Kaiser Electronic Records Project Hits Some Bumps
Kaiser Permanente's $4 billion initiative to provide its 8.6 million members with electronic health records continues to encounter technical problems that put patients in potentially dangerous situations, according to Kaiser documents and employees, the Los Angeles Times reports.
Kaiser's Health Connect program has been fully deployed at Baldwin Park Medical Center and South Sacramento Medical Center, and the HMO over the next two years plans to expand the computerized system to nearly three dozen more hospitals. However, concerns about the program led the California Department of Managed Health Care to request information, which is a first step before a possible formal investigation, according to the Times.
Internal Kaiser "Availability Trend" reports found that over nine months in 2006, the Health Connect system was available 88% of the time on certain days, and less than 80% in some locations. Experts say Kaiser's availability rate is very low as the industry increasingly is aiming for systems with availability 99.99% of the time. When hospital staff have to revert to paper records, it increases the risk of error, the Times reports. There were nearly two dozen reported instances where the system's unreliability might have risked patient safety between Feb. 27, 2006, and Nov. 5, 2006, according to a 772-page problem report.
Kaiser says its availability statistics included minor outages, making its rate artificially lower than others in the industry. Officials at the HMO acknowledge that the program has had technical problems but maintain that they have been resolved and that patient safety was never compromised.
Bruce Turkstra, Kaiser's interim CIO, said Kaiser reviewed reported possible safety risks and made changes when necessary. He added that the system's reliability also has improved and now is available on average 99.2% of the time.
However, several former and current Kaiser employees say all of the problems associated with Health Connect have not been corrected.
Justen Deal, a Los Angeles Kaiser project supervisor who worked on the new system, said, "The truth is there are a lot of people inside the company who are worried the project is costing too much and is putting patients at risk." Deal in November 2006 was placed on leave after sending a critical e-mail about the project to employees.
Health Connect's current price tag is more than double its original estimate. Kaiser CEO George Halverson said costs increased from $1.8 billion February 2003 to $3.2 billion in September 2003 in part because the company decided to add EHRs in all its hospitals later that year. Officials, however, cannot explain why the current budget is $800 million more.
Kaiser in 2002 ended a five-year project to transition to EHRs, writing off $442 million, after executives determined it could not accommodate the HMO's size, the Times reports (Costello, Los Angeles Times, 2/15).