The Experts below are selected from a list of 18270 Experts worldwide ranked by ideXlab platform
Michael H Kanter - One of the best experts on this subject based on the ideXlab platform.
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Kaiser Permanente creatinine safety program a mechanism to ensure widespread detection and care for chronic kidney disease
The American Journal of Medicine, 2015Co-Authors: John J Sim, Steven J Jacobsen, Mark P. Rutkowski, David C Selevan, Michael Batech, Royann Timmins, Jeff Slezak, Michael H KanterAbstract:Abstract Background Chronic kidney disease is highly prevalent but is challenging to diagnose because of the need to establish chronicity. Within the current healthcare environment, a single abnormal creatinine measurement often can go without a follow-up, which can lead to missed diagnoses or diagnostic errors. The Kaiser Permanente Southern California creatinine safety program (the Creatinine SureNet) was created to help ensure that all single abnormal creatinine results had a follow-up evaluation. Methods In the period February 1, 2010, to March 1, 2014, the electronic health records were used to capture individuals with single abnormal creatinine results that went >90 days without a repeat measurement. A coordinated effort among a centralized regional nurse and providers was used to communicate with patients and order a repeat creatinine measurement. Results A total of 12,396 individuals were identified (84% ambulatory care encounters). A total of 6981 individuals (52%) followed up with a repeat measurement. Female patients, non-Hispanic whites, and older individuals were more likely to obtain a repeat measurement. Subsequently, 3668 individuals had chronic kidney disease confirmed. Within 6 months, 1550 patients had chart documentation of their chronic kidney disease and 336 patients had a nephrology consultation. Conclusions The ambulatory care environment, given its high volume and various prioritizations, is an under-recognized area where diagnostic errors are not uncommon and failure to follow up on abnormal test results can occur routinely. The Kaiser Permanente Southern California Creatinine SureNet program leverages the electronic health records and its multidisciplinary resources in an effort to ensure that patients with potential chronic kidney disease are identified and managed properly.
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systemic implementation strategies to improve hypertension the Kaiser Permanente southern california experience
Canadian Journal of Cardiology, 2014Co-Authors: John J Sim, Joel Handler, Steven J Jacobsen, Michael H KanterAbstract:The past decade has seen hypertension improving in the United States where control is approximately 50%. Kaiser Permanente has mirrored and exceeded these national advances in control. Integrated models of care such as Kaiser Permanente and the Veterans Administration health systems have demonstrated the greatest hypertension outcomes. We detail the story of Kaiser Permanente Southern California (KPSC) to illustrate the success that can be achieved with an integrated health system model that uses implementation, dissemination, and performance feedback approaches to chronic disease care. KPSC, with a large ethnically diverse population of more than 3.6 million, has used a stepwise approach to achieve control rates greater than 85% in those recognized with hypertension. This was accomplished through systemic implementations of specific strategies: (1) capturing hypertensive members into a hypertension registry; (2) standardization of blood pressure measurements; (3) drafting and disseminating an internal treatment algorithm that is evidence-based and is advocating of combination therapy; and (4) a multidisciplinary approach using medical assistants, nurses, and pharmacists as key stakeholders. The infrastructure, support, and involvement across all levels of the health system with rapid and continuous performance feedback have been pivotal in ensuring the follow-through and maintenance of these strategies. The KPSC hypertension program is continually evolving in these areas. With these high control rates and established infrastructure, they are positioned to take on different innovations and study models. Such potential projects are drafting strategies on resistant hypertension or addressing the concerns about overtreatment of hypertension.
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complete care at Kaiser Permanente transforming chronic and preventive care
The Joint Commission Journal on Quality and Patient Safety, 2013Co-Authors: Michael H Kanter, Jim Bellows, Gail Lindsay, Alide ChaseAbstract:Article-at-a-Glance Background In 2004 Kaiser Permanente Southern California (KPSC) recognized the potential to improve the quality of care. Healthcare Effectiveness Data and Information Set (HEDIS) performance was below what regional leadership aspired to achieve, exceeding the 90th national percentile on only 15 of 34 measures. Beginning in 2005 regional leadership identified several system opportunities to enhance evidence-based, person-focused care. Development of Complete Care KPSC developed and implemented a comprehensive delivery system redesign and expanded and integrated existing clinical information systems, decision support, work flows, and self-management support—collectively referred to as Complete Care. The goal of Complete Care is to transform care for healthy members, those with chronic conditions, and those with multiple comorbidities. To date, KPSC has applied Complete Care to 26 chronic conditions and areas of preventive and wellness care. Implemented in all care settings and optimizing the roles of all health care team members to maximal scope of practice, Complete Care provides evidence-based, person-focused care addressing a large set of protocol-based health needs for every individual during every encounter within the health care system. Results On 51 HEDIS metrics, KPSC improvement using Complete Care averaged 13.0%, compared with 5.5% improvement in the national HEDIS 50th percentile. Conclusion Implementation of Complete Care at KPSC was followed by six-year quality gains that outpaced changes in the HEDIS national percentiles for many measures. Additional care gaps have been included in proactive office encounter checklists; these relate to elder care, advance directives, posthospital care, immunizations, health maintenance, and pregnancy care.
Keren Stronach - One of the best experts on this subject based on the ideXlab platform.
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The Pathways Study: a prospective study of breast cancer survivorship within Kaiser Permanente Northern California.
Cancer causes & control : CCC, 2008Co-Authors: Marilyn L. Kwan, Christine B. Ambrosone, Marion M. Lee, Janice Barlow, Sarah E. Krathwohl, Isaac J. Ergas, Christine H. Ashley, Julie R. Bittner, Jeanne Darbinian, Keren StronachAbstract:Objective With 2.3 million breast cancer survivors in the US today, identification of modifiable factors associated with breast cancer recurrence and survival is increasingly important. Only recently new studies have been designed to examine the impact of lifestyle factors on prognosis, including Pathways, a prospective study of women with breast cancer in Kaiser Permanente Northern California (KPNC).
Natalie Aboubechara - One of the best experts on this subject based on the ideXlab platform.
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Process-Based Treatment of Diabetes in Kaiser Permanente Southern California: How to Make Diabetes Care "Complete".
Current diabetes reports, 2017Co-Authors: John P. Martin, Natalie AboubecharaAbstract:Purpose of Review The purpose of this review was to provide an overview of the Kaiser Permanente Southern California (KPSC) Complete Care management strategy.
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Process-Based Treatment of Diabetes in Kaiser Permanente Southern California: How to Make Diabetes Care “Complete”
Current Diabetes Reports, 2017Co-Authors: John P. Martin, Natalie AboubecharaAbstract:Purpose of Review The purpose of this review was to provide an overview of the Kaiser Permanente Southern California (KPSC) Complete Care management strategy. Recent Findings The KPSC Complete Care program allows members of care management teams to coordinate the administration of care for patients with diabetes. Summary This program encompasses teams of physicians, physician assistants, pharmacists, nurse practitioners, registered nurse (RN) care managers, office-based RNs, health educators, and many others to contribute to the glycemic and overall health outcomes for our patients with diabetes. The 2016 Kaiser Permanente National Clinical Practice Guideline for Adult Diabetes Clinician Guide and the supplemental KPSC Treat-to-Target (TTT) Type 2 Diabetes A1c Control algorithm are used to assist KPSC clinicians by providing guidance for shared decision-making, as well as the selection and sequence of appropriate pharmacological treatment. Collaboration with pharmacy through the Formulary and the Drug Utilization Action Team (DUAT) allows the organization to manage member resources while consistently offering patients the highest quality and value health care possible. Recent technology integrations have also contributed to the success of the program.
Henry R. Shinefield - One of the best experts on this subject based on the ideXlab platform.
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assessing costs and cost effectiveness of pneumococcal disease and vaccination within Kaiser Permanente
Vaccine, 2000Co-Authors: Steven Black, Tracy A Lieu, Thomas G Ray, Angela M Capra, Henry R. ShinefieldAbstract:Objective: To review studies of the costs of pneumococcal disease and the cost effectiveness of pneumococcal conjugate vaccination conducted in association with the Kaiser Permanente Pneumococcal conjugate Efficacy Trial. Results: for each birth cohort of 3.8 million infants, routine pneumococcal conjugate vaccination program for healthy infants would prevent more than 12 000 (78% of potential) meningitis and bacteremia cases, 53 000 (69% of potential) pneumonia cases, and 1 million (8% of potential) otitis media episodes. Before accounting for vaccine costs, the vaccination program would reduce the costs of pneumococcal disease by $342 million in medical and $415 million in work-loss and other costs. Vaccination of healthy infants would result in net savings for society if the vaccine cost less than $46 per dose, and net savings for the health care payer if the vaccine cost less than $18 per dose.
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Efficacy of Heptavalent Conjugate Pneumococcal Vaccine (Wyeth Lederle) in 7,000 Infants and Children: Results of the Northern California Kaiser Permanente Efficacy Trial
Pediatric Research, 1999Co-Authors: Steven Black, Bruce Fireman, Henry R. Shinefield, Paula Ray, Edwin Lewis, Robert Austrian, George Rainer Siber, Jill Hackell, Robert Kohberger, Ih ChangAbstract:Efficacy of Heptavalent Conjugate Pneumococcal Vaccine (Wyeth Lederle) in 7,000 Infants and Children: Results of the Northern California Kaiser Permanente Efficacy Trial
Saro H Armenian - One of the best experts on this subject based on the ideXlab platform.
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cardiovascular disease risk profiles in survivors of adolescent and young adult aya cancer the Kaiser Permanente aya cancer survivors study
Journal of Clinical Oncology, 2016Co-Authors: Chun Chao, Smita Bhatia, Robert Cooper, Somjot Brar, Lennie F Wong, Saro H ArmenianAbstract:PurposeTo describe the epidemiology and risk factors for cardiovascular disease (CVD) in survivors of adolescent and young adult (AYA) cancer.MethodsWe identified a retrospective cohort of 2-year survivors of AYA cancer who were diagnosed between the ages of 15 to 39 years (1998 to 2009) at Kaiser Permanente Southern California. A comparison group without cancer was selected and matched 10:1 to cancer survivors on the basis of age, sex, Kaiser Permanente Southern California membership, and calendar year. Patients were followed through December 31, 2012, for coronary artery disease, heart failure, and stroke. Time-dependent Poisson regression was used to evaluate the effect that cancer survivorship had on the risk of developing CVD, adjusted for cardiovascular risk factors (CVRFs; ie, diabetes, hypertension, and dyslipidemia), ethnicity, smoking, and overweight/obesity. Among cancer survivors, mortality risk by CVD status was examined using Cox regression.ResultsA total of 5,673 2-year survivors of AYA can...