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Community Medicine • Total Health
Penn State College of Medicine | AMSA • FMIG
February 13, 2013
Ted Eytan, MD MS MPH • The Permanente Federation • twitter: tedeytan

 © 2013 The Permanente Federation, LLC

 Photograph: Ted Eytan, MD, http://www.flickr.com/photos/22526649@N03/8463718666
Tweed Ride | Washington, DC, November, 2012
Photograph: Ted Eytan, MD, http://www.flickr.com/photos/taedc/8155481030/
© 2013 The Permanente Federation, LLC
Community Medicine • Total Health
Penn State College of Medicine | AMSA • FMIG
February 13, 2013
Ted Eytan, MD MS MPH • The Permanente Federation • twitter: tedeytan

 © 2013 The Permanente Federation, LLC
Why Total Health? Why not?


A state of complete
physical, mental and
social well-being for
individuals, families,
communities, society.                   Leonora Brogan - Kaiser Permanente Center for Total Health

                                                 http://kp.org/centerfortotalhealth




© 2013 The Permanente Federation, LLC
Welcome to
The Kaiser Permanente Center for Total Health
             kp.org/centerfortotalhealth
Operations & Innovation


                         interactive displays   exam room




                       walking wall                         telepresence




12 February 13, 2013
The last time you had a health issue, did you get
 information, care, or support from….?
                     Doctor/Health Professional                                                                         Non-clinician source

                                                                                                                                          All patients


      60%                        32%                                                                        30%
                                                                            70%
                          8%

                                      2002

                                                                                                                                2011
Sources: Fox S, Fallows D. Internet Health Resources: Health searches and email have become more commonplace, but there is room for improvement
in searches and overall Internet access. Washington, DC; 2003:27. Available at: http://www.pewinternet.org/Reports/2003/Internet-Health-
Resources.aspx; Fox S. The Social Life of Health Information, 2011. Washington, DC; 2011. Available at: http://www.pewinternet.com/Reports/2011/
Social-Life-of-Health-Info.aspx
    © 2013 The Permanente Federation, LLC | Slide produced by Ted Eytan, MD • @tedeytan
The last time you had a health issue, did you get
   information, care, or support from….?
                       Doctor/Health Professional                                                                                Non-clinician source

                                                                                  All patients



                                   32%                                                                                       70%                              30%
         60%                                               70%                          30%

                            8%

                                        2002                                                  2011


                                                                                                                                                                2012
Sources: Fox S, Fallows D. Internet Health Resources: Health searches and email have become more commonplace, but there is room for improvement in
searches and overall Internet access. Washington, DC; 2003:27. Available at: http://www.pewinternet.org/Reports/2003/Internet-Health-Resources.aspx; Fox
S. The Social Life of Health Information, 2011. Washington, DC; 2011. Available at: http://www.pewinternet.com/Reports/2011/Social-Life-of-Health-Info.aspx
Fox S, Duggan M. Health Online 2013. Washington, DC; 2013. Available at: http://www.pewinternet.org/Reports/2013/Health-online.aspx
      © 2013 The Permanente Federation, LLC | Slide produced by Ted Eytan, MD • @tedeytan
4 million members connected, via kp.org
                                                                     5,000,000 members


                                                                   In the 3rd Quarter 2012
                                                                   3.3 million emails
                                                                   8 million test results reviewed
                                                                     2,500,000 members
                                                                   2.4 million appointments made
                                                                   34 % signed on 5 or more times




20032005 2007
              2009
Source: Kaiser Permanente Web Analytics, updated 12/18/2012
                                                              2012 (3Q)
    © 2013 The Permanente Federation, LLC
4 million members connected, via kp.org

                                                              5,000,000 members

                                                                                  In the 3rd Quarter 2012
                                                                                  3.3 million emails
                                                              2,500,000 members   8 million test results reviewed
                                                                                  2.4 million appointments made
                                                                                  34 % signed on 5 or more times
     20032005
              2007                      2009
                                                      2012 (3Q)




Source: Kaiser Permanente Web Analytics, updated 12/18/2012
    © 2013 The Permanente Federation, LLC
More : The relationship
 § Nine million Kaiser Permanente
    members have 24/7 access to their
    medical information anywhere in the
    world from their mobile devices
 § Patients can
         – email their providers
         – check lab test results
         – order prescription refills
         – manage appointments




  © 2013 The Permanente Federation, LLC
Health doesn’t happen here




 © 2013 The Permanente Federation, LLC
It happens here
It happens here




Photo: M.V. Jantzen - http://www.flickr.com/photos/mvjantzen/8464490630/
It happens here




La Mesa Medical Offices, California   Photograph: Ted Eytan, MD, http://www.flickr.com/photos/taedc/8382776635/
What about Family Medicine? What are we?

§ More concerned with people than things
§ View things holistically rather than as elements or parts
§ More of a pathfinder than a traditionalist
§ See medicine as a means to helping others, and by instinctive action makes others aware of
   her/his* service orientation
§ Views her/himself more as an “artist” in dealing with others and their problems – a healer
   rather than a “scientist” dealing with disease processes or malfunctioning organs, though s/he
   has great respect for the values of science. However, s/he sees it as a means to an end rather
   than an end in itself
§ More concerned with their community as a whole than many of her/his colleagues because, to
   them, the community is the extension of their patient-family units and, in a sense, a
   “laboratory”. Also, because s/he is concerned with people and humanity, s/he is concerned
   with the success of the human organization
       – Reference: Wilson V. Specialist in family practice--prototype of a doctor. GP. 1969;40(2):151–7. Available at: http://www.ncbi.nlm.nih.gov/
         pubmed/5798063 [Accessed January 5, 2013]. - *Adjusted for gender neutrality by Ted Eytan, MD




© 2013 The Permanente Federation, LLC
kp.org/thrive
© 2012 The Permanente Federation, LLC

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Community Medicine • Total Health

  • 1. Community Medicine • Total Health Penn State College of Medicine | AMSA • FMIG February 13, 2013 Ted Eytan, MD MS MPH • The Permanente Federation • twitter: tedeytan © 2013 The Permanente Federation, LLC Photograph: Ted Eytan, MD, http://www.flickr.com/photos/22526649@N03/8463718666
  • 2. Tweed Ride | Washington, DC, November, 2012 Photograph: Ted Eytan, MD, http://www.flickr.com/photos/taedc/8155481030/ © 2013 The Permanente Federation, LLC
  • 3. Community Medicine • Total Health Penn State College of Medicine | AMSA • FMIG February 13, 2013 Ted Eytan, MD MS MPH • The Permanente Federation • twitter: tedeytan © 2013 The Permanente Federation, LLC
  • 4. Why Total Health? Why not? A state of complete physical, mental and social well-being for individuals, families, communities, society. Leonora Brogan - Kaiser Permanente Center for Total Health http://kp.org/centerfortotalhealth © 2013 The Permanente Federation, LLC
  • 5. Welcome to The Kaiser Permanente Center for Total Health kp.org/centerfortotalhealth
  • 6. Operations & Innovation interactive displays exam room walking wall telepresence 12 February 13, 2013
  • 7. The last time you had a health issue, did you get information, care, or support from….? Doctor/Health Professional Non-clinician source All patients 60% 32% 30% 70% 8% 2002 2011 Sources: Fox S, Fallows D. Internet Health Resources: Health searches and email have become more commonplace, but there is room for improvement in searches and overall Internet access. Washington, DC; 2003:27. Available at: http://www.pewinternet.org/Reports/2003/Internet-Health- Resources.aspx; Fox S. The Social Life of Health Information, 2011. Washington, DC; 2011. Available at: http://www.pewinternet.com/Reports/2011/ Social-Life-of-Health-Info.aspx © 2013 The Permanente Federation, LLC | Slide produced by Ted Eytan, MD • @tedeytan
  • 8. The last time you had a health issue, did you get information, care, or support from….? Doctor/Health Professional Non-clinician source All patients 32% 70% 30% 60% 70% 30% 8% 2002 2011 2012 Sources: Fox S, Fallows D. Internet Health Resources: Health searches and email have become more commonplace, but there is room for improvement in searches and overall Internet access. Washington, DC; 2003:27. Available at: http://www.pewinternet.org/Reports/2003/Internet-Health-Resources.aspx; Fox S. The Social Life of Health Information, 2011. Washington, DC; 2011. Available at: http://www.pewinternet.com/Reports/2011/Social-Life-of-Health-Info.aspx Fox S, Duggan M. Health Online 2013. Washington, DC; 2013. Available at: http://www.pewinternet.org/Reports/2013/Health-online.aspx © 2013 The Permanente Federation, LLC | Slide produced by Ted Eytan, MD • @tedeytan
  • 9. 4 million members connected, via kp.org 5,000,000 members In the 3rd Quarter 2012 3.3 million emails 8 million test results reviewed 2,500,000 members 2.4 million appointments made 34 % signed on 5 or more times 20032005 2007 2009 Source: Kaiser Permanente Web Analytics, updated 12/18/2012 2012 (3Q) © 2013 The Permanente Federation, LLC
  • 10. 4 million members connected, via kp.org 5,000,000 members In the 3rd Quarter 2012 3.3 million emails 2,500,000 members 8 million test results reviewed 2.4 million appointments made 34 % signed on 5 or more times 20032005 2007 2009 2012 (3Q) Source: Kaiser Permanente Web Analytics, updated 12/18/2012 © 2013 The Permanente Federation, LLC
  • 11. More : The relationship § Nine million Kaiser Permanente members have 24/7 access to their medical information anywhere in the world from their mobile devices § Patients can – email their providers – check lab test results – order prescription refills – manage appointments © 2013 The Permanente Federation, LLC
  • 12. Health doesn’t happen here © 2013 The Permanente Federation, LLC
  • 14. It happens here Photo: M.V. Jantzen - http://www.flickr.com/photos/mvjantzen/8464490630/
  • 15. It happens here La Mesa Medical Offices, California Photograph: Ted Eytan, MD, http://www.flickr.com/photos/taedc/8382776635/
  • 16. What about Family Medicine? What are we? § More concerned with people than things § View things holistically rather than as elements or parts § More of a pathfinder than a traditionalist § See medicine as a means to helping others, and by instinctive action makes others aware of her/his* service orientation § Views her/himself more as an “artist” in dealing with others and their problems – a healer rather than a “scientist” dealing with disease processes or malfunctioning organs, though s/he has great respect for the values of science. However, s/he sees it as a means to an end rather than an end in itself § More concerned with their community as a whole than many of her/his colleagues because, to them, the community is the extension of their patient-family units and, in a sense, a “laboratory”. Also, because s/he is concerned with people and humanity, s/he is concerned with the success of the human organization – Reference: Wilson V. Specialist in family practice--prototype of a doctor. GP. 1969;40(2):151–7. Available at: http://www.ncbi.nlm.nih.gov/ pubmed/5798063 [Accessed January 5, 2013]. - *Adjusted for gender neutrality by Ted Eytan, MD © 2013 The Permanente Federation, LLC
  • 17. kp.org/thrive © 2012 The Permanente Federation, LLC