Kaiser Permanente nearing launch of nationwide info exchange

Kaiser Permanente has implemented a secure health information exchange that is going to be expanded nationwide.  Kaiser Permanente and VA engaged in first Nationwide Health Information Network (NHIN) production exchange for treatment purposes on December 17th, 2009 in San Diego, CA.

Kaiser Permanente is nearing the launch of a nationwide information exchange, giving its 9 million members an opportunity to have their medical records shared over the Internet with public- and private-sector partners.  Kaiser’s membership includes about 500,000 veterans, who receive care at Kaiser facilities and Veterans Affairs Department hospitals.

The software that allows providers to view and extract medical record data uses the standards and specifications set by HHS. The data is encrypted, and patients have to give their consent before their health information is shared.

Kaiser ensuring patients take the drugs they’re supposed to.

Half of patients in the developed world don’t properly take their drugs for chronic conditions.

The additional costs for treating diseases that progress unchecked run into the hundreds of billions of dollars a year. One study estimates nearly 90,000 people die prematurely in the U.S. each year because of poor adherence to high-blood-pressure treatment alone.

So how do you get people to take their medicine? There isn’t one answer, because there isn’t one reason people aren’t sticking to their regimens. Cost, forgetfulness, side effects and doubts about effectiveness can all be factors, among others. And for many people the health-care system isn’t designed to monitor or encourage adherence to drug prescriptions.

Providers like Group Health and Kaiser Permanente, a large managed-care consortium based in Oakland, Calif., can track refills because they manage all aspects of their patients’ care, so all information for each of their patients is collected in one easy-to-access electronic record. Alec Does, a family-medicine physician at Kaiser Permanente Anaheim Hills, says that when he shows patients records indicating they haven’t been consistently filling their prescriptions, “90% of the time, they’ll open up” and start talking about any issues they’re having.

But most people don’t get their care from such comprehensive providers, so their doctors rarely have access to their pharmacy records.

The first step is to engage the patient with a simple, open-ended question, says Elizabeth Oyekan, area pharmacy director at Kaiser Permanente South Bay Medical Center: What’s getting in the way of picking up your medications?

“That will give you some concrete information, and then you target the solution to the individual patient,” she says. Kaiser has created a set of online tutorials to help doctors and others engage more effectively with patients who are skipping their medications.

If a patient is worried about side effects, a health-care provider might offer a substitute for the medication, or a lower dose. For the forgetful, it could be as easy as using a simple pillbox, or maybe something more technologically advanced, such as text-message reminders or souped-up pillboxes with audio or visual alerts.

If money is the problem, the solution may be generic substitutes, a mail-order program (which not only provides drugs at a lower cost but also helps those who have trouble getting to a pharmacy), or a drug company’s assistance program.

Kaiser Permanente leads nationally in electronic health records.

Kaiser Permanente has been a leader nationally in electronic health records. Kaiser spent more than $4 billion over more than a decade to develop its HealthConnect  system that tracks more than 8.6 million members in nine states. The system, completed last year, is the largest civilian electronic health record system in the world.

Oncologist Dr. Jenny Devitt, HealthConnect leader for San Diego, called the system “mind-boggling.”

“It’s totally transformed what we do,” she said. Devitt said that in addition to allowing care providers throughout the Kaiser system to share patient data, a popular feature allows doctors and patients to e-mail through a secure website.

“It takes me more time (during the workday) but maybe if I answer their questions, they won’t get sick and end up in the hospital or coming in for an appointment,” she said. “In the long run, it may save me time and the patients really like it. They like it a lot.”