1. World Health Care Congress
Building the 21st Century Health System
April 14, 2009

2. Moderator
Lane Bailey
President, Global Public Affairs
GolinHarris
email: lbailey@golinharris.com
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3. World Health Care Congress
Building the 21st Century Health System
April 14, 2009
Jack Cochran, MD, FACS
Executive Director
The Permanente
Federation

4. Kaiser Permanente
HealthConnect™
KP HealthConnect™ is the largest
civilian deployment of an electronic health record
8.6 million members covered
Complete 36 million records
90 thousand daily users (physicians, nurses, staff, etc.)
Accessible 2.7 million active online users
1.3 million lab results online monthly
Connected 500 thousand emails monthly
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5. Technology in the Hands of
Physicians – Transforming Care
 Registries
 Prompts and Alerts
 Guideline Reminders
 Decision Support
 Predictive Modeling
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6. The Kaiser Permanente Collaborative
Cardiac Care Service (CCCS)
Coordination among:
 Nursing team
 Cardiac rehabilitation program
 Pharmacy team
Patients enrolled in CCCS
experienced a reduced
incidence of all-cause mortality
by 89%.
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7. Jack Cochran, MD, FACS
Executive Director
The Permanente Federation
(510) 271-5886
fax: (510) 267-2194
email: jack.h.cochran@kp.org
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8. World Health Care Congress
Building the 21st Century Health System
April 14, 2009
Phil Fasano
Chief Information Officer
Kaiser Permanente

9. Our Health IT Vision
(tools that spread health)
Research capabilities for internal
Smart experts and external agencies
Infrastructure that is pervasive and
Networked resilient and supports interoperability
Video and voice on-
Collaborative demand to enable real-time collaboration
New technologies integrated
Affordable with workflows that create efficiencies
Proactive identification of and
Preventive outreach to at-risk populations
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10. Our Health IT Journey
(all the data, about all the patients, all the time)
Real-Time, Personalized
Health Care
QUALITY SERVICE
AFFORDABILITY
This is our journey and our obligation
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11. Phil Fasano
Chief Information Officer
Kaiser Permanente
email: phil.fasano@kp.org
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12. World Health Care Congress
Building the 21st Century Health System
April 14, 2009
Scott Shreeve, MD
CEO & Founder
Crossover Healthcare

13. Care Financing Continuum
Fully Capitated Fee for Service
• Provider Risk • Payor Risk
• Preventive Care • Disease Care
• Coordination of care • Lack of coordination
• Some navigation help • Consumer left to navigate
• Results • Results
– Better Quality – Highly variable quality
– Lower Cost – High costs
– Better Outcomes – Worse outcomes
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14. The Cathedral vs. The Bazaar
VS
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15. Cathedral Care
Vertical Characteristics:
• Kaiser, Mayo, Intermountain, VA, etc
Ancillary
• Optimization at the system level
Services
• Full coordination of care
• Information technology supports
Hospital
• Incentives aligned for outcomes
Services
• Reward for results
• Patient consumer for life
Physician
Services
• Consumer is guided through process
Patient
Services
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16. Bazaar Care
Non - Integrated Characteristcs:
• Fee for Service
Ancillary
• Optimization at the component level
Services
• Disease Care
• Lack of coordination
Hospital
• No Accountability
Services
• Consumer left to navigate
• Incented for volume not value
Physician
Services
• Churn and burn; “treat ‘em & street ‘em”
Consumer
Services
(None)
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17. Bazthedral - or - Cathzaar
Virtually Comments:
• Can you create a software and services
Ancillary
integration layer that coordinates
Services
patients, provides, and payment that can
dramatically improve health value?
Organizing Entity
Hospital
• Virtualization accomplished through
Services
financing (payment / business models),
delivery, (new types of arrangements),
and incentives (increased payment for
Physician
high value) innovation
Services
• Medical Home -> Accountable Care ->
Health Vitality organizations
Consumer
Services
(None)
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18. Bazthedral or Cathzaar
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19. Scott Shreeve, MD
CEO and Founder
Crossover Healthcare
email: scott.shreeve@crossoverhealth.com
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20. World Health Care Congress
Building the 21st Century Health System
April 14, 2009
Matthew Holt
Author
The Health Care Blog

21. Health 2.0: User-Generated Healthcare
Social
Content
Networks
Search
Tools
Transaction
Data

22. A continuum of Health 2.0?
User-generated Users connect to Partnerships to Data drives
health care providers reform delivery discovery
Use of Web 2.0 Tools and Reforms in payment All the data collected
technologies for communities created structures, in a combination of a,
patients and as part of Web 2.0 in transparency, and b & c produces leaps
physicians to health care, which technology produce ahead in the process
communicate and then becoming changes in delivery of care and eventually
investigate without connected to the structure and process in drug and procedure
connecting to the system (i.e. creating around chronic care discovery.
health care system appointments, treatment, excellence
conducting centers for particular
transactions, procedures, etc.
managing clinical
events)
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23. Matthew Holt
Author
The Health Care Blog
email: matthew@health2con.com
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24. World Health Care Congress
Building the 21st Century Health System
April 14, 2009