Kaiser On-the-Job® (KOJ)

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Presentation transcript:

Kaiser On-the-Job® (KOJ) Presentation to COLA Return To Work Coordinators October 22, 2009 Presented By: Valarie Hartzell Executive Account Manager 714-512-7798

Kaiser Permanente (KP) Integrated medical care delivery system founded on the principle of pre-paid care for industrial injuries Kaiser Permanente offers the value of conservative, evidence based medicine Kaiser Permanente physicians are exclusive to our network We stand alone in our ability to have so much impact on the customer (employer), user of services (employee/injured worker) and the claims administrator (TPA/insurer)

Kaiser On-the-Job® (KOJ) • Developed by Kaiser Permanente in the early 1990’s • 1993 - First KOJ facility opened • 2007 - KOJ had over 533,500 industrial patient visits • 2008 - 50 Dedicated Occupational Health Clinics in California • Medical care and treatment for all injured workers (KP & Non- KP) • Integrated health care delivery system • Board Certified physicians Trained in Occupational Medicine Specialized in a wide range of areas, including orthopedics, cardiology, neurology, infectious diseases, psychiatry, physical medicine & rehabilitation, and many others Dedicated – KOJ MDs are committed to provide high quality care to employees • KOJ case coordinators and case managers to facilitate communication

COLA MPN – Kaiser On-the-Job® (KOJ) Injured worker access to KOJ and KP providers through the COLA MPN COLA MPN Website/Worksite Referral KOJ Network Structure: 1) Initial treatment - KOJ – Occupational Health Centers 2) If KOJ is closed, seek treatment at Kaiser Permanente After Hours – Urgent Care locations 3) If After Hours – Urgent Care is closed, seek treatment at Kaiser Permanente Emergency Departments 4) Specialty referrals available within Kaiser Permanente 5) Ancillary services available within Kaiser Permanente

Benefits of Kaiser On-the-Job® (KOJ) • Reporting High quality Strive for timeliness • Quality, evidence-based medicine Focus on Causation ACOEM Guidelines • Integrated Medical Care delivery Regional Oversight Professional & staff development Physician Education Apportionment Impairment Ratings Legislative & Regulatory Updates Patient Satisfaction Surveys/Employee Satisfaction Technology KP HealthConnect

KP HealthConnect Largest civilian health care information technology implementation in the United States Electronic medical record Real-time appointment scheduling Real-time prescription fills & tracking Digitized x-rays Patients contact physicians electronically Reinforces RTW Identifies & shares best medical practices Shares & prompts physicians to medical conditions Employer specific data on work force injury & illness Medical staff can share patient information system-wide

Partnering with Kaiser On-the-Job® (KOJ) • Establish relationship with Kaiser On-the-Job® staff Meet KOJ staff & physicians Shared RTW philosophy Get to know the KOJ case managers/case coordinators • KOJ clinic protocol Injured worker will be seen by Physician, with some exceptions A Doctor’s First Report of Injury will be sent to payer Injured worker will be given a work status form after each treatment at KOJ Work status will also be faxed as indicated in the treatment referral form presented by IW at point of service • Questions regarding RTW or other issues Call the KOJ Clinic - Contact the Case Coordinator/Case Manager Refer to KOJ Clinic Contact List for names and direct phone numbers

Your Kaiser On-the-Job® (KOJ) Team Regional Chief Physicians and Regional Administrators oversee the operations and services for occupational health centers across the Region. Chief Physicians work with the Regional Chief Physicians to oversee the operations and services for occupational health centers. Clinic Managers (Department Administrators) hospital administrators responsible for occupational health centers and related services within a specified geographic area. Case Managers/Case Coordinators provide utilization management and review for work-related injuries and illnesses. They help coordinate activity between the treating physician, the employer and the payer for the injured or ill worker. They may also help to facilitate return to work.

Who to call for assistance…. Kaiser On-the-Job® (KOJ) Clinic Contacts: Case Coordinator/Case Manager Return to work and treatment questions, authorizations, specialty access, transfer of care, message to the physician Clinic Manager Service Issues, appointment access, staff courtesy Physician Chief Clinical, quality of care questions/concerns See KOJ Clinic Contact List for names and direct phone numbers, by clinic

Additional Assistance … Regional Contacts: Marketing information, profile updates & general questions: Valarie Hartzell, KOJ Executive Account Manager 714-512-7798, Valarie.M.Hartzell@kp.org Charmayne Hale, KOJ Associate Account Manager 510-625-3032, Charmayne.M.Hale@kp.org KOJ Operations – Southern California Region Esther Liu, Assistant Administrator, Operations 626-405-7929, esther.liu@kp.org KOJ Operations – Northern California Region Angela Broadbent, Associate Director, Operations 510-625-3263, angela.broadbent@kp.org

Kaiser On-the-Job® Thank you! Thank you!