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Torrance, CA, United States

HealthCare Partners, a division of DaVita HealthCare Partners, manages and operates medical groups and affiliated physician networks in California, Nevada, Florida, Arizona, and New Mexico. As of September 30, 2014, HealthCare Partners provided integrated care management for approximately 836,000 patients.As a coordinated care provider, HealthCare Partners aims to provide higher quality care at a much lower cost to patients. A major way that it accomplishes this is through preventative medicine: identifying at-risk patients and recognizing symptoms early on to take care of illness and disease before it develops and becomes more costly to treat. They have also identified predictable diseases that account for major portions of expenses, and have been able to standardize care, improving overall results while lowering costs. Wikipedia.

Korf B.R.,University of Alabama at Birmingham | Rehm H.L.,HealthCare Partners
JAMA - Journal of the American Medical Association | Year: 2013

Advances in understanding the molecular basis of rare and common disorders, as well as in the technology of DNA analysis, are rapidly changing the landscape of molecular genetic and genomic testing. High-resolution molecular cytogenetic analysis can now detect deletions or duplications of DNA of a few hundred thousand nucleotides, well below the resolution of the light microscope. Diagnostic testing for "single-gene" disorders can be done by targeted analysis for specific mutations, by sequencing a specific gene to scan for mutations, or by analyzing multiple genes in which mutation may lead to a similar phenotype. The advent of massively parallel next-generation sequencing facilitates the analysis of multiple genes and now is being used to sequence the coding regions of the genome (the exome) for clinical testing. Exome sequencing requires bioinformatic analysis of the thousands of variants that are identified to find one that is contributing to the pathology; there is also a possibility of incidental identification of other medically significant variants, which may complicate genetic counseling. DNA testing can also be used to identify variants that influence drug metabolism or interaction of a drug with its cellular target, allowing customization of choice of drug and dosage. Exome and genome sequencing are being applied to identify specific gene changes in cancer cells to guide therapy, to identify inherited cancer risk, and to estimate prognosis. Genomic testing may be used to identify risk factors for common disorders, although the clinical utility of such testing is unclear. Genetic and genomic tests may raise new ethical, legal, and social issues, some of which may be addressed by existing genetic non-discrimination legislation, but which also must be addressed in the course of genetic counseling. The purpose of this article is to assist physicians in recognizing where new approaches to genetic and genomic testing may be applied clinically and in being aware of the principles of interpretation of test results. ©2013 American Medical Association. All rights reserved. Source

Young L.M.,HealthCare Partners
Clinics in Geriatric Medicine | Year: 2014

Physical abuse of the elderly is a significant public health concern. The true prevalence of all types is unknown, and under-reporting is known to be significant. The geriatric population is projected to increase dramatically over the next 10 years, and the number of abused individuals is projected to increase also. It is critical that health care providers feel competent in addressing physical elder abuse. This article presents cases illustrating the variety of presenting symptoms that may be attributed to physical elder abuse. © 2014 Elsevier Inc. All rights reserved. Source

Hongsermeier T.,HealthCare Partners
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium | Year: 2011

The goal of the CDS Consortium (CDSC) is to assess, define, demonstrate, and evaluate best practices for knowledge management and clinical decision support in healthcare information technology at scale - across multiple ambulatory care settings and Electronic Health Record technology platforms. In the course of the CDSC research effort, it became evident that a sound legal foundation was required for knowledge sharing and clinical decision support services in order to address data sharing, intellectual property, accountability, and liability concerns. This paper outlines the framework utilized for developing agreements in support of sharing, accessing, and publishing content via the CDSC Knowledge Management Portal as well as an agreement in support of deployment and consumption of CDSC developed web services in the context of a research project under IRB oversight. Source

Rehm H.L.,Harvard University | Rehm H.L.,HealthCare Partners
Nature Reviews Genetics | Year: 2013

With the declining cost of sequencing and the ongoing discovery of disease genes, it is now possible to examine hundreds of genes in a single disease-targeted test. Although exome- and genome-sequencing approaches are beginning to compete, disease-targeted testing retains certain advantages and still holds a firm place in the diagnostic evaluation. Here I examine the current state of clinical disease-targeted sequencing and evaluate the benefits and challenges of incorporating sequencing tests into patient care. © 2013 Macmillan Publishers Limited. All rights reserved. Source

Porter M.E.,Harvard University | Pabo E.A.,Brigham and Womens Hospital | Lee T.H.,Harvard University | Lee T.H.,HealthCare Partners
Health Affairs | Year: 2013

Primary care in the United States currently struggles to attract new physicians and to garner investments in infrastructure required to meet patients' needs. We believe that the absence of a robust overall strategy for the entire spectrum of primary care is a fundamental cause of these struggles. To address the absence of an overall strategy and vision for primary care, we offer a framework based on value for patients to sustain and improve primary care practice. First, primary care should be organized around subgroups of patients with similar needs. Second, team-based services should be provided to each patient subgroup over its full care cycle. Third, each patient's outcomes and true costs should be measured by subgroup as a routine part of care. Fourth, payment should be modified to bundle reimbursement for each subgroup and reward value improvement. Finally, primary care patient subgroup teams should be integrated with relevant specialty providers. We believe that redesigning primary care using this framework can improve the ability of primary care to play its essential role in the health care system. © 2013 Project HOPE- The People-to-People Health Foundation, Inc. Source

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