Shadowing in the Medical Offices of the Future / Agents of Change – Kaiser Permanente, Colorado

Center for Complementary Medicine, Kaiser Permanente Colorado (View on Flickr.com)

There is a medical exam room at Kaiser Permanente labeled “acupuncture,” as well as “massage,” and “chiropractic.” Actually more than a few, at Kaiser Permanente Colorado’s Center for Complementary Medicine (@kpccm), which is now entering its 10th year of service, complete with tweeting staff Melissa Glassey (@MelissaGlassey) Meghan Dukes, D.C. (@KPChiroDukes) and Shari Engkvist (@ExpNutrition).

I trained in a medical school where integrative medicine ( as it is now often referred to ) was part of the curriculum (University of Arizona), and a residency located in the integrative medicine capital of the world as it is sometimes called (Seattle, WA). In both situations I learned a healthy respect for the abilities, and the limitations of allopathic medicine. It’s the same thing I say about technology, to know it well means to know its limitations, too.

Data vs Facts (View on Flickr.com

I’m here with several teams from Kaiser Permanente, including our Digital Workforce Group, who, like me, believe in data versus facts, and enjoy being part of a health system where we take care of real people. To be in health information technology and not have access to a functioning care delivery system is a huge gap. To work in a functioning care delivery system as a technologist and not observe excellent care being delivered is a huge loss.

Fortunately, I work with leaders, physicians, nurses, and for members, who want their care givers to understand the experience so it can be made even more excellent. 

Center for Complementary Medicine

Tracy Mc Cubbin, MD, is the Medical Director of the Kaiser Permanente CCM. She’s an emergency medicine physician with significant leadership and academic credentials, and is clearly as passionate about the service today as when it was founded. She tells me she is an agent of change (sounds familiar :)), and, as an emergency room physician, she became interested in the ways that people’s presenting conditions could be managed differently or prevented altogether before needing to use the emergency room. This service accepts patients who are Kaiser Permanente members as well as those who aren’t, and connects to our medical care program at the same time. 

And, there’s a prep kitchen, where patients can learn how to produce delicious and healthy meals. When I arrived, the physicians and staff were talking about whether enough frozen bananas had been secured for today’s healthy smoothie demonstration. Not something that is typically part of a medical center conversation…

And yes, the forks rock here, too.

Englewood Medical Offices

Englewood is one of Kaiser Permanente Colorado’s  (@KPColorado) first medical office buildings, reskinned using the Total Health Environment template. The medical and nursing group here is cohesive and collaborative. I shadowed Felipe Hernandez, MD, a University of California trained Board Certified Family Medicine specialist as he delivered full spectrum care to members and families of all ages. As with every physician at Kaiser Permanente, his patients can access him through their mobile devices for email, test results, and appointment scheduling, and he can respond and coordinate care through the KP HealthConnect electronic health record. 

As I’ve mentioned before, Kaiser Permanente is a post-EHR organization, so the physicians I observe here, Felipe included, don’t typically focus on the computer anymore – they can use it seamlessly while they focus on the patient. Also as an EHR-competent physician, Felipe normally works all the appropriate cues into his exams, so patients and families know how his use of the EHR is helping their care. The other thing that’s noticeable here is the focus on relationships, both with colleagues, and with patients and their families. In true family medicine form, there’s an investment in the person, the person’s family dynamics, and the environment around them, and this is totally supported in this 21st century medical practice – leading the nation in quality measures health system (see: Kaiser Permanente Share | Kaiser Permanente Leads the Nation in 16 Health Plan Quality Measures).

A big group that came with me, which makes me even more happy to be part of this health system. Technology for technology sake without the member experience in mind doesn’t mean very much. Here it doesn’t have to, because the member experience is in mind. Thanks, Kaiser Pemanente Colorado physicians, nurses, staff, and members for teaching us.

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Ted Eytan, MD