Managed Care - June 2008 - (Page 51)

PLAN WATCH Kaiser’s EMR Push Pays Off It has not been easy to launch the massive HealthConnect system, but officials at the health plan say it has been rewarding By Frank Diamond alk to Louise Lang, MD, the executive vice president for clinical systems and quality at Kaiser Permanente, about how the health plan managed to install what it calls the biggest electronic medical record system in the world, and she’ll mention several things. First, that EMRs happen to be what CEO George Halvorson made his reputation on. Before going to Kaiser Permanente in 2002, Halvorson pushed hard for the installation of EMRs at HealthPartners in Minnesota. T A drop in office visits atients who use secure e-mail to contact their doctors are 7 percent to 10 percent less likely to schedule an office visit, according to a study by Kaiser Permanente. The company tracked about 4,700 members who are registered in its HealthConnect program. The health plan looked at how those members contacted doctors’ offices for 3 to 14 months before registering with HealthConnect, and then 2 to 13 months afterward. “A quarter of the respondents indicated they would have scheduled an appointment in lieu of electronic messaging and were satisfied with and appreciated the alternative mode of care,” says a report on the program. Of course, whether Kaiser Permanente’s success can be replicated by other health plans is an open question. The report notes that with Kaiser Permanente, “Patients and physicians generally used electronic messaging free of the reimbursement concerns that presently challenge the U.S. health care system.” P Then, there’s the need for doctor buy-in, something that Kaiser Permanente’s group model made easier. There’s also the health plan’s historic inclination to invest in methods that might improve quality without necessarily being obsessed about the bottom line. It’s only when the conversation’s wrapping up that Ravi Poorsini, a Kaiser spokeswoman, interjects that Lang is the reason that the EMR project works. “Louise really spearheaded a lot of it,” Poorsini says. Before going to Kaiser, Lang was the chief operating officer of Straub Clinic & Hospital in Honolulu, and she held the same post at Group Health Cooperative of Puget Sound. “I had credibility with other executives because I was a known successful operating executive,” she says. Also, “George made it very clear that this implementation was our number one organizational priority. There was no argument about that. ” Preferred alternatives to electronic patient-physician messaging* Calling office for advice Scheduling an office visit Calling nurse advice line Other Walking in for unscheduled medical care 44% 25% 18% 11% 3% *Total exceeds 100% because of rounding Source: Kaiser Permanente Program Office National Market Research No argument It cost Kaiser Permanente $4 billion to launch HealthConnect — $3 billion for the actual implementation and $1 billion reserved for maintenance over 10 years. The company is so big that the scale of the effort proved to be much more daunting than anything Halvorson or Lang had tried before. HealthConnect links 8.7 million enrollees in nine states to all of Kaiser Permanente’s 13,000 physicians in 421 medical offices and clinics. There’s another phase to come. Only 13 of the system’s 36 hospitals have put HealthConnect in place. Kaiser expects that 14 hospitals will bring up the system this year, with the remaining nine hospitals slated for implementation in 2009 and early 2010. JUNE 2008 / MANAGED CARE 51

Table of Contents Feed for the Digital Edition of Managed Care - June 2008

Managed Care - June 2008 Editor’s Memo Contents Viewpoint Letters News and Commentary Legislation & Regulation Medication Management Compensation Monitor Plans Chart Course in Rough Waters A Conversation With Barbara Starfield, MD Smoke Signals from Payers Slow Going for Clinical Decision Support Back Pain and Physical Therapy Formulary Files PlanWatch Outlook

Managed Care - June 2008

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