Advertisement

Using Information Technology at Kaiser Permanente to Support Health Equity

  • Ronald L. Copeland
  • Winston F. WongEmail author
  • Jason Jones
  • Margo Edmunds
Chapter

Abstract

The mission of Kaiser Permanente, the largest not-for-profit integrated health care delivery system in the USA, is “to provide high-quality, affordable health care services to improve the health of our members and communities we serve.” This paired focus on the health of individuals and communities derives from the organization’s core value of health equity, which encompasses two notions: (1) the organization’s own members must have equal access to the highest-quality care, regardless of socioeconomic or any other factors; and (2) that health systems must address unhealthy environmental factors that disproportionately pose barriers to both members’ and the larger community’s ability to thrive. Health information technology (IT) is a critical enabler of Kaiser Permanente’s work to address health equity. This chapter describes the specific IT systems and tools used by Kaiser Permanente to identify and narrow or eliminate disparities in care for its members, including one of the nation’s largest electronic health records (EHRs), panel health management tools, a patient portal, and various telehealth technologies. The chapter concludes with a caution—that use of information technology in health care can itself lead to disparities in care—and discusses ways that delivery systems can and must work to ensure a future in which these tools are used to improve care for everyone.

Keywords

Health equity Health disparities Total health Population health management Health care analytics Cultural competency Cultural humility Telehealth Information technology HealthConnect My Health Manager Electronic health records Patient portal 

Notes

Acknowledgments

For their assistance in the development and writing of this chapter, the authors wish to thank Dr. Patricia Connolly, Dr. Marc Klau, Dr. Murray Ross, Joy Lewis, Laura Tollen, and David Snow.

References

  1. Agency for Healthcare Research and Quality/U.S. Department of Health and Human Services. (2016). 2015 National healthcare quality and disparities report and 5th anniversary update on the national quality strategy (AHRQ Pub. No. 16-0015). Rockville, MD: Author.Google Scholar
  2. Bradley, E. H., Elkins, B. R., Herrin, J., & Elbel, B. (2011). Health and social services expenditures: Associations with health outcomes. BMJ Quality and Safety, 20, 826–831.  https://doi.org/10.1136/bmjqs.2010.048363 PubMedCrossRefGoogle Scholar
  3. Burns, E. (2014, January 24). Kaiser Permanente VP prescribes bigger role for health care data analytics. Retrieved from http://searchbusinessanalytics.techtarget.com/feature/Kaiser-Permanente-VP-prescribes-bigger-role-for-healthcare-data-analytics
  4. Caligiuri, P. (2012). Cultural agility: Building a pipeline of successful global professionals. San Francisco, CA: Jossey-Bass.Google Scholar
  5. Columbia University Mailman School of Public Health. (n.d.). Population health methods: Hot spot detection. Retrieved from https://www.mailman.columbia.edu/research/population-health-methods/hot-spot-detection
  6. Crosson, F. J., & Tollen, L. A. (2017). Managing the care and costs of a defined insured population. In I. G. Cohen, A. K. Hoffman, & W. M. Sage (Eds.), The Oxford handbook of U.S. healthcare law. New York, NY: Oxford University Press.Google Scholar
  7. Diamond, C. C., Mostashari, F., & Shirky, C. (2009). Collecting and sharing data for population health: A new paradigm. Health Affairs, 28(2), 454–466.  https://doi.org/10.1377/hlthaff.28.2.454 PubMedCrossRefGoogle Scholar
  8. Garrido, T., Raymond, B., & Wheatley, B. (2016, April 7). Lessons from more than a decade in patient portals [Blog post]. Retrieved from http://healthaffairs.org/blog/2016/04/07/lessons-from-more-than-a-decade-in-patient-portals/
  9. Garrido, T., et al. (2015). Race/ethnicity, personal health record access, and quality of care. The American Journal of Managed Care, 21(2), e103–e113.PubMedGoogle Scholar
  10. Health IT Analytics. (2015, December 15). Can population health management succeed without IT support? [Blog post]. Retrieved from http://healthitanalytics.com/news/can-population-health-management-succeed-without-it-support/
  11. Heiman, H. J., & Artiga, S. (2015). Beyond health care: The role of social determinants in promoting health and health equity. The Henry J. Kaiser Family Foundation. Retrieved from http://kff.org/disparities-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/
  12. Jackson, C. S., Oman, M., Patel, A. M., & Vega, K. J. (2016). Health disparities in colorectal cancer among racial and ethnic minorities in the United States. Journal of Gastrointestinal Oncology, 7(1), S32–S43.  https://doi.org/10.3978/j.issn.2078-6891.2015.039 PubMedPubMedCentralCrossRefGoogle Scholar
  13. Kaiser Permanente. (2016a). Fast facts about Kaiser Permanente. Retrieved December, 2016, from https://share.kaiserpermanente.org/article/fast-facts-about-kaiser-permanente/
  14. Kaiser Permanente. (2016b). 2015 annual report. Retrieved from https://share.kaiserpermanente.org/static/kp_annualreport_2015/#quality
  15. Kaiser Permanente. (2017a). About Kaiser permanente. Retrieved from https://share.kaiserpermanente.org/about-kaiser-permanente/
  16. Kaiser Permanente. (2017b). Grants overview. Retrieved from https://share.kaiserpermanente.org/article/grants-overview/
  17. Kaiser Permanente Institute for Health Policy. (2014). Capturing the patient voice: Video ethnography as a tool to transform care. Retrieved from https://www.kpihp.org/kaiser-permanente-policy-stories-v3-no-3-capturing-the-patient-voice-video-ethnography-as-a-tool-to-transform-care/
  18. Kanter, M. H., Lindsay, G., Bellows, J., & Chase, A. (2013). Complete care at Kaiser Permanente: Transforming chronic and preventative care. The Joint Commission Journal on Quality and Patient Safety, 39(11), 484–494.  https://doi.org/10.1016/S1553-7250(13)39064-3 PubMedCrossRefGoogle Scholar
  19. Kanter, M. H., Martinez, O., Lindsay, G., Andrews, K., & Denver, S. M. (2010). Proactive office encounter: A systematic approach to preventive and chronic care at every patient encounter. The Permanente Journal, 14(3), 38–43.PubMedPubMedCentralGoogle Scholar
  20. Liang, L. (Ed.). (2010). Connected for health: Using electronic health records to transform care delivery. San Francisco, CA: Jossey-Bass.Google Scholar
  21. McGinnis, J. M., Williams-Russo, P., & Knickman, J. R. (2002). The case for more active policy attention to health promotion. Health Affairs, 21(2), 78–93.  https://doi.org/10.1377/hlthaff.21.2.78 PubMedCrossRefGoogle Scholar
  22. Meng, D., Palen, T. E., Tsai, J., Mcleod, M., Garrido, T., & Qian, H. (2015). Association between secure patient–clinician email and clinical services utilisation in a US integrated health system: A retrospective cohort study. BMJ Open, 5(11).  https://doi.org/10.1136/bmjopen-2015-009557 PubMedPubMedCentralCrossRefGoogle Scholar
  23. Moy, E., Dayton, E., & Clancy, C. M. (2005). Compiling the evidence: The national healthcare disparities reports. Health Affairs, 24(2), 376–387.  https://doi.org/10.1377/hlthaff.24.2.376 PubMedCrossRefGoogle Scholar
  24. National Institutes of Health/U.S. Department of Health and Human Services. (2015). Racial and ethnic categories and definitions for NIH diversity programs and for other reporting purposes, notice number: NOT-OD-15-089. Retrieved from https://grants.nih.gov/grants/guide/notice-files/NOT-OD-15-089.html
  25. Neuwirth, E. B., Schmittdiel, J. A., Tallman, K., & Bellows, J. (2007). Understanding panel management: A comparative study of an emerging approach to population care. The Permanente Journal, 11(3), 12–20.PubMedCrossRefGoogle Scholar
  26. Numerof, R. E. (2015, October 15). Preparing for population health management [Blog post]. Retrieved from http://social.eyeforpharma.com/column/preparing-population-health-management
  27. Office of Disease Prevention and Health Promotion/U.S. Department of Health and Human Services. (n.d.) Healthy people 2020. Retrieved March 26, 2017, from https://www.healthypeople.gov/
  28. Office of Management and Budget. (1997). Revisions to the standards for the classification of federal data on race and ethnicity. Federal Register, 62(210), 58782–58790.Google Scholar
  29. Office of the National Coordinator for Health Information Technology/U.S. Department of Health and Human Services. (2014, February 24). Record demographics. Retrieved from https://www.healthit.gov/providers-professionals/achieve-meaningful-use/core-measures-2/record-demographics
  30. Palen, T. E., Ross, C., Powers, J. D., & Xu, S. (2012). Association of online patient access to clinicians and medical records with use of clinical services. Journal of the American Medical Association, 308(19), 2012–2019.  https://doi.org/10.1001/jama.2012.14126 PubMedCrossRefGoogle Scholar
  31. Pew Research Center. (2017, January 12). Mobile fact sheet. Retrieved from http://www.pewinternet.org/fact-sheet/mobile/
  32. Radding, D. (2017, March 31). Preventing colon cancer in Latino members [Blog post]. Retrieved from https://lookinside.kaiserpermanente.org/preventing-colon-cancer-latino-members/?__prclt=chHvIJVJ
  33. Reed, M., Graetz, I., Gordon, N., & Fung, V. (2015). Patient-initiated e-mails to providers: Associations with out-of-pocket visit costs, and impact on care-seeking and health. The American Journal of Managed Care, 21(12), e632–e639.PubMedGoogle Scholar
  34. Roblin, D. W., Houston, T. K., Allison, J. J., Joski, P. J., & Becker, E. R. (2009). Disparities in use of a personal health record in a managed care organization. Journal of the American Medical Informatics Association, 16(5), 683–689.  https://doi.org/10.1197/jamia.M3169 PubMedPubMedCentralCrossRefGoogle Scholar
  35. Squires, D., & Anderson, C. (2015). U.S. health care from a global perspective: Spending, use of services, prices, and health in 13 countries. The Commonwealth Fund. Retrieved from http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2015/oct/1819_squires_us_hlt_care_global_perspective_oecd_intl_brief_v3.pdf
  36. Stenmark, S., Solomon, L., Allen-Davis, J., & Brozena, C. (2015, July 13). Linking the clinical experience to community resources to address hunger in Colorado [Blog post]. Retrieved from http://healthaffairs.org/blog/2015/07/13/linking-the-clinical-experience-to-community-resources-to-address-hunger-in-colorado/
  37. Tractica. (2015). Population health management market to double in size to $31.9 billion by 2020. Retrieved from https://www.tractica.com/newsroom/press-releases/population-health-management-market-to-double-in-size-to-31-9-billion-by-2020/
  38. Turley, M., Garrido, T., Lowenthal, A., & Zhou, Y. Y. (2012). Association between personal health record enrollment and patient loyalty. The American Journal of Managed Care, 18(7), e248–e253.PubMedGoogle Scholar
  39. Zhou, Y. Y., Garrido, T., Chin, H. L., Wiesenthal, A. M., & Liang, L. L. (2007). Patient access to an electronic health record with secure messaging: Impact on primary care utilization. The American Journal of Managed Care, 13(7), 418–424.PubMedGoogle Scholar
  40. Zhou, Y. Y., Kanter, M. H., Wang, J. J., & Garrido, T. (2010). Improved quality at Kaiser Permanente through e-mail between physicians and patients. Health Affairs, 29(7), 1370–1375.  https://doi.org/10.1377/hlthaff.2010.0048 PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ronald L. Copeland
    • 1
  • Winston F. Wong
    • 1
    Email author
  • Jason Jones
    • 1
  • Margo Edmunds
    • 2
  1. 1.Kaiser PermanenteOaklandUSA
  2. 2.AcademyHealthWashington, DCUSA

Personalised recommendations