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"We are looking at evaluating the vendors across the space to see who would be the one or two vendors to handle all of our requirements," said Dr. Scott Adelman, who oversees new technology purchasing at Kaiser. "We hoping to have a contract in place by next year."
Kaiser is interested first in vendors that would provide hardware and support to medical devices that can remotely monitor patient data, such as blood pressure, heart rate and weight. A patient at home could step onto the bathroom scale, for instance, and the patient's weight would be uploaded into an electronic health record for doctors to read.
"My personal dream," said Karita Ilvonen, a researcher on loan to Kaiser's Garfield Center from Stanford Medical Informatics, "If I could have one thing, it would be the scale locking the fridge door."
IMetrikus Inc., a Carlsbad company, makes a device that transmits data recorded using some 40 different biometric measurement devices, such as blood pressure cuffs, glucose monitors and insulin pumps, representing major conditions from chronic heart failure to diabetes and asthma. The data can be sent wirelessly or using a telephone line and the company also has created a feature that reacts to the data received - for instance an uptick in a person's blood glucose level - by sending the patient information about what adjustments to make.
WebVMC LLC, based in Georgia, and Honeywell HomMed LLC, in Brookfield, Wis., also make similar applications that Kaiser is considering. Down the road, Kaiser hopes to use technology that allows patients to talk to physicians using their home television sets."We have a working group sorting through some of the technical issues," Adelman said. "This is something we will need in the future." He said the concept could be useful in Kaiser's Hawaii region, where doctors currently fly to different islands to visit patients. Technologies like the glucose patch collect data automatically, however many of these products aren't on the market yet.
Kaiser isn't the only provider hoping to leverage such technologies. The Sutter Health affiliate Palo Alto Medical Foundation is currently working with iMetrikus, Palm Inc., Sprint Nextel, LifeScan Inc. and Epic on a glucometer that would connect to a patient's electronic health record via a cellular telephone line. The device is undergoing beta testing.
Peter Boland, a Berkeley health care consultant who has done work with Kaiser, says this new model of care is important to groups with an economic model based on patient visits that over the years have been pared down from 15 to 12 to 9 minutes. "There is only so much you can pare back," Boland said. Kaiser is uniquely motivated to try out these strategies, he added, because it is both a provider and a payer, and because it serves an aging population of patients that are on their third generation with the company. Other health care companies see about 20 percent churn in their patient base, he said.
The challenge, according to researchers, will be finding vendors that can handle Kaiser's many requirements, such as being able to interface with Epic Systems Corp., the platform of Kaiser's billion-dollar electronic medical records program, HealthConnect. To this end, Kaiser is one of 120 companies that formed a nonprofit more than a year ago called Continua Health Alliance to encourage compatibility between technologies as they are being developed. Kaiser also needs to work with companies that have a spectrum of products and can handle a variety of diseases. The biggest challenge is understanding what technologies will dramatically change the way health care is delivered. "The old way that medicine used to be delivered was incremental changes in technology driven by the vendors," Adelman said. "Vendors would come and say 'We have CT scanner model 1,' or 'We have model 2.' I think that drove up the cost of health care. Everybody wanted the latest and greatest toy." The Garfield Center in San Leandro hopes it can change that by telling companies what best suits Kaiser's future needs.