What is innovation? In a very real sense, it is the heartbeat of Kaiser Permanente. As a short video put it at a recent Innovation 4.0 Retreat that I was privileged to attend, “It’s in our DNA.”
But if you want to know the definition, “innovation” is summed up in a few seconds by Dr. Morris F. Collen, on the job at Kaiser Permanente since 1942. Yes, that’s right, 1942. He still comes to the Division of Research he founded in Oakland, California a couple days a week.
“Innovation, to me,” says this pioneer physician who helped create the field of Medical Informatics, “means new developments that create change of sufficient importance to alter and even disrupt the practices and procedures that they’re designed to change.”
Want a quick tutorial on innovation at Kaiser Permanente? Take at look at the short video Innovation at Kaiser Permanente to learn more.
by Bryan Culp
I recently attended a reception to celebrate the opening of the new Kaiser Foundation Research Center (KFRC) Hospital in Vallejo, California. This hospital is Kaiser Permanente’s National Center of Excellence for people with disabilities, and it offers unique care to patients recovering from trauma, stroke, neuromuscular and orthopedic diseases.
“Many will rise and walk,” I remembered as I entered the new therapeutic gym, which is the at the heart of this facility because every new patient aspires first to return to mobility. The memorable phrase, evocative of miracle stories, was the title given to an article penned by science writer Paul de Kruif, who described for readers of Reader’s Digest in 1946 Dr. Herman Kabat’s experimental treatments for the disabling effects of polio. Kabat offered a glimmer of hope to many afflicted with polio and neuromuscular diseases, Henry Kaiser, Jr., being one of them.
I walked from the gym into the open air of the roof-top terrace where patients on the path to mobility learn the pavement surfaces, curbs and cutouts a pedestrian encounters in daily routines. I admired the recently installed, vintage 1953 Kaiser Manhattan in which patients learn how to transfer from a wheelchair to a car and how to maneuver in the confined space of an automobile.
For years the hospital had used a nondescript Chevrolet for this purpose. But when the new hospital was in the design phase, the planners consulted with Heritage Resources with the idea to build-in to the new facility signature artifacts. The Kaiser Manhattan was an ideal choice for a transfer vehicle. The center’s therapists knew its heft and spaciousness offered real advantages, and true to history, the marquee had once served in this capacity in the hospital’s founding era. This particular example, with 76,000 miles on the odometer, was located in Arizona bearing a California heritage plate that read, “Henry.” After battery and oil were removed for safety, and adjustable seats were installed to aid patient training, the car was lifted into place on the roof terrace.
I can say confidently, having seen this new hospital close-up, that the mirror-like chrome on the magnificent Manhattan reflects more than past glory. It reflects this stunning and entirely new facility that speaks to every patient, past and present, in so many words saying: “We believe in you!”
By Tom Debley
Harvard Business School Professor Clayton Christensen has taken to the pages of Business Week magazine to argue we would better off with health care systems in which doctors and insurers are on the same side of the ledger as the patient. That would be a system such as Kaiser Permanente. So what is the difference between his position and that of Sidney R. Garfield, the physician co-founder of Kaiser Permanente? Well, 65 years.
Professor Christensen, an expert on the topic of disruptive innovation, says that to do otherwise means “we’re guilty of business model malpractice on a grand scale.” As the headline on Christensen’s article put it, “The way to cut costs is to put care and insurance in the same bed.”
Garfield, talking about what he called his “new economy of medicine,” responded to the belief expressed a day earlier by another physician who claimed the most expensive thing in a hospital was an empty bed.
“He wasn’t referring to our hospital,” Garfield told his Portland, Oregon, audience, referring to the first Kaiser Permanente hospital in the Pacific Northwest, built during World War II in Vancouver, Washington.
“The most expensive thing in our hospital is a filled hospital bed,” Garfield added. “This new economy is geared to the preventive medicine of the future. It puts the patient, the doctor, the hospital, the employer and the insurance company all on the same side of the ledger. They all benefit by the patient remaining well.”
Garfield was a disruptive innovator long before the modern term was coined by Professor Christensen in 1995. As Garfield once said, “We are talking about changes – and changes are irritating and disturbing, but being disturbed is essential to progress.” (See my earlier blog, “Disruptive Innovation” at the Core of Kaiser Permanente History.)
Argues Christensen today, integrated delivery systems, including Kaiser Permanente, “can provide better care at 20 to 30 percent lower cost. Clearly, systemic problems require systemic solutions.”
If Dr. Garfield was 65 years ahead of the curve on that one, consider that it was 50 years ago this spring that he first argued that the computer should become the center of medical care delivery. Last week, on March 3, he would have been smiling as Kaiser Permanente announced that every medical facility within its health system — 431 medical offices and 36 hospitals — is now equipped with Kaiser Permanente Health Connect®, the largest private sector electronic health record in the world.
We’ll have more to say about Dr. Garfield and the computer on the 50th anniversary of his first talk on that topic in May.
Tom Debley is director of Kaiser Permanente’s Heritage Resources program and author of “The Story of Dr. Sidney R. Garfield: The Visionary Who Turned Sick Care into Health Care,” available directly from the publisher, The Permanente Press, as well as from Amazon.com both in paperback and on Kindle.