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IT at the Heart of Real-Time, Personalized Healthcare #PBLS


Last session at the SAS/BetterManagement.com event this week on IT and personalized healthcare. Yan Chow of Kaiser Permanente presented on their vision for IT-enabled healthcare. Kaiser is an integrated system with 8.6M patients and 180,000 employees and physicians. Integrated means that insurance/delivery are all aligned and Kaiser is very focused on prevention. It is also a not for profit so it spends heavily on research and community investments as well as providing funds for 100,000 uninsured patients. Lastly it is a big researcher and a big investor in medical technology.

One of the biggest patients have is whether their healthcare provider knows them – their drugs, their allergies, their lifestyle etc. Beginning in 2003 they started to invest in technology to answer this question – they selected EPIC and have deployed it for more or less everyone. This is a very large implementation of electronic medical records, probably the largest outside the government/military. 7 Petabytes of data, 380M views per week and 80,000 concurrent users! Only about 1.5% of healthcare providers have a comprehensive electronic medical record so this is huge.

The system is designed to be cross-channel (web, call center, visit) or connected and consistent in that the same care, and evidence-based care, is delivered all the time. This focus on evidence-based medicine is a big shift for doctors who are basically trained using an apprentice approach. The system is also personalized and this is where predictive analytics comes in.

The system has what they call Smart Tools to identify at-risk populations so they can intervene earlier and more effectively. People in Kaiser are 30% less likely to die from heart disease and they have reduced by 88% the risk of post cardiac arrest mortality! The system already brings patients in using a portal and in the future they see virtual care teams all being connected through the system.

To personalize care it is necessary for patients to see the effects of treatments and health decisions in the context of their unique physiology. Kaiser uses Archimedes a tool designed to modeling disease and impact at a molecular level. This allows people to see the impact of a disease or a lifestyle decision on them personally.

From a predictive analytics perspective they are focused on improving their information management and strategy. They have to consolidate and standardize data across systems as well as develop a common analytic infrastructure so they can develop a Center of Excellence around BI and analytics. Kaiser has a lot of data so this is an area with lots of opportunity.

To support innovation Kaiser has developed the Garfield Innovation Center – 37,000 sf facility that has a ward, operating rooms and more for full-scale simulations, workflow design and space design. Colors, equipment, wiring and connectivity approaches and more are all investigated and the best outcome selected for future use as Kaiser builds out new facilities. It also has a tele-health simulator representing a home to see how technology could be used to provide remote consulting on health issues and monitor them remotely. This involves a lot of rules-based automation to provide 24×7 support with a virtual team of people engaged through this model. Making the patient the center of the treatment network. The 21st Century house call will be remote, by satellite say.

An interesting presentation on Kaiser, its business model and its technology.


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