Today was my very first work with the media as an employee of The Permanente Federation. I was asked to support a national conversation led yesterday by colleagues George Peredy, MD, Simon Cohn, MD, and Andy Wiesenthal, MD, regarding interoperability of health records between Kaiser Permanente and Veterans Affairs, which I was happy to do.

The interview took place at Washington’s NewsChannel 8, in Rosslyn, VA, which also hosts ABC News 7 and the Politico organizations. As I was walked around the facility, they said I could snap photos of the newsroom, so I did, and they are posted here.

As part of preparing for the day, I reviewed some of the numbers around Kaiser Permanente member adoption of personal health records, and I have to say, it is really at a scale that is unfathomable (or at least at a scale I will need to begin fathoming) - almost 2.5 million members with access to secure features on kp.org, 300,000 new users in the 2nd quarter of 2008, 1.5 million secure e-mails sent to doctors, 4.2 million test results viewed online. There are on average 122,000 visits to kp.org every day - in the space of a week this may be as many outpatients as some health systems manage in a year.

I didn’t get asked information at that level of detail - it just reminded me that there’s a lot to represent in this organization. I did get asked about the demonstration that happened yesterday, by anchor Dave Lucas and he seemed very impressed at the potential breakthrough this could be for Wounded Warriors and patients everywhere. It turned out that Dave has good experience here - he said after the interview that he’s been a medical reporter for 15 years and knows how patients see the value of being connected to their information at the right time. I think the work demonstrated yesterday is a great step forward, and that it’s great to have people in media who work with patients and know what they expect to see in their health care system. We all improve that way.

I’m not sure if I’ll get access to video to post here or not, but in the meantime, thanks to everyone at NewsChannel 8 for the warm welcome (even at the front desk, where I got great coaching to “smile, and it’ll be all right.”), and for the chance to have a seat in the world-famous Goss’ Garage while I was waiting!

Chicago can get really really cold.

I found this out when I braved what I would call a challenging travel experience, along with several other HIT experts, to attend a new Joint Commission Public Policy Roundtable, addressing the creation of a nationally interconnected Health Information Technology System.

It was both worth the effort and I left welcoming the Joint Commission’s leadership and support. And since I originally hail from Phoenix, Arizona, I am apt to exaggerate the harshness of winter travel, anyway.

If you are not familiar with The Joint Commission, it is an organization with an important mission and positioned to “Help Health Care Organizations Help Patients.” I’ve encountered The Joint Commission’s work in my Informatics leadership role and it has definitely shaped improvements in quality, safety, and affordability of care. There is a lot of respect there.

Convening a roundtable like this is part of a larger process that includes an expert panel, the creation of a white paper, and conferences to influence policy. This roundtable covered a nice cross section of the HIT landscape, with sections on:

• Realizing the Benefits of HIT
• Creating Incentives to Spur HIT Adoption
• Overcoming Implementation Barriers
• Achieving Interoperability

Further, the attendees represented a core group of some of the most dedicated individuals to furthering a better health care system through technology. What was useful for me was the fact that most of the experts talking about HIT are from institutions which have viable PHR’s, or are working to build them. These are groups that understand the realistic promise in this area.

The most striking pieces of data to me were around adoption of HIT by physician practices, still in a range that we find disheartening - 14% by one definition, and by another, even lower at 4%. While patient centered HIT doesn’t require an EHR, it’s certainly easier to support it with an EHR. There was also an excellent overview by Dr. David Blumenthal from Massachusetts General Hospital of the different factors supportive of HIT adoption in different countries - everything from public support, to the presence of certified products, to peer support.

In terms of input I provided, it was to keep the patient at the center of the discussions, to promote patient adoption of HIT as well as physician adoption of HIT, and that transformation using HIT is really an element of an organization’s continuous improvement strategy. HIT doesn’t make this happen, but it makes improvement happen much more beneficially.

How did I leave this roundtable? Overall, very enthusiastically.

On the way to the airport from the meeting, I was able to share a ride with Don Detmer, MD, who is to me something of an Informatics hero, and a person who I believe has even more energy than I do. Don talked about the idea that there is a role for everyone to play, and we shouldn’t get seduced by the concept that there is one stakeholder responsible for forward movement. This is really important for us on the PCHIT initiative as we take our experience and put together some key attributes in our Personas work (coming soon). The other thing he did was recount some of his experience to me, which had a common thread throughout - the work of an inspired leader changed attitudes and then behavior to a different status quo.

I think we should look forward to the publication of the Joint Commission’s white paper on Creating a Nationally Interconnected Health Information Technology System and I am glad that this organization is applying resources to supporting our health system in this way.

December 13th through December 14th:

• The Information Technology & Innovation Foundation: Why a dose of IT May be…. - Another discussion of suggested direction for Health Care IT, and where Interoperability fits
• Neil Calman MD: HIT before HIE (and not without my knowing what?s out there about ME) - A blog post that I have read and referenced a few times about HIT and HIE.
• Medicare Spending, The Physician Workforce, and Beneficiarie’ Quality of Care - Impact of physician workforce mix on Medicare beneficiaries’ care.
• The Atlantic Monthly: Overdose - Argument that the physician shortage is really a glut, of specialists
• Vote on Mass. retail medical clinics delayed again - The Boston Globe - MinuteClinics coming to Massachussetts. Reference to data around standardized sore throat care.
• NPR : Washington, D.C. Facing HIV/AIDS Epidemic - Information about HIV/AIDS in Washington, DC