Kaiser Permanente

KAISER PERMANENTEHEALTHCONNECT HEALTHCONNECT & DISASTER PLANNING SOUTHERN CALIFORNIA WILDFIRES KAISER PERMANENTEACTIVITIES Kaiser Permanente

Kaiser Permanente At-a-Glance • Nation’s Largest not-for-profit Integrated Healthcare Delivery System • Would be ~ 60 on Fortune 500 • 9 States and the District of Columbia • Nearly 8.7 million members • Labor Management Partnership • 32 Medical Centers

Kaiser Permanente At-a-Glance • > 421 Medical Offices • > 14,000 Physicians • > 159,000 Employees • > 558,000 Surgeries/year • > 91,000 Deliveries/year • > 129 Million Prescriptions/year • > 36 Million Doctor Office Visits/year

2007 Southern California Wildfires • Location: Southern California Santa Barbara County to the US-Mexico Border • Dates: October 20 – November 9, 2007 • Burned area: 500,000 acres • Fatalities: 14 • Injuries: At least 70

Kaiser Permanente Activities • Emergency operations established • Provided broad communication to staff via the Hospital Incident Command System (HICS): • Instructed to check the Staff Hotline • Established Labor Pool under the HICS model • Redirected staff from closed facilities to operating facilities • Prepared to receive 22 patients from evacuated medical centers and Skilled Nursing Facilities

Kaiser Permanente Activities • National Healthcare Continuity Management staff: • Deployed to San Diego Medical Center Hospital Command Center • Established national support for increased demand for pharmaceuticals, medical supplies, lab services, courier services, and extraordinary policy development and approval • Continuously monitored and tracked fire activity close to and impacting our medical facilities • Used hotel rooms previously booked for conferences to transfer healthy moms, babies, and stable patients • Cancelled elective surgeries, meetings and patient education classes

Protecting Healthcare DeliveryExpanding the “Continuity” Function Healthcare Continuity Management (HCM) Business Continuity Management (BCM) Foundation Development Implementation Systematic Planning Risk Assessment Threat Assessment Management (TAM) EOC Management Threat Policy Development Integration Measured Response Share Best Practices

Integration of Planning and Response

Ongoing Risk Mitigation Clinical Smallpox Vaccination Policy and Tools Public Facilities Policy SARS Bioterrorism Response Plan Facilities Anthrax Smallpox Healthcare Communication Community Continuity & Linkages Anthrax Policy and Tools Management Education Pandemic Community West Nile Influenza Linkages Virus SARS Resource Toolbox Team Deployment Supply Legal Chain Manager’s Toolbox Pandemic Influenza People/ HR Healthcare Risks Work Group Activity Risk Mitigation Tools

Electronic Health Record System – KP HealthConnect™ • Epic Systems Corporation • Highly-sophisticated information management and care delivery system designed to enhance the quality of patient care • Integrates electronic medical records with appointments, registration and billing to provide access to comprehensive member and medical information from a single system • Launched in December 2003 • Will link all Kaiser Permanente facilities across the nation and provide patients, members, physicians and other authorized health care providers with online access to clinical information 24/7

Electronic Health Record System – KP HealthConnect™ More than 2.3 million Kaiser Permanente members currently use My Health Manager to perform several online health management tasks. Members can: • Send an email to their doctor • Make appointments • Order pharmacy items • View lab test results • Act on behalf of a family member • View information from past visits

Revolutionizing Our Healthcare System • At Kaiser, experimentation with new technologies like KP HealthConnect occurs at the Sidney R. Garfield Health Care Innovation Center in San Leandro, Calif. Kaiser opened the facility in 2006 to test such new technologies as a videoconferencing system linking health care professionals to patients in their homes.

Revolutionizing Our Healthcare System • Dr. Yan Chow, a pediatrician with Kaiser, demonstrates a videoconferencing system that would allow doctors to speak with patients in their homes.

KP HealthConnect™ During the Wild Fires • As our facilities opened and closed due to fires, patients were successfully diverted to open and available medical facilities • Receiving physicians, nurses, and other clinical staff could successfully access relevant medical records for health history, lab results, current prescriptions, etc. • Physicians working from home or other remote locations could: • Check their in-baskets (and those of their peers and covering RNs) • Renew prescriptions • Check lab results • Call patients and direct them to open facilities • Conduct telephone triage for future appointments, prescriptions, lab tests, etc.

KP HealthConnect™ & Disaster Planning Aha Moment Electronic Health Records Should be Part of Disaster Planning Benefits Realization Benefits Realization OptimizationLeveraging system to achieve transformation Cascaded to Medical Centers & Regions Integration with other initiatives& business systems Incorporated into Nat’l BCP Program Stabilization Stabilizing what we have deployed Exercised During Nat’l Drills Briefed Senior Leadership Deployment/Rollout

KP HealthConnect™ Sample Infrastructure Design Production Disaster Recovery data center data center

Established downtime policies and procedures include: End users training in downtime procedures before go-live Formal notification procedures to alert of downtime and resumption to normal workflows Routine tests to provide end users with the essential patient information such as downtime Medical Record Numbers (MRN) and Hospital Account Record (HAR) numbers, and printed materials so that usual tasks can be performed during downtime KP HealthConnect™ Downtime Policies & Procedures

KP HealthConnect™ Business Continuity Ownership • Who needs to be involved? Everyone! • Technical representatives • Admitting and scheduling • Nurse and physician champions • Pharmacy • Interface and ancillary systems • Executives and steering committees • Revenue cycle • Trainers • Others…

KP HealthConnect™ Business Continuity Ownership (continued) Downtime protocol are validated by the executive level as it has significant implications for patient safety and operations An owner or point person is appointed to head up Business Continuity Planning Downtime committees: • Update policies and procedures • Make key decisions regarding protocol • Coordinate organization and planning efforts

Electronic Health Records of the Future • Kaiser Permanente and Microsoft Corp partnered in a pilot program that will allow Kaiser Permanente members to store their personal health data securely within an online site managed by Microsoft • The Kaiser Microsoft partnership allows for the transfer of prescription information, test results and other health data from KP HealthConnectTM to Microsoft's Health Vault • Patients can control what information they want to store, where, and who has access to it

Kaiser Permanente