Integrated delivery network Kaiser Permanente is often held up to other providers as a model for transforming care. Its historical role as both insurer and provider led to a value-based approach long before that approach became an industry buzzword, and its hospitals dominate the still short list of providers that have reached Stage 7 of the HIMSS Analytics EMR Adoption Model.  

At HIMSS, two Kaiser clinical informatics experts will explore what happens after Stage 7. Ann O’Brien, director of clinical informatics, and Julie Vilardi, executive director of strategic projects and clinical informatics, will share the lessons they’ve learned about identifying a clinical need, finding a technological solution, implementing that solution, and assessing whether it’s made a difference.

O’Brien and Vilardi, both nurses, will present twice:  first at the Sunday nursing informatics symposium, and again at a roundtable during the regular meeting.

“Your EHR provides the backbone, but then you need to look at your workflow and your clinical and business quality drivers,” O’Brien says. “We’ve developed our own clinical transformation model:  how to set standards, build reports, and do data mining out of our system to see where we are in improving quality. If we say the best care is to have antibiotics in the first hour, what are we doing in terms of reminders and alerts to achieve that?”

O’Brien says Kaiser is doing lots of work around preventing pressure ulcers, which are the most common medical error and the second most expensive one to treat.

Kaiser’s nurses have asked for ways to reduce what O’Brien calls “non-value-added tasks,” such as looking for items and information and having to log on to the EHR repeatedly. In response, the clinical informatics team is developing a dashboard that allows nurses to see at one glance how their patients are doing and how they need to prioritize tasks. They’re also establishing a rapid log-in based on ID badges, so that nurses only have to do the full log-in process once per shift.

O’Brien and Vilardi will look at how clinical informatics is coping with the prospect of an influx of members from the Affordable Care Act, and how Kaiser is pushing for “virtual care” that takes place outside its facilities.

HIMSS attendees may feel that Kaiser is a law unto itself, and that its lessons can’t easily be applied to organizations with a traditional structure, but Vilardi disagrees, saying that in some ways, the changes they advocate will be easier to execute in a smaller environment. “It takes us awhile to make a commitment to a technology solution because we’re so big,” she says. “I think these are pretty concrete examples and will resonate.”

Kaiser staff will present during “Leveraging Technology to Drive Transformational Change,” at 10:30 a.m. on March 3, and at Roundtable 304 at 2 p.m. on March 5.


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