SHIFT Communications experts discuss all things healthcare and media.

A New Definition of Total Health

By Amanda Guisbond @agbond

Before last week, I thought I had a pretty strong understanding of the definition of health: a state of physical and mental well-being.  However, following my visit to Kaiser Permanente’s Center for Total Health my view of what defines “health” has broadened to include a number of new and important factors, in our care and the care of our loved ones.

Lauren Fifield of Practice Fusion and me at Kaiser’s Center for Total Health

Taking a step back for a second, I had the fortuitous pleasure of visiting Kaiser’s Center for Total Health in our nation’s Capitol while I was there for National Health IT Week on behalf of HIMSS.  I reached out to Dr. Ted Eytan, Physician Director at the Permanente Federation, to invite him to participate in NHIT Week activities and was pleasantly surprised when he turned the invite on me and asked that I join him on a tour of the Center.  I didn’t know this until meeting him but Dr. Eytan is one of the kindest people and biggest healthcare enthusiasts I’ve met to-date.  He’s probably given that tour many times over, but his excitement in teaching people about Kaiser did not wane for one moment while I was there.

A few quick things about Kaiser that framed my journey through the Center and made it far more remarkable:

  • If you look at the list of 100 or so hospitals that have achieved Stage 7 on the HIMSS EMR Adoption Model, something may stand out to you: many of them are Kaiser facilities.  All of Kaiser’s hospitals are Stage 7 hospitals (the highest Stage) on the HIMSS EMRAM – aka they are 100% paperless and healthcare information exchange, which is comprised of sharing of data between the EMR and community based EMR, is a reality.  Kaiser is also a HIMSS Enterprise Davies Award Winner.  These two designations are NO small achievement.
  • Kaiser providers focus on prevention as much if not more than caring and treatment of the sick.
  • Post-World War II, Kaiser spearheaded prepaid health plan adoption in the U.S.
  • Dr. Eytan and my co-tour buddy Lauren Fifield of Practice Fusion (based in San Francisco) attested “People in California LOVE Kaiser.” It’s nice to think people love a healthcare provider.

A sleek, modern and calm space, the Center for Total Health is designed as a forum for healthcare innovators, leaders and influencers to get acquainted with Kaiser.  Visitors can explore “total health” through an explanation of Kaiser’s history, a series of interactive displays including stories from Kaiser members and physicians and education on some of the innovations/technologies Kaiser uses in patient care.  Dr. Eytan explained you can rent the space for events and meetings – DO IT.

Some things I got to learn about and “play” with included:

Compact, portable imaging tool at Kaiser’s Center for Total Health

  • An iPod-sized imaging machine and example of ‘reverse innovation’ from India/China to the U.S.
  • Telepresence, the act of looking into a large TV screen that then displays back the person on the other end and makes you feel as if you’re right there with them (for remote patient-physician encounters).
  • A multi-lingual dual phone for non-English speaking patients that enables them to pick up one receiver and dial an AT&T translator who can help bridge the communications gap between the patient and their physician, who is dialed into the second receiver.

Telepresence — and a picture of a picture

Now to the semi-epiphany about Total Health – and the role our environment plays in health and wellness.  I had no idea until told, but Kaiser takes environmental health very seriously and considers it essential to their mission to replicate “total health” nationwide.  Kaiser was the first company to publically report its carbon emissions and requires that all of their suppliers submit a sustainability scorecard.  Kaiser also has a “sustainable food expert” on staff whose job is to research and select healthier hospital food including organic food.  Dr. Eytan said that some of their hospitals even have their own farmers markets located just outside the facility, to encourage folks in the local community to attend the market and eat at the hospital’s food courts.

The goal is for each Kaiser location to be considered a beacon of health for the local community and a place people can visit even if they’re not sick.  In other words, making people healthier starts with healthcare, but only a small percentage of “total health” is actual medical care (just 10 percent according to Dr. Eytan and his colleagues, although I’m struggling to find a citation online).  As such, Kaiser is focused on improving not only the 10% (medical care) but the 90% of healthcare that helps patients and the surrounding community lead better, healthier, happier, and more sustainable lives.  It was inspiring to hear about all the great and SMART things Kaiser is implementing in order to transform the definition of “total health.”

Thanks to Dr. Eytan and my tour of the Center, I have a new appreciation for “total health” and what it means as well as how our environment and local community play an important part.  In fact, one thing I’d love to see Kaiser promote more is their definition of “total health” – an ecosystem of factors that may include physical and mental well-being, family health, community health, and sustainable living – or something along those lines.

Did anything about my tour takeaways surprise you?

If you’re in the D.C. area and touch healthcare/health technology, I highly recommend that you reach out to Dr. Eytan and ask about taking a tour – you won’t regret it!

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3 thoughts on “A New Definition of Total Health

  1. Dear Amanda and the SHIFT team,

    It’s true – I and we love giving tours of the Center for Total Health because we get to share the inspiration (and aspiration) of the people who exist in our communities and our nation, who want what we want. I can tell from the postings on this blog that you and colleagues have written that we similarly inclined, toward a bigger vision of health than just technology or tools.

    And of course, I love your blog post :), including your call to action for Kaiser Permanente at the end.

    You’re right, and you’re going to see the concept of Total Health highlighted even more, because it resonates so well (because it’s what people want….). The Center for Total Health (@kptotalhealth) is a part of that. There’s a companion blog called History of Total Health ( and a blog at the Center for Total Health itself ( Promoting Total Health is really promoting what we’ve always been about, so it goes hand in hand.

    And…no struggling for references! The 10% of impact on a person’s health coming from medical care comes from a study done in 2002, that was a follow-up to one done in 1993. There’s even a newer piece of work in 2011 that goes further to look at the impact of social conditions on health. I put up a few pie charts to show the differences on my blog a few months ago…drum roll please… – for your scientific analytic pleasure.

    Please come back again, bring friends, a fun discussion, and yes, we’ll happily keep giving tours …call us, text us, mail us, tweet us….

  2. Pingback: A New Definition of Total Health – HealthyComms | Ted Eytan, MD

  3. Pingback: Communicating the Value of Exercise « HealthyComms

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