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E-Patient Update: The Kaiser Permanente Approach To Consumer Health IT

Posted on May 19, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Usually, particularly when I have complaints, I don’t name the providers or vendors who serve my healthcare needs, largely because I don’t want to let my personal gripes overshadow my analysis of a particular health IT issue.

That being said, I thought I’d veer from that rule today, as I wanted to share some details on how Kaiser Permanente, my new provider and health plan, supports consumers with health IT functions. Despite having started with Kaiser – in this case the DC metro division – less than a week ago, being an e-patient I’ve had my hands all over its Web – and mobile-based options for patients.

I’m not going to say the system is perfect by any means. There are some blind alleys on the web site, and some problems in integrating clinical information into consumer records, but so far their set-up largely seems thoughtful and well-managed.

Having allegedly spent $4 billion plus on its Epic rollout, it’s hard to imagine how Kaiser could have realized that big a return even several years later, but it seems that the healthcare giant is at least doing many of the right things.

Getting enrolled

My first contact with Kaiser, after signing up with Healthcare.gov, was a piece of snail-mail which provided us with our insurance cards and a summary of our particular coverage. The insurance cards included my health plan ID/medical record number.

To enroll on the core Kaiser site, kp.org, I had to supply the record number, my birth date and a few other basic pieces of information. I also downloaded the KP app, which offers a far-more-elegant interface to the same functions.

Medical appointments

Once logged in, it was easy to choose a primary care doctor and OB/GYN by searching the site and clicking a selection button. If you wished you could review physician profiles and educational history as well as testimonial quotes from patients about that doctor before you chose them.

Having chosen a doctor, booking an appointment with them online was easy.  As with Zocdoc.com, you entered a range of dates for a possible consult, then chose the slot that worked for you. And if you need to cancel one of those appointments, it’s easy to do so online.

Digital communication

I was glad to see that the Kaiser portal allows you to email your doctor directly, something which is less common than you might think. (My last primary care group wouldn’t even put their doctors on the phone.)

Not only that, everyone I’ve talked to at KP so far– three medical appointments, as I was playing catch-up — has stressed that the email function isn’t just for show. My new providers insisted that they do answer email messages, and that I shouldn’t hesitate to write if I have questions or concerns.

Another way KP leverages digital communications is the simple, but effective, device of texting me when my prescriptions are due for a refill. This may not sound like much, but convenience matters! (I can also check med reminders by logging in to a custom KP meds app.)

Data sharing

Given that everyone at Kaiser uses the same Epic EMR, clinicians are of course more aware of what their colleagues are doing than my past gaggle of disconnected specialists. They seem quite serious about reading this history before seeing me, something which past physicians haven’t always done, even if I was previously seen by someone else in their practice.

KP also uses Epic’s Care Everywhere function, which allows them to pull in a limited summary of care from other Epic-based providers. While Care Everywhere has limits, the providers are making use of what they can.

One small wrinkle was that prior to two of my visits, I filled out a questionnaire online and when asked to submit it to my electronic patient record, did so. Nonetheless, I was asked to fill out the same questionnaire again, on paper, when I saw a specialist.

Test results

KP seems to be set up appropriately to share standard test results. However, I’ve already had one test, a mammogram, and in doing so found out that their data sharing infrastructure isn’t quite complete.

After being scanned, I was told that I’d receive my results via snail-mail, in about two weeks. I’m glad that this was a routine screening, rather than a test to investigate something scary, as I would have been pretty upset with this news if I was worried.

My conclusions

I don’t want to romanticize Kaiser’s consumer HIT services. After all, looked at one way, KP is only doing what integrated health systems are supposed to do, and not without at least a few hitches.

Still, at least on first view, on the whole I’m pretty happy with how Kaiser’s interactive functions are deployed, as well the general attitude staff members seem to have about consumer use of HIT tools. Generally speaking, they seem to encourage it, and for someone like me that’s quite welcome.

As I see it, if providers outside of the Kaiser bubble were as married to a shared infrastructure as KP providers are, my care would be much improved. Let’s see if I still if I still feel that way after the new health plan smell has worn off!

New App Allows For HIPAA-Compliant Group Texting by Clinicians

Posted on June 11, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

John wrote previously on EMR and HIPAA about the need for HIPAA Secure Texting and a company he’s advising that does secure text messaging called docBeat.

Well, another new app called Medigram is being tested which will allow clinicians to send HIPAA-compliant text messages within a defined group. The app is currently in closed beta with docs at Stanford Hospital, Lucille Packard Children’s Hospital and the Palo Alto VA Hospital, according to iMedicalApps.com.

According to the company, Medigram meets not only HIPAA requirements but also privacy/security provisions in Subtitle D of HITECH.  It does so, in part, by using SSL connections between mobile apps and its servers, as well as NIST-approved 256-bit AES encryption to secure chat data.

Secure texting certainly seems like a good idea, given how mobile-friendly this generation of clinicians has turned out to be.  And it’s hard to argue Medigram’s core pitch, which is that texting is far more interactive than a pager. Given that a surprisingly large number of doctors still use pagers, improving on the model seems like a good thing.

My theory is that the app, if otherwise usable and bug-free, will be a big hit during its beta. If so, I expect to see HIPAA-compliant instant messaging turn up next. Smaller, presumably agile companies specializing in B2B messaging — such as HipChat, Trumpia and 24im — are logical candidates to develop such a utility. (This article outlines several other enterprise IM firms, just in case you want to dig deeper.)

Of course, there’s also Google and Microsoft, both of which have large IM bases. Perhaps creating a secure version of an existing product (such as Messenger) will be less of a marketing challenge than say, HealthVault.

Regardless, I’ll be quite interested to find out how the beta turns out — I’ll keep you posted. Meanwhile, here’s a video in which Medigram describes its product.