True Business Transformation – A Real Example


    Kaiser Permanente is a healthcare services provider that is pretty big in California, especially Northern Calfornia. It started an active Six Sigma program in the mid-’80s and a lot of its efforts seem to be coming to fruition recently. Although what it does may have little to do with outsourcing, it seems to have some practical, simple and very real lessons for companies that are looking to provide business transformation kinds of consulting and services.

    Kaiser Permanente has been our healthcare services provider for the past two years-plus. In that time, we have seen a remarkable increase in service quality from a patient’s point of view! What used to be a two to three hours visit to the doctor, the laboratory (if tests are needed) and the Kaiser pharmacy (if medicines are prescribed), now takes no more than 30 to 40 minutes! Kaiser provides all these services under one roof (as an HMO).

    About a year ago, it rolled out its electronic records system to our local Kaiser clinic. Instantly, so many things got easier for us, the patients. Quality of care is better, you get your service faster and I am positive it is cheaper for Kaiser to provide its services also. For every patient, it used to waste time searching for your patient records file. Now there is a computer in every office and staff can just scan your patient ID card; the system pulls up everything about you in an instant. Moreover, now we can set up appointments with our own doctors – even in other Kaiser facilities around here, since our doctors have duty some days of the week in other facilities. With electronic records if your doctor is on vacation, you can see another doctor elsewhere in another Kaiser facility.

    We remember carrying orders for lab tests on paper from the doctor to the lab. Someone then enters what is on paper into a computer system. From there a lab assistant calls for you to have blood drawn for tests and so on. These days the doctor orders the tests right into the computer, you just show up at the lab, and they are ready for you. There used to be three clerks to enter the lab order and three assistants to do the tests. There always used to be a 20 minute wait. Now there are only two lab assistants who also staff the check-in computer stations – with no wait, literally. Quality, speed and lower cost at the same time is really possible with some creative process improvement!

    The Internet and email have made the patient experience that much better also. Now Kaiser allows patients to log in through a browser, see some of their patient records, set up appointments with their doctor and even look up lab results as they come in. Kaiser sends me an email alert, once the latest lab result is ready to be seen! Doctors have begun encouraging patients to send them email with questions, if any, after a visit.

    The process improvement that really impressed me had nothing to do with technology. It seems to have really changed attitudes of employees also. I was getting my immunization shots updated before I left on a business trip to India. The immunization nurse gave me four of those shots that I needed. I was then waiting downstairs at the pharmacy, to pick up my malaria tablets. The immunization nurse had gone on the Internet, looked up some more information about travel to India, realized that I missed one of the shots needed, came searching for me down to the pharmacy and had me come upstairs to get it! How was that for service?

    Seems like Kaiser has truly embraced the essence of continuous process improvement! We hear about how poor and expensive healthcare delivery is in the United States all the time. It is companies like Kaiser that will be the examplars for services! Now why shouldn’t your bank, home insurance company or anybody providing you services do the same things?

    First comes thought; then organization of that thought, into ideas and plans; then transformation of those plans into reality. The beginning, as you will observe, is in your imagination. – Napoleon Hill


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