Linking Plan and Providers in Disaster Response Through an ...

Linking Plan and Providers in Disaster Response Through an Electronic Medical Record

Linking Plan and Providers in Disaster Response Through an Electronic Medical Record

Skip Skivington

KAISER PERMANENTEACTIVITIES

Kaiser Permanente

SOUTHERN CALIFORNIAWILDFIRES

HEALTHCONNECT & DISASTER PLANNING

KAISER PERMANENTEHEALTHCONNECT

Kaiser Permanente At-a-GlanceKaiser 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-GlanceKaiser 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

KAISER PERMANENTEACTIVITIES

Kaiser Permanente

SOUTHERN CALIFORNIAWILDFIRES

HEALTHCONNECT & DISASTER PLANNING

KAISER PERMANENTEHEALTHCONNECT

2007 Southern California Wildfires2007 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

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 PERMANENTEACTIVITIES

Kaiser Permanente

SOUTHERN CALIFORNIAWILDFIRES

HEALTHCONNECT & DISASTER PLANNING

KAISER PERMANENTEHEALTHCONNECT

Kaiser Permanente ActivitiesKaiser 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

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 ActivitiesKaiser 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

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

Healthcare Continuity Management (HCM)

Business Continuity Management

(BCM)

Foundation Development Implementation Systematic Planning Risk Assessment

Threat Assessment Management

(TAM)

EOC Management Threat Policy Development

IntegrationMeasured Response

Protecting Healthcare DeliveryProtecting Healthcare DeliveryExpanding the “Continuity” FunctionExpanding the “Continuity” Function

Share Best Practices

Integration of Planning and ResponseIntegration of Planning and Response

OtherCC

National Command Center

Regional CC

HospitalHCC

HospitalHCC

Regional CC

HospitalHCC

HospitalHCC

OtherCC

Executive Oversight Group

Healthcare Continuity Management

Workgroups

· Clinical· Facilities· Supply Chain· People· Community

Linkages· Communications· Public Policy· Legal

Planning

Response

Ongoing Risk MitigationOngoing Risk Mitigation

Facilities

CommunityLinkages

SARS

Smallpox Anthrax

PandemicInfluenza

Team Deployment

West NileVirus

Smallpox Vaccination Policy and Tools

Bioterrorism Response Plan

Anthrax Policy and Tools

SARS Resource Toolbox

Manager’s Toolbox

Pandemic Influenza

Legal

Facilities

SupplyChain

Communication&

Education

PublicPolicy

People/HR

Clinical

CommunityLinkages

HealthcareContinuity

Management

Healthcare Risks Risk Mitigation ToolsWork Group Activity

KAISER PERMANENTEACTIVITIES

Kaiser Permanente

SOUTHERN CALIFORNIAWILDFIRES

HEALTHCONNECT & DISASTER PLANNING

KAISER PERMANENTEHEALTHCONNECT

Electronic Health Record System – Electronic Health Record System – KP HealthConnect™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

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

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

Electronic Health Record System – Electronic Health Record System – KP HealthConnect™KP HealthConnect™

Revolutionizing Our Healthcare SystemRevolutionizing 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.

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

Revolutionizing Our Healthcare SystemRevolutionizing Our Healthcare System

KP HealthConnect™ During the Wild FiresKP 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.

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.

KAISER PERMANENTEACTIVITIES

Kaiser Permanente

SOUTHERN CALIFORNIAWILDFIRES

HEALTHCONNECT & DISASTER PLANNING

KAISER PERMANENTEHEALTHCONNECT

KP HealthConnect™ & Disaster PlanningKP HealthConnect™ & Disaster Planning

Benefits Realization

Briefed Senior Leadership

Cascaded to Medical Centers

& Regions

Incorporated into Nat’l BCP Program

ExercisedDuring Nat’l

Drills

StabilizationStabilizing what

we have deployed

Integration with other initiatives& business systems

OptimizationLeveraging system to achieve transformation

Benefits Realization

Deployment/Rollout

Aha MomentElectronic Health

Records Should be Part of Disaster Planning

Production Disaster Recoverydata center data center

KP HealthConnect™ KP HealthConnect™ Sample Infrastructure DesignSample Infrastructure Design

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™ KP HealthConnect™ Downtime Policies & ProceduresDowntime Policies & Procedures

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™ KP HealthConnect™ Business Continuity OwnershipBusiness Continuity Ownership

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

KP HealthConnect™ KP HealthConnect™ Business Continuity Ownership (continued)Business Continuity Ownership (continued)

Electronic Health Records of the FutureElectronic 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 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