8765 hours and Total Health : Joslin Diabetes Innovation 2012

Joslin Diabetes Innovation 2012 15927Another suitcase, another big meeting room View on flickr.com

Yesterday (Sunday), I had the honor of reuniting with ePatientDave ( @epatientdave ), along with Sue Kirkman, MD from the American Diabetes Association, and moderated (icing on the cake) by Joe Kvedar, MD ( @jkvedar ) on the stage of Diabetes Innovation 2012, hosted by the Joslin Diabetes Center.

Our topic was patient perspective, patient engagement, and shared decision making. Dave, ever so on top of what’s new in this world, spoke about some of the deep dives he’s doing with the research community and new frontiers of “give me my .. data”

In representing Kaiser Permanente and the Kaiser Permanente Center for Total Health (@kptotalhealth) in Washington, DC, I stayed focused on the every-day-normal activities that a health system does to involve patients and families in their care. This includes some of the data points I gathered below.

As part of that conversation, one of our esteemed audience members mentioned an important number: 8765. That’s the number of hours in a year, and he says, the overwhelming majority of them are not spent with doctors. Sue also endorsed this when she talked about “99.9”, which is the percentage of time people with diabetes are not being attended to in the health care system.

I didn’t say it as eloquently on stage as I would have wanted to (15 minutes, really bright lights, ePatientDave-force-of-nature sitting next to me :)), however, I can say it here, which is that this is the “why” of the investment in the concept of Total Health.

It means supporting the 8765 through access to your personal physician and health care team via mobile device for messaging, lab test results, as well as actions that support people at the level of family, community, and society.

At the level of medical care, creating access outside of the medical office through secure e-mail has been shown to significantly improve measures of chronic condition management, including blood pressure, lipid control, and glycemic control. This is the very well-done (in my opinion) study that I quoted on stage (see: Now Reading: Improved Quality At Kaiser Permanente Through E-Mail Between Physicians And Patients | Ted Eytan, MD)

Beyond the medical office, efforts including changing the environment where we live work and play through programs including HealthWorks, Community Benefit, and Environmental Stewardship (prevention is the new HIT), get at the rest of the 8765. As I say, a physician doesn’t want to feel when they step out of their medical offices that all of the work they are doing in those offices is being defeated by the environment around them. It’s not why we went into medicine, definitely not why we went in to Permanente medicine.

That’s what I wanted to say about the 8765 – in a tweet, it is that once you start listening to your patients when they are not in the exam room, you’ll learn that they are not living inside the exam room, they’re living a life.

Here’s the data I brought with me to share yesterday:

  • 4,020,271 members registered as of July 31, 2012!
  • 600,000 unique adult and children subjects for act as a family member
  • This is 64% of the eligible population
  • 34 % of registered members signed on 5 or more times in the last quarter alone
  • 31.1% of registered members viewed one or more lab test results (17,000,000 viewed online)
  • 26.8% of registered members sent one or more email (7,000,000 sent through 7/31/12)
  • 17% of visits are now from a mobile platform, up from 16% in July
  • members who use the Kaiser Permanente personal health record, My Health Manager,  are 2.578 times more likely to stay with their health care, this number is higher for members in their first year

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