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Kaiser Permanente: Medical Devices and Health IT Improving Quality of Care. Tom Judd, MS, CCE, CPHQ, CPHIMS National Project Director, Clinical Technology Kaiser Permanente WHO-PAHO Health Technology Consultant. Presentación. Healthcare Context US & Colombia

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Kaiser permanente medical devices and health it improving quality of care

Kaiser Permanente: Medical Devices and Health IT ImprovingQuality of Care

  • Tom Judd, MS, CCE, CPHQ, CPHIMS

  • National Project Director, Clinical Technology

  • Kaiser Permanente

  • WHO-PAHO Health Technology Consultant


Presentaci n

Presentación

  • HealthcareContext

    • US & Colombia

  • Medical DeviceIndustry, Quality, and Health IT

    • Health IT =healthcarecomponent of Information & Communication Technologies (ICTs) in US

    • Health IT also = Medical DevicesIntegratedwith EMR/EHRs, aka “DeviceInteroperability”

  • Kaiser Permanente (KP) & Medical Devices

    • QualityDefined & CareDelivery

    • Devices: TheirRequirements, Integrated Management, & Testing

  • KP Technology-Related Case Studies & Outcomes

    • ForAcute & ChronicDisease, Costs, PatientEngagement

  • Conclusions & Appendices


Context an interesting time in healthcare

Context: An interesting time in Healthcare!

US: Affordable Care Act (ACA) reimbursement … meaningful use of EHRs (Electronic Health Records) & HIEs (Health Info. Exchanges)

  • The use of Health IT improves quality of care

  • Note improvements in Heart Failure & Pneumonia to Sepsis & Stroke, from 7/14 study

    Columbia:

  • One Health Leader: “Our law required that by 2013 everybody should have a EHR, but that law has not been implemented; the most serious risk is that nothing has been written about standards of HIE. This is where the proposal of IHE profiles can become a real advantage to Latin American countries.”

  • From MinSalud: http://www.minsalud.gov.co/English/Paginas/Because-we-colombians-are-entitled-to-timely-and-quality-health-services.aspx

    The Business Case for Medical Device Quality: McKinsey

    • Quality issues rightly concern every stakeholder in the medical device industry value chain

    • Optimum Quality … reliably meets/exceeds expectations of customers/regulators while maximizing value


Context an interesting time in healthcare1

Context: An interesting time in Healthcare!

  • US: Chronic Disease Management (CDM) – medical devices needed!

    • Centers for Disease Control: 75% of healthcare expenses devoted to CDM

    • Need for the Affordable Care Act to align incentives between providers, payers, patients

  • Colombia:

    • Colombia also deals with high prevalence & cost for CDM

    • Maternal mortality surveillance another national focus, eg, one of several Maternal Child Health (MCH) issues

  • Can technology better address CDM Google’s Moonshot: Human Bodies

    • Baseline pilot: find biomarkers from diagnostic devices so CDM detected and treated earlier

    • Stanford/Duke University medical teams to analyze genomes, metabolism, data from wearable devices


Explosion of devices at what cost

Explosion of Devices … at what Cost?

In context of tremendous device growth last 20 years


Device industry quality business case

Device Industry Quality Business Case

Factors in rising complexity of device/user environment

  • Interoperability

  • Wireless

  • Mobile Health (mHealth)

  • Device Security

  • Human Factors

    All Increasing the likelihood of significant Q issues

  • Device consumers claim quality (Q) is a key consideration in purchasing

  • Q typically means efficacy, durability, and ease of use

  • Device Quality Systems need to catch up with industry demands

  • Through its value chain: including manufacturers and regulators as well as payors, doctors, and patients for risk areas


Device business case how to respond

Device Business Case – How To Respond?

  • Baxter Infusion Device Recall in 2010

  • Numerous design flaws

  • FDA Total Product Life Cycle created

Industry Quality example, 2013

  • Challenges

  • quality costs

  • problem prevention

  • low-quality supplier performance

  • Transformation

  • reduce quality-related costs while increasing capacity

  • reorganization of the quality function

  • Introduce proactive quality, system for tracking, dialogues around key indicators, and root-cause problem solving

  • Results

  • Reduction in cost of Q by 35%

  • improved profit by 2.5% revenues

FDA notes 7 opportunities, 2011

Design & reliability

Monitoring & feedback

Supplier management

Quality metrics & systems

Quality organization

Performance management

Quality culture

  • Pew Charitable Trust to FDA, 2014

  • New approach to device development

    • ensure timely pre-market studies

    • robust post-market surveillance infrastructure

    • unique device identifier (UDI) capture in EHRs

    • and use of clinical registries


Us fda health it and medical devices

US FDA, Health IT and Medical Devices

  • FDA Safety and Innovation Act (FDASIA)

  • A nationwide health IT (HIT) infrastructure

  • Risk-based framework for HIT

  • FDA to focus its attention/oversight on device health IT functionality

  • How devices used in EMR/EHR workflows*

*Each of 12 EHR workflow device uses defined in Appendices


Kaiser permanente who we are

Kaiser Permanente – Who We Are


Kp and quality

KP and Quality


Our technology journey

Our Technology Journey

Over the past decade Kaiser Permanente transitioned to a truly technology-enabled company; our next decade will ensure that health IT becomes one of our enduring competitive advantages.

  • Strategic Priorities

  • KP HealthConnect (EHR = Electronic Health Record)

  • Health Plan

  • Digital Health

  • Big Data & Analytics

  • Clinical Technology

  • Corporate Infrastructure

  • Risk Management

  • Digital Health

  • Mobile

  • Internet

  • Intranet

  • Social

  • New Platforms

  • Claims

  • Lab

  • National Pricing

  • OneLink

  • Pharmacy

  • Revenue Cycle

  • Data Centers

  • Continuous Availability

  • Analytics

  • Archimedes

  • Point

  • Panel Support Tool

  • EMR/EHR

  • Inpatient

  • Oncology

  • Outpatient

  • Registration

  • Scheduling

  • Communication Tools

  • Contact Center

  • Wireless

  • Voice

2015 +

  • Online

  • My Health Manager

  • E-visits

  • Rx Refill

  • Lab Review

  • Regulatory

  • 5010

  • HIPAA

  • ICD-10

  • Medicare Modernization Act

  • Meaningful Use

2004 - 2014

Real-time,

personalized

Delighting our Consumers and Care Team

Paper-based

Paperless


Using the ehr for better outcomes

Using the EHR for Better Outcomes

How KP Uses Technology Improves Outcomes, Cost, & Patient Engagement

Overview then Case Studies

  • Meeting US EHR Meaningful Use requirements

  • CPOE (Computerized Practitioner Order Entry), best practice alerts/alarms on EHR drive evidence-based care

  • Social media interfaces driving Patient Engagement

  • Interactive patient care at Point of Care

  • Data mining for Clinical Decision Support (CDS) tools

  • Medical device integration in hospitals and clinics

  • Patient data from mobile applications for CDMs (chronic disease)

  • Wireless infrastructure/RTLS (real time location systems) improve clinical workflows

  • Emerging Genomic patient evaluation

  • Facilitates telehealth for improved access & e-consult


Us ehr meaningful use regulations

US EHR “Meaningful Use” Regulations

CDM

mmmmmmmmmmmmmmmmm


Evidence based personalized care

Patient Facing

Clinician Facing

Shared

Evidence-Based, Personalized Care

  • Location and proximity

  • Virtual Care / Videoconferencing

  • Hourly Rounding

  • New roles –Transition Coordinator

  • ‘Ready Room’

  • Interactive Patient Care

  • Patient Schedule

  • Device integration

  • EMR optimization

  • Hand hygiene

  • RFID tags

  • Falls Prevention

  • Medication Administration

  • Integrated Communications

  • Mobility / mobile devices

  • Workflow Automation

  • Predictive Analytics

  • Real Time Dashboards

Patient Empowerment

Interactive Patient Care: IPC Systems return control to the patient in their hospital room by providing increased autonomy, capability, and comfort


Patient engagement focus

Patient Engagement Focus

Social Media Tools

Care Where You Are


Integrated mobile apps for patients clinicians

Integrated mobile apps for patients & clinicians

  • Mobile electronic health record

    • Android and Apple iOS

    • View part of your health record

    • See your lab results

    • Send a secure message to your physician

    • Refill your prescriptions

    • Book an appointment with your physician

  • KP Locator

    • iPhone platform

    • Find any KP facility using iPhone GPS

  • Every Body Walk

    • App to encourage fitness and walking

  • Professional Applications for access

    to EMR/EHR by clinicians

KP, George Panagiotopoulos, June 2013


Inpatient room of the future nurses

Inpatient Room of the Future: Nurses

Moving to an Integrated Environment

A Nurse’s Day - Inpatient

  • Practice work environment is challenging

  • Patients and families often feel un-empowered

  • Technology is often not integrated

  • Data and information needed for clinical practice decisions is not always easy to locate

  • The environment does not support efficiency

  • Communication often requires multiple devices

“Time and Motion” Study Findings

7% of a nurse’s time is spent on patient assessment

17%of a day shift nurse’s time (median) is spent onmedication administration

35% of a nurse’s time is spent on documentation

Day shift nurses spend about 30.8% of their time in patient roomswith all of their patients

Care Coordination 20.6%

Convergence of:

voice

secure messaging

alerts

presence

EMR integration

workflow automation

usability

Hendrich, A., et al, A 36- Hospital Time and Motion Study:

How do Medical-Surgical Nurses Spend their Time?

The Permanente Journal Summer 2008 v12. No 3


Smart care strategy with health it

Smart CARE Strategy with Health IT

Clinical Transformation

Design

* Reference Appendix A: SmartCARE Components

* *Source: Kaiser Permanente Annual Report 2010

Bedside Devices

Infrastructure

Device-EHR Middleware

Design

Interactive Patient Care

Location & Proximity

Communication

Computing Technology


Benefits of medical device integration

Benefits of Medical Device Integration

  • Benefits of Integration

    • Time saved (primarily Nursing; up to 35% of time)

    • FTE efficiency gains (ECG and Anesthesia)

    • Revenue capture and reduction in supplies (ECG billing and Anesthesia)

    • Reduced Adverse Events

    • Incremental Overtime reduction (Nursing and other clinical staff)

  • Focus on critical devices

    • Provide real-time patient information

    • Require most documentation time from clinicians

    • Potentially the most medical errors ($17B/year in US) due to manual EHR entry (25% of manual entry vital signs have 1 or more errors)

    • Create revenue capture opportunities


Case studies

Case Studies

  • Health 360 / Interactive Patient Care (slides 21-28)

    • Multi-Vendor Collaboration

    • Inpatient & Care Anywhere

  • Clinical Decision Support-CDS & Dashboard (29-31)

    • Sepsis identification

    • Community acquired Pneumonia

  • Mobile Vital Signs (32-39)

    • Mobile devices capturing vital signs directly to EHR

  • Telehealth(40-44)

  • Value of Health IT and mHealth(45-49)


Case study 1 transforming care delivery

Case Study 1: Transforming Care Delivery

Care anytime, anywhere

Convenient & affordable

Personalized

PATIENT

Perspective

Real-time access

Immersive user experience

Automated & coordinated

Clinician

Perspective


Coalition of leading companies

Coalition of Leading Companies

Delivering the next generation of total health solutions


Health360 overview

Health360 Overview

Health360 brings together clinicians, IT and operations to scale new technologies to create market-leading differentiation and accelerate the transformation to a personalized member-driven model of care

Objectives

  • Seamless patient experience

  • More efficient clinical workflows

  • Accelerate virtual care and enhanced access strategies

Scope & Approach

  • Defines an enterprise strategy for new technologies (e.g. mobile, video, analytics, social, etc.)

  • Focuses on a 3-year time frame to keep pace with technology, market forces and consumer expectations

  • Establishes “platforms of innovation” to ensure critical capabilities implemented quickly

Phase One: Building the Foundation

  • Secure Text Messaging Platform

  • Enterprise Video Teleconsulting Platform

  • Event Management Platform

  • Rapid Sign-On to KP HealthConnect

  • Real-time Resource Location (care teams, patients, bed status, ClinEngr.)

  • Mobile Facility Wayfinding Application

  • Interactive Patient Education

  • Remote Diabetic Monitoring


Scope in 2013

Scope in 2013

Description

Based on stakeholder feedback, Health360 has launched four efforts to streamline communications, re-engineer clinical workflow, and empower our members and their care circles

Converges voice, messaging, video, and clinical alerts onto a flexible mobile platform and improve accessibility to our EMR

Clinical Mobility & Communications

Enables care anywhere with any device through a secure video teleconsult platform

Real Time Location Awareness

Enhances the clinical environment by enabling real time access to contextual clinical information at the point of care

Video Teleconsults

Provides interactive devices for patient and family engagement, education, and communications

Interactive Patient

Care


Interactive patient care use case example

Interactive Patient Care: Use Case Example

Core IPC Scope

Extended Function IPC Scope

Core Functionality

  • Competitive Advantage

  • Patient Self-Service

  • Patient Experience (Satisfaction& Quality)

Room ControlsLights

Blinds

SurveysReal Time Service Recovery

Metrics

EducationPatient Education Videos

Medication Teaching Library

EntertainmentInternet

TV/Movies

Dietary

Pain Management

Care Team Efficiency

Staff Satisfaction

eCareboard

Nurse/Doctor Communication

Staff Responsiveness Service Recovery

2-Way Integration w/Health Connect

(Patient Education, Pain Mgmt.)

Connection To Family And Friends

Patient Engagement

Remote Consult

My Team

Clinical Communication Integration (IPC Event Management – Text, Email

About Me

2-Way Video

Edu. & Discharge Instruction @Home

IPC Via Nurse/Clinician Tablet

My Day

Video Interpreter Services

Patient to Family Video Conferencing

Patient Education

Clinician to Clinician Video Conf.

IPC MobilityClinician Tablet (IOS, Win8)

Smart Device IPC Remote ControlHome Portal (Pat. Edu, Discharge Info)

Alarm Interaction(Event Triggered Look-In)

  • Increased Patient Satisfaction

  • Patient Self-Service

  • Increased Nurse Face-time

  • Increased Staff Satisfaction

Tele-Sitting

“Health360” IPC Track

  • Remote Care and Consultation

  • Care Team Collaboration

  • Patient-family member interaction


The roadmap

The Roadmap

This roadmap illustrates how we will evolve from having multiple point solutions to delivering seamless communication tools that enable and transform the care experience

Phase 1

Secured Messaging & EMR Access

Phase 2Alarm & Workflow Integration

Phase 3

Access Anywhere

End State

Today

  • Secure messaging

  • Voice

  • Physician EMR Access

  • Clinical alarms & alerts

  • Nurse call management

  • Off-campus communication

  • Real-time presence location integration

  • Nurse EMR Access

  • Single device supporting multiple functions

  • Quiet and unnecessary interruptions

  • Intelligent routing and escalation of messages

  • Standardized platform

  • Multiple devices with disparate integration

  • Noisy and plenty of interruptions

  • Wasted time searching for people

  • No standard for mobile integration with EMR


Kaiser permanente medical devices and health it improving quality of care

Future Activities

In collaboration with regional stakeholders, Health360 has identified the following mobile and virtualization capability initiatives to focus in on the next six months.

Description

Proposal

Desired Outcome

Video Teleconsulting Use Cases

Enabling real-time consultation between remote healthcare providers, patients and care teams through video-conferencing

Pilot a Specialists-to-Emergency Department (ED) video teleconsultation ‘turnkey’ solution

Decreased wait times, reduce costs, improve flexibility for on call specialists

Conduct pilot to acquire, analyze, visually present, and take action on patient biometric data collected from 50 KP members within diabetic population

Reduce emergency department and hospital readmits, improve A1C levels, reduce time on data collection during consultations

Integrate personal generatedhealth-related data including biometric devices, fitness data

Member-generated Data

Proactively identify patients at risk; reduce hospitalization and length of stay; ability to predict adverse events

Implement predictive models to improve identification, care protocols, and outcomes for high risk patients

Optimize predictive algorithms to identify patients at risk for clinical deterioration in real-time by conducting a pilot

Advanced Alert Monitoring

Improve member experience, satisfaction, and safety; increase in member appointment on-time arrivals

Utilize wayfinding to improve a member’s ability to find KP facilities and appointment location

Conduct wayfinding pilot to evaluate technology and low fidelity solutions

Mobile Wayfinding


2014 kp diabetes mhealth pilot

2014 KP Diabetes mHealth Pilot


Predict tools

Case Study 2: Clinical Decision Support

‘Predict’ Tools

The general idea is that Predict allows us to implement patient scoring and risk algorithms, from simple ones like CURB-65 that generate a score of 0,1,2,3,4 or 5 to more complex ones like a risk of Severe Sepsis score at ED Triage that generates a percentage of risk, from 0 to 100%.

SIRS = Systemic Inflammatory Response Syndrome (”Shock”) Tool

The Predict framework holds many calculations that can be viewed by an end user in Print Groups, Patient List Columns or Smartlinks. The algorithms are stored in a smarttext record and the functions run when a user accesses the information or on a timed cycle with a batch job.

Severe Sepsis (Infection) Tool

CURB =Community Acquired Pneumonia Tool


View of predict smartlinks in kp ehr

View of ‘Predict’ Smartlinks in KP EHR


Clinical care dashboard

Clinical Care Dashboard


Case study 3

Case Study 3

  • Describe the current Med/SurgenviroMobile Vital Signs National Proof of Concept, KP NW Pilot

  • Review the current state of vital signs accuracy and latency

  • Describe the Mobile Vital Signs Pilot

  • Review pilot data

  • Provide recommendations & next steps


Nursing workflow on med surg

Nursing workflow on Med/Surg


Research data on med surg vital signs

Research data on Med/Surg Vital Signs

KPNW


Goals for data integration in med surg

Goals for Data Integration in Med/Surg


Pre pilot metrics

Pre-Pilot Metrics

Mobile Vital Signs (VS)

Summary

  • Documentation error rate:

  • 1.48 min latency between VS taken and documented in EHR

  • 213.1 mins to take 68 sets of VS

  • 3.3 min/set of VS


Pilot 6 month pilot began mid june 2013

Instant Wins

Challenges

Pilot: 6 month pilot began mid-June 2013

  • Log on process

  • Battery life

  • Charge capture rows can not be integrated.

  • No warning to end user if server is down

  • Defaults

  • Patient ID

  • Immediate transmission of VS

  • KPHC downtime transmission

  • MORE rows

  • Data easily entered

  • Time savings

EHR View of Integrated Values

KPNW


Post pilot metrics

Success Metrics:

Feedback

Metrics

Post Pilot Metrics

  • Vital Sign (VS) Accuracy

  • VS Latency

  • Total time VS collection

  • End user satisfaction

  • Workflow efficiency

  • 100% Accuracy if used correctly.

  • Immediate transmission of VS.

  • 1. 4 minute time savings per VS transmission.

  • Mixed Satisfaction

  • Rate it a 5 if taking multiple VS

  • Rate it a 1 if taking single set of VS

  • Log on process is tedious at first

  • Workflow change

Costs

KPNW


Recommendations

Recommendations

Value:

  • Most value when vital signs are taken on a series of patients in one care interaction i.e., all 7am vitals taken in a row.

  • Improved value when nurses can sign on to the Neuron (med device middleware) with a barcode to identify themselves rather than manual log on.

    IT Considerations:

  • Requires a robust wireless infrastructure

  • Requires the latest Capsule DataCapture(middleware) version

    Training and Go-live:

  • Develop a robust Super User team

  • Test the system one last time before go-live

KPN


Case study 4 telehealth

Case Study 4: Telehealth

Leverage technology and process to support the Imagine Care Anywhere strategy demonstrating a positive impact to the following key aspects of the traditional care delivery model:

  • Cost - minimize unnecessary ED visits; maximize utilization of in-network and specialty resources; reduce travel for both patients and providers

  • Quality – leverage optimal resources regardless of location; encourage cross-training and collaboration between providers through real-time consults; improve consistency in care delivery

  • Access – expedite access to care; provide access to specialists for remote locations; expand internal provider to provider consults

  • Continuity of Care – remote monitoring allows for targeted intervention; reduce point-in-time evaluations; improve medication compliance


Developing a telehealth it strategy

Developing a Telehealth IT Strategy

The Telehealth IT program will support the regional business needs, market expectations and the Care Anywhere strategy.

Transforming Care

  • Business Needs

  • Consistent, predictable member experience through KP.org

  • Seamless provider workflow

  • Appropriate integration to existing systems

  • Use Cases

  • Develop member access to on-demand video teleconsults as a natural part of daily clinical workflow

  • Leverage clinical peripheral device data to enhance care delivery outside KP facilities

  • Internal Business Drivers

  • Care Anywhere Strategy

  • Cost Pressures

  • Limited Specialty Resources

  • Rapidly Expanding Membership

  • Aging Population

  • Market Influences

  • Competition

  • Health Reform

  • Technology Evolution

  • Member Expectations

Telehealth

Solution

Engaging Members

Expanding Provider Capacity

  • Technology

  • Demonstrated, scalable applications & architecture that are device independent (ie, mobile support)

  • High availability with 24X7 support

  • Flexible to regional needs

  • IT Operations

    • Streamlined and centralized support

    • Published SLAs

    • Flexible training program

Leveraging Technology


The telehealth platform evolution

The Telehealth Platform Evolution

The KP Telehealth SaaS platform is the foundation for flexible regional implementations of comprehensive Telehealth programs including video, remote monitoring and on-demand access to clinical care.

2015

24X7 On-Demand Video Consults w/ full KPHC and Analytics Integration

2014-2015

  • Remote Monitoring

  • (Support for Peripherals)

  • Collecting clinical data to support timely interventions

  • Improving adherence to medication and care plans

  • Improved outcomes with reduced readmissions

  • Support post discharge members in the home environment

2014-2015

2013-2015

2011-2014

  • Intelligent Routing

  • (For Video & UCC)

  • Provider staffing efficiencies

  • Expanded coverage

  • Expedited access to care

  • Drive to the right communication tool

  • Internal Teleconsults

  • Care collaboration

  • Improve timely access to specialists

  • Member & Provider satisfaction

  • (Expanding to scale)

  • External Teleconsults

  • Reduced transports and transportation time

  • Support patient education programs

  • Improve timely access to care

  • Provide triage to appropriate level of care

  • Member & Provider satisfaction

Green – currently available

Blue – in design


Video visits @ kp

Video Visits @ KP

Currently in production across all regions:

  • Cisco Movifor use on the KP network where there is a dependency of Avizia Clinical Carts (ieTelestroke)

  • Vidyo for use on/off the KP network across any device. Working to seamlessly integrate with Epic (KPHC), KP.org and KP Flagship App.

    • Over 5,000 clinician accounts

    • Over 5,000 video visits in 2014 YTD


Medical devices

Medical Devices

  • A variety of medical devices can be attached to the Avizia or Cisco carts to support clinical needs

    • Stethoscope, dermatoscope, otoscope, ultrasound, etc

    • Two video sources and one audio source are supported concurrently


Case study 5 realized value of health it

Case Study 5: Realized Value of Health IT


Transforming care with health it

Transforming Care with Health IT

Vilardi, O’Brien, KP, HIMSS, March,2013


Himss davies ehr health it award

HIMSS Davies EHR Health IT Award

  • How health systems use the EHR in innovative ways, once fully deployed, eg, Stage 6 or 7 - demonstrate via case studies

    Deploy CPOE, CDS, & measure ROI; see http://apps.himss.org/davies/

    1. Clinical Value (Core Case Study)

    2. Return on Investment (Core Case Study)- hard & soft ROI

    Hawai‘i Pacific Health, Hawai‘i’s largest health system and largest private employer, has demonstrated an annual return on investment from an integrated EHR of 9.0% over ten years. Success was achieved through the integration of all revenue cycle functions and by driving financial and clinical performance through transparency, collaboration, and accountability.

    • Reduce support costs by consolidating 32 major systems. These systems included RIS, pharmacy systems,patientscheduling systems, 7 patient accounting systems, 3 charge masters, 7 patient management systems, 4 medical records /coding systems, a standalone EMR, and a clinical messaging system.

    • Improve net revenue through the reduction of avoidable write-offs. Prior to the implementation, approximately 2.6% of annual hospital gross revenue ($16 million) was being written off to bad debt and avoidable administrative adjustments. A reduction to 2.0% could produce improvements of more than $1 million in net revenue annually.

    • Reduced transcription costs. Movement toward online clinical documentation and integrated voice recognition would mean less dependence on Transcription.

    • Improved Cost-to-Collect. Operating on a single platform allowed savings through improved efficiency, better charge capture, and consolidation of 3 hospital billing groups and 3 physician billing/coding groups.

Hawai‘i Pacific Health’s EHR has been critical to improvements in overall safety, quality, and effectiveness of care. Significant measureable improvements have been achieved in reducing or eliminating ventilator associated pneumonia, catheter associated urinary tract infections, and central line associated bloodstream infections. Similar improvements have been accomplished in core measures, including very good performance in children’s asthma and recently adopted perinatal core measures. Outpatient clinical care improvements in diabetes, hypertension and cancer screening have benchmarked HPH Clinics to the 90th percentile of the country on many measures. The EHR, and Health IT as a whole, has served as the cornerstone of this success.

KP won in 2011!


Kp mhealth in the near future

KP mHealth in the Near Future


Future care delivery all user environments

Future: Care Delivery All User Environments


Gracias

Gracias

Tom Judd

[email protected]


Kaiser permanente medical devices and health it improving quality of care

Appendices

Device requirements, testing & integration management – KP (5)

Audit of KP Devices Integrated – KP (7)

Use of Medical Device data in EMRs - Tim Gee (3)

Convergence of Medical & IC Technologies - Steve Grimes (2)

Wireless Health IT Innovation – KP (2)

Health Information Exchanges – KP (2)

Interoperability and Security – HIMSS 2014 (1)

IHE (Integrating the Healthcare Enterprise) – (5)

References (2)

Presenter Notes (1)


References page 1

References, page 1

  • Health IT Effectiveness Study, July 2014 http://www.healthcareitnews.com/news/ending-debate-emr-effectiveness

  • McKinsey Business Quality study www.mckinsey.com/~/media/McKinsey/dotcom/client_service/Public%20Sector/Regulatory%20excellence/The_business_case_for_ medical_device_quality.ashx

  • FDA re Impact of CDM www.cdc.gov/chronicdisease/resources/publications/aag/chronic.htm

  • ACA Incentives http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/special-report-chronic-care-crisis

  • Google’s New Moonshot Project: the Human Body, Wall Street Journal July 28, 2014

  • Understanding Barriers to Medical Device Quality, FDA, October 2011. www.fda.gov/downloads/AboutFDA/CentersOffices/CDRH/CDRHReports/UCM277323.pdf

  • Kaiser Permanente (KP) National Product Council (NPC): http://www.obesitydevices.org/DDOMD%20Session%205/Hiatt.pdf

  • FDA re Baxter: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm210664.htm

  • Pew to FDA: www.pewtrusts.org/~/media/Assets/2014/07/PewcommentstoFDARegardingExpeditedAccesstoNewMedical_Devices.pdf?la=en

  • FDASIA: http://www.healthit.gov/sites/default/files/fdasiahealthitreport_final.pdf

  • Tim Gee, Presentation, 3rd Annual Medical Device Connectivity Conference, 2011

  • Steve Grimes, CE-IT Community, July 2014, http://ceitcollaboration.org/docs/VirtualTH14_TownHall_June2014.pdf

  • West Health Institute: https://s3.amazonaws.com/wwhi.org/interop/WHI-The_Value_of_Medical_Device_Interoperability.pdf


References page 2

References, page 2

  • M. Chow and J. Vilardi, The Patient Room of the Future: Where Workflow, Care and, Convenience Converge, KP,HIMSS 2014

  • CERC: Connected Environment Requirements Catalog, KP, 2012

  • MD Fire: MD PnP (Medical Device Plug-and-Play) Program 2012, http://www.mdpnp.org/uploads/MD_FIRE_August_2012_v2.0.pdf

  • M. Davis and J. Johnson, Challenges with Sustaining a Test Environment to Support Interoperability of Medical Devices,, KP Clinical Technology, AAMI 2014

  • M. McNeil (Philips) and T. Cullen MD (CMIO VA), Strategies for Evolving Security Partnerships, HIMSS 2014

  • FDA UDI, http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/UniqueDeviceIdentification/default.htm?utm_source=Members-Only%20Updates2014

  • The KP Implant Registries: Effect on Patient Safety, Quality Improvement, Cost Effectiveness, Research Opportunities, TPJ, 2012, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383159/

  • Navigating the Intersection of Medical Devices, Health IT To Boost Patient Safety. California Health Foundation, http://www.ihealthbeat.org/insight/2014/navigating-the-intersection-of-medical-devices-and-health-it-to-improve-patient-safetyAugust 2014

  • Integrating the Healthcare Enterprise (IHE), http://www.iheusa.org, 2014

  • HIMSS Analytics EMRAM Model, http://www.himssanalytics.org/emram/emram.aspx, 2014

  • HIMSS Davies Enterprise EHR Award, Kaiser Permanente 2011 Case Studies: http://www.himss.org/files/HIMSSorg/content/files/CaseStudies-2011HIMSSEnterpriseDaviesAwardWinningApplication-KaiserPermanente.pdf

  • Kaiser Permanente Annual Report 2013, http://share.kaiserpermanente.org/static/kp_annualreport_2013/#technology

  • W. Suarez, MD, and Younkin, Interoperability Through HIEs, HIMSS 2014


Tom judd ms cce cphq cphims facce tom judd@kp org

Tom Judd, MS, CCE, CPHQ, CPHIMS, FACCE – [email protected]

  • Education

    • MS AE, 1973, Naval Postgraduate School; BS AE, 1972, US Naval Academy; Navy Officer, Jet Pilot, USNA faculty; graduate work Biomedical Engineering, Johns Hopkins University/Medical School

    • Nationally certified in Health Technology (HT, aka Clinical Engineering-CE), Quality, & Health Information

  • Professional Positions

    • National Project Director, Clinical Technology Kaiser Permanente-KP, Atlanta, Georgia, US, 2006-present; focus on medical device-EHR integration; Interoperability & mHealth

    • Former Director of Quality and Patient Safety, KP Georgia, 1994-2006

    • Various HT/CE roles: teaching, community, and hospital systems, 1979-1994

    • WHO-PAHO Health Technology Advisor, 1989-present, in 40 countries

  • National/Global Roles

    • HIMSS National Davies Enterprise EHR Award Committee, 2010-2014

    • American College of Clinical Engineering (ACCE): 1990-2014; Fellow, Advocacy Chairman

    • Created ACCE Advanced Health Technology Seminars, 1991-2014 (health leader training now provided for 70 countries focused on HT Management, Policy, Regulatory, and Industry Issues)


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