Kaiser Permanente Hawaii: Providing Total Care for Patients Every Day

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KPH-thumbKaiser Permanente has been leading the way with innovative, integrated models of care delivery for 50 years, operating as an Accountable Care Organization long before the term became an everyday buzzword.

The organization is one of the nation’s largest not-for-profit health plans and includes Kaiser Foundation Hospitals, Kaiser Foundation Health Plan, Inc., and The Permanente Medical Groups. It is spread throughout six geographic regions in the United States.

In Hawaii, Kaiser Permanente is blazing a trail with top-ranked health plans and an array of wellness programs.

In addition to the health-plan arm, Kaiser Permanente Hawaii includes one hospital, located on Oahu, and 20 medical offices and clinics throughout the islands. The group cares for about 20 percent of Hawaii residents.

Cultivating and delivering total health

By being a part of a patient’s health from insurance coverage through treatment, Kaiser Permanente emphasizes total health, with numerous wellness programs and outreach efforts.

“We put our members at the center of everything we do and strive to provide the safest, highest-quality care in our everyday medical program,” Janet Liang, president of Kaiser Permanente Hawaii, said. “We provide direct patient care for nearly all members in the state.”

The organization has been recognized for its efforts, garnering many awards for the Moanalua Medical Center, a 235-bed acute-care facility. The hospital has received an A safety rating from The Leapfrog Group and is the only Baby-Friendly designated hospital in Hawaii.

The hospital, and Kaiser Permanente as a whole, has a robust safety program, working with the Institute for Healthcare Improvement and other patient-safety groups across the country.

“We consistently look at safety measures to ensure we are one of the leading organizations in the United States,” Liang said. “What really pushes us from good to great is when we deploy a reliable process to the frontline staff who are invested in and understand our obligation and mission to patients.”

As part of the commitment to treating the whole individual and focusing on wellness, Kaiser Permanente Hawaii has received Level 3 Patient-Centered Medical Home recognition at all 16 primary-care clinics.

Liang said the organization is continuing to innovate and set the standard for coordinated care, especially in light of health-care reform.

“When you have all the pieces from doctors to hospitals, pharmacy, lab, therapists, and the right financial incentives, you get the ideal environment to do the right thing, rather than trying to work within rules that disincentivize you to put the individual at the center,” she said. “The total health agenda is becoming more prevalent as hospitals become more like an ACO. The industry is moving toward the model we have.”

Liang also said Kaiser Permanente does a lot of outreach in the community, conducting health education and bringing care to individuals to help prevent illness or chronic diseases. The organization has a presence at workplaces, schools, and community centers.

The KP Walk program is designed to improve employee health by encouraging employees at all locations to walk 30 minutes a day, five days a week. By logging their minutes, employees earn rewards.

Everybody Walk is an extension of the program, without the rewards, open to anyone. All one has to do is sign on and make a pledge to walk more and improve their health.

For years, the organization has been involved in efforts to curb obesity through its Community Health Initiatives for Healthy Eating Active Living, which supports obesity prevention collaboratives in communities, non-profit organizations, and government agencies. In addition, Kaiser Permanente was a partner with HBO for a series on the obesity epidemic in the United States, titled “Weight of the Nation.”

Staying Connected Through Technology

Kaiser Permanente has made significant investments in health information technology with efforts to connect every hospital and care provider across all of the islands for the exchange of basic information.

The organization has an integrated electronic health record and received HIMSS (Health Information and Management Systems Society) Stage 7 ranking for medical technology.

Providers in Hawaii use Internet-based tools to meet with patients, having roughly 1.2 million visits online annually. Patients are also able to view their medical test results through an online health record.

With the electronic medical record in place, Kaiser Permanente Hawaii is reaching out to other health-care sites to improve connectivity across the state and to collect information to further the organization’s disease-prevention mission.

Liang said the organization just worked with hospitals in Hawaii to open medical records to viewing for physicians across the islands so that they can see patients who end up in the emergency room anywhere in the state.

Furthermore, the nephrology group is now able to identify patients early on with the potential for chronic kidney disease and reach out to those individuals with preventive efforts.

Health-care reform is encouraging changes as it puts more emphasis on technology and wellness, and Liang said reform is bringing exciting opportunities to Kaiser Permanente as the group gains a better understanding of exchange markets and how consumers will now shop for insurance.

“Reform means changing the way we think, market, sell, and introduce ourselves to a community,” she said. “We are planning on growth. More people covered by insurance is a good thing for the health-care industry as a whole.”

From the provider side, reimbursement changes will continue to be a challenge. Hawaii is one of the lowest markets for premiums and government reimbursements, so efficiency has always been a goal for health-care organizations in the state.

“By following 20 percent of the marketplace, we can demonstrate over time what happens to the population,” Liang said. “We are excited to showcase that. We have a lot of members that we have taken care of since birth and are beginning to be able to show some lifetime results.”

Looking toward the future, she believes collaboration will be the key to being successful in this changing market.

“We are seeing more people converse together,” she said. “It’s hard to go it alone, whether you’re a hospital, health plan, or office. It’s time for us all to collaborate within our communities.”

-by Patricia Chaney

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