  {"id":19136,"date":"2016-11-18T16:25:54","date_gmt":"2016-11-18T21:25:54","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-rctom\/submission\/the-dr-will-see-you-nowon-the-screen\/"},"modified":"2016-11-18T16:25:54","modified_gmt":"2016-11-18T21:25:54","slug":"the-dr-will-see-you-nowon-the-screen","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-rctom\/submission\/the-dr-will-see-you-nowon-the-screen\/","title":{"rendered":"The Dr. Will See You Now\u2026On the Screen"},"content":{"rendered":"<p>Healthcare costs have been on the rise and hundreds of digital health startups seeking a solution to lower costs. $3.9B was invested during the first half of 2016 in seed and Series A deals looking to shake up the heavily regulated and antiquated system.<a href=\"#_edn1\" name=\"_ednref1\">[i]<\/a>\u00a0 Of that funding, there were a record-breaking 151 companies that raised more than $2M.<a href=\"#_edn2\" name=\"_ednref2\">[ii]<\/a><\/p>\n<p>While there has been a huge influx of new companies into the healthcare space, Kaiser Permanente, one of the largest and oldest (since 1945) U.S. players has also been heavily investing in health tech and leading the charge on implementation.<a href=\"#_edn3\" name=\"_ednref3\">[iii]<\/a><\/p>\n<figure id=\"attachment_19046\" aria-describedby=\"caption-attachment-19046\" style=\"width: 300px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Kaiser-photo-2.png\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-19046\" src=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Kaiser-photo-2-300x200.png\" alt=\"Source: https:\/\/www.fastcoexist.com\/3057404\/world-changing-ideas\/kaiser-permanente-designed-a-health-center-that-puts-patients-first \" width=\"300\" height=\"200\" srcset=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Kaiser-photo-2-300x200.png 300w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Kaiser-photo-2-768x512.png 768w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Kaiser-photo-2-1024x683.png 1024w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Kaiser-photo-2-600x400.png 600w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Kaiser-photo-2.png 1200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-19046\" class=\"wp-caption-text\">Source: https:\/\/www.fastcoexist.com\/3057404\/world-changing-ideas\/kaiser-permanente-designed-a-health-center-that-puts-patients-first<\/figcaption><\/figure>\n<p>Kaiser has had the same business model for years: they are both the insurer and provider, from primary care to hospitals. This model incentivizes them to lower the total cost of care and hence focus on preventative health and lower cost settings. Kaiser\u2019s business model has been quite successful; in 2015, Kaiser generated about $60B<a href=\"#_edn4\" name=\"_ednref4\">[iv]<\/a> in operating revenue while caring for 10.6M members.<a href=\"#_edn5\" name=\"_ednref5\">[v]<\/a><\/p>\n<p>Despite their success, Kaiser is not resting on their laurels. Over the past several years, Kaiser has been upgrading their operating model, shifting to more technological solutions. Last year, Kaiser had more tele-visits than in-person encounters, 59M vs. 50M respectively.<a href=\"#_edn6\" name=\"_ednref6\">[vi]<\/a><\/p>\n<p>While there are many telemedicine startups, Kaiser\u2019s competitive advantage comes from their HMO model where members must see a Kaiser physician, resulting in the consolidation of their records in a single Electronic Medical Record. Kaiser patients receive (arguably) better care because those physicians have access to the patients\u2019 complete record.<\/p>\n<p>Kaiser recently opened several \u201chealth hubs\u201d seeking to improve the experience of going to the doctor with online check in and co-pays, text alerts when the Dr. is ready.<a href=\"#_edn7\" name=\"_ednref7\">[vii]<\/a> If a patient needs to see a specialist that isn\u2019t at their site, they are able to do a video visit on the large screen in the exam room. These new exam rooms are expected to increase the number of visits by 20%-40% and to save 10% via space-conscious floor plans, and technologies and workflows.<a href=\"#_edn8\" name=\"_ednref8\">[viii]<\/a><\/p>\n<p>Kaiser is also investing in longer term transformational research at their 37,000 square foot test warehouse in northern CA.<a href=\"#_edn9\" name=\"_ednref9\">[ix]<\/a><\/p>\n<p>Some of the pilots include:<\/p>\n<ul>\n<li>Monitoring and tracking a patients\u2019 living space for falls, sleep, diet, etc.<\/li>\n<li>Driverless car that can be dispatched out to the patient to determine if they need to go to the hospital.\n<div class=\"mceTemp\">While some ideas could seem far flung or questionable in efficacy, I applaud Kaiser for the focus on innovation and experimentation to question the status quo. Kaiser even started a venture capital arm to invest in digital health and quickly incorporate new technology.<a href=\"#_edn10\" name=\"_ednref10\">[x]<\/a><\/div>\n<\/li>\n<\/ul>\n<p>While Kaiser has had success in implementing and shifting toward digital solutions relatively quickly, it hasn\u2019t been without issues. One IT upgrade cost $1 billion rather than the budgeted $500 million.<a href=\"#_edn11\" name=\"_ednref11\">[xi]<\/a> Kaiser also faced some push back from the nurses in their Oakland hospital opening that<\/p>\n<figure id=\"attachment_19071\" aria-describedby=\"caption-attachment-19071\" style=\"width: 300px\" class=\"wp-caption alignright\"><a href=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Kaiser-photo-1.png\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-19071\" src=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Kaiser-photo-1-300x169.png\" alt=\"Source: https:\/\/www.fastcodesign.com\/product\/health-hub-experience-guide\" width=\"300\" height=\"169\" srcset=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Kaiser-photo-1-300x169.png 300w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Kaiser-photo-1-600x338.png 600w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/Kaiser-photo-1.png 720w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-19071\" class=\"wp-caption-text\">Source: https:\/\/www.fastcodesign.com\/product\/health-hub-experience-guide<\/figcaption><\/figure>\n<p>incorporated digital monitoring. The nurses were concerned about the reliability of the machines and some technicians were afraid of losing their jobs to these new machines. As a result, the local paper ran an article where some nurses claimed the heart monitoring machines had failed and the nurses had no way to know.<a href=\"#_edn12\" name=\"_ednref12\">[xii]<\/a><\/p>\n<p>Kaiser should implement a change management program to help the techs, nurses, administrators, and physicians along the transformation journey as new technology impacts their role in delivering care. The negative reaction and press from the Oakland hospital could have significantly impacted the trust of the community. Some of the investments Kaiser is exploring could be incredibly beneficial and transformational changes for healthcare, but if they employees are not brought along and shown why they should trust the new way, Kaiser\u2019s membership and employee morale could suffer.<\/p>\n<p>&nbsp;<\/p>\n<p>(796 words)<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"#_ednref1\" name=\"_edn1\">[i]<\/a> Susan Hall, \u201cHealth IT investments: Proven winners or scrappy startups,\u201d Fierce Healthcare, November 16, 2016, <a href=\"http:\/\/www.fiercehealthcare.com\/it\/who-will-bring-health-it-transformation-and-how-soon?utm_medium=nl&amp;utm_source=internal&amp;mrkid=38888469&amp;mkt_tok=eyJpIjoiWVRZME0yTmtObVJoTlRCbCIsInQiOiJ3ZDA2RFNcL2lLdXQ2VWRYUHRYSFpKN3FtejY4RlBIMW1jTHFsYnhiOFwvZyt6b0h1Zm1sdWJJdHNXcDV5bm40R05uc1wvdXhlNk9MSkM5dlUxVXhyWTl6YlJRQm1RdUdWaGFQNWZzMGVWcjBGaz0ifQ\">http:\/\/www.fiercehealthcare.com\/it\/who-will-bring-health-it-transformation-and-how-soon?utm_medium=nl&amp;utm_source=internal&amp;mrkid=38888469&amp;mkt_tok=eyJpIjoiWVRZME0yTmtObVJoTlRCbCIsInQiOiJ3ZDA2RFNcL2lLdXQ2VWRYUHRYSFpKN3FtejY4RlBIMW1jTHFsYnhiOFwvZyt6b0h1Zm1sdWJJdHNXcDV5bm40R05uc1wvdXhlNk9MSkM5dlUxVXhyWTl6YlJRQm1RdUdWaGFQNWZzMGVWcjBGaz0ifQ<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref2\" name=\"_edn2\">[ii]<\/a> Mitchell Mom, Ashlee Adams, Digital Health Funding 2016 Midyear Review, Rock Health, <a href=\"https:\/\/rockhealth.com\/reports\/digital-health-funding-2016-midyear-review\/\">https:\/\/rockhealth.com\/reports\/digital-health-funding-2016-midyear-review\/<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref3\" name=\"_edn3\">[iii]<\/a> \u201cKaiser Permanente\u2019s \u2018Health Hub\u2019 Design Named a Finalist in Fast Company\u2019s 2016 Innovation Awards,\u201d Kaiser Permanente press release (Pasadena, CA, September 19, 2016) <a href=\"https:\/\/share.kaiserpermanente.org\/article\/kaiser-permanentes-health-hub-design-named-finalist-fast-companys-2016-innovation-awards\/\">https:\/\/share.kaiserpermanente.org\/article\/kaiser-permanentes-health-hub-design-named-finalist-fast-companys-2016-innovation-awards\/<\/a><\/p>\n<p><a href=\"#_ednref4\" name=\"_edn4\">[iv]<\/a> Melanie Evans, Modern Healthcare, February 12, 2016, \u201cKaiser Permanente reports growth in membership, revenue in 2015\u201d <a href=\"http:\/\/www.modernhealthcare.com\/article\/20160212\/NEWS\/160219960\">http:\/\/www.modernhealthcare.com\/article\/20160212\/NEWS\/160219960<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref5\" name=\"_edn5\">[v]<\/a> Caroline Chen, \u201cTaking Bids on the Hospital of the Future,\u201d Bloomberg Businessweek, July 22, 2016, <a href=\"http:\/\/www.bloomberg.com\/news\/articles\/2016-07-22\/taking-bids-on-the-hospital-of-the-future\">http:\/\/www.bloomberg.com\/news\/articles\/2016-07-22\/taking-bids-on-the-hospital-of-the-future<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref6\" name=\"_edn6\">[vi]<\/a> Ibid.<\/p>\n<p><a href=\"#_ednref7\" name=\"_edn7\">[vii]<\/a> Jeff Ferenc, \u201cKaiser Permanente opens first of community health hubs,\u201d May 18, 2016, <a href=\"http:\/\/www.hfmmagazine.com\/articles\/2197-kaiser-permanente-opens-first-of-community-health-hubs\">http:\/\/www.hfmmagazine.com\/articles\/2197-kaiser-permanente-opens-first-of-community-health-hubs<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref8\" name=\"_edn8\">[viii]<\/a> Adam Bluestein, \u201cKaiser Permanente Designed a Health Center that Puts Patients First,\u201d Fast Company, March 22, 2016, <a href=\"https:\/\/www.fastcoexist.com\/3057404\/world-changing-ideas\/kaiser-permanente-designed-a-health-center-that-puts-patients-first\">https:\/\/www.fastcoexist.com\/3057404\/world-changing-ideas\/kaiser-permanente-designed-a-health-center-that-puts-patients-first<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref9\" name=\"_edn9\">[ix]<\/a> Ibid.<\/p>\n<p><a href=\"#_ednref10\" name=\"_edn10\">[x]<\/a> Robert Siegel, \u201cWhat If Healthcare Could Start With Technology?\u200a\u2014\u200aBernard Tyson, CEO Kaiser Permanente\u201d, The Industrialists Dilemma, February 12, 2016 <a href=\"https:\/\/medium.com\/the-industrialist-s-dilemma\/what-if-healthcare-could-start-with-technology-bernard-tyson-ceo-kaiser-permanente-5052658a6212#.2gm3yfyms\">https:\/\/medium.com\/the-industrialist-s-dilemma\/what-if-healthcare-could-start-with-technology-bernard-tyson-ceo-kaiser-permanente-5052658a6212#.2gm3yfyms<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref11\" name=\"_edn11\">[xi]<\/a> Ibid.<\/p>\n<p><a href=\"#_ednref12\" name=\"_edn12\">[xii]<\/a> Sam Levin, \u201cThe Trouble with Kaiser&#8217;s Technology,\u201d East Bay Express,\u00a0September 10, 2014, <a href=\"http:\/\/www.eastbayexpress.com\/oakland\/the-trouble-with-kaisers-technology\/Content?oid=4067393\">http:\/\/www.eastbayexpress.com\/oakland\/the-trouble-with-kaisers-technology\/Content?oid=4067393<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Despite being over 70 years old, Kaiser Permanente is leading the digital health transformation.<\/p>\n","protected":false},"author":2530,"featured_media":0,"comment_status":"open","ping_status":"closed","template":"","categories":[2062,729,41,1142,2028],"class_list":["post-19136","hck-submission","type-hck-submission","status-publish","hentry","category-digital-health","category-health-delivery","category-healthcare","category-healthcare-management","category-telemedicine"],"connected_submission_link":"https:\/\/d3.harvard.edu\/platform-rctom\/assignment\/digitization-challenge-2016\/","yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The Dr. Will See You Now\u2026On the Screen - Technology and Operations Management<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/d3.harvard.edu\/platform-rctom\/submission\/the-dr-will-see-you-nowon-the-screen\/\" \/>\n<meta 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