John Wocher

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John Wocher

• Senior Vice President, Kameda Medical Center,
  Ciba, Japan.

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The development of Kameda medical centre as one
of the best quality service providers in Japan
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Achieving Excellence by Implementing Global
Trends in Healthcare

• John C. Wocher
• MHA, F.A.C.H.E
• Executive Vice President
• The Kameda Medical Center

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IntroductionJohn C. Wocher, MHA, FACHE

• Kameda Medical Center
• Kamogawa, Chiba, Japan
• Executive Vice President

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What Are They?

• More Emphasis on the Healing Environment
• Acceptance of EBM
• Telemedicine
• Emerging Risk Management
• International Benchmarking

• A Patient Focused Patient Centered Approach
• An Electronic Medical Record System
• More Disclosure
• Competition Choice

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Kameda Strategy

• One at A Time
• Implemented at Kameda

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The Healing Environment

• Holistic Roots
• Mind Body
• Physical, Mental, Social, Financial, and Cultural
• Sound, Air, Light, Color, Privacy, Temperature,
  Contact/Communication, andChoice
• Patient Empowerment Control

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Quickly

• Sound Internal, External, Privacy, and Control
• Temperature Ability to Control
• Privacy Control, Security Personalization
• Light Too much? Not Enough?

• Color Can lift the spirit and delight the
  senses
• Communication Internal and External
• Amenity For Patients, Families, Visitors, and
  Staff Also
• Etc

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Patient Rooms
The Palmetto Pavilion, Medical University of
South Carolina, Photos by Rick Alexander Inc.
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Kameda Clinic
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Inpatient Room - Kameda
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Patient Bathroom - Kameda
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Labor Delivery - Kameda
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Inpatient Room - Kameda
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Healing Space
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Patient Amenities
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Grossmont District Hospital, La Mesa California
Photographer Owen McCormic. Lennon Associates -
Design
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Evidence Based Medicine

• Is a Universal Concept
• Can Be Internationally Benchmarked
• Supports Research
• Improves Patient Confidence
• Reduces Medical Errors
• Promotes Standardization
• Should Improve Quality
• Mayreduce costs?

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Benchmarking

• Measure yourself, with yourself, over time, in
  key performance indicators
• Measure yourself, against others, over time, in
  these key performance indicators
• Identify Best Practice
• Equal or exceed this best practice in your
  institution
• Simple and effective to implement

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Other Creative Ideas

• Sister Hospital Relationships
• International Staff Exchanges
• Collaborative Research
• Summer Internships in Management
• Group Purchasing Data Access
• International Guidelines
• Direct Import

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Risk Management

• What is it? What is the Purpose?
• Too Err is Human
• 1st is to do no harm (Protect Patients)
• 2nd is to Improve Overall Performance

• 3rd is to Protect Against a Catastrophic Media
  Event
• 4th is to Minimize Litigation
• RM is the least expensive insurance

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Telemedicine

• Emerging Technology
• A Primary Care/Specialist Interface?
• A Rural Medicine Tool?
• A Key Component in Home Health Care?
• International Possibilities? Yes.
• Patient Participation? Yes.

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Patient Centered Care

• Planetree
• Patient Focused Care
• The Empowered Patient
• Centered on Choices
• Staff Model
• Honesty and Transparency
• At Kameda Patient in Control
• No Cell phone Ban
  Private Dining
• 24H Visiting/ All Private
  Rooms
• Concierge Services/Room
  Service
• Say Yes Culture and more!

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Electronic Medical Records

• How Realistic?
• Cost Benefit
• Standards
• Privacy/Security
• Regulatory Issues

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Obstacles.

• Often overambitious bite off more than you can
  chew tendency
• IT personnel will not admit that they dont know
  it all.when they dont.
• Heresy if you oppose, so we blindly agree.
• An IT illiterate CEO
• General assurances from suppliers it will be all
  right and we can take care of that.
• Relying too much on consultants be careful
  here.
• Somehow, not buying proven, off-the-shelf
  solutions instead ordering custom made, tailored,
  untested, and costly software.
• A hesitancy to bring the Bad News to seniors
• No one truly accountable for mistakes
• And, a myth Having a contract makes it easy to
  sue a supplier. Not true.
• Adapted From Collins T with Bicknell D (1977)
  Crash Ten Ways To Avoid A Computer Disaster
  (Simon and Shuster), New York
• Or. They like the idea, but dont support it
  because the DONT LIKE YOU!

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What Is Challenging In EMR Work?

• Constancy of Purpose Leadership, Clear Vision,
  and Driving Force
• Keeping Medical Approach, NOT Information System
  Approach Standardizing Wherever Possible
• Physician Turnover Naysayers
• Provider Ownership
• Rumors, Bugs, and Myths.
• Cookbook Medicine Big Brother

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Characteristics of Kameda EHR

• Enterprise-Wide Integrated
• Paperless/Filmless in Clinic - 1995
• Inpatient Totally Digitalized in 1998
• Community Networked Since 1995
• Home Health Care From 1998
• Cradle to Grave Registration
• Web Based in 2002

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Secret to Success!!!!!

• A Constant Patient Focus Concept is the Best
  Navigator for IT Success in Health Care and
  Demands a Team Approach.

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And.

• If you take just one quote with you on EMR
  development
• Customization prior to standardization will
  result in failure. Beware the 200 vendors out
  there, each offering the unique solution to your
  needs. And as in medicine, each IT solution
  should answer one question Is this also in
  the patients best interest?
• If yes, proceed.

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Amenity, Creativity Design

• Healthcare Facilities do NOT have to be
• Dark, Dull, Square, Boring, Intimidating, Plain,
  or Average
• Goal Delight Patients, Not Simply Satisfy

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Opportunities...
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Kameda
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Kameda (Continued)
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Kameda (Continued)
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Conclusions.

• Trends are often rapid
• Trends are often dynamic, evolving, improving
• Doing the right thing is not a trend, but a
  constant in our profession
• Examine your corporate culture

• Make history, dont just read history
• Benchmark to establish Best Practice
• Think TEAM Treat Everybody As Me
• Constant focus on the patient
• Use technology to the maximum benefit

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Implications

• Healthcare overall a multi-billion yen
  opportunity
• Eldercare an emerging and important business
  opportunity
• Womens healthcare can be a mega-opportunity
• Marketing is emerging opportunity
• Risk Management an emerging opportunity
• How many MBAs in hospitals? Not Enough!
• Emerging IT infrastructure
• Global Opportunities? Yes!

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What We Are Attempting

• A
• New
• Perspective

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The ability to step back allows Kameda to

• Integrate All Aspects
• See Detail and Big Picture
• Focus On Any Aspect
• Share Perspective
• See Whole Person
• Look at Lifetime Versus Event
• Evaluate Cradle To Grave

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In Conclusion - We Believe

• Competition and Choice is GOOD
• Patient Empowerment is GOOD
• Financing Evidence Based Innovation is GOOD
• Patient as Full Team Member is GOOD
• Broad Perspective of Quality of Life is BETTER
  Than Narrow Perspective on Episode of Care
• Quality Can ALWAYS be Improved

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Thank You!
Johnwocher_at_kameda.jp http//www.kameda.or.jp
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Questions Anytime
johnwocher_at_kameda.jp