Kaiser Permanente: George Halvorson, Chairman & CEO

by HCE Exchange on June 30, 2013

George Halvorsen George Halvorson

The roots of Kaiser Permanente date back to the depression era when a pre-payment system for hospital services was developed for workers on the aqueduct project in the Mojave Desert, California. Today the organization is a care delivery and care financing entity covering about 8.6 million people. The group operates hundreds of care sites and employees more than 160,000 people.

“We look at the situation very much like a country looks at healthcare because we are both financing and delivering care. Most of our competitors either deliver care or sell insurance. We do both,” says George C. Halvorson, Chairman and CEO, Kaiser Permanente.

More Than Putting Medical Information into a Computer

Kaiser Permanente maintains the largest civilian medical records database in the world. “The paper medical record is heavily flawed by the fact that each piece of data is isolated by the paper,” says Halvorson. The problem with electronic medical records is that they often suffer from that same isolation. Connectivity is Kaiser Permanente’s key.

“It’s a step that a lot of people who are looking for electronic medical information skip,” Halvorson says. “They forget the ergonomics. They forget the fact that if this information is not available in an easy to use way, it won’t be used. It’s like designing a GPS for your car and locating it in the trunk.”

Kaiser Permanente has developed their IT system with information flow in mind. First they looked at details such as where should the information be stored, who should have access to it, and what should that access look like. The next step in the process of building an efficient IT system was to look at how the data should be sorted for optimal benefit. “We have the computer sorting through the database for the patients for a given physician so that we can give a physician advice and counsel about how to optimize things for their patient population,” says Halvorson.

“The using process is a science and art form and skill set all by itself, and that’s a process we’re embarking on,” says Halvorson. “We’re extracting the data from the computer and figuring how to use it.” The organization has had programs where the death rate from heart disease has been cut more than 70 percent through optimal use of the data in the computer and linking that data to the caregivers who are, in turn, linked to the patients.

Technology as Key to Reduce System Costs

“The best care costs less,” says Halvorson. “If you have half as many heart attacks, half as many asthma crisis … that’s better for the patients and costs less. The rest of health care is setting no goals and doing absolutely nothing in any systematic way in terms of preventive care.”

Halvorson cites asthma as the number one growing condition for kids in America, a top cause of death, and a high expense to our healthcare system. He promotes use of the electronic database to reduce the number of asthma related health problems. “You need to identify every single kid with asthma. You need to have connectivity so that the data about those kids who have an asthma attack flows from the hospital back to the primary caregiver.”

Through provider education, you can use the current database and create a process that creates a more systematic diagnosis. Then you have to add the mechanisms to transport the data. The structural advantage of electronic medical records is minimal unless the connectivity issue is addressed.

“You start creating the data flows between caregivers and you start creating the mechanisms because they have a purpose. Once they are in place for the first purpose, they can be multi-purposed and used for other functionality. Just connecting for the sake of connecting wouldn’t happen in any other industry in the world, but connecting for the sake of improving something happens all the time. So if we connect for the purpose of improving something [for instance, reduced asthma attacks in children] that gives us a connectivity template that we can extend to the next issue, the next problem, the next medical condition,” says Halvorson.

Kaiser Permanente’s Outlook

Kaiser Permanente is expanding within its existing geographic locations. “We’re building another half dozen hospitals and we’re building probably a couple dozen other care sites,” says Halvorson “The likelihood of us jumping into an entirely new area is less likely just because it makes less logistical sense. There are enough people living in proximity to where we are now that those are more than adequate markets.”

Physicians at Kaiser Permanente are salaried. “If you look at the great care systems of America—the ones where the providers function as teams—most of them have salary- based physicians. That’s a good model because it takes out of play the decision making at the point-of-care that happens just to increase caregiver revenue,” Halvorson says. He believes the care support model and tool kit now in place at Kaiser Permanente will improve physician performance in “fee for service” models, as well.

Growing Healthcare Coverage for All

Halvorson says universal coverage is the end goal and it is only by covering everyone that we will begin to see healthcare costs fall. “If the kids don’t have the ability to use the care delivery system—if no one is reminding them what needs to be done and if no one is tracking what is or isn’t being done, then the likelihood of care improvement shrinks immeasurably. We need kids covered so we can provide better care for kids. Once we provide better care for kids, the cost of care for those kids will go down and that will make universal coverage more affordable,” he says.
“We need care improvement in America. We spend twice as much per capita as any other country in the world and we still have 40 million people uninsured. In many areas, we have care outcomes that aren’t as good as the outcomes in other countries. We need to do better and we are only going to do better if we do that systematically.”

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{ 1 comment… read it below or add one }

William Wendt March 3, 2011 at 9:09 am

Good morning Sir, I am trying in every way to get an appointment with the CEO of kaiser located in Springfield, Virginia area and I have not been able to find an email site or a way to contact such person. I am begging someone to assist me in a way to make this request happen. I am asking you and I plan to continue to search the web site until I can get an appointment. Even when I contact membership service they will not aloow me the opportunity to speak with the CEO. My wife needs immediate help. Please help me and point me in the right direction. My home telephone number is 540-720-6388. I would greatly appreciate anything you could do to help. have a good day.

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