Infused with the sights and sounds of the beach: the new Kaiser Permanente Santa Monica Medical Office

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2016.05.24 Kaiser Permanente Santa Monica 05110 (View on Flickr.com)

As discussed in this FastCompany article, Kaiser Permanente Santa Monica is the second medical office opened using the new design principles discussed there.

Where Kaiser Permanente Antelope Valley, which I visited later in the week, demonstrates congruence with total health in its exterior, Santa Monica does that for the interior.

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2016.05.24 Kaiser Permanente Santa Monica 05138 – Physicians of the future practice the medicine of total health (Kim Petrick, MD, Family Medicine specialist and Greg Saccone, MD, Internal Medicine Specialist, Southern California Permanente Medical Group) (View on Flickr.com)

You can’t see it in the photos; however, speakers in the entry area play the sounds of people and places around Santa Monica.

The colors and art are congruent with the surrounding community and sourced locally.

Thanks to Greg Saccone, MD and Kimi Petrick, MD from Southern California Medical Group, for taking the time to give us a tour.

More photos below, enjoy. You can learn more about this medical office here: Kaiser Permanente Opens New Medical Offices in Santa Monica – Kaiser Permanente Share

Photo Friday: Kaiser Permanente Antelope Valley, Lancaster, CA USA

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2016.05.26 Kaiser Permanente Antelope Valley 05192 (View on Flickr.com)

I’m breaking the “photo is usually from Washington, DC” informal rule this week, which I do occasionally when I find something visually compelling elsewhere, in this case the beautiful LEED Gold certified Kaiser Permanente Antelope Valley Medical Office Building.

Opened in 2014, it combines the science of wind flow studies, high technology and personalized health care, and connection to the community through locally sourced art, site placement, and visual cues (poppies, pinwheels, butterflies).

We got to visit with eye surgeon Diana Shiba, MD (@DianaShibaMD) who came to visit us in Washington, DC previously:

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2016.04.15 Diana Shiba, MD at Center for Total Health 00364 (View on Flickr.com)

Rest of the photographs below + a video flyover here. Enjoy this trip to the future.

Kaiser Permanente – Antelope Valley Medical Offices from J&M Concrete Contractors on Vimeo.

A Historic LGBTQ Health Symposium on a Historic Day

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2016.04.13 National Kaiser Permanente LGBTQ Health Symposium 2333 – We can, we will totally do this – P.L. Maillard and Richard Mehlman, MD, Kaiser Permanente Los Angeles (View on Flickr.com)

A Historic Day in Health Care

I actually mentioned the coming enforcement of Section 1557 of the Affordable Care Act in my presentation at this symposium in 2014, and again on this blog in 2015.

See: Presentation: Being a Transgender Ally and Unconscious Bias – and 2nd Annual Kaiser Permanente LGBTQI Health Symposium: Future of Inclusion

Imagine, then, 2 years later, that the final regulation was released, in Washington, DC, just a few hours before history was made at this event itself.

A Historic Day at Kaiser Permanente

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Member led, not member “participated” – 2016.04.13 National Kaiser Permanente LGBTQ Health Symposium 04818 (View on Flickr.com)

In 2016, the symposium, held in Universal City, California, hosted the first member led (not member participated) session at this Contuing Medical Education accredited event.

(And not to worry, we fulfilled all the CME requirements, even with a member-led session, and some we didn’t have to, including being 100% Pharma Free)

It was also the first national (rather than regional) LGBTQ Health Symposium for Kaiser Permanente.

When Cadence Valentine hosted a conversation with our members on stage, they did it on the day that health policy finally aligned with science – after an 80+ year mismatch, in front of 350 of the most passionate therapists, nurses, doctors, health leaders in the universe.

The topics included what the health system needs to do, now, not just to keep people from getting killed, not just to keep people alive, to help them thrive.

As Cadence said:

and

What a wonderful opportunity, on this historic day, to see the future in the context of the people who deserve to live it well.

I’d also like to comment on another thing I saw – the spontaneous, authentic recognition of the care teams by their patients from the stage, with those care teams in the audience. I know many of these nurses, physicians, therapists. They bring 100% of themselves to their work in this space, in professions that are just learning what LGBTQ health care is, much less able to recognize them for it.

Not just national leaders, world leaders

We were also honored to be visited on this day by Gail Knudson, MD (@Gail_Knudson), from the Provicial Health Services Authority of British Columbia (@PHSAinBC), and the President-Elect of the World Professional Association of Transgender Health (@WPATH).

I still have memories of Gail personally attending to my education about the future of transgender person health when my colleague Dana and I visited a year ago as part of KPLantern (see: Visiting the Transgender Person Health Program, Vancouver BC #KPLantern).

It’s incredible to learn this year at the progress British Columbia has made in spreading its world-class program to more of the province:

Leading in PrEP

Since the symposium covered all of LGBTQ, I learned a lot about Kaiser Permanente’s PrEP program. It’s the largest in the world. At one point the leaders of programs in three service areas did a roll call of new HIV infections:

It’s incredible what we can do when we put our minds, and our human spirit to things, isn’t it 🙂 .

Still so much more to do

In 2016 there is greater dissatisfaction with the status quo, expressed openly in the room.

This includes the way we address our members/patients when they come to see us; keeping them informed of changes and improvements in services available; connecting them to each other and to services closer to where they live, work, learn, play.

This is good. I see a future where we will prevent unnecessary suffering and demonstrate through action what it looks like when health care learns to love better, which is totally happening.

Human Potential and Listening

You know what else about our patients. Each person is a unique human being, on a pathway of their own, with the the potential to do great things for themselves and society through their total health. That’s what we are here to help them produce. This is a link I sent out many times this year, as a demonstration of just one of the things Cadence accomplished for society in the last year: Real Life ‘Danish Girl’: Transgender Woman Helped Actor Prepare for Film | NBC Southern California

At the same time, in so many contexts and health circumstances, I hear the thing that so many other patients have said, and continue to say: “let us help you.”

Listening is one of the best therapies for our health system. It works so well. And so does love. Which always wins.

There aren’t another 350 members, nurses, physicians, and health leaders who I would have rather spent this historic day with. If you didn’t get to appreciate the future with your patients in the wake of this news, I encourage you to. It’s the key to you being the best nurse, Doctor, therapist for the people you serve.

Photos from the day, click to enlarge.

ILNX: Innovation Is Never Easy

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2016.05.12 ILNX Day 2 04773 (View on Flickr.com)

This week is the 10th year of the Innovation Learning Network (@HealthcareILN) and its in person meeting is at the Kaiser Permanente Garfield Innovation Center (@KPGarfield).

I think the theme from interacting with the people here is that innovation is hard, and (not but) there is a lot of passion. It’s really helpful to hear the scripts that organizations use to either support or control (or is it “center”?) innovation. A lot of them sound the same, almost down to the word. To me, that validates the existence of a network like this.

More photos below, enjoy.

Save the Date: 2016 Kaiser Permanente National LGBTQ Health Symposium – Open to All

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National Kaiser Permanente LGBTQ Symposium Save the Date 160210 (View on Flickr.com)

As the flyer says. May 13. Universal City, California

We’ll have special speakers, including

Registration web site coming soon – you do not need to be affiliated with Kaiser Permanente to attend (and see the future) – see you there!

#KPLantern is beginning – Human Centered Insights into Transgender Person Health, to make it better

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KPLantern- Help Kaiser Permanente Become a Leader in trans*-inclusive care (View on Flickr)

Beginning next week, I am (temporarily) joining the nationally recognized Kaiser Permanente Innovation Consultancy (@KPInnovation) for KPLantern:

Lantern is a project that Kaiser Permanente is undertaking to gain insight into the diverse experiences, challenges, and goals of being a transgender person in our current society and use that insight to better design health and care resources and experiences for our transgender members.

For the past several years I have been working with our members, staff, nurses, doctors, leaders, communities on the journey to support the total health of all of the populations we serve, which includes people who are transgender. It’s the way of Total Health.

This is, for me, an opportunity to learn to do that better, via human-centered design approaches, with a great team, supported by a great organization that is ready to lead in providing transgender person health care.

And by lead, we mean by being great collaborators, community citizens, respectful partners with our members, their loved ones, and their communities. The team, led by Dana Ragouzeos and Katherine Duong, has a ton of experience in human centered design across a swath of projects and vulnerable populations + the curiosity to learn more. Check out the Consultancy’s portfolio online – it’s fantastic and engaging.

The project is under the umbrella of health care quality improvement, which means that there are important (and required) protections in place around the confidentiality of the work, the findings, and the people who we learn from, similar to health care itself. These protections bring safety for the people who we engage, and credibility of the work. We’re here to improve the health and lives of the people we serve – that’s the goal. I may speak of progress in the work, but won’t post any protected information.

This flyer will start going out to recruit subjects for the field work. Feel free to circulate it yourself, add comments to me below, and follow-along here. Hashtag is #KPLantern, the project will go through May, 2015. The Kaiser Permanente Center for Total Health team (@KPTotalHealth) will be participating along with the Consultancy.

We’re here because we support the total health of 9.5 million people. The prize, though, is the 316 million Americans who will find themselves so lucky to be in a country and community enriched by someone they know who is L,G,B,T,Q, in good health, and achieving their life goals.

The name of this project comes from two places. The first is the location where a team of passionate people dreamed it up, on the corner of Eastern Lantern and Golden Lantern in Dana Point, CA at the 2014 Permanente Executive Leadership Summit. The second is the fact that this is a unique opportunity for us to shine light on a population that has not been holistically served by the health care system. We have the opportunity to illuminate real, inspiring opportunities.

Eastern Lantern and Golden Lantern Streets, Dana Point California (View on Flickr.com)

Transgender person care wasn’t on the map when Kaiser Permanente’s first hospital was created in 1933, but the values that created this work were. It’s in our DNA 🙂

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Desert Center, 1933 (View on Flickr)

Through the eyes of interior architects: The new Garfield Innovation Center + future of healthy building

Adding to my repertoire of agents for good in producing Total Health, I have recently connected with the architecture community, since community colleague Scott Kratz ( @ScottKratz ), you know the person behind DC’s most awesome future bridge park (@DCBridgePark), asked for my help in moderating this panel: Panel: Improving Health Through Active Design | AIA DC.

While I was getting to know those amazing people, I also happened to be visiting the brand newly opened Kaiser Permanente Garfield Innovation Center (@KPGarfield) in San Leandro, California, as part of the meeting of the Council on Innovation of The Conference Board (@ConferenceBoard).

There I got to meet, for the first time, Kaiser Permanente’s facilities innovation team, including Linda Raker, Jennifer MacDonald, and Abelardo Ruiz. What excellent timing for my learning journey.

I’ve known the work of this team for a really long time, because they have shaped almost all of the spaces I’ve worked in or received medical care in. The Center for Total Health (@KPTotalHealth), Garfield Center’s sibling and co-innovator in Washington, DC, is connected to their inspiration, so it’s kind of like a child finding a parent for the first time. So many questions.

Here’s what the new spaces look like. Now heading into its 9th year, The Garfield Center appears transformed into an “ideate and test” space PLUS a place to dialogue, work, and dream space.

That is me in the current “women’s” bathroom. I’ll be writing a post about why that’s special in a little bit – too much innovation for one post 🙂

As part of the Council of Innovation meeting, we got a special tour of the brand new Kaiser Permanente Oakland Medical Center (no photos taken except for one, clinical areas), where Linda and Jennifer discussed how their work, dubbed “The Total Health Environment” comes together to create a healing, humane space. It’s a unique opportunity to see the intention that people bring to our health, in ways that aren’t visible. Linda and Jennifer have given me some of their materials to share here, which I will, in prep for the panel above. And/or just come to the panel and hear about designing for health from the experts.

Our faciliites innovation team works very much in the tradition of one of our founders, Sidney Garfield, MD, who hoped to be an architect early in his career, and made a name for himself eventually for designing compassionate, healing spaces – the payment model and other ideas came later. His descendants number 35 in the design organization today, and thousands in the facilities organization that are together implementing 4,000 projects at Kaiser Permanente, very much part of a healing, sustainable, health, system.

Thanks a ton to our facilities innovation team, Garfield Innovation Center and its Director Jennifer Liebermann (@JRuzekLieberman) for re-opening the doors to all of the invisibles that are really visible when it comes to achieving total health.

Presentation: “Health is the new HIT” – Stanford University Biomedical Informatics 207

Can’t stick to script… View on Flickr.com

Even as a graduate of the University of California, it is hard to deny that Stanford is something of a place of worship when it comes to biomedical informatics 🙂 . I *think* I’ve been here before, but I’m not sure. If I was I probably didn’t fit in, because I *do* remember traveling in bioinformatics circles and, well, I would talk about things like this…Now Carol did ask me to include health policy-ish things, which explains the oversampling of DC images (well, that would have happened anyway).

Thanks to my colleague, Carol Cain, PhD (@ccain), alum of the class of 2006, for inviting me to attend and discuss, and this time, to fit in, with a superbly awesome group of students. Carol has a great ancestry and great descendents at the same time :).

It’s happened – health information technology is now in service to health! I ended up at University of California later in the day where I snapped some photos which are below. The cultures are so …. distinctive. See what you think. Enjoy, comments welcome.

Oh, I didn’t get a chance to tell the “18F” story, but it’s here on my blog… Innovation in Collaboration: What 18F and Kaiser Permanente South Bay have in common | Ted Eytan, MD

And….thank you’s to: Susan Campbell-Weir from the kp.org team for the information about Spanish kp.org (and the entire kp.org team), Mike McNamara, MD and Michelle Edlund from Kaiser Permanente Northwest (@KPNorthwest) for the information about OpenNotes (@MyOpenNotes) at Kaiser Permanente, and Michael Jantzen (@mvs202) for the lovely visualizations of Capital Bikeshare data (@bikeshare)

2nd Annual Kaiser Permanente LGBTQI Health Symposium: Future of Inclusion

This post is about the Symposium itself, which was held in Universal City, California (more info and agenda here). I posted previously about my presentation here: Presentation: Being a Transgender Ally and Unconscious Bias | Ted Eytan, MD 

Patients, and Doctors included

We did something I have never done before this time. I often (and regularly) bring our members/patients on stage to share their experiences.

The amazing duo, Co-Chairs April Soto, MD, Family Physician, HIV specialist, Amy Porter, MD, Pediatrician, LGBT Champion, Southern Califronia Permanente Medical Group

What I have never done is bring their doctor with them at the same time. This particular physician is April Soto, MD, who is a family medicine specialist in Pasadena, HIV specialist, for Southern California Permanente Medical Group. I think this is a next, new phase of patient voice, bringing both aspects of the relationship forward, to understand how health is produced in a safe, comfortable environment.

It was amazing for me. Why? Because we tend to think about patients and physicians only having relationships in the exam room, that they can’t learn from each other outside of the exam room. We know that’s not true anymore with the advent of a simple yet transformational technology : email. The science also shows that we can’t create an atmosphere of diminished bias/acceptance of our patients for who they are if we (physicians) only connect with them in an atmosphere of inequality.

I’d like to see a whole session about this, rather than a part of one in the future. Thanks to both of you 🙂 .

From “How do I do this, to how do I do this well?”

At last year’s symposium, transgender person health care was new for Kaiser Permanente. So new that people were just learning the basics. This year the questions were different, less about what the right treatment is, more about how to provide the treatment the best. In this packed room of 300 people, I heard doctors stand up and thank patients for helping them understand their situation better, so they can be better doctors for them. 

For me, these events are as much anthropology as they are continuing education. I am extremely encouraged by what I am seeing.

The power to change lives

Of course there was a panel of exceptional people, our members, who spanned the spectrum of LGBTI health. They reminded all of us what we may take for granted at times, what we don’t want to acknowledge at other times, that there is immense power in the healing relationship that can be used for good, or not-as-good.

I think it’s great that as our world learns to love better, our profession has the capacity to lead. 

I met a bunch more doctors this time who are driven to be fair, compassionate, and apply the best science that exists, even if parts of our profession don’t want to. They are incredible people as well. As far as the rest of the profession/world goes, It’s okay, as Lady Gaga once said, our generation has the power to change that, too 🙂 .

Thanks again to our hosts, the Kaiser Permanente Southern California Permanente Medical Group, and all of our members, nurses, and doctors who are producing health for all. I’m proud of you!

Visiting the Kaiser Permanente Transgender Member Care Service, Kaiser Permanente Los Angeles Medical Center

Kaiser Permanente LAMC View on Flickr

The signs aren’t even fully unveiled, at the beautiful new Kaiser Permanente Los Angeles Medical Center (@KP_LAMC) in the Hollywood neighborhood of Los Angeles, California. We found ourselves here because we asked to be. For people in the Kaiser Permanente non-profit health system, including me, this is an iconic place. It opened in 1953 and now includes 900 physicians and 6000 employees – it’s almost as large as an entire region of Kaiser Permanente (or Group Health Cooperative, where I came from).

We came here, myself and Melanie Hiller, the President of KP Pride, lesbian, gay, bisexual, transgender, intersex, queer employee resource group of Kaiser Permanente Mid-Atlantic States, to learn about the care of people who are transgender. Anna Pitinyan, RN, BSN, was our teacher – she is the Transgender member care coordinator for Kaiser Permanente Southern California, which serves close to 4,000,000 members.

When I was here for the first ever LGBTQI Health Symposium (see: Clinicians from the future practice the medicine of inclusion – Kaiser Permanente LGBT Health Symposium | Ted Eytan, MD), Anna’s role didn’t exist yet, and the room I was in was filled with nurses, physicians, and members learning together how to support transgender person health. Filled.

Now, 11 months later, transgender person health care is maturing into a service that guides our members through the transition process, in the context of a larger United States health system that is still deciding whether it wants to take care of these individuals. It was great to see.

We spent the day in the Endocrinology medical offices, where new consultations for hormone therapy happen, and briefly shadowed C. Scott Thomas, MD, and Jill Silverman, MD. One of our faculty from last year’s course, Tisha Baird, MD  stopped in to say hello.

One one level, I didn’t see much different here than I usually see in a Kaiser Permanente medical center – Permanente physicians and nurses using the latest technology, engaging with their peers and colleagues across specialties, oriented toward the best outcome for our members/patients. The quote I usually make applies here too – our doctors and nurses sometimes don’t realize how advanced their care is, because it is normal to them.

On another level, I observed an organization at a nidus of change, as an arranger and provider of care that hasn’t been embraced by the medical or nursing professions previously, and now, in California, it’s part of what we do. Anna showed us how she helps members navigate through the transition process. She is becoming known in the community, and she knows where members can get accurate information during a potentially confusing time.

I asked her at the end of our visit if she considered herself and ally. She said yes. This is what I find when I meet people who are providing heath care for this population – another expert is created, another professional in their professional and personal community who is changing attitudes, eliminating bias, producing health for the entire LGBTQI community, far beyond what they do in their professional role. It’s happening.

And by the way, yesterday was another reminder of the role that nurses play in the leadership of a modern health system. There is one. It’s really important. Always remember to shadow nurses when you shadow physicians, Kaiser Permanente happens to have 49,000 awesome ones.

Most physicians today will relate that the care of people who are transgender is not included in their curricula. That’s changing, fortunately (see this paper as evidence); until then, doing this well requires curiosity and an interest in promoting the health of everyone equally, because as the brand new walk in front of the hospital says, everyone matters. I think the walk says it better than that.

“You Matter” – Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA View on Flickr

We’re here as part of the Kaiser Permanente 2nd Annual LGBTQI Health Symposium, which is a place where we meet others who are practicing the medicine of inclusion. So cool that we get to meet fellow allies for good health working in our world class medical centers, too. 

What a difference just a year makes. I can’t wait to see what’s going to happen in just the next 12 months. The world is going to learn to love even better thanks to this work.

Thanks to Anna, Scott, Jill, Tisha, and all of the members, nurses, physicians and staff (special shoutout to our über host, PL Maillard, MPT, MHA, Assistant Medical Center Administrator) of the iconic Kaiser Permanente Los Angeles, we’re happy to be a part of the family!