Kaiser Permanente has a history of integrating virtual care programs. The organization’s provider and payer model has allowed it to explore digital health early on.
“We have some unique opportunities because we are an integrated organization,” Dr. Patrick Courneya, EVP and chief medical officer at Kaiser Permanente, told MobiHealthNews. “We have healthcare delivery on the clinical side and hospital side ... so we have greater flexibility for new types of care and new ways of delivering care that are not as constrained by the payment model.”
At HIMSS19, Courneya will discuss his experiences implementing virtual care at Kaiser Permanente in his presentation “Teaming up for change: Virtual care lessons.”
The organization started investing in automated medical records and working with different technologies early on. This gave the system an opportunity to start creating a “whole ecosystem with venues of care,” according to Courneya.
“Obviously Kaiser Permanente and the rest of the industry have been using the telephone as a way of delivering care, advising and prescribing medications for certain straightforward things for a long time. We aren’t different from anyone else in that way. But we also had the opportunity to incorporate texting, secure messaging, chat capabilities, video, etc., into that ecosystem,” he said. “We found a way that can directly connect to the longitudinal record so we have a clear idea of which of those technologies are being used and how they are being used. We also have the opportunity to use those tools to facilitate clinician-to-clinician interactions as well.”
Courneya noted that while Kaiser Permanente's integrated model allowed it to get a jump start on implementing some of these technologies, changing industry attitudes and reimbursement criteria could give other health systems an opportunity to innovate.
“It does make it easier for us now but we recognize that that advantage, if you think of that way, will evaporate over time. In fact, I think that is one of the big trends that we are seeing as payers, including traditional health plans, become more comfortable opening up reimbursement. We see that difference evaporating fairly rapidly and I think that is going to be an important enabler of more use of telehealth services,” Courneya said. “One place that is happening perhaps more rapidly is in the conversations people are having about how do we meet the needs of people in rural communities who have unique challenges of access of getting medical expertise.”
Looking ahead to the future, Courneya isn’t pinning his hopes on one technology. Instead, he said it’s important the organization implement the technology effectively so that it is addressing a problem.
“I think the greatest promise isn’t a specific tool but how organizations, like ours, use those tools to solve problems we have identified. So the questions would be what are the best, highest quality, safest ways to use a chat function or text function and secure messaging, and how do we know the care we are delivering in those different types of technologies are safe and high quality and creating the outcomes you want?" he said. "I would argue it is not what those technologies are as to how effectively and creatively and wisely they are being used.”
So what is Courneya’s advice for providers looking to use more virtual care tools in the future?
“Meticulous attention to the design and attention to both sides of the interaction and using the technology — whether that is the experience that the patient is having in using the technology or a clinician is having and using the technology — and doing it in a way so that both sides of that interaction feel a sense of confidence and trust in a tool that is well suited to the problem they are trying to address. So that kind of thoughtful attention to design is critically important. The other is recognizing that these are new venues of care, and they need to have a framework for understanding what delivering high-quality safe care means. And the third is being intentional about it and measuring it so you aren’t putting anyone at risk.”
Courneya will be presenting at a HIMSS19 session called “Teaming up for change: Virtual care lessons.” It’s scheduled for Wednesday, February 13 from 11:30 a.m. to 12:30 p.m. in room W207C.
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