Hospitals are changing with the times, particularly with the introduction of new technologies, as well as a changing funding paradigm. Special Sections Editor Brad Graves, with the help of Health Care Reporter Jared Whitlock, asked several senior hospital executives about the advent of new technologies and approaches — in short, what we might expect from the hospital of the future. Here are their edited responses.
Senior Vice President and Area Manager Kaiser Permanente San Diego
Q: Artificial intelligence is all the buzz in health care. How is your hospital using AI or how does it plan to do so?
A: AI is transformational. Kaiser Permanente actively evaluates how AI can help us improve the lives of those we care for. One example: in San Diego, Kaiser Permanente uses the da Vinci robot to provide minimally invasive surgery — improving outcomes and reducing complications. AI is also being used at Kaiser Permanente in the form of predictive analytics — specifically, a program called Advanced Alert Monitor, which uses algorithms developed by the Kaiser Permanente Division of Research. The program analyzes electronic health record data from Medical-Surgical inpatients; proactively identifies those with a high likelihood of clinical deterioration; and then alerts e-Hospital nurses who connect with Rapid Response care teams at the local medical center. Originally developed in our Northern California Region, this AI program is currently being spread across the organization.
Q: Health care is moving toward an emphasis on outcomes and value rather than volume. How is your hospital system preparing for this shift?
A: Quality care has always been Kaiser Permanente’s driving mission. Unlike other hospitals, our integrated care delivery model does not rely on volume of patients for success. On the contrary, the healthier our patients are, the healthier our organization is. Kaiser Permanente’s health plan, hospitals and 1,400 local Southern California Permanente Medical Group physicians work seamlessly to provide our patients the highest quality care possible — from wellness and prevention programs, to primary care, to specialty care in more than 90 specialties.
Q: From a business perspective, what’s the greatest challenge and opportunity in San Diego health care right now?
A: The greatest challenge to health care today is affordability. Excellent health care means nothing if patients can’t afford it. Despite the fact that health care cost trends are decreasing, health care is still too expensive. At Kaiser Permanente, we believe the opportunity is to improve cost trends by improving quality, expanding care delivery options and improving overall community health.
Q: How might your hospital be using telemedicine to gain a competitive edge?
A: For years, Kaiser Permanente patients have embraced telemedicine as an effective method of receiving care — both in the hospital and medical office settings. We know that telemedicine increases patient engagement and can improve patient outcomes, while offering patients flexibility and efficiency. Our approach to telehealth includes telephone visits, video conferencing, specialty care video/telephone consults, web-based applications, and visits via mobile device. Because of our integrated system, and our electronic health record, all telehealth visits are automatically integrated into the patient’s medical record, creating a seamless, high quality care experience.
Q: Any other thoughts on what the hospital of tomorrow might look like?
A: The hospital of the future is here today. San Diego is blessed with a wealth of excellent care providers, and several recently built or expanded hospitals. As new hospitals are built, they incorporate the latest technology and processes that improve patient care. The newest hospitals are also built to adapt to and adopt rapidly changing health care technology and care delivery improvements. For example, the Kaiser Permanente San Diego Medical Center, opened in 2017, incorporated over 20 new technologies that had not been previously integrated into a hospital setting. Since opening, the hospital has adapted the technology to better serve our patients and improve patient outcomes.
Q: Any thoughts on how a hospital of tomorrow might interact with its community? Will it be appreciatively different than today?
A: At Kaiser Permanente, we understand health is more than just health care. We know that clinical care influences only about 20 percent of health outcomes; the other 80 percent is influenced by other nonmedical factors such as healthy behaviors, social and economic influences, and the conditions of our environment. That’s why we engage in a program we call CULTVATE, to help improve the “upstream” determinants of health in San Diego. In 2018, we invested more than $45 million in support of improving the health of our San Diego community, including programs to improve economic opportunity, foster healthy behaviors, support social services and increase community capacity, and create a more livable, sustainable San Diego.
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