A trip to the Reinvention of Primary Care at Group Health Cooperative (Pictures and Quicktime VR)

“C’mon Ted, let me show you the visual system for Primary Care.”

I am still in Seattle, and visiting colleagues from Group Health Cooperative, where I learned about LEAN, in large part from Lee’s efforts (Group Health Permanente, Group Health’s medical group, is part of The Permanente Federation, so we are still in the family).

It’s never enough to just have lunch with Lee Fried, one of the LEAN senseis at Group Health Cooperative, and co-founder of the Daily Kaizen blog with me. He has to fill your head full of innovative ideas – just what I needed after spending two days discussing innovation last week in Oakland. Fortunately, I always have more room for ideas… So we walked over to the Group Health campus and headed to one of the conference rooms on the top floor.

What Lee showed me was a whole room of visual displays used to track the progress of the reinvention of primary care. This includes everything from leadership/manager standard work, call management, use of virtual medicine, preparation for visits, as well as the vision, strategic plans, outcomes, and staffing.

All are available visually, across all the primary care medical centers of Group Health, by entering this room. I asked Lee how this room is updated, given that medical centers span the State of Washington. He told me that leaders come here, in person, to update status, point out problems, and propose countermeasures.

What Lee probably doesn’t know about this particular room is that it is the room where I had most the academic sessions (didactics, faculty meetings, etc.) during my residency.

Back then, we were discovering the wonder of the World Wide Web, and how all of the data anyone would ever need would be reachable from a computer desktop. I never would have guessed that white boards and paper would be used to visually assess the health of a primary care system several years later. However, I would have predicted that Group Health would always use the most rational, effective techniques available to support its members, which they are doing.

Feel free to track their progress on their blog, Reinventing Primary Care. Didn’t think we’d be blogging back then, either!

Images: Click on any to enlarge

Primary Care Panoram

Primary Care Panoramic

Quicktime Virtual Reality: For the technologically adventurous. Allows you to move around the room using your mouse. Quicktime Plugin (PC & Mac) is required.

{qtvr https://www.tedeytan.com/wp-content/uploads/pcpanoram1.mov 400 300 devalvr( “autoplay”, “3”, “autoplayspeed”, “-4”) selection( Choose viewer: , detect, devalvr, qt)}
{qtvr uploads/pcpanoram2.mov 400 300}


Thanks for sharing pictures and for blogging about this. I met Lee and saw this first hand last week — great stuff. I'll have to blog about it next week. Will definitely share your Quicktime VR images. Very cool.

Thanks, Mark! I think it's really important to show visual systems using visuals! I have found that the digital camera hasn't found its way into the toolboxes of many leaders, but hopefully that's changing. I wonder if there is a Flickr group for visual systems?

The next frontier is video… with BlackBerries, iPhone 3GS, and FlipVideo cameras, we should be getting a lot more "short film" submissions from the lean world, I'd hope! Even more powerful, the examples I've seen of people doing this.


Ted Eytan, MD