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Change Management

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Kaiser Permanente - Key figures of a health care leader

Who would have expected to meet one of the US, if not worldwide, health care leaders in the San Francisco Bay Area? Kaiser Permanente serves nearly 11 million members in eight US states with extraordinary results, applying the Kaiser Permanente model, which is based on integration, innovation and technology.

We had the opportunity to meet Molly Porter, director of Kaiser Permanente International, a nonprofit subsidiary that develops educational programs and presentations about Kaiser Permanente for international health care leaders. And it seems that Kaiser Permanente has found the right path to really care for the health of its members (and not just provide medical treatment of diseases).
Interesting, but not surprising, that participants in the Kaiser Permanente International programs include a long list of organizations from the Netherlands and the Nordic countries (Finland, Sweden and Norway), which are considered the leading countries in health care system innovations in Europe. The number of participating organizations from CEE-countries is in contrast embarrassingly low – just for instance: Austria 1, Romania 1, Hungary 0.

Kaiser Permanente's Total Health strategy addresses societal, economic, and behavioral factors in our communities


According to Kaiser Permanente, the determinants of health are 40 % social and economic factors, 30 % individual health behavior, 10 % the physical environment and just 20 % medical care.
If you pay an overall health service provider per capita, as in the Kaiser Permanente system, it means that the healthier a member is the more “profitable”. This leads to a strong interest and focus on all prevention activities, an aspect with which European health care systems are constantly struggling. Kaiser Permanente is continuously observing the overall health-situation of its members using all available data. As a consequence, KP tries to motivate changes in individual behavior and even influence the living circumstances when possible. Another aspect of integration is represented by the way health problems are diagnosed and treated – always integrative teams (general practitioners, specialists, nurses, psychotherapists, physicians etc.) are taking care of patients so that they get almost all needed services in a Kaiser Permanente medical center.
With the exception of special situations such as emergencies, members are only allowed to use Kaiser Permanente resources, which cover the whole range of services delivered by 180,000 employees (including 51,000 nurses), 19,000 physicians, 38 hospitals, and more than 600 medical office buildings.

Transparency and Performance Management

You may seldom find such a transparent performance management system as at Kaiser Permanente. This system tracks both information about the health status of its members as well as the performance (results/outcomes) of its doctors and health care teams.
Kaiser Permanente could therefore within the last years manage to extend its market position as a cost leader in the US to also a leading position in terms of quality and effectiveness.

Optimized IT-usage

Kaiser Permanente calls the current time the “information age of care”. This means that IT is a key element in the communication with members/patients (for instance by increasing the proportion of phone and especially internet communication), but also for data recording and analyses for the observation of members’ health status. The principle for all IT applications is a consequent customer-orientation. This means that the member/patient is always in the center and the core goal is to improve his or her health status (or maintain it if it is already on a high level). At Kaiser Permanente, IT-applications such as ordering prescription refills online or scheduled telephone visits, which are currently just being tested or implemented in European countries, have been a reality for many years

One of the most-used terms in Molly Porter’s speech was “change” – change as the secret to improve the health status of members but change also as the key for continuous improvement of the health care organization.
This led finally to a system which one European health care expert once described as “sometimes the members are treated like children, but it works”.

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