Kaiser has aches, pains going digital

Patients’ welfare is at stake in the electronic effort, experts say.

By Daniel Costello, Times Staff Writer
February 15, 2007
Kaiser Permanente’s $4-billion effort to computerize the medical records of its 8.6 million members has encountered repeated technical problems, leading to potentially dangerous incidents such as patients listed in the wrong beds, according to Kaiser documents and current and former employees.

At times, doctors and medical staff at the nation’s largest nonprofit health maintenance organization haven’t had access to crucial patient information, and system outages have led to delays in emergency room care, the documents show.

Other problems have included malfunctioning bedside scanners meant to ensure that patients receive the correct medication, according to Kaiser staff.

Concerns about Kaiser’s effort, called Health Connect, recently led the California Department of Managed Health Care to request information about the project, a first step before a possible formal investigation.

The HMO’s problems come as it plans to expand the computerized system over the next two years to nearly three dozen more hospitals — most in California — where the sickest patients are treated and ensuring patient safety is most difficult. Currently, the system is fully rolled out only in two hospitals, Baldwin Park Medical Center and South Sacramento Medical Center.

Kaiser’s effort, one of the largest and most ambitious electronic medical records projects in the country, is seen as a possible national model. With evidence suggesting that digitized recordkeeping can lower health costs and save lives, President Bush is pushing for every American to have an electronic medical record by 2014.

But the glitches illustrate the difficulties a massive healthcare provider might encounter trying to implement a complex computerized system.

Kaiser officials acknowledge that Health Connect has had technical challenges but say those have been resolved and patient safety has never been compromised. Patients should feel safe getting care at any Kaiser facility, they say.

They add that medical staff revert to paper records and established downtime procedures when the new computerized system isn’t available.

“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.”

Kaiser’s size — millions of members, 12,000 physicians, 431 medical offices and more than three dozen hospitals covering nine states — makes trying to go paperless a Herculean effort. Some problems are inevitable.

And Health Connect has had early successes. During routine data analysis using its digital records two years ago, Kaiser was the first to identify problems with Merck & Co.’s arthritis drug Vioxx, which was later pulled from the market after a study showed it increased the risk of heart attack.

Because the computerized system reminds women leaving doctors’ offices to return for their mammograms on time, the number of women receiving timely tests has increased throughout the system, Kaiser said.

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