Why You Should Seek Integrated Health Care

Alex Menter, MD, a Permanente Medicine oncologist at Kaiser Permanente Colorado, always found his patient Stephanie* to be cheerful and upbeat at her appointments — even though she was being treated for a brain tumor. Before one of her recent appointments, Dr. Menter received an automatic notice from the Kaiser Permanente electronic health record (EHR) system that Stephanie was overdue for a depression screening. When she arrived at the medical office, the staff had her complete the screening, and that’s when Dr. Menter discovered that Stephanie was battling “pretty severe depression.”

“It wasn’t coming up when I was talking to her, and it wasn’t something she’d brought up on her own,” says Dr. Menter, who was named a 5280 Top Doctor in 2018.

That same day, Stephanie was connected with Kaiser Permanente’s Supportive Care team so they could address her depression immediately. She recently told her care team members that she had begun to improve. It all happened without Stephanie having to get a referral and call around to find an in-network therapist who was not only accepting new patients, but who also had immediate appointment availability. Instead, in Kaiser Permanente’s integrated care model, Stephanie’s care was coordinated for her by clinicians across different medical specialties. This coordination is what distinguishes truly “integrated” care at Kaiser Permanente from that at other health care providers.

It all starts with the EHR, which allows physicians to communicate and stay up-to-date on every patient’s care. It also helps ensure that patients get the right screenings, tests, and procedures while preventing duplicate or unnecessary ones. The American Society of Clinical Oncology says that “the ability to exchange information electronically can help doctors and other members of the health care team provide higher-quality, better-managed, and safer care for patients.”

Getting the right screenings is critical to cancer care because the key to beating the condition is detecting it early. That’s why Kaiser Permanente Colorado performed more than 100,000 breast, cervical, and colon cancer screenings in 2017, and routinely scores among the highest-rated plans for numerous HEDIS (Healthcare Effectiveness Data and Information Set) prevention and screening measures. For instance, Kaiser Permanente Colorado was the highest-performing plan in the state for breast cancer screenings in 2017, in the 90th percentile nationwide for cervical cancer screenings, and among the highest-performing plans in the state for colorectal screenings.

Truly integrated health care allows for more collaboration among doctors and the care teams they lead. Cancer patients, in particular, benefit from integrated care because they have complicated medical histories and interact with several medical departments (oncology, radiation oncology, surgery, primary care, etc.). At Kaiser Permanente Colorado, tumor boards are a prime example of this collaboration. A tumor board is a group of doctors from various specialties who meet regularly to review cancer cases and discuss possible treatment plans.

Lisa,* a 50-year-old with an often incurable stage IV cancer that had spread from the original site to other organs, was one recent beneficiary of a tumor board. When radiation oncologists, medical oncologists, and general surgeons met to discuss her case, they developed an innovative treatment plan that included chemotherapy, radiation, and surgery. The usual “standard of care” for such cases was chemotherapy alone. Lisa is currently cancer free — for a type of cancer where remission is rare.

“Outside of Kaiser Permanente, the multidisciplinary review and case discussion might not have taken place,” Dr. Menter says. “And the opportunity for an alternative approach — and a possible cure — might not have been pursued. We have all of our surgeons, medical specialists, and other care team members under the same roof, working together, as opposed to patients having to travel back and forth between different clinics and doctors.

“Many of our doctors come to Kaiser Permanente because they want to spend more time taking care of patients and less time focusing on the business aspects that come with running a medical practice,” Dr. Menter adds. “Cancer care is getting more complex over time, and it’s good to have care teams where our patients are the top priority.”

 
*Names have been changed

Other Permanente Medicine oncologists and doctors involved in cancer care who were named 5280 Top Doctors include Margrit Juretzka, MD, gynecologic oncology; John Christopher Sohayda, MD, radiation oncology; and Stephen P. Johnson, MD, interventional radiology. Along with Dr. Menter, they’re among more than 1,200 Permanente Medicine physicians serving Kaiser Permanente members across Colorado.

Kaiser Permanente’s 2018 5280 Top Doctors

Matthew S. Koehler, MD-Anesthesiology
Keri J. Propst, MD-Anesthesiology
Jennifer N. Kelloff, MD-Child Abuse Pediatrics
Laurent Lewkowiez, MD-Clinical Cardiac Electrophysiology 
Elisa S. Kapler, MD-Dermatology
Barry A. Schoelch, DO-Diagnostic Radiology
Ryan Paterson, MD-Emergency Medicine
Deborah Fromm, MD-Family Medicine 
Daniel P. Jones, MD-Family Medicine 
Micheline Kuhr, MD-Family Medicine 
Jennifer Osborne, MD-Geriatric Psychiatry
Margrit Juretzka, MD-Gynecologic Oncology
Alexander R. Menter, MD-Hematology, Medical Oncology 
Frank Becky, MD-Internal Medicine 
Lynn L. Rooney, MD-Internal Medicine
Stephen P. Johnson, MD-lnterventional Radiology
Morgan L. Swank, MD-Maternal & Fetal Medicine
Heidi Ray, MD-Neurology
Sirisha Komakula. MD-Neuroradiology
Eric K. Bode, MD-Nuclear Medicine
Jody L. Gibson, MD-Obstetrics & Gynecology
Tyler L. Skaife, MD-Orthopedic Sports Medicine
Timothy R. Muratore, MD-Orthopedic Surgery 
Gary L. McDonald, MD-Otolaryngology 
David Barclay, MD-Pediatric Anesthesiology
Brian Bagrosky, MD-Pediatric Radiology
Sorenna Kirkegaard, MD-Pediatrics 
Sarah Beth Van Scoy, MD-Pediatrics 
Edward T. Melkun, MD-Plastic Surgery 
Kristy Bauman , MO-Pulmonary Disease 
John Christopher Sohayda, MD-Radiation Oncology 
John-Paul Morfin. MD-Rheumatology
Walter D. Conwell, MD-Sleep Medicine 
David C. Gerhardt, MD-Sports Medicine 
Christopher Jockel, MD-Surgery of the Hand
Justin Green, MD-Urology