Viewpoint: Kaiser Permanente group CEO on how the healthcare system can regain public trust

Many Americans have lost trust in the healthcare system, but organizations can take steps to gain it back, according to Richard Isaacs, MD, CEO and executive director of Oakland, Calif.-based Permanente Medical Group. 

COVID-19 exposed gaps in the healthcare system that have increased mistrust, Dr. Isaacs wrote in a Sept. 8 Harvard Business Review article. Research from the 2022 Edelman Trust Barometer shows that 48 percent of Americans say the pandemic eroded their confidence in the medical system's capabilities, according to the article. 

These concerns are validated, Dr. Isaacs said. The U.S. experienced more COVID-19 deaths than other industrialized countries, government coordination lacked, and people of color and rural residents suffered most. 

In the article, Dr. Isaacs made five recommendations to restore public trust in healthcare, using Kaiser Permanente's initiatives as examples. 

His roadmap to improved trust: 

1. Shift to value-based care from a "fee-for-service" model. Value-based models allow organizations to expand their capabilities and encourage cultural competence. According to Dr. Isaacs, Kaiser Permanente's consistent technological upgrades made the shift to virtual care easier, and its attention to culture allowed the health system to reach less trusting, unvaccinated populations. 

2. Improve the U.S.' public health technology infrastructure. More accessible public health data improves communication, and seeing physician leaders advocate for it improves public trust, Dr. Isaacs said. 

3. Enhance patient engagement by utilizing technology. Rather than focusing on the accessibility and convenience of telemedicine, Dr. Isaacs recommends leveraging its full power to improve healthcare delivery itself. For example, Kaiser Permanente used an app and digital watch pairing to monitor its cardiac rehabilitation patients. As a result, enrolled patients were nearly twice as likely to complete the at-home care course, according to Dr. Isaacs. 

4. Move care from hospitals to homes where possible. Shifting healthcare to the home saves space for critical patients while improving accessibility and delivery outcomes. Patients treated at home have fewer readmissions and complications, and 90 percent of patients in Kaiser Permanente's advanced care at home program gave it "top marks," Dr. Isaacs said. 

5. Meet patients where they are. Dr. Isaacs said patients should not have to "wade through layers of red tape or endure long commutes in traffic" to get care. Kaiser Permanente fosters patient engagement with easy online tools that allow them to communicate with their physicians, he said. 

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