 2010)
With the new system, Simpson-Tucker indicates, the hospital hopes to realize an annual savings of approximately $257,000, from reduced theft and increased utilization of existing equipment (and, therefore, fewer rentals). (Swedberg, 2010)
The future for RFID is an emerging technology that will continue to evolve. It already has many uses from tracking inventory, monitoring temperatures to tracking pharmacy kits, patient movements and improving the accuracy of reporting to the Joint Commission.
References
Press Release. (2015). Kaiser Permanente celebrates 70 years as the nation’s first fully integratedhealth plan and health care provider. Retrieved from http://share.kaiserpermanente.org/article/kaiser-permanente-celebrates-70-years-as-the-nations-first-fully-integrated-health-plan-and-health-care-provider/#sthash.7cWa6MC3.u77JLCYG.dpuf Kaiser Permanente Share. (2013). Our History. Retrieved from http://share.kaiserpermanente.org/article/history-of-kaiser-permanente/
Kaiser Permanente Share. (n.d.). About Kaiser Permanente. Retrieved from http://share.kaiserpermanente.org/about-kaiser-permanente/
Kaiser Permanente Share. (2014). KP volunteers help with rebuilding in New Orleans, with muscle and heart. Retrieved from http://share.kaiserpermanente.org/article/gulf-coast-rebuilding-project-2014-overview/#sthash.sZMia8eW.dpuf
Brozina, C. (2014). New Orleans school gets a fresh and healthy facelift. Retrieved from http://thrivingschools.kaiserpermanente.org/new-orleans-school-gets-a-fresh-and-healthy-facelift/
Kaiser Permanente Thriving Schools [PDF]. (n.d) Retrieved from http://thrivingschools.kaiserpermanente.org/wp- content/uploads/2015/03/KPTS_insert_FINAL_2015.pdf
Venturino, J. (2015). Fire up your feet! Gets families, students, schools more active. Retrieved from http://thrivingschools.kaiserpermanente.org/fire-up-your-feet-gets-families-students- schools-more-active/
Kish, N. (2015). Health IT keeps Kaiser Permanente providers and patients plugged in. Retrieved from http://share.kaiserpermanente.org/article/health-it-keeps-kaiser-permanente- providers-and-patients-plugged-in/
Swedberg, C. (2010). San Jose Medical Center installs ZigBee-based RTLS across 10 buildings. Retrieved from http://www.rfidjournal.com/articles/view?7470/