Kaiser Permanente: The Future of Virtual Medicine is Here

When the COVID-19 pandemic set in and men and women around the world desperately needed care and information, there was no time to lose. Fortunately, members of Kaiser Permanente in Southern California were set with immediate access to top quality virtual medical care. Kaiser Permanente’s Virtual Medical Center (VMC) in So Cal was already up and running – ready to treat patients online in the midst of an unprecedented pandemic.

As a result of early preparedness, nearly 90% of Kaiser Permanente’s services – including COVID-19 treatment – were able to go online immediately when the crisis began.

What was it like to be on the cutting edge of virtual medical delivery, while at the same time on serving thousands of patients during the early, anxious days of the pandemic? Labor 411 spoke to Dr. Khang A. Nguyen, Director of the Virtual Medical Center – about some of the VMC forward-looking features and about life on the medical front lines during the pandemic. Dr. Nguyen is also a practicing physician with 19 years of service with the health care organization that serves 4.6 million members in Southern California.

Labor 411: It sounds like something out of science fiction. Can you explain about the evolution of the Virtual Medical Center?

Dr. Khang A. Nguyen: The VMC was established in 2018 and today we’re answering about 22 million calls a year. We provide patients with a lot of transactions through our call centers – finding out where they want to go, who they want to see and form the entire operations around what the member wants. But we didn’t do a lot of clinical care delivery here.

So we took this opportunity to take care of patients right at that moment, to go from an agent directly to a doctor or nurse. It’s really a model we’re leaning toward more and more. We’re calling in “Care on Demand.”

411: How else does the call center help streamline access?

KN: Because we’re the front door, we also manage a lot of the appointments. We helped redesign the website to increase booking online. We went from a 6% booking online pre COVID, up to about 21% over a period of one year. With COVID, members want to get care through the phones and through the KP.org and then having an operational outfit like the VMC to help coordinate with their team to provide that care.

411: That’s the call center part of services. How does the telemedicine component of VMC work, especially during the pandemic?

KN: When the coronavirus hit, it really shook up the entire health care industry. We had patients afraid to come see their doctors. I’m still a practicing physician, and I was on the phone with patients with chest pain who I would have sent to the ER and they just wouldn’t come in. They were more afraid of coronavirus than they were of having a heart attack or a stroke. The care delivery teams had to literally change on a dime and go virtual over a two week period. We introduced new technology for video medical visits. We had to change all our guidelines for booking. Schedules had to change to have more virtual visits. Doctors and staff alike all had to go remote. It took uprooting of the entire organization from staff to doctor to the receptionists and the back office medical assistants. Everyone had to go virtual.

411: What has the patient’s experience been like?

KN: We have worked in collaboration with our local areas to get patients to the right place to care for their needs, whether they have coronavirus or not. We also set up care teams. We now have doctors who are taking live calls, so now you can call in, and be offered a prompt to speak to a doctor or a nurse live without ever speaking to an agent.

The second option is go through an agent first, and then speak to a nurse or doctor. It’s all live and it’s staff-coordinated by the VMC. We call it “Care on Demand” – that was not available 10 weeks ago.

On the website and the mobile app, we also reprogrammed the system to go all virtual. Patients are offered a video visit or a telephone appointment to speak to a doctor and they determine whether or not it is safe and necessary for you to come into the ER or urgent care or to one of our facilities that are still open for face-to-face care. As we are moving toward the on-demand model, we thought about what were the opportunities we had to deliver care. We launched something called “Chat with the Doctor” that was not available six weeks ago.

The idea has been to go online with certain conditions and be able to talk to a doctor live on KP.org. It is still experimental, but it is working and we’re looking at ways to expand it.

411: Are these virtual services available to members system-wide?

KN: With the coronavirus emergency, it was up to organizations like Kaiser Permanente to deliver a shift in health delivery systems. Now these services have become solutions at every Kaiser Permanente. Because of our integrated model, as we all faced similar challenges, we all came up with very similar solutions.

411: How have the patients responded to all of these new services and procedures?

KN: The reaction has been pretty astonishing. They are very relieved that we are here for them 24/7 and that and we are expanding our services. One doctor said he couldn’t believe that we got this rolled out in the middle of a crisis.

As with every crisis, some patients are very afraid and frustrated. You couple that with people losing jobs, and sometimes all we can do is listen. But the things we do control, we try and do our best.

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