Linking Plan and Providers in Disaster Response Through an Electronic Medical Record. Skip Skivington



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Linking Plan and Providers in Disaster Response Through an Electronic Medical Record Skip Skivington

Kaiser Permanente KAISER PERMANENTE HEALTHCONNECT HEALTHCONNECT & DISASTER PLANNING KAISER PERMANENTE ACTIVITIES SOUTHERN CALIFORNIA WILDFIRES

Kaiser Permanente At-a-Glance Nation s Largest not-for-profit Integrated Healthcare Delivery System Would be ~ 60 on Fortune 500 9 States and the District of Columbia Nearly 8.7 million members Labor Management Partnership 32 Medical Centers

Kaiser Permanente At-a-Glance > 421 Medical Offices > 14,000 Physicians > 159,000 Employees > 558,000 Surgeries/year > 91,000 Deliveries/year > 129 Million Prescriptions/year > 36 Million Doctor Office Visits/year

Kaiser Permanente KAISER PERMANENTE HEALTHCONNECT HEALTHCONNECT & DISASTER PLANNING KAISER PERMANENTE ACTIVITIES SOUTHERN CALIFORNIA WILDFIRES

2007 Southern California Wildfires Location: Southern California Santa Barbara County to to the the US-Mexico Border Dates: October 20 20 November 9, 9, 2007 2007 Burned area: area: 500,000 acres acres Fatalities: 14 14 Injuries: At At least least 70 70

Kaiser Permanente KAISER PERMANENTE HEALTHCONNECT HEALTHCONNECT & DISASTER PLANNING KAISER PERMANENTE ACTIVITIES SOUTHERN CALIFORNIA WILDFIRES

Kaiser Permanente Activities Emergency operations established Provided broad broad communication to to staff staff via via the the Hospital Incident Command System (HICS): Instructed to to check check the the Staff Staff Hotline Hotline Established Labor Labor Pool Pool under under the the HICS HICS model model Redirected staff staff from from closed closed facilities to to operating facilities Prepared to to receive 22 22 patients from from evacuated medical centers and and Skilled Skilled Nursing Facilities

Kaiser Permanente Activities National Healthcare Continuity Management staff: staff: Deployed to to San San Diego Diego Medical Center Center Hospital Command Center Center Established national support for for increased demand for for pharmaceuticals, medical supplies, lab lab services, courier courier services, and and extraordinary policy policy development and and approval Continuously monitored and and tracked fire fire activity close close to to and and impacting our our medical facilities Used Used hotel hotel rooms rooms previously booked for for conferences to to transfer healthy moms, moms, babies, and and stable stable patients Cancelled elective surgeries, meetings and and patient patient education classes

Protecting Healthcare Delivery Expanding the Continuity Function Healthcare Continuity Management (HCM) Business Continuity Management (BCM) Threat Assessment Management (TAM) Foundation Development Implementation Systematic Planning Risk Assessment Share Best Practices EOC Management Threat Policy Development Integration Measured Response

Integration of Planning and Response Workgroups Healthcare Continuity Management Planning Response Executive Oversight Group National Command Center Clinical Facilities Supply Chain People Community Linkages Communications Public Policy Legal Regional CC Regional CC Other CC Hospital HCC Hospital HCC Hospital HCC Hospital HCC Other CC

Ongoing Risk Mitigation SARS Facilities Smallpox Anthrax Pandemic Community Influenza Linkages Team Deployment West Nile Virus Facilities Community Linkages Legal Clinical Healthcare Continuity Management People/ HR Public Policy Communication & Education Supply Chain Smallpox Vaccination Policy and Tools Bioterrorism Response Plan Anthrax Policy and Tools SARS Resource Toolbox Manager s Toolbox Pandemic Influenza Healthcare Risks Work Group Activity Risk Mitigation Tools

Kaiser Permanente KAISER PERMANENTE HEALTHCONNECT HEALTHCONNECT & DISASTER PLANNING KAISER PERMANENTE ACTIVITIES SOUTHERN CALIFORNIA WILDFIRES

Electronic Health Record System KP HealthConnect Epic Epic Systems Corporation Highly-sophisticated information management and and care care delivery system system designed to to enhance the the quality quality of of patient patient care care Integrates electronic medical records with with appointments, registration and and billing billing to to provide provide access access to to comprehensive member and and medical information from from a single single system system Launched in in December 2003 2003 Will Will link link all all Kaiser Kaiser Permanente facilities across across the the nation nation and andprovide patients, members, physicians and and other other authorized health health care care providers with with online online access access to to clinical clinical information 24/7 24/7

Electronic Health Record System More than 2.3 million Kaiser Permanente members currently use My Health Manager to perform several online health management tasks. Members can: Send an email to their doctor Make appointments Order pharmacy items View lab test results Act on behalf of a family member View information from past visits KP HealthConnect

Revolutionizing Our Healthcare System At Kaiser, experimentation with new technologies like KP HealthConnect occurs at the Sidney R. Garfield Health Care Innovation Center in San Leandro, Calif. Kaiser opened the facility in 2006 to test such new technologies as a videoconferencing system linking health care professionals to patients in their homes.

Revolutionizing Our Healthcare System Dr. Yan Chow, a pediatrician with Kaiser, demonstrates a videoconferencing system that would allow doctors to speak with patients in their homes.

KP HealthConnect During the Wild Fires As As our our facilities opened and and closed closed due due to to fires, fires, patients were were successfully diverted to to open open and and available medical facilities Receiving physicians, nurses, nurses, and and other other clinical clinical staff staff could could successfully access access relevant medical records for for health health history, history, lab lab results, results, current current prescriptions, etc. etc. Physicians working from from home home or or other other remote remote locations could: could: Check Check their their in-baskets (and (and those those of of their their peers peers and and covering RNs) RNs) Renew Renew prescriptions Check Check lab lab results results Call Call patients and and direct direct them them to to open open facilities Conduct telephone triage triage for for future future appointments, prescriptions, lab lab tests, tests, etc. etc.

Kaiser Permanente KAISER PERMANENTE HEALTHCONNECT HEALTHCONNECT & DISASTER PLANNING KAISER PERMANENTE ACTIVITIES SOUTHERN CALIFORNIA WILDFIRES

KP HealthConnect & Disaster Planning Aha Moment Electronic Health Records Should be Part of Disaster Planning Integration with other initiatives & business systems Optimization Leveraging system to achieve transformation Benefits Realization Incorporated into Nat l BCP Program Cascaded to Medical Centers & Regions Benefits Realization Deployment/Rollout Stabilization Stabilizing what we have deployed Briefed Senior Leadership Exercised During Nat l Drills

KP HealthConnect Sample Infrastructure Design Production data center Disaster Recovery data center

KP HealthConnect Downtime Policies & Procedures Established downtime policies and procedures include: End users training in downtime procedures before go-live Formal notification procedures to alert of downtime and resumption to normal workflows Routine tests to provide end users with the essential patient information such as downtime Medical Record Numbers (MRN) and Hospital Account Record (HAR) numbers, and printed materials so that usual tasks can be performed during downtime

KP HealthConnect Business Continuity Ownership Who needs to be involved? Everyone! Technical representatives Admitting and scheduling Nurse and physician champions Pharmacy Interface and ancillary systems Executives and steering committees Revenue cycle Trainers Others

KP HealthConnect Business Continuity Ownership (continued) Downtime protocol are validated by the executive level as it has significant implications for patient safety and operations An owner or point person is appointed to head up Business Continuity Planning Downtime committees: Update policies and procedures Make key decisions regarding protocol Coordinate organization and planning efforts

Electronic Health Records of the Future Kaiser Kaiser Permanente and and Microsoft Corp Corp partnered in in a pilot pilot program that that will will allow allow Kaiser Kaiser Permanente members to to store store their their personal health health data data securely within within an an online online site site managed by by Microsoft The The Kaiser Kaiser Microsoft partnership allows allows for for the the transfer of of prescription information, test test results results and and other other health health data data from from KP KP HealthConnect TM TM to to Microsoft's Health Health Vault Vault Patients can can control control what what information they they want want to to store, store, where, where, and and who who has has access access to to it it