Over the last decade or two, Kaiser Permanente has done such a good job at managing coronary artery disease (CAD) that it is no longer the number-one cause of mortality for Kaiser members. Last week, a number of media covered a Kaiser CAD management success story that was presented at an Alliance for Health Reform forum in Washington, DC.

This particular intervention, the Collaborative Cardiac Care Service (CCCS), is a multidisciplinary approach developed by KP’s Colorado region and summarized in an article in Summer 2008’s The Permanente Journal. It achieved dramatic improvements in care management, including:

• Improved cholesterol screening (increasing from 55% to 96%)
• Improved LDL control to <100 mg/dL (jumping from 22% to 77%)
• Reduction in all-cause mortality associated with CAD by 76%
• High patient and physician satisfaction

The CCCS intervention was extensive, involved a wide range of clinicians, and integrated existing chronic care management strategies with its new HealthConnect electronic infrastructure. What is also clear is that it relied on a wide range of information therapy (Ix) principles and strategies.

• CCCS made considerable use of information triggers to determine which Kaiser members to target, the particular information needs of each member, and when to prescribe the Ix.
• Critical components of CCCS involved the timely prescription of evidence-based information to Kaiser members — everything from smoking cessation to medication adherence and from testing reminders to diet & exercise education.
• CCCS also integrated different forms of Ix — many data elements collected through HealthConnect produced system-triggered information prescriptions, but they also had clinician-prescribed Ix from physicians, nurses, pharmacists, and counseling/educator experts. (I’m not sure whether the intervention specifically included consumer-prescribed Ix as well — e.g., information prescribing from other members in peer groups such as in group visits, social networks, etc.)

Ix interventions like this likely will not only improve care quality and reduce costs, but will lead to engaged and empowered consumers, like the Kaiser member described in the recent Wall Street Journal article on Ix.

This entry was posted on Tuesday, March 31st, 2009 at 9:21 am and is filed under Chronic Care Management, Ix Strategies, Research. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.