The massive expo hall at the HIMSS10 conference may have left health care providers bewildered about choosing an electronic health record system, let alone implementing one. The example of Kaiser Permanente, which began implementing EHR six years ago, offers providers both advice and hope.
The undertaking, not surprisingly, involved numerous challenges, noted Jan Oldenburg, the senior practice leader of Kaiser’s Internet Services Group.
- Kaiser’s eight regions all wished to maintain some independence.
- The IT department was used to custom coding add-ons to its applications.
- Many doctors believed records belonged to them, not to patients.
Furthermore, Kaiser identified some key aspirations in implementing EHR, Oldenburg said.
- Records needed to be made available to patients — and quickly. (No one likes waiting several days for lab results.)
- Records had to both respect the intelligence of patients — by not referring to a condition as “heart trouble,” for example — and provide education in context.
- Patients needed a secure system for email communication with their doctors.
- Clinicians, nurses and even labor leaders needed to be involved with the entire decision making process.
Kaiser began with EHR software from Epic Systems Corp., adding applications along the way for such tasks as e-prescribing and patient behavior analysis. Emphasis was placed on standards — all transactions, even internally, are based on Health Level 7 International standards — and on using features out of the box. The finished product, called KP HealthConnect, emerged in 2004.
Six years later, at HIMSS10, Kaiser announced it has finished implementing EHR across its entire network of 431 clinics and 36 hospitals. In addition, 24 Kaiser hospitals now have reached HIMSS Analytics Stage 7, which represents HIMSS’ highest level of EHR adoption. The provider also said 3 million of its 8.6 million patients, or roughly half of adult patients who use the Internet at least a few times a year, are using Kaiser’s personal health record (PHR) system, known as My Health Manager.
Implementing EHR and PHR certainly comes with risks, the greatest of which can disrupt physician workflows and put patients in harm’s way. But the rewards — easily accessible records, educated patients, engaged physicians and, of course, meaningful use incentives — are well worth the effort.