E-Mail About Kaiser Electronic Records Project Drew Scrutiny

A November 2006 e-mail from a Kaiser Permanente employee describing problems with the company's electronic health record system and the reaction to it shows that "in the digital age, flicking away whistleblowers isn't as easy as it once was," the Wall Street Journal reports.

The employee, Justen Deal, whose department was involved with employee training on Kaiser's HealthConnect EHR system, said the high cost of developing the system drew his attention, and he began accessing budget reports, system engineering data and other documents from online systems.

Before he sent the e-mail, Deal wrote a letter to the Kaiser chief compliance officer and board members to warn them about the "potentially catastrophic failure" of HealthConnect. Deal received a letter from Kaiser's assistant general counsel saying that an internal investigation found no misconduct or problems with HealthConnect.

However, Deal was not "satisfied" and sent the e-mail, the Journal reports.

In the 2,000-word e-mail, which Deal attempted to send to all Kaiser Permanente employees, he wrote, "We're spending recklessly, to the tune of over $1.5 billion in waste every year, primarily on HealthConnect, but also on other inefficient and ineffective technology projects." Deal also accused Kaiser CEO George Halvorson and other officials of "misleadership," which he said could compromise the ability of the company to provide quality care.

On the next business day, Halvorson wrote in an e-mail to the company's employees that once complete, Kaiser's EHR system "will prove the point beyond debate of whether or not [it] can handle our total volume."

Deal's e-mail is "an unfortunate combination of partial facts, old data, incomplete data, 'conspiracy' thinking and naiveté," Halvorson said in his e-mail, which was sent to the entire company.

Deal "quickly became a cause celebre in the blogosphere and beyond," as his e-mail leaked outside Kaiser and was interviewed by health IT Web sites and other publications, according to the Journal.

Ensuing media reports prompted the California Department of Managed Health Care to begin to monitor the performance of the project.

At the same time, Kaiser launched its own "communication tactics, including paying Google to place a special link to Kaiser at the top of any page with search results for "Justen Deal," the Journal reports. In addition, the company launched a "KP News Center" site, which included its official response to a story in the Los Angeles Times about the issue.

Deal was fired in January not because of the e-mail but "rather because he violated numerous company policies, including making an unauthorized order for three Apple laptops that he converted to his own use," according to a company spokesperson. Deal disputed the claim and said the orders were approved by his superiors.

Clifford Dodd, Kaiser's CIO, resigned the Monday after Deal's e-mail was sent. Kaiser said the timing was a coincidence but gave no cause for his departure (Rundle, Wall Street Journal, 4/24).