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:
Rest of the photographs below + a video flyover here. Enjoy this trip to the future.
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.
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.
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:
#KPLGBTQ16 roll call : KPSF, KPSunset, KPWestLa – zero new HIV infections, largest PrEP program in the world.
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.
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.
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.
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.
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 🙂
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.
Photos of/from GCNext
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.
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.
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)
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 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 🙂 .
I am meeting with our President. I will not stop fighting. This must end. Our generation has the power to end it. Trend it #MakeALawForJamey
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.
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.
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!