LEADERSHIP CORNER
Kaiser president calls organization 'good place to grow'
Interviewed by David Butts
Advertiser Staff Writer
Janice Head
Title: President
Company: Kaiser Permanente Hawaii
Age: 51
College: University of Colorado, Northern Illinois University
Breakthrough job: Joining Kaiser Permanente in 1996
• • •
Q. Why did you leave California, where you were vice president for a Kaiser service area with 700,000 members, for Hawai'i where there are only 233,000 people served by Kaiser?
A. The regional presidents within Kaiser Permanente are a distinguished body, and being a part of that group and part of the decision making at that level of the company was a real opportunity. In California, I reported to a regional president. Now, to sit shoulder to shoulder with my former boss around the regional president's table, it's a really neat experience to be at that level of the company.
Here, I have responsibility for everything. I have to know every piece of the business.
Q. Has the glass ceiling been a real experience for you?
A. It has been a real experience, but not in Kaiser Permanente. I've found this organization to be very supportive of talent regardless of what it is packaged in. If you have skills and are willing to work hard and contribute to the organization, it's a very good place to grow. The majority of the regional presidents are women. We have seven regions, and five of them are (headed by) women.
At Intermountain Health Care (in Salt Lake City, where Head worked for 11 years before joining Kaiser), it was harder. There were very few women in the top level of the organization.
I joined Kaiser Permanente as a nursing leader, a position that is traditionally held by a nurse. So, in seven years (I) went from there to a regional president.
Q. What is the top focus for you at Kaiser?
A. Managing our cost structure to keep our insurance affordable. It's maintaining affordability in the marketplace. You (also) have to maintain the quality of care. If you don't do that, it doesn't matter whether you are affordable or not. That's the first hurdle. Then there are all the challenges of the escalating cost of technology, of pharmaceuticals, of all the infrastructure that we have to have because of legislative mandates; and the complexities of meeting all the regulatory requirements of running a healthcare business creates part of the cost that we have to learn to deal with.
Nobody is lowering their prices these days, and everything is getting more expensive. The consumer wants the best there is. If the latest technology is available, that's what folks want to have.
Q. What can you do to keep prices low?
A. We are going to spend tens of millions of dollars over the next several years on a new automated, electronic medical record, which will tie together all of the healthcare information for an individual. It will increase efficiencies because lab work done at one clinic will be immediately available if that patient shows up in the emergency room 24 hours later, and we won't have to repeat the test. By having a full history that is immediately accessible no matter where the patient appears in our system, (that) saves costs in having to have X-ray couriers bring old charts and transport things, and (costs in) not having all the data available so a physician repeats tests or brings in additional consultants because they don't have all the history they need.
It will also allow members much more flexible access to physicians (through channels) like electronic visits, e-mail communication with providers, being able to access their own medical records online to look up (such things as) "When was I supposed to get that tetanus shot?" or "When were the kids due for an immunization?"
Q. Haven't the technology improvements been a long time coming?
A. Healthcare is nowhere caught up with the type of technology that's been used everywhere else. You can go to Japan and get money out of a machine on the wall with a card that you take with you.
Q. Why is the medical field so far behind?
A. We haven't been regulated like the banks have. Every insurance company has its own system of creating a medical record number for you. Whereas in banking those account numbers are all standardized. Healthcare has never done that. ...
Until HIPAA (Health Insurance Portability and Accountability Act passed in 1996) there were no regulations of how any of this was processed or coded. It is all these separated systems, and people just used whatever they like. Now HIPAA is going to bring a little more consistency for at least some of the insurance elements.
Q. When are we going to have a card with our health records that we carry with us?
A. Actually HIPAA is going to help with that a lot. As much as we grouse about the cost of implementing all of the elements of HIPAA, it really is going to bring healthcare onto a more standardized format and make data much more portable and interchangeable.
Q. What does the future hold for a consumer?
A. In the future, you wake up in the middle of the night with heartburn that has been bothering you for weeks. Go to your computer, sign onto our Web site, make an appointment for the next morning with our physician, or just e-mail a note saying, "This is what I am experiencing, could you mail in a prescription?" In the morning, you check back for messages which say, "We called something in to your pharmacy," or "The doctor wants to see you. Please make an appointment."
When you get there, the office knows what your complaint is, what your co-payment needs to be, whether you have any outstanding health maintenance issues that you need to follow up on. ...
All the information at the initial encounter at the reception desk follows to the computer screen which the nurse opens. There is also a tracking mechanism that gives immediate access to all previous medical records and then keeps all the information from that visit.
Let's say symptoms get worse and it's the middle of the night, (so) you call the advice nurse. The advice nurse will have access to all information collected in previous visits and will determine whether you need to see a physician in the morning or try some home remedies, or that you need to go to the emergency room.
Q. When do you expect this to happen at Kaiser?
A. We want to be fully implemented in Hawai'i in three years. We are going to start implementation in January.
Q. You increased rates by 9 percent this year. This scares employers. Is there an end in sight to the increase in costs?
A. No, I don't know where this is going to lead us. It feels to me that there is going to have to be some fundamental change in the way we look at healthcare and who shares in that responsibility. Right now the employers are bearing the brunt of that expense. What you see happening in other places is a greater sharing of the healthcare expense. The consumer is bearing more of that through co-insurance, where you pay 20 percent of a visit, or higher co-pays.
