Kaiser Internal Report Details EHR System Problems

November 14, 2006

An internal report from Kaiser Permanente details the specific problems associated with the nearly $4 billion electronic health records system being implemented by Kaiser Foundation Health Plan/Hospitals, Computerworld reports.

The system, called HealthConnect, was developed by Epic Systems and is intended to give about 100,000 Kaiser physicians and employees access to 8.6 million EHRs, and provide e-messaging capabilities, computerized order entry and electronic prescriptions. It also is intended to integrate scheduling, registration and billing for Kaiser members through the company’s Web site (Rosencrance, Computerworld, 11/13).

The system was scrutinized last week after a project supervisor for Kaiser, Justen Deal, sent an e-mail to every company worker and warned that the EHR system is expensive and unreliable. Kaiser’s CIO, J. Clifford Dodd, resigned four days after the e-mail was sent (iHealthBeat, 11/8).

One of the main problems for HealthConnect is the Citrix Application Delivery infrastructure, which cannot handle the load of the Epic Systems, according to Deal. “For every user who connects to HealthConnect, they connect via Citrix, and we’re running into monumental problems in scaling the Citrix servers,” Deal told Computerworld.

However, Scott Herren, group vice president and general manager at Citrix Systems’ Virtualization System Group said the issue is the overall system’s architecture, which cannot accommodate such large loads of data, not scalability.

Deal and an IT employee – who spoke on the condition of anonymity – said another problem is the adaptability of the Epic software. The software was written in Massachusetts General Hospital Utility Multi-Programming System language, which was developed in the 1960s, they said.

The 722-page Kaiser internal report contained hundreds of technical problems within the system, some of which affect patient care. According to the report, 10 significant power outages included:

  • An outage on May 9, 2006, that lasted for 55 hours and affected “every Kaiser Permanente Region. …Providers/clinicians across KP would not have access to medical information to treat members, process lab and pharmacy requests and in some cases were in full down-time modes … with the inability to access current medical information for decision making”;
  • One on May 10, 2006, that lasted about 37 hours in which “The [users] reported that the potential for patients to not get the treatments they need and the possibility of patients receiving incorrect medications”; and
  • One on Oct. 10, 2006, for over three hours, where physicians and nurses in several facilities could not retrieve important medical data to treat patients (Computerworld, 11/13).

Link: http://www.ihealthbeat.org/index.cfm?Action=dspItem&itemID=127234

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