I am here in Oakland, California, and having completed my first presentation about Kaiser Permanente’s work in health care information technology, I have now done my first live demonstration of Kaiser Permanente’s work, at the Sidney R. Garfield Health Care Innovation Center, in Oakland, California.

Just as with the presentation, I was a little nervous about the demonstration. Unlike the previous health information technology environment I was a part of, this one is between 10 and 100 times as vast, and I wanted to respect the work of the experts who were involved in making it happen.

And, the experts have done great work - I looked at a specific aspect of Kaiser Permanente’s care, highlighted in this television advertisement, that has resulted in a 30% lower death rate from cardiovascular disease among Kaiser Permanente members relative to other Californians. Kaiser Permanente, by the way, has funded expansion of this program to patients outside of Kaiser Permanente through its Community Benefit work.

The demonstration was attended by other Kaiser Permanente experts and members of the national media, to see “today” and “tomorrow.” And there’s lots of tomorrow happening here, because the reality is that there are still very few organizations that are at this maturity level of electronic health record use.

I’m including some photographs below, and I am supported in sharing them here, just as the innovation will be shared. There’s a fully simulated hospital ward, ambulatory medical center, and even a patient’s home (because that’s where the hub of good health should be). A lot of what is being developed here will find its way to patient care inside of, and outside of Kaiser Permanente. A lot of it already has. From reading Sidney Garfield’s writings, this is by design. Enjoy and feel free to let me/us know what you think.

• Visitor count for major social networking sites - are health portals far behind? - Monthly user visits for the major web sites. kp.org, which sees on average 122,000 member visits a day, is not quite Facebook traffic'd (it's about a tenth of the size), but it is greater than Twitter. Impressive.

Here are my photos, with a tiny bit of emphasis on the DC contingent (click any to see larger)

It’s hard to keep up with the energy here. In March, 2008, the motto (thanks to Susannah Fox), was “7 words.” This time, we seem to have become more efficient, and the motto is “4 letters,” and the driving 4 are “H-T-M-L” coined by Anna-Lisa Silvestre, VP of Online Services for Kaiser Permanente.

Why? Because during the consumer engagement demonstrations, Anna-Lisa’s team prepared the user experience based on static HTML to demonstrate the look and feel, rather than a dynamic demonstration. The others did not fare as well. But that’s okay with me - doing live demonstrations are never easy, and I trust that the organizations involved are going to do great work. I’ve had worse happen on stage - it happens. Perfection is not expected, just the ability to fix mistakes quickly.

I was asked yesterday about the energy level, and my answer is based on comparison to meetings which are of people working to help other people (clinicians, doctors, nurses). This gathering is of people who are working to help people just like them, and who are empowered enough to know what is needed. It’s very stimulating for me, and it should be stimulating for our health system. There is so much more we can do for patients that we aren’t doing, yet.

One more 4 letter word - Jane Sarasohn-Kahn (quoted in the New York Times today) mentioned to me that on our panel yesterday that the doctor, the patient, and the health economist did not disagree when it came to talking about Health 2.0, when it might be expected that we should. I have been saying that the killer app of Health 2.0 is “listening to people” but I like that Jane said:

In Health 2.0, “Love is the Killer App.”

Presentation: Office of the National Coordinator Shop Floor Tour, Ted Eytan, MD

These were the words of Mark Snyder, MD, Associate Medical Director, Information Technology, Mid-Atlantic Permanente Medical Group, as he demonstrated a new paradigm of information sharing using a simulated medical record, taking the record (represented by a notepad) out of his hands, and placing it in a member’s hands. This happened during a “process walk” that we set up to show the workflow of secure e-mail in a medical practice, at Kaiser Permanente’s West End Medical Center, in the heart of Washington, DC.

The visit came about because I was asked to provide information to the Office of the National Coordinator (ONC) about Group Health Cooperative’s work in adopting secure e-mail as part of care across the State of Washington. Since I am a believer of Genchi Genbutsu through the work I have been doing in LEAN, I invited the group to “come and see for yourself,” and they did.

With assistance from the staff at Kaiser Permanente’s West End Medical Center, including Medical Center Chief Doug VanZoeren, MD, I presented the Group Health Health Profile, an electronic health risk appraisal linked to an electronic health record, along with data about adoption of our patient portal, MyGroupHealth. Mark Snyder followed with information about Kaiser Permanente’s HealthConnect project and associated personal health record, kp.org. He indicated that 100,000 of Kaiser Permanente Mid-Atlantic’s members have signed on to the system, giving it a steeper adoption curve than even Group Health as Mark pointed out, since it is has been on the scene for less time. It is now fully operational, though, and forging ahead with features like direct booking of primary care appointments.

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