Thursday, February 15, 2007

Keeping my fingers crossed for Kaiser

There was a depressing story in today's Los Angeles Times about Kaiser's $4 billion EHR implementation project. Apparently, technical problems with the project have dramatically increased costs (by about $1 billion) and are also threatening patient safety. Not suprisingly, morale seems to be dropping faster than George Bush's credibility (okay, maybe not that fast), and it's not clear that management has fully grasped the seriousness of the situation, as reflected in the following pair of quotes:

"This is the worst [technology] project I have seen in my 25 years in the business," said Andrew Brewer, a systems analyst for Kaiser who worked on the project for two years before voluntarily leaving the HMO last week.

"This is one of the largest and most ambitious efforts anywhere in the world to modernize our healthcare system," Kaiser Chief Executive George Halverson said. Considering that, he said, "it couldn't be going better."

As one who's also on the front lines of EHR implementations, I feel Kaiser's pain. Large-scale EHR implementation is extremely challenging, and the end-users are usually not nearly as flexible and forgiving as they should be given the immaturity of the technology.

Though they're a continent away, I'm worried about Kaiser's implementation, because a failure at Kaiser will reverberate throughout the healthcare industry. Why is that? It's because when you tick off the key success factors for effective EHR implementation, Kaiser seems to have it all.

As an HMO, they are both insurer and health care provider, which means that they stand to capture all of the benefits of their EHR. They can order their physicians to use the systems in ways that offer the greatest value, and they can fully capture all of the gains that accrue from better outcomes, higher safety, and cost efficiency. They've got world-class researchers who can use the EHR data to not only better measure their own progress, but to also generate tons of interesting and ground-breaking research. Finally, they've got an extremely capable staff, and they're using one of the best EHR products from one of the most highly regarded EHR companies in the industry (Epic).

In short, if Kaiser can't get this done, and also show that they're getting real value after it's up and running, there'll be a lot of disillusionment about the prospects of getting it done among the 80% of physicians who don't have an EHR today -- physicians who don't have anywhere near the sophistication, resources, and incentive that Kaiser has.

So, best of luck, Kaiser, in your efforts to turn this around. I'm rooting for you!


Anonymous said...

Anonymous said...

The problems with HealthConnect are very worrying. In addition to the severe budget overruns, there also are serious (and yet to be answered) questions regarding instances in which the system had a negative impact on patient safety. You're right in that a failure at KP would ripple across healthcare.

The comparative quotes you pulled from the article tell a frightening story... There's a complete disconnect. KP management has to get on the same page as their physicians and nurses, and information technology engineers. The quote you see from KP's CEO isn't just for PR consumption. He really believes the system is working perfectly. Until someone in Oakland wakes up, KP is going to keep heading, full steam ahead, with a project that has some fundamental architectural and technological flaws. Which means more time and dollars wasted, and potentially more patients impacted.

Anonymous said...

Read more about Kaiser here...

Andrew Brewer, the former Kaiser IT consultant, is also the Father of My Baby. Kaiser is not what you think.

This website will enlighten.