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People using technology to transform care: the 21st century care innovation project.

What is Dr Barton talking about and how is this possible? Dr Barton and many other primary care clinicians across Kaiser Permanente (KP) are part of a pilot project called the 21st Century Care Innovation Project. The purpose of this project is to leverage the use of KP HealthConnectTM (an organizationwide electronic health record system) to transform care and create thriving physician practices. The Health Plan and delivery systems of KP, like the rest of the nation’s health care systems, are facing significant cost pressures from employer groups and the largest single purchaser—Medicare. There is increasing risk of losing customers who can’t afford insurance premiums. Adding pressure to KP’s cost position in the market is its multibillion dollar strategic investment in KP HealthConnect and the need to rebuild aging facilities. For primary care practitioners, the model for delivering care is still based on a production model where patients move through a complex system. The majority of work for physicians and staff revolves around dealing with what is in front of them in the moment. There is little time, room, or incentive for changing work to create flexibility and capacity to meet the growing needs of members. Now more than ever, there is a need to transform care delivery so that health care is more cost effective, convenient, and satisfying for KP members and provides a fulfilling work environment for clinicians and staff. Design In September 2005, the KP Partnership Group (KPPG) chartered the 21st Century Care Innovation Project in collaboration with the Institute for Healthcare Improvement (IHI). The project outcome is to improve patient care delivery by making primary care more patient centered, and simultaneously developing a more fulfilling and sustainable work environment for physicians and staff (Table 1 and Figure 1). This collaboration of KP labor partners and nine innovation teams from five KP regions and Group Health Cooperative focuses on changing the work they do, not just improving efficiency (Table 2). The overall direction for designing a new primary care model was established by leaders from the Permanente Medical Groups and Kaiser Foundation Health Plan and Hospitals and built from the tenets of the Blue Sky vision.