Who at Kaiser Permanente has not been cornered and pummeled with questions about health care at a family gathering, community meeting, or dinner party in the last few years? I suspect that the number is small, given the ongoing national debate. The sheer amount of news coverage which managed care receives illustrates the point. A computer scan of a national news database for the term "managed care" for the first 11 months of 1997, for example, turned up 28,801 referenceson average, 86 stories printed or broadcast per day across the United States.

As a result, Permanente physicians may be caught off guard. Many face being asked questions for which they do not have answers simply because they were not even aware something had become a public issue. Frequently, questions are generated by stories published in newspapers or aired on newscasts which we neither read nor saw. Topics range from criticism leveled by a politician against Kaiser Permanente to a problem in a medical office across town or across the country.

Media relations staffs are responding by developing prototypical systems for keeping physicians better informed about the news via e-mail and perhaps someday by an Intranet system, so they can be better prepared to tell Kaiser Permanente's story. This is precisely the reason that the media relations staff in the California Division has been experimenting with an electronic news clipping service that allows Kaiser Permanente leaders and physicians to keep up with news headlines and with full texts of news articles via e-mail on a daily basis.

The idea stems from old paper-based news clippings that media relations staffs have used for years. These services would photocopy key news articles about the organizations they serve and distribute them to key leaders, usually from a few to perhaps 30 or 40 people. In late 1995, we realized just how difficult it was becoming in the computer age for anyone to keep up with the sheer volume of news in the world. We saw, too, how many more people need to have informationand need it quickly. We began to develop an electronic news clipping service, and to look for ways to give wider distribution to news about Kaiser Permanente.

One illustration of how the world of information has changed, and how it affects Permanente physicians, is how chain ownership of newspapers once owned locally now makes virtually all local news national. Two years ago, for example, a story in the daily newspaper in Walnut Creek, Calif., about Kaiser Permanente's medical center in that city wouldn't have mattered much to someone in Ohio. Not any
more. Since Walnut Creek's hometown newspaper has been purchased by the Knight-Ridder chain, that same story is now instantly available to editors at three dozen Knight-Ridder newspapers across the U.S. Nine are in communities served by Kaiser Permanente, including newspapers in divisions serving Colorado, Kansas, North Carolina, Ohio, and Texas in addition to California. Likewise, stories about Kaiser Permanente in any one of those newspapers can be "shipped out" instantly over the Knight-Ridder newswire to all those papers. Compound this by the fact that more than 80% of newspapers are now owned by chains. Add that to the instantaneous ability of television and radio to move information via satellite and fiber-optics. The effect is obvious: We at Kaiser Permanente must face the fact we live in a public relations fishbowl.

Today, this means everyone at Kaiser Permanente is in the public relations business. How well each one of us can tell the Kaiser Permanente storybe it a media relations representative at a news conference or a physician at a community meetingdepends on how well we keep ourselves informed. We need to know not only who and what we are as an organization, but also to understand how we are viewed by the media and by the people who read newspapers, watch television, listen to the radio, or track information on the World Wide Web.

To date, the help we have provided in this endeavor in California included a daily news clipping service which resulted from the recent merger of two services in the former Northern and Southern California Regions. Using a combination of computer databases, Internet sites, and e-mail services, the California Division News Bureau, (a Public Affairs division) electronically scanned as many daily newspapers in California as possible and collected transcripts of key radio and television newscasts to assemble a daily electronic packet of news. The focus is on stories in which Kaiser Permanente is specifically mentioned as well as on articles and newscasts about key health care trends. California Division Daily News Clippings are distributed daily via e-mail to hundreds of people in leadership roles, and are made available on one e-mail system for tracking by any physician.

The format includes a headline summary, because no one has time to read everything. This strategy allows the recipient to quickly scan the headlines and names of news organizations. The reader can then make a judgment about the need to know more and can skip directly to the article he or she wants to read. The clippings can also be stored for later retrieval. Likewise, a physician leader who knows he or she will going to a community meeting in the evening can read that day's news in which Kaiser Permanente has been mentioned. That physician can then contact the local public affairs or community and government relations staff for additional information that may be useful for answering questions.

While California has been experimenting with these new techniques made possible through information technology, the Program Office also has begun work in this area and is currently exploring the feasibility of a Program-wide approach to a uniform system that can serve all divisions. Program Office already has in place a news-clipping prototype from which a full national service can grow.

In California, the California Division Daily News Clippings are increasingly being supplemented with more widespread internal distribution via e-mail of news releases prepared for distribution to the media, with postings on Kaiser Permanente's World Wide Web site, and dissemination through various Web locations, including America Online. Well over 100 news releases were distributed this way in 1997 alone.

As these systems are developed, the goal is to give Permanente physicians and others access to up to-the-minute information so they can be better communicators. In the meantime, any physician who uses the World Wide Web can set up his or her own interim system to capture news about Kaiser Permanente. Following are two examples. At America Online, you can go to the "News" section on the "Channels" page that is part of your opening screen. Click on "Search & Explore," then click on "Search." Once you are on the search page, bookmark it so you can come back to it easily. Fill in the search box with "Kaiser Permanente" and run your search. You should come up with 25, 50, or more recent articles or news releases. The second system is the Excite! "News Tracker." For this free service, you need only go to the page at http://nt.excite.com/. Look for the "News Tracker" box and follow the instructions from there to set up a search for Kaiser Permanente. Once you have saved (bookmarked) this site, you can come back anytime. Just click on the name you have given your search, ie, "Kaiser" or "Permanente," and up will come any current stories from the database's News Tracker searches. And just remember, the next time you think you will be in a setting in which you will be pummeled with questions, arm yourself with a quick scan of recent news. After all, when people ask you a question it is because you are their expert source at that moment.

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