KP-CMI's integrated diabetes care management is topic at South African health policy conference; case studies published

(January 23, 2002) - Because of its unique evidence-based approach to diabetes care management, Kaiser Permanente's Care Management Institute (KP-CMI) was one of six international case studies featured at a South African conference that focused on the role medical research plays in developing health policy.

Kaiser Permanente's success in translating medical research findings into concrete health policies that benefit its members led to the invitation, according to Robert Crane, senior vice president and director of Kaiser Permanente's Institute for Health Policy.

The conference and the publication of the case studies presented there were sponsored by the New York-based Milbank Memorial Fund, which supports research and communication on significant U.S. health policy issues, and the Cochrane Collaboration, an international organization dedicated to the synthesis of medical knowledge.

KP-CMI is a unique, pioneering institution with a mandate to drive, fund, and catalyze care management activities throughout Kaiser Permanente's nonprofit HMO. In order to create, implement, and evaluate effective care management programs, KP-CMI combines the latest medical knowledge about successful clinical approaches, population-based outcomes measurement, and advanced practice tools.

Case study: a strategy of "making the right thing easier"

Kaiser Permanente representatives - Crane, William Caplan, MD, KP-CMI Director of Clinical Development, and Matthew Stiefel, KP-CMI Associate Executive Director -- delivered the case study describing in detail how a strategy of "making the right thing easier to do" in adult diabetes care has produced significant improvements in clinical processes and outcomes for Kaiser Permanente members.

The study focused on KP-CMI's efforts to synthesize evidence-based knowledge about the best clinical practices for adult diabetes to create its integrated care management program.

Kaiser Permanente was selected as a participant, Crane said, because of its unique integrated structure that allows Kaiser Permanente research, and that of others, to be translated into concrete care guidelines that benefit its own members.

"Historically, it's been difficult for researchers in the United States to have their research findings converted into good health policy," he said. "A lot of policy is made by anecdote in this country."

But it was clear from the other conference participants that things are often worse in other countries, Dr. Caplan noted.

"The theme from the other case studies was that discussions of health policy in these countries were often adversarial between governments, physicians, and pharmaceutical manufacturers," he said. "I think the major issue was that there hasn't been a foundation of trust established among all these groups."

Similarity in issues facing six countries

The conference attracted medical researchers and health policy experts from Australia, Canada, Norway, the United Kingdom, and South Africa in addition to Kaiser Permanente as the sole U.S. representative.

Stiefel said he found a surprising amount of similarity in the issues that the six participating countries face in implementing effective health policy based on good clinical research. "One of the overarching lessons was that when researchers and policy makers have good communications and relationships, it really helps the policy makers reach better judgments for which they're responsible," he said.

Crane said the South African meeting also gave Kaiser Permanente representatives insights on how other countries are dealing with new health policy issues, such as how to select drugs for formularies on the basis of their cost-effectiveness, not just their cost.

For a copy of the Milbank publication with all six case studies, click on this link: http://www.milbank.org/2001cochrane/010903cochrane.html.

In addition to Dr. Caplan, Crane and Stiefel, the Kaiser Permanente case study authors were Kendra Rothert, KP-CMI Program Evaluation Consultant; and Helen Pettay, KP-CMI Director of Communications.