Innovation in the Kaiser Permanente Colorado Region: Where We've Been, Where We Are Going.

Across the Kaiser Permanente(KP) Colorado Region, innovativegroups manage patient care visitsdifferently: At the Baseline MedicalOffice, a physician assistant man-ages patients with multiple co-mor-bidities using population registries.At the Hidden Lake Medical Office,diabetic patients are seen inmultistation group visits. At the Au-rora Centrepoint Office, a team usesmultistation group visits to care forthe elderly. Another group in thisoffice is utilizing different visit types(Internet, group, RN, mid-level, etc)to manage patient demand streamin a joint effort with the call center.At the Complementary MedicineCenter, mind-body medicine tech-niques are utilized with selectedpatients with chronic conditions. Allof these teams are attempting tostreamline care, improve quality andservice, and impact affordability. Allare receiving support from the In-novation Support Team in Colorado.Why an InnovationSupport Team? Why now?A “perfect storm” looms: 46 millionuninsured A mericans, steadily risinghealth care costs, and the baby boomgeneration approaching retirement.In 2004, Jack Cochran, MD, Execu-tive Medical Director of the ColoradoPermanente Medical Group, andChris Binkley, then President of Kai-ser Foundation Health Plan of Colo-rado issued a charge: address thecrisis of affordability through thevehicle of innovation. An infra-structure was developed to “helpcultivate the spirit of innovationso that anyone in our organiza-tion can effect change that willlead to improved care, memberloyalty, and affordability.” As partof this infrastructure, KP Coloradodeveloped a Knowledge Manage-ment Team (“K-Team”) (Table 1)and an Innovation Support Team (“I-Team”) (Table 2).Innovation isn’t new in the KPColorado Region. As in other re-gions, KP Colorado is innovating inpatient care; however, the effortshave been random and “on themargins” of the day-to-day exigen-cies of patient care in an expensive,traditional, inefficient, “one-clinicianone-exam room one-patient one-appointment” model. Many in KPColorado have been reluctant to trynew ways of care delivery for fearof failure. Even when successful,new ideas were seldom dissemi-nated, resulting in duplicating effortsand mistakes in implementation.K-TeamKnowledge Management is a sig-nificant aspect of innovation. InColorado, there is an importantIntranet-based communication hub:“kpcolorado.net”; decision-supportcapabilities of HealthConnect; andresources available on the KP Clini-cal Library. However, computer-based archives alone are insuffi-cient for spreading knowledge. Thecharge of K-Team is to link organi-zational “creators” and “dissemina-tors” of knowledge, and build oncentral repositories to facilitate“just-in-time” knowledge sharing sothat individuals in the organizationcan connect with each other to