Dr. Ted Eytan of Kaiser on health IT, walking meetings, innovation (transcript)

This is the transcript of my recent podcast interview with Dr. Ted Eytan of Kaiser Permanente.David E. Williams:            This is David Williams, co-founder of MedPharma Partners and author of the Health Business Blog.  I’m speaking today with Dr. Ted Eytan of Kaiser Permanente.  Ted, what’s your role at Kaiser and how did you get there?Dr. Ted Eytan:            I work for the medical groups in a part of the organization called the Permanente Federation.  I’ve been there since 2008. Formerly I worked at Group Health Cooperative in Washington State, where I was a practicing physician and also supported the rollout of their electronic health record and their personal health record.Williams:            What are the main things you’re trying to do in your role?Eytan:            I’m trying to carry out the aspirations of our medical groups, which could be anything from care delivery using technology to communications work that I’ve done with our communications folks in Oakland at Kaiser Permanente, which you’ve probably seen.Williams:            Yes I have.  2011 seems like it’s going to be a big year for your areas. Are particular things that you have on your list that you want to get accomplished?Eytan:            An organization like Kaiser Permanente is in a special situation that I think will help everyone. It has completely implemented its electronic health record and personal health record so in the coming year it will really be about leveraging it to improve the health of our patients and community.Beyond just turning it on and making it work, we will work on things like improving population care and communicating the benefits about how to engage patients and families.  One specific thing that’s happening right now is the KP.org personal health record is being rerolled out in a new format, which you will see happen across the country in 2011.Williams:            Assuming you’re successful, how will life change for a patient and how much of that is IT related compared to other things that are going on?Eytan:            What I’m hoping for in 2011 is that a lot of things will change for a lot of patients outside of Kaiser Permanente because they will experience some of the great things that an electronic health record and personal health record can do for them.  So that’s the big thing: from nothing to something for everyone else.For Kaiser Permanente members it will be much easier to interact using the electronic medical record by engaging your family members in the use of it. Family members will be more easily able to communicate with your doctor and do things like refill prescriptions.  There will be more ease of use and more data available online.Williams:            Talk a little bit about the family element. I’ve heard before about having family members have access but what does that do for a typical patient?Eytan:            It does a ton actually.  One thing that people realize quickly when they deliver these communications to patients is something very healthy, which is that you’re not often just treating the patient.  You’re taking care of the patient and the family or you need to communicate with the family who is actually providing a lot of the care to the patient.So when you develop a personal health record and only give the patient access to it you’re often missing a big portion of the care delivery for that person.  It was learned pretty quickly at Kaiser Permanente to make that access available to parents, and to children of aging parents, so that they could manage a person’s health and have it appropriately tracked and attributed to the right person, which can now be done.Williams:            It’s often older people that have chronic diseases and maybe have more reason to use a personal health record.  What are you seeing for some of the ‘digital natives’ who have grown up with all sorts of electronics and are used to communicating with these different tools?  Are you seeing different usage patterns for the younger group?Eytan:            The good healthy tension is that no matter how much communication is currently provided by a personal health record it’s never enough.  The reality is that health care in the IT space for consumers is way behind other industries in providing these services.When you talk to a person they say I expect this kind of connectivity, I expect my doctor to have electronic health records, I expect everything to be online even to the point of people actually mistakenly believing that their doctor has an electronic health record when they don’t (outside of Kaiser Permanente). It’s causing some challenges because a lot of people don’t think there’s a problem.So in Kaiser Permanente, where there is this connectivity, I think people are saying they want more, which is good.  They say accessing e-mail directly and securely through the web is great, but where’s mobile, where’s text messaging, where’s social media?Williams:            Mobile has caught on in the non-health care world. I know health care lags, but can we expect to see much of mobile in the next year or two?Eytan:            In general I think that we will.  I don’t know exactly what people will see in the coming year but my assumption is that for our physicians, 14,000 of them who have discovered the benefit of taking care of people when they’re not physically in front of them, it’s a natural progression to think about taking advantage of all the mobile things that gives access to more people in more places, more conveniently. That is what we’re all about.Williams:            Just to change the subject a little bit away from IT and health care toward wellness, I know that you’re a big proponent of walking meetings.  What’s that all about?Eytan:            Absolutely, I love walking meetings and now I’m really excited.  About four or five years ago when I was at Group Health, we were given pedometers for the first time to wear around. I had this little transformation and my boss and the people around me did as well, which is why are we spending an hour looking at each other in a room when we could be walking around and discovering our community together?  So we started doing walking meetings.Our offices happened to be about two blocks away from the Space Needle and I purchased a pass so we could actually go up in the Space Needle and have our meeting up there, which was a nice little walk.  So ever since then it’s been my norm that when I meet with a person it’s a walking meeting.I’ve written a post on my blog about how to do it and the benefits of it. Beyond exercise it really brings a new relationship with the person, because when you go somewhere with someone it’s much more personal than just sitting in a room with them. I really enjoy meetings more than I did ever because I’m doing something interesting at the same time I’m talking about something interesting.Williams:            What about those times that you actually need to have a bunch of papers and things in front of you?  Does it still work for that?Eytan:            That is so interesting, because when I was starting people would say we need to sit in front of a computer and discuss this thing.  Well what I’ve actually learned is that the part about sitting in front of a computer is really assisted by organizing your thoughts.  So if you really truly do need to see something that’s online or a piece of paper then what I would do is walk for about 30 minutes and organize our key takeaways and what the problem is that we’re trying to solve. Then when we get in front of the computer or in front of the papers we’ll have a more directed, focused view of what we’re trying to see and it works out just great.  Everything you do in work is better when you can organize it in advance and it’s better to do it with the person right there.Williams:            What if people are just at their desks?  Are there ways you can move around at your desk?Eytan:            Well I posted something on my blog (Starting a walking meeting revolution – Photos and story of a homemade walkstation).  Several colleagues of mine have set up treadmills that are walk stations where they walk two miles an hour all day long.  That’s an option.I don’t smoke but in the old days when people did smoke they took these little smoke breaks, which were actually quite social and ways to clear your head and prepare yourself for what you’re doing.  I actually find taking walking breaks is really helpful, so if I do lunch I actually don’t go somewhere and eat.  I’ll actually just walk somewhere, pick something up and walk back. Or three or four times a day, a ten minute walk around the building is quite healthy and mind clearing.Williams:            You’re  part of a big organization but one that’s also known for innovation. I don’t think of those two things going together, being big and being innovative. Is it unique to Kaiser or is it possible in general to have innovation in a large enterprise?Eytan:            A lot of people think that innovation goes with smaller and lack of innovation goes with bigger.  The reality from my experience is that innovation is about having ideas and execution. At some level you really can’t innovate except in a large organization because only they have the resources to actually change the way things are done.You can definitely generate smaller ideas and make smaller things happen in small organizations but making it happen can be quite facilitative in a large organization.  I don’t mean to say that one is more likely to happen than the other. It’s all about the way things are structured and prioritized.  I absolutely think it can be done in a large organization.Kaiser Permanente is an example of one.  We’re probably not the only one.Williams:            It sounds like you have a pretty exciting job in an interesting place that a lot of people are focused on right at the moment.  What would you say is the one thing that you like best about what you do?Eytan:            What I like best is the values and the kind of health care that is practiced here, which is really about providing value and tools to patients to achieve their life goals.  It’s really not about making sure that we do a lot of procedures or have a lot of patient visits.  It’s really thinking always about how we make it so that the person is productive or they enjoy their family life or they can travel. It is amazing that every conversation I’m in as part of this organization is always going to that place.  That’s the best part.Williams:            I’ve been speaking today with Dr. Ted Eytan of Kaiser Permanente.  Ted, thanks so much.Eytan:            Thank you very much.