[1] KP HealthConnect is an integrated electronic medical record and business system that aims to improve quality, service, and affordability. [2] It includes elements such as a patient portal, secure messaging, and connectivity between clinics, hospitals, and other providers. [3] Early results show increases in online access for members, reductions in office visits and calls, and high member satisfaction with virtual care options such as telephone visits.
The Scope of Health Information Technology: Progress and ChallengesAndrew Oram
Presents an overview of health IT technologies, such as devices, telehealth, electronic health records, analytics, coordinated care, and health information exchange. The goal is not just to list trends but to show their relationships and dependencies, suggest ways they can contribute to improvement in health care, and provide frameworks for understanding their strengths, weaknesses, and impacts.
The Scope of Health Information Technology: Progress and ChallengesAndrew Oram
Presents an overview of health IT technologies, such as devices, telehealth, electronic health records, analytics, coordinated care, and health information exchange. The goal is not just to list trends but to show their relationships and dependencies, suggest ways they can contribute to improvement in health care, and provide frameworks for understanding their strengths, weaknesses, and impacts.
Describes Indian Council of Medical Research, ICMR Institutes, importance of IT in health care, Health Information System and Mobile based Surveillance Quest using IT. For more information visit: http://www.transformhealth-it.org/
What is Health Informatics?
HI Goals
HI stakeholders
HI subfields / subspecialties
Healthcare trends & HI
HI professional environments
HI education / training opportunities & degrees
HI organizations / journals / meetings / events
HI professional certificates
HI books
Nursing informatics
What is nursing informatics?
Evolution of nursing informatics
Role of the Nurse as knowledge worker
Medical Informatics
Consumer Informatics
A study guide developed in preparation for the CPHIMS exam in 2010. This guide focuses on the content in the recommended text. I also recommend consulting the recommended readings.
Describes Indian Council of Medical Research, ICMR Institutes, importance of IT in health care, Health Information System and Mobile based Surveillance Quest using IT. For more information visit: http://www.transformhealth-it.org/
What is Health Informatics?
HI Goals
HI stakeholders
HI subfields / subspecialties
Healthcare trends & HI
HI professional environments
HI education / training opportunities & degrees
HI organizations / journals / meetings / events
HI professional certificates
HI books
Nursing informatics
What is nursing informatics?
Evolution of nursing informatics
Role of the Nurse as knowledge worker
Medical Informatics
Consumer Informatics
A study guide developed in preparation for the CPHIMS exam in 2010. This guide focuses on the content in the recommended text. I also recommend consulting the recommended readings.
Presentation I used as a Strategic Account Manager to sell affiliate programs (purchase subsidies) to strategic accounts. RAMP stands for Regional Affiliate Marketing Program.
Healthcare institutions are aggressively moving towards meeting compliance with MU1 and MU2 with the implementation of full-featured Electronic Health Records. Concomitantly, there will be a massive increase in the amount of clinical data captured electronically. Business intelligence (BI) which traditionally has focused on financial data can be leveraged to use clinical data to support providers in delivering high quality, efficient care. In addition, BI coupled with population health analytics can help meet many Accountable Care Organization needs. This presentation will discuss the Denver Health journey in using BI in a variety of was to facilitate the attainment of high quality care.
Napier Healthcare: Making Connected Healthcare a RealityFang Yih Teng
These slides were part of the presentation by Napier Healthcare Solutions at one of HiMSS Asia Pacific's first webinars of 2018. Speaking on January 24, 2018, Anil Kumar, VP of Product Management, Napier Healthcare, guided the audience through the complex of technological, regulatory and commercial issues surrounding the often misunderstood concept of Connected Health, and shared strategies that healthcare providers can adopt to kickstart initiatives toward delivering connected healthcare.
PRESENTATION OVERVIEW
Extending healthcare services and management across the continuum of care seamlessly and effectively has been a major challenge facing healthcare systems across the globe. But applying new technologies and business models can make it a reality – making it possible to setup and run an integrated system of care that takes each patient through the entire range of health services covering acute care all the way to ambulatory care, extended care and home care. This presentation is a discussion of how they all come together on a single connected platform to deliver on the promises of true connected health: cost savings; heightened efficiencies; superior standards of care; and, enhanced quality of life for people everywhere.
TECHNOLOGY TALKING POINTS:-
• Cloud
• Mobility
• Internet of Things, Advanced Connectivity
• Telemedicine and Telehealth
• AI and Cognition–Chatbots and Voice Assistance
• Data Analytics and Business Intelligence
APPLICATION CONTEXTS:-
• Hospitals (Acute and Ambulatory Care)
• Long-term Care (including Nursing Homes and Remote Patient Monitoring)
• Home Care
• Hospices/Palliative Care
• Corporate & Community Wellness
• Population Health Management
• Care Coordination
Overview of Healthcare IT Security including research based statistics and leveraging best practices to ensure sustainability and compliance for providers
IT solutions play a crucial role in the healthcare industry, revolutionizing patient care and administrative processes. From electronic health records and telemedicine to data analytics and artificial intelligence,technology enables efficientinformation sharing, remote monitoring, and personalized treatment plans. IT solutions enhance medical accuracy, reduce errors, and optimize resource utilization, ultimately improving patient outcomes and streamlining healthcare operations. These advancements empower healthcare professionals to deliver high-quality care while reducing costs and increasing accessibility for patients.
The KIMS Story: The Interplay with TechnologyMED E Talks
Dr. Sheriff Sahadulla, the Group CEO of KIMS Healthcare Group. KIMS is a top-notch healthcare group with footprints across South India and GCC countries. This presentation is on the KIMS story, and its interplay and occupation with the beast called technology.
Visit our Website : https://www.medetalks.com/
Contact Us @ https://www.medetalks.com/contact-us.html
Like our Facebook page @ https://www.facebook.com/MedeTalks
Follow us on Twitter @ https://twitter.com/MedeTalks
Follow us on Linkedin@ https://www.linkedin.com/company/medetalks-2019/
Software Delivery At the Speed of AI: Inflectra Invests In AI-Powered QualityInflectra
In this insightful webinar, Inflectra explores how artificial intelligence (AI) is transforming software development and testing. Discover how AI-powered tools are revolutionizing every stage of the software development lifecycle (SDLC), from design and prototyping to testing, deployment, and monitoring.
Learn about:
• The Future of Testing: How AI is shifting testing towards verification, analysis, and higher-level skills, while reducing repetitive tasks.
• Test Automation: How AI-powered test case generation, optimization, and self-healing tests are making testing more efficient and effective.
• Visual Testing: Explore the emerging capabilities of AI in visual testing and how it's set to revolutionize UI verification.
• Inflectra's AI Solutions: See demonstrations of Inflectra's cutting-edge AI tools like the ChatGPT plugin and Azure Open AI platform, designed to streamline your testing process.
Whether you're a developer, tester, or QA professional, this webinar will give you valuable insights into how AI is shaping the future of software delivery.
Search and Society: Reimagining Information Access for Radical FuturesBhaskar Mitra
The field of Information retrieval (IR) is currently undergoing a transformative shift, at least partly due to the emerging applications of generative AI to information access. In this talk, we will deliberate on the sociotechnical implications of generative AI for information access. We will argue that there is both a critical necessity and an exciting opportunity for the IR community to re-center our research agendas on societal needs while dismantling the artificial separation between the work on fairness, accountability, transparency, and ethics in IR and the rest of IR research. Instead of adopting a reactionary strategy of trying to mitigate potential social harms from emerging technologies, the community should aim to proactively set the research agenda for the kinds of systems we should build inspired by diverse explicitly stated sociotechnical imaginaries. The sociotechnical imaginaries that underpin the design and development of information access technologies needs to be explicitly articulated, and we need to develop theories of change in context of these diverse perspectives. Our guiding future imaginaries must be informed by other academic fields, such as democratic theory and critical theory, and should be co-developed with social science scholars, legal scholars, civil rights and social justice activists, and artists, among others.
UiPath Test Automation using UiPath Test Suite series, part 3DianaGray10
Welcome to UiPath Test Automation using UiPath Test Suite series part 3. In this session, we will cover desktop automation along with UI automation.
Topics covered:
UI automation Introduction,
UI automation Sample
Desktop automation flow
Pradeep Chinnala, Senior Consultant Automation Developer @WonderBotz and UiPath MVP
Deepak Rai, Automation Practice Lead, Boundaryless Group and UiPath MVP
КАТЕРИНА АБЗЯТОВА «Ефективне планування тестування ключові аспекти та практ...QADay
Lviv Direction QADay 2024 (Professional Development)
КАТЕРИНА АБЗЯТОВА
«Ефективне планування тестування ключові аспекти та практичні поради»
https://linktr.ee/qadayua
Smart TV Buyer Insights Survey 2024 by 91mobiles.pdf91mobiles
91mobiles recently conducted a Smart TV Buyer Insights Survey in which we asked over 3,000 respondents about the TV they own, aspects they look at on a new TV, and their TV buying preferences.
Connector Corner: Automate dynamic content and events by pushing a buttonDianaGray10
Here is something new! In our next Connector Corner webinar, we will demonstrate how you can use a single workflow to:
Create a campaign using Mailchimp with merge tags/fields
Send an interactive Slack channel message (using buttons)
Have the message received by managers and peers along with a test email for review
But there’s more:
In a second workflow supporting the same use case, you’ll see:
Your campaign sent to target colleagues for approval
If the “Approve” button is clicked, a Jira/Zendesk ticket is created for the marketing design team
But—if the “Reject” button is pushed, colleagues will be alerted via Slack message
Join us to learn more about this new, human-in-the-loop capability, brought to you by Integration Service connectors.
And...
Speakers:
Akshay Agnihotri, Product Manager
Charlie Greenberg, Host
Key Trends Shaping the Future of Infrastructure.pdfCheryl Hung
Keynote at DIGIT West Expo, Glasgow on 29 May 2024.
Cheryl Hung, ochery.com
Sr Director, Infrastructure Ecosystem, Arm.
The key trends across hardware, cloud and open-source; exploring how these areas are likely to mature and develop over the short and long-term, and then considering how organisations can position themselves to adapt and thrive.
Accelerate your Kubernetes clusters with Varnish CachingThijs Feryn
A presentation about the usage and availability of Varnish on Kubernetes. This talk explores the capabilities of Varnish caching and shows how to use the Varnish Helm chart to deploy it to Kubernetes.
This presentation was delivered at K8SUG Singapore. See https://feryn.eu/presentations/accelerate-your-kubernetes-clusters-with-varnish-caching-k8sug-singapore-28-2024 for more details.
Future Visions: Predictions to Guide and Time Tech Innovation, Peter Udo DiehlPeter Udo Diehl
I'm excited to share my latest predictions on how AI, robotics, and other technological advancements will reshape industries in the coming years. The slides explore the exponential growth of computational power, the future of AI and robotics, and their profound impact on various sectors.
Why this matters:
The success of new products and investments hinges on precise timing and foresight into emerging categories. This deck equips founders, VCs, and industry leaders with insights to align future products with upcoming tech developments. These insights enhance the ability to forecast industry trends, improve market timing, and predict competitor actions.
Highlights:
▪ Exponential Growth in Compute: How $1000 will soon buy the computational power of a human brain
▪ Scaling of AI Models: The journey towards beyond human-scale models and intelligent edge computing
▪ Transformative Technologies: From advanced robotics and brain interfaces to automated healthcare and beyond
▪ Future of Work: How automation will redefine jobs and economic structures by 2040
With so many predictions presented here, some will inevitably be wrong or mistimed, especially with potential external disruptions. For instance, a conflict in Taiwan could severely impact global semiconductor production, affecting compute costs and related advancements. Nonetheless, these slides are intended to guide intuition on future technological trends.
Transcript: Selling digital books in 2024: Insights from industry leaders - T...BookNet Canada
The publishing industry has been selling digital audiobooks and ebooks for over a decade and has found its groove. What’s changed? What has stayed the same? Where do we go from here? Join a group of leading sales peers from across the industry for a conversation about the lessons learned since the popularization of digital books, best practices, digital book supply chain management, and more.
Link to video recording: https://bnctechforum.ca/sessions/selling-digital-books-in-2024-insights-from-industry-leaders/
Presented by BookNet Canada on May 28, 2024, with support from the Department of Canadian Heritage.
Kubernetes & AI - Beauty and the Beast !?! @KCD Istanbul 2024Tobias Schneck
As AI technology is pushing into IT I was wondering myself, as an “infrastructure container kubernetes guy”, how get this fancy AI technology get managed from an infrastructure operational view? Is it possible to apply our lovely cloud native principals as well? What benefit’s both technologies could bring to each other?
Let me take this questions and provide you a short journey through existing deployment models and use cases for AI software. On practical examples, we discuss what cloud/on-premise strategy we may need for applying it to our own infrastructure to get it to work from an enterprise perspective. I want to give an overview about infrastructure requirements and technologies, what could be beneficial or limiting your AI use cases in an enterprise environment. An interactive Demo will give you some insides, what approaches I got already working for real.
JMeter webinar - integration with InfluxDB and GrafanaRTTS
Watch this recorded webinar about real-time monitoring of application performance. See how to integrate Apache JMeter, the open-source leader in performance testing, with InfluxDB, the open-source time-series database, and Grafana, the open-source analytics and visualization application.
In this webinar, we will review the benefits of leveraging InfluxDB and Grafana when executing load tests and demonstrate how these tools are used to visualize performance metrics.
Length: 30 minutes
Session Overview
-------------------------------------------
During this webinar, we will cover the following topics while demonstrating the integrations of JMeter, InfluxDB and Grafana:
- What out-of-the-box solutions are available for real-time monitoring JMeter tests?
- What are the benefits of integrating InfluxDB and Grafana into the load testing stack?
- Which features are provided by Grafana?
- Demonstration of InfluxDB and Grafana using a practice web application
To view the webinar recording, go to:
https://www.rttsweb.com/jmeter-integration-webinar
"Impact of front-end architecture on development cost", Viktor TurskyiFwdays
I have heard many times that architecture is not important for the front-end. Also, many times I have seen how developers implement features on the front-end just following the standard rules for a framework and think that this is enough to successfully launch the project, and then the project fails. How to prevent this and what approach to choose? I have launched dozens of complex projects and during the talk we will analyze which approaches have worked for me and which have not.
Essentials of Automations: Optimizing FME Workflows with ParametersSafe Software
Are you looking to streamline your workflows and boost your projects’ efficiency? Do you find yourself searching for ways to add flexibility and control over your FME workflows? If so, you’re in the right place.
Join us for an insightful dive into the world of FME parameters, a critical element in optimizing workflow efficiency. This webinar marks the beginning of our three-part “Essentials of Automation” series. This first webinar is designed to equip you with the knowledge and skills to utilize parameters effectively: enhancing the flexibility, maintainability, and user control of your FME projects.
Here’s what you’ll gain:
- Essentials of FME Parameters: Understand the pivotal role of parameters, including Reader/Writer, Transformer, User, and FME Flow categories. Discover how they are the key to unlocking automation and optimization within your workflows.
- Practical Applications in FME Form: Delve into key user parameter types including choice, connections, and file URLs. Allow users to control how a workflow runs, making your workflows more reusable. Learn to import values and deliver the best user experience for your workflows while enhancing accuracy.
- Optimization Strategies in FME Flow: Explore the creation and strategic deployment of parameters in FME Flow, including the use of deployment and geometry parameters, to maximize workflow efficiency.
- Pro Tips for Success: Gain insights on parameterizing connections and leveraging new features like Conditional Visibility for clarity and simplicity.
We’ll wrap up with a glimpse into future webinars, followed by a Q&A session to address your specific questions surrounding this topic.
Don’t miss this opportunity to elevate your FME expertise and drive your projects to new heights of efficiency.
FIDO Alliance Osaka Seminar: Passkeys at Amazon.pdf
L2 Using Information Technology
1. 21st Century Care Innovation Project
Using InformationPrimary Care with KP Primary Care
Transforming Technology to Redesign
HealthConnect
Institute for Healthcare Improvement’s 8th Annual International Summit
on Redesigning the Clinical Office Practice
Nashville, TN, March 25-27, 2007
Charles Kilo, MD, MPH
CEO, GreenField Health, Portland, OR
Chuck.Kilo@GreenFieldHealth.com
Reginald Wallen, MD
Physician Director, MidAtlantic Permanente Medical Group
Reginald.Wallen@kp.org
2. Objectives
By the end of this session, participants will be able to:
• Describe the components of a practice IT system
• List considerations for workflow redesign during IT
selection and implementation
• Discuss critical aspects of using an IT system to
improve quality of care
• Challenge each other to think flexibly about their
practice and their patient’s future
3. Its not about the IT…
• We will discuss aspects of the technology, but we will
focus on what IT enables us to do for our patients
• Care and caring are at the center – the future is about
caring for the patient, not about the visit
• EHR implementation is a Trojan horse – it provides
the opportunity to question and redesign processes,
workflow, roles and how you interact with patients
Leverage the opportunity
Don’t pave the cowpaths
• Implementation is an ongoing journey, not a one time
event
4. Chronic Care Model: What are the challenges?
Community Health System
Resources and Health Care Organization
Policies
Clinical
Self- Delivery
Decision Information
Management System
Support Systems
Support Design
Informed, Productive Prepared,
Activated Proactive
Interactions Practice Team
Patient
Improved Outcomes
5. Basic Elements of IT for Primary Care
Foundations
• Practice management software for billing and scheduling
• EHR with integrated scanning, faxing, e-prescribing (integrated with PM)
• Decision-support (patient & practice)
• Disease Registry
• Clinic / Medical Group intranet
Systems for connecting with patients
• Patient facing shared record/personal health record
• Secure messaging
• Patient e-newsletter
System-basics
• High-speed internet connection
• Connectivity to other critical IT (e.g., hospital, lab, radiology)
• VPN for secure use from home
• System Software and Security – OS, antivirus, anti-spam, back-up
6. Organizing Principles
• Your primary focus in the design your practice system
will determine what your system will look like when
you’re done, including your IT.
• Options include, for example:
Improving physician efficiency/productivity
Improving clinical quality
Integration with colleagues
Market differentiation
Patient at the center
7. Organizing Principles – GreenField Health
Use our team and our system design to deliver on the
promises of:
• Relationships
• Service
• Clinical Reliability
Continually work to integrate care across boundaries
14. Hardware and the Network: The Basics
Application software Diagnostic Equipment (ECG,
EHR, PMS, Outlook®, MS Spirometer)
Office ® Messaging
Decision support Internal
Servers External
Application software Network
Images Local area network
Fax and email (LAN) within
User Devices Wide area network
Wired PCs (WAN) between
Wireless PCs Interfaces between systems
Scanners
15. What are the key adoption challenges?
1. Cost
2. Intimidation
3. Lack of management capability
4. Lack of IT experience
5. Lack of desire, will, compelling need
16. Environmental challenges
Where do I start?
Where do I get advice?
Are others going to pay me to have an HER, or
will others pay for my EHR?
What is the role of health systems and their
ability to provide IT to independent medical
practices?
What’s the role of QIOs?
17. 21st Century Care Innovation Project
Transforming Primary Care with KP
HealthConnect
Introduction to
KP HealthConnect
18. What is Kaiser Permanente HealthConnect?
• More than just an electronic medical record
• The development and deployment of a highly-
sophisticated information management and delivery
system
• A program-wide system that will integrate the
clinical record with appointments, registration and
billing
• A complete health care business system that will
enhance the quality of patient care and support the
KP Promise
19. KP HealthConnect Supports:
Quality Our Personal & Affordable
Patients Can Trust Convenient Service Health Care
High Quality Personal Affordable
• We have clinical information • We have and use up-to-date • We reduce the cost of care
available 24/7. clinical, social and patient and improve visit experiences.
• Our clinical outcomes are preference information. • We decrease the cost of paper
unsurpassed. • We provide patients information medical records.
• Our clinicians know in real- for shared decision making. • We maximize appropriate
time the recommended best • We enhance personalized care. revenue capture.
practices. • Our pricing matches our risk.
• We are the national leaders in Convenient • We administer benefits and
patient safety. new products both correctly
• We enhance our research to • Our patients access information and efficiently.
support evidence-based care. via telephone, Web and email. • We continually improve
• We actively support our patients’ operations.
participation in their own care.
• We minimize wait times and out-
of-pocket costs with efficient
access to care.
• We achieve superior integration
and continuity of care.
20. Program Scope
Web Access Portal
Ancillaries Care Delivery Core Health Plan Finance
Scope of KP HealthConnect Suite
Outpatient Inpatient
Outpatient Membership/ General
Pharmacy Admission, Discharge
Scheduling and Transfer
Benefits Ledger
Referral & Utilization Management
Health Information
Management
Lab Registration Claims Capital
Clinicals Processing Planning
Clinicals Pharmacy
Radiology/ Financial
Benefits
Imaging Emergency Reporting
Accumulation
Department
Billing
Others Operating Room
(immunizations,
Health Information Pricing
EKG, dictation)
Management Billing System
Data Warehouse / EDR Enterprise Data Repository
21. Members Can Actively Participate in Care
Care Delivery Core
www.kp.org Access medical record
Member Web Portal Scope of KP HealthConnect Suite
Outpatient Inpatient
Make/change appointments
Scheduling
Scheduling
Send messages to doctor Admission, Discharge
And Transfer
Registration Clinicals
Check lab results
Pharmacy
Access health Information Clinicals Emergency
Department
Review eligibility & benefits Operating Room
Billing
Billing
Account summary
24. Progress to Date
Nearly 5 million members have a partial or complete KP
HealthConnect ambulatory record
All members will have one by mid-2008
Access to KP HealthConnect through kp.org is live in 7
of our 8 regions
More than 1.7 million members are currently registered on
kp.org
Two KP hospitals are now live with KP HealthConnect
A total of 36 hospitals will be live by the end of 2009
(including hospitals currently under construction)
By the end of 2006, the KP HealthConnect practice
management deployments will be complete
25. Percentage of KP Population Coverage by
Year/Suite
100% 2007
2008
2007
90% 2009 2006
80%
2007
70% 2006
60%
2008
50%
2005
40% 2006
2005
30%
20%
2005 2007
10% 2004
2004 2006
0%
Practice Management Outpatient Clinicals and Inpatient Clinicals KP HealthConnect Online
Billing & Registration Decision Support
Population coverage based on actual & planned finish dates
26. “Blue Sky”
In 2015, the care delivery
model is a consumer-centric
paradigm where the
consumer presumes choice.
Members will characterize KP
as providing customized and
fully integrated/leveraged
services with secure and
seamless transitions from
person to person with care
that can occur in their homes
for an affordable cost.
28. Members are Utilizing KP.org Features
As of July 2006
Number of kp.org registered users: 1,706,009
Lab tests released online: 4,529,426
Test viewed online: 1,437,699
Member messages sent: 624,461
Average messages sent per member: 2.0
Visits to past office visits: 85,846
Visits to Your future appointments: 279,857
29. Online Access Is Improving Member
Experience
Preliminary research in the Northwest region
shows that member usage of online features is
resulting in statistically significant:
Reductions in primary care visits
Reductions in telephone calls
High member satisfaction with online
alternatives
30. 21st Century Care Innovation Project
Creating a Patient-Centered
Focus, where the care team and
work flow are organized to meet
the needs of the population
Empowering Members to be the
“real” primary care provider with
the care system providing people
and tools to support the member
Supporting Panel Ownership by
the primary care provider which
enables caring for a person as a
total being; earlier intervention in
disease progression; and greater
oversight of members with
chronic disease
Offering Alternatives to 1:1 Face-
to-face Office Visits which can
build capacity and give members
choice
31. Telephone visits are enabled and enhanced
by KP HealthConnect
While telephone visits could have been (and were on a small scale)
provided previously, Whittier has found that KP HealthConnect
enables greater ease, efficiency, and scale.
With KP HealthConnect…
All the relevant patient information
are easily accessed by the
provider during a telephone visit.
“Real-time” processing (notes,
lab-orders, Rx orders) is possible
during a telephone visit.
Work is completed during the
telephone visit with few or no
hand-offs required.
Case: Telephone Visits @ Whittier
32. Providers report that telephone visits are a
better way to manage patient demand
Case: Telephone Visits @ Whittier
Whittier Family Medicine Provider Survey, 4/2006
(10 Providers, 1: strongly disagree; 5: strongly agree)
5
4.7 4.6 4.6
4
3
2
1.5
1
0
Model makes Better way to manage Model gives me I want to go back to
my day easier patient demand for more control over old system
care my day
Whittier Family Medicine providers report that the phone visits gives them more
control and is a better way to manage patient demand.
The Medical Assistants for the physicians doing a higher quantity of phone
visits can use that time to assist in Population Care Management duties and
outreach for clinical strategic goals (PAP, Mammo, & Pneumonia vaccine
reminders)
33. Members are very satisfied with the telephone
visits.
Members Satisfaction with Telephone Visits
Members who had a telephone visits are
highly satisfied.
8%
87% ranked their satisfaction with the
5%
telephone visits a “5” on a scale of 1-5
(low/high). 87%
80% of members surveyed would be willing
5 = Highly Satisfied
4 = Satisfied
to “pay” something for a telephone visit. 3 = Neutral
Whittier is learning that members need to
be made aware of their options. Members' Willingness to
Pay for Telephone Visits
Whittier is working on “educating”
Percent Responding
members of their options and recently 25%
20%
had a test where all calls coming in for
15%
a physician was triaged first by an RN. 10%
Almost 40% of all calls resulted in a 5%
telephone encounter. 0%
$0 $5 $10 >$15 $ - Uncertain
how much
Dollar Amount
Note: KP is pursuing detailed surveys with Whittier members in July/August 2006 to get in-depth understanding of member reaction to telephone visits.
Case: Telephone Visits @ Whittier
34. Whittier is not doing the same work differently
but different work.
Old Model New Model (in testing)
1. Most patient-provider interaction 1. Patient has option to speak to
occurs face-to-face in the office. provider over the phone or email if
appropriate.
2. Medical Assistants spend the 2. Medical Assistants are able to use
majority of time processing their time to help proactively care for
patients, even those coming in patients with chronic conditions, e.g.
for “inappropriate” office visits. lab reminders, outreach, etc.
3. RNs triage and book follow-ups 3. RNs triage and offer members on
for nearly all patients requesting alternative care options and handle
appointment with physician. appropriate calls themselves.
We believe we are building capacity in our care team.
35. Access: Increasing capacity to touch more of
patients on our panel
Camp Springs Touches (Visits & Telephone) / Physician FTE
1050
791
~ 42 touches/
850 day/physician
650
292
~14 touches/
450 day/physician
250
Nov-06
Jan-06
Jun-06
Jul-06
Feb-06
Mar-06
May-06
Dec-05
Apr-06
Aug-06
Sep-06
Oct-06
Dec-06
From 2006 utilization for Camp Springs membership,
•Office Visit rate = 0.16
•Telephone rate = 0.27
Source: Clarity Warehouse. Report run by: National Analytical support. Note: Telephone includes TAVs and telephone encounters.
36. Access: Increasing capacity to touch more of
patients on our panel
Comparison of 21st CCI teams
Percent of Panel Touched - Office or Phone Encounter
2006
100%
Team 1 Camp Springs
Team 2
80% 73% Team 3 76%
69% Team 5
62% Team 4
56%
60% 51%
40%
20%
0%
Camp Springs IM - % of paneled members with
•76% of CS IM members engaged by
PCP encounter by month
office visits and phone encounter during
2006. 25%
20%
15%
10%
5%
0%
Jan-06 Feb- Mar- Apr-06 May- Jun-06 Jul-06 Aug- Sep- Oct-06 Nov-06 Dec-
06 06 06 06 06 06
Source: Clarity Warehouse. Report run by: National Analytical support. Note: Telephone includes TAVs and telephone encounters.
37. More Touches -- Less Visits
Average daily ‘Touches’ Average Daily ‘Touches’ with
before panel management panel management
80 80
70 70 US mail contacts
60 RN and HCT contacts
60
No. of Daily Contacts
No. of Daily Contacts
Email contacts
50 50
Phone contacts
40 40
Annual health goals
30 30
quot;Fast Trackquot;'s
20 20
Group visits
10 10 Office visits
0
Office visits
1 0 1
CEC Presentation 5/2/2005 Gerard F Livaudais MD, MPH Kaiser Permanente Hawaii Region
39. What can we do?
Demo Site: http://devinternal.or.kp.org/im/demo/login.cfm
40.
41. GreenField Health
Primary care practice
Research and development on delivery system design
Leadership in local and national performance
improvement initiatives (e.g., ACP, AAFP, IHI, AAMC,
etc.)
Services:
1. GreenField Health – 6 physicians
2. Practice management services
3. Teaching and consulting in practice performance
improvement
43. Staff Workspace
User Devices:
Digital Wired PCs +
Vitals Printers Telephones
Users
44. Devices for Clinical Users
Pen Tablet Convertible
•Battery
•Battery
•Screen
•Screen
•Stylus for point and click
•Stylus for point and click •Wireless Antennae
•Wireless Antennae •Physical keyboard like
•Virtual Keyboard Docking Stations notebook
•Voice files •Power •Voice files
•Handwriting recognition •Battery recharges •Handwriting recognition
•All Applications on the network •All Applications on the
•Node on the network
•All network devices (printers, network
•Nothing without a computer (either
fax) •All network devices
above)
(printers, fax)
Options that connect to Docking Station:
LCD Screen (no touch) Physical Keyboard Physical Keyboard
w/Touch Pad (plus mouse)
45.
46.
47.
48.
49.
50. Beyond the Visit at GreenField Health:
Distribution of Patient Encounters
Number of Encounters by Type per Patient per Year
E-mail Phone Care
4.8 4.9
Office Visit
1.7
51. E-visits
The Myths are Not True
• Patients are very respectful of clinician time
• Managing challenging patients
• Patient are connecting to us as the trusted source, not
besieging us with garbage from the internet
• A great opportunity for managing challenging patients
• Doctors will not participate
Visit Prep
• Eliminates the need for some visits
• Makes visits shorter and more satisfying
• Eases documentation
52. Secure Messaging and E Visits
Issues of Reimbursement
• Easiest in integrated models
• Spreading adoption by insurers
• In addition to direct payment, consider:
Impact on overall productivity
Stickiness – patient allegiance to your practice
The energy of innovation
It’s the right thing to do
53. Knowledge Management
• Access to the right information at the right time to
support the continuous healing relationship
• Understanding the needs of our patients if they are
in the office or at home – population management
• Decision support to make the right thing the
easiest thing to do
54. “We Know You”
• Numerous options exist within the EHR to
allow providers to better “know” their patients.
Snapshot
Demographics
Problem Lists
Social Documentation
Health Maintenance Alerts
Flowsheets
Questionnaire
63. Summary
• Redesigning our practices around our
patients’ needs is our goal
• IT enables changes that we have always
wanted to make
• The EHR is a Trojan horse - Use the great
magnifier at the moment of flexibility to
improve all of your processes, clarify roles
and responsibilities and be more patient
centered