Uncertainty has become the norm with health care information management, but few entities have handled and risen to the challenge like health plan and health care provider Kaiser Permanente. The not-for-profit carries an operating revenue of approximately $42 billion yearly and serves more than 8.8 million members. CIO and EVP Philip Fasano joined Kaiser Permanente in 2007 and has lead a team of 6,000 IT employees through a handful of sweeping implementations in the last few years, including the establishment of HealthConnect, the largest civilian electronic health record repository. Fasano recently discussed some of the high-level approaches he said need to be in order before any IT implementation goes out for a bid, and what, if anything, health agencies can do to plan for requirements and pools of new patients from federal health care reform.
Information Management: Your HealthConnect system is often held up as a model for the industry. Give me a synopsis of how you’ve been able to make it work and what you’re able to do with all of that patient data.
Fasano: Every one of our programs is very large, so they all have a large amount of data tied to them. I can tell you, when we look at our KP HealthConnect program and all the capabilities that it has given our organization, the data that resides in that system is a treasure trove and we’re always looking to leverage that in valuable and insightful ways. This is true for our physicians in particular, with some advanced analytics capabilities to manage chronic conditions of all of our patient population across our entire organization every single day. And it makes meaningful difference to those patients. We purchased Epic medical systems, which is our framework. As far as our data repository, we use products from Teradata and Oracle and IBM systems, and we go across all three of those vendors significantly and leverage their products and services deeply. As far as the outcomes, they often come from the simple things we do, like useing data to help diabetics manage their diabetes effectively. The impact of those types of things are shown in real simple ways, like a 50 percent reduction in hospitalization for our diabetic patients versus the general population. The outcomes that are received are really meaningful to the patient. The value is derived, obviously, by leveraging the data with some basic insights and capabilities that we put in there for our care teams.
What was the concept you had going in for the system? It certainly sounds like more than some IT team meetings and compliance checks.
Our organization has a very long history of focus on prevention and preventive care for our patients, which is a very different orientation than the larger health care market. That heritage has played right into our implementations of technology capabilities. We have about 15,000 physicians with that same heritage and when they look at IT, they value what we provide them in terms of information that helps them achieve their goals with prevention. We align our use of data, our creation of analytics andthe tools we put in place with that particular focus. It doesn’t matter the condition -- if it’s diabetes like in the example I gave you, or if its congestive heart failure -- there are significant preventative outcomes based on that work in IT and information.
Being out in front of some of these EHR matters, what advice would you give to a colleague a year or two behind where you’re at?
Quite frankly, when you’re doing this type of work, you have to connect it with the mission of your organization. Being mission driven – and health care is mission driven, anyone in health care is here because they want to make people’s lives better – technology that appeals to that premise and improves outcomes for patients. Physicians tend to clamor for it and really want to lead initiatives when it aligns with that purpose. Delivering a shared vision that is not just an IT vision on better health grounds the work in patient outcomes, which ultimately raises everything to a higher purpose. Every time we’re able to do that in our department, we end up collaborating in ways that have a major impact and an immense focus on bringing capabilities to our patients.
How do you hammer that home, especially to a team of your size?
It starts with the CIO. Any CIO in this industry really has the obligation to personally engage with mission of the enterprise. You have to be the sponsor for that direction and purpose and culture to the IT organization. It has to be taken on as a personal commitment to make sure the entire organization they lead, all the way into the data center, understands why they’re there. To the extent the CIO can do that and provide the messaging and engage their managers on a consistent basis … we’re always talking about delivering life-critical systems. When you align your work with a purpose of life-critical systems, all of a sudden, uptime, availability, your data centers, your physical assets and people align their work in those systems with that mission. You start to see progress toward achieving always-on environments that in turn support applications that back up physicians, clinicians and patients, and, ultimately, better outcomes.
There’s been no shortage of excitement recently in the health care space. How are you planning for responses to huge issues like health care reform and the related decision by the Supreme Court from earlier this summer?
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