TPR – Reimagining Health Care Delivery: Kaiser Permanente’s Jodie Lesh

With the unprecedented and warp-speed disruption of COVID-19 shelter-in-place orders, The Planning Report interviewed Kaiser Permanente Chief Transformation Officer, Jodie Lesh, who has been helping to lead the healthcare organization’s work in reimagining the healthcare delivery system of the future for over 15 years. Ms. Lesh shares her team’s recent collaboration with the LA Garment District to solve medical-supply chain challenges. Lastly, Jodie, a former chair of the LA County Economic Development Corporation, shares her work on the intersection between economic stability, healthy communities, and Kaiser Permanente’s initiatives to enhance access, affordability, and outcomes through innovation and human-centered design.

“The entire health care industry was built on the idea of people coming to our space for care …For the future, what we have to do is push care out to where the patient or member is. That’s our reimagined idea—care anywhere. What we’re trying to do now—what we will do—is turn this industry upside down.” Bernard Tyson, former Chairman and CEO, Kaiser Permanente
“This ultimately will be the future of care: to understand how people make healthcare decisions, what people need to be effective at that, and how can we design solutions that are personalized.”—Jodie Lesh

Given that at Kaiser Permanente you lead their Office of Transformation, let’s begin with a quote from Kaiser’s former CEO, Bernard Tyson, on the future of healthcare, who said last year: “The entire health care industry was built on the idea of people coming to our space for care …For the future, what we have to do is push care out to where the patient or member is. That’s our reimagined idea—care anywhere. What we’re trying to do now—what we will do—is turn this industry upside down.”

With COVID-19 upending many industries, comment on the prophetic nature of this vision and what responsibilities fall on your shoulders to realize that reimagined idea as the organization navigates this unprecedented moment in public health?

I do think it was prophetic, but that was Bernard; he had incredible vision. Bernard saw things in the future that other people couldn’t see. We thought that the industry might turn upside-down, but I’m not sure even he realized the whole world would turn upside-down—which is exactly what happened. In doing so, it’s shed light on some of the deficiencies in the healthcare system but also some of the great opportunities to address them. I think that’s what Bernard meant, that consumer expectations will change, are changing, and have changed—and that will change our industry. I can’t think of an event that affected people’s perception about what is safe, how they should receive care, or how they should live their lives more than COVID-19.

As an example, we had been steadily increasing our use of virtual care over many years leading up to this. But now, in the last five weeks, our use of telehealth has increased about 70 to 80 percent. What we thought might not be possible— or something that might take many years to achieve—we literally did in a matter of weeks. Because that was the right thing to do and that was the expectation people had—that we would meet them where they are. In this case, where they were was in their homes. So, I think it was very prophetic. The industry will never be the same again—on a number of fronts—but particularly around how care is delivered. We’ll see huge change and that presents an incredible opportunity for the industry.

Elaborate on your role leading Kaiser Permanente’s Office of Transformation.

Let me start by saying that no one owns innovation and transformation. No one owns it anywhere; no one owns it at Kaiser Permanente. I certainly don’t own it. But a year and a half ago, when Bernard created this position, what he wanted me to do was think ahead and reimagine what was possible for our system. It’s interesting that he used ‘reimagine’ in that quote, because that is a word that he and I used a lot with each other. What could be? He put me in this role to help the organization think about what might be possible and then try to move the organization along those lines.

There are many incredibly innovative people at Kaiser Permanente, and the entire history of the organization and model is innovative. But I think he put me in the role so that innovation and transformation would be somebody’s day job—not something that people would do on the side—but that we would actually put real resources, focus, and funding towards thinking about what might be possible in the future and then accelerate that movement.

Bernard also acknowledged that the industry, even before all this, was under incredible pressure. He spoke a lot about a single-payer system and how it was not something he felt was a good idea or necessary; but, he did recognize that significant change needed to occur to make healthcare more affordable and accessible.

One of the things that Bernard championed—and something he told me when I came into this job—was that healthcare was unaffordable and that we needed to look at affordability not in terms of relative affordability—not whether we were less expensive than our competitors—but absolute affordability. Could people actually afford to receive the care? That was his mission: to make care truly accessible and affordable. He talked about making the “front door of healthcare” accessible to all so that people, especially people in poverty, people of color, weren’t forced to use the ‘back door’— the emergency room— as the front door to care. I was put in this role to be a thought partner with him about the possibilities for the industry.

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