March 5, 2013

HealthConnect® enables care improvement and transformation

OAKLAND, Calif. — While Kaiser Permanente is widely known for being a leader in health information and the use of electronic health records, a less known fact is how their class-leading clinical technology is fueling transformational health research and clinical practices.

Kaiser Permanente published nearly 1,000 research articles in 2012. The body of work demonstrates the tremendous power of Kaiser Permanente HealthConnect®, the largest private electronic health record system in the world.

Leveraging Kaiser Permanente’s paperless patient record database, researchers discovered, among other things, that protection against the whooping cough vaccine wanes during the five years after vaccination and the HPV vaccine is not associated with increased sexual activity in young girls. This research made a difference in clinical care, including updated guidelines and clinical advisory recommendations, as well as sparking conversations between doctors and patients everywhere.

“Kaiser Permanente is unique because we both pay for and deliver care — so we are in the business of keeping people healthy and effectively managing illnesses. A seamless flow of information among all of our clinicians enables us to perform at the highest levels,” said Elizabeth McGlynn, PhD, director of the Kaiser Permanente Center for Effectiveness and Safety Research. “And our researchers are able to use this clinically detailed information to answer critical questions about what interventions and systems are safest and most effective for which patients. Doing this work in a delivery system also means we can translate those insights back into policy and practice.”

Kaiser Permanente operates one of the largest non-university research programs in the United States. Kaiser Permanente clinicians and researchers have approximately 2,000 studies in progress at any given time and they publish 900–1,000 articles annually. Using data from the all-electronic health record to conduct studies that would be more expensive and time-consuming in a paper-based system, Kaiser Permanente researchers explore a number of health-related topics, including how vaccines, medications and lifestyle factors affect the whole population.

2012 translational medicine highlights

  • Study suggests rests routinely done on patients with microscopic blood in urine can be avoided
  • Protection against whooping cough waned during the 5 years after 5th dose of DTaP
  • Study affirms safety of HPV4 vaccine for adolescents and young women in routine clinical care
  • Study shows elevated risk of blood clots and arterial blockage in women taking birth control pills containing drospirenone
  • Automated phone and mail notices increase medication adherence

KP HealthConnect also helps to improve clinical outcomes at Kaiser Permanente through seamless care coordination, providing access to patients’ records for all their doctors, pharmacists and specialists. And the system delivers information at the point of care about what treatments and protocols are recommended based on analyses.

“Kaiser Permanente HealthConnect® makes our great physicians even better. By analyzing longitudinal data on real clinical encounters, treatments and outcomes, we are identifying what really works,” said Scott Young, MD, executive director of the Kaiser Permanente Care Management Institute. “We then translate that research into practice by creating actionable clinical guidelines that are available in real time in the exam room and at the bedside. We’re making the right thing easier to do. The result has been lower mortality rates from heart attacks, strokes, cancer and sepsis than the rest of the country.”

Research influencing changes in clinical guidelines

In 2012, research facilitated by KP HealthConnect supported clinical change, including guideline and advisory changes from Kaiser Permanente and federal agencies. Most importantly, the findings informed conversations between doctors and patients about treatment. For example, researchers used KP HealthConnect to determine that microscopic traces of blood in urine samples do not necessarily indicate cancer, as the medical community previously thought. Due to those findings, Kaiser Permanente Southern California released new practice guidelines, significantly reducing unnecessary exposure to radiation.

Similarly, the U.S. Food and Drug Administration updated its safety advisories in 2012 to include the increased risk of blood clots with birth control pills containing a progesterone-mimicking hormone, based on epidemiological data including a Kaiser Permanente study.

Helping patients with medication adherence

In an effort to advance patient care, a number of Kaiser Permanente studies in 2012 used health care records to study trends in medication adherence. Researchers found mail-order pharmacies improve adherence and reduce health care disparities, and automated phone calls are effective tools for encouraging patients to pick up their prescriptions. They also found patients connected to the tools on are “highly confident” in their ability to manage chronic conditions and have improved health outcomes.

Using research to improve clinical care

In part because of its commitment to integration and translating research into meaningful clinical change, Kaiser Permanente is a leader in health care quality across hundreds of patient quality measures. Nearly all of Kaiser Permanente’s hospitals have the top score of “A” for patient safety from the Leapfrog Group, and the health system leads the nation with the most No. 1 rankings in effectiveness-of-care measures among commercial care plans from the National Committee for Quality Assurance. In addition, Kaiser Permanente's implant registries, which rely on Kaiser Permanente HealthConnect®, recently won the 2012 annual John M. Eisenberg Patient Safety and Quality Award, sponsored by The National Quality Forum and The Joint Commission. These registries are models of integration across medical centers in nine states, and they represent strong partnerships among health plan administration, hospitals and physician medical groups united to improve the quality of care for patients.