This week’s photo set is a picturesque view of some of the most photographed monuments in our nation. Enjoy!

Yesterday was the final day of the Kaiser Permanente HealthConnect Online Leadership discussion, which carried themes over from the previous day around making a Personal Health Record work for members. Of note:

• Improving the ways members achieve secure access to the PHR. During the recent natural disasters in Southern California, Kaiser Permanente established a telephone-based process for members to verify their identity to use the PHR, for people who no longer had access to basic items like mailboxes and reliable computer access. This allowed them to continue to manage their health during difficult times. The system will eventually be expanded to include all members across the nation, with an online version that can provide secure identity verification.
• Helping the industry to define the ideal PHR based on working models. Jan Oldenberg, from the Kaiser Permanente Internet Services Group, is bringing the experience of the organization to the public as it creates definitions and requirements for what a PHR should be. In this way, communities do not have to guess at the services and features that are most useful to patients as they ask for these services. Of note, Jan and the group are engaged in the HL7 PHR Standards Definition, which is currently accepting public comment until tomorrow. We (and all of you) are reminded to review these and provide input. When standards are agreed upon, we can all move forward quickly.
• Customer Service Support. A PHR brings support needs with it, and Kaiser Permanente logs in the neighborhood of 40-50,000 calls a month, tied predictably to new feature rollouts, but also to issues that can be resolved by listening to members. I was personally delighted to hear that since Northern California began automatically sharing lab results in August, 2007, call volume for lab results has remained flat, despite larger volumes of information being shared with members. From my own work with PHR’s, I know that it is never too early to involve customer service support professionals in implementation. Going even further, it is never a bad time to sit with customer service professionals in person as they support members on the phone, in person. I’ve done this and it’s an incredible learning experience.

And the end of two days, I learned a lot, even as a pioneer in the PHR space myself. Here is an organization that is up and running in a big way, and they are beyond asking “should we do this?” They are saying, “We are doing this for our patients. Now, how do we do this better?”

There were no blanket statements, like, “we should do it this way.” Instead, I heard a lot of, “what do we know about what members need, and what works for them?” and “As a member, how would I feel about this or that approach?” - Many times.

Thanks again to Kaiser Permanente, and especially Judy Derman, Senior Practice Leader, Internet Services Group, and Kate Christensen, MD, Medical Director, Internet Services Group, for letting me sit in, and letting me share what I saw here. I think it’s useful to have this snapshot out there for leaders who are moving the practice of medicine forward in a patient/person/family-centered way.

PCHIT links for November 26th through November 28th:

• Are Your Patients Ready for Electronic Communication? - October 2007 - Family Practice Management - Nice story about a practice that learns its patients are ready. Helpful survey included
• The Digital Office - Special edition on PHR’s, from HIMSS
• Society for Adolescent Medicine: Advocacy/Policy - Position paper on confidentiality / privacy for teens
• Pacific Business Group on Health - Page on Building Healthcare Value - nice summary from the purchaser perspective

Kate Christensen, MD, Medical Director, kp.org, with Paulanne Balch, MD, Physician Lead for HealthConnect Online, Colorado Region

Greetings from Oakland, where I have been graciously invited to attend a get together of Kaiser Permanente’s clinical and business leadership for HealthConnect Online, which serves the personal health record connected to the electronic health record, HealthConnect, and accessible through kp.org.

I will say that even in the absence of the PCHIT work, I would want to be here. Why? Because I have always thought that the most innovative staff within Kaiser Permanente support the HealthConnect project, and the most innovative of that group support HealthConnect Online.

This was the first such meeting with every Kaiser Permanente region now fully live with the PHR, with Ohio up now for 30 days. And from my perspective, the news is good. As each region of the system discussed their current and future plans for the PHR, commentary focused on value of each feature for the members. I really liked what Gail Sands, Director of Innovative Projects for the Ohio region said: “This is the patient’s chart. They should know what’s inside.”

Strides in Transparency

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When I was shadowing at an organization recently, a patient asked, “Are there many patients from South America in your community (in Washington State)?” I responded, that, no, I didn’t think so. His response was, “Have you looked?”

One of my goals during my experience is to look, all around me. This has not been an opportunity that I have had previously, as much of my work was directed toward the membership of our organization. To start this journey, I joined the District of Columbia Primary Care Association, which is “a nonprofit health care reform organization founded in 1998 to improve the health of DC’s vulnerable residents by ensuring that they receive high quality primary health care — regardless of their ability to pay.”

It’s interesting for me to realize as a proponent of primary care in my community, that I didn’t know if a similar organization exists in Seattle (I am told it does). In the meantime, though, I am really looking forward to learning more about the community that DCPCA serves. DCPCA is engaging in a program to implement electronic health records in community health centers, and managing Medical Homes DC.

PCHIT links for November 15th through November 21st:

• Healthy San Francisco: - San Francisco starts a Medical Home program
• Nurture by Steelcase > Home - Work by Steelcase for a supportive health care environment
• EHRs Lack Features To Boost Patient Care, New York City Official Says -

November 19th through November 21st:

• Analysis - health08.org - Side by side analysis of candidates’ health reform proposals. From Kaiser Family Foundation
• Technorati Weblog: Blogosphere - Important reference on the growth of blogs and splogs, from Technorati
• Pew Internet & American Life Project - Internet Typology Quiz - What are you?

These were the words of a very young visitor to the Smithsonian American Art Museum piece, “Electronic Superhighway: Continental U.S., Nam June Paik, 1995.”

The Washington, DC portion of the piece has a very small television with a very customized view of things.

Site 3, after New York and Boston will be California. Josh and I will be spending time with Partners Kaiser Permanente and California Healthcare Foundation, as well as several care providers in a shadowing capacity.

Speaking of New York, Josh, Dorothy, and I joined Neil Calman, MD, on the monthly Ix Insights Webinar, where Neil we talked about the first visit to New York, and Neil’s work to support patient centered primary care in a large community clinic system. You can review the whole thing on the Center for Information Therapy web site.

November 14th through November 17th:

• ImproveHealthCare - Changing Physician Education - Improving medical students understanding of health policy.
• Life as a Healthcare CIO: Data, Information, Knowledge, and Wisdom - Interesting system to support accurate imaging ordering
• Jay Parkinson + MD + MPH » Blog Archive » The Cancer vaccine and me. - Interesting discussion of HPV vaccine. The $360 charge is 65% profit.
• Enterprise 2.0: Using Social Media in the Workplace - Don’t be scared of Web 2.0 in the workplace. Nice webinar for enterprise audiences.