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TECH/HEALTH PLANS: Gadfly tells me I’m MIA on Kaiser

Gadlfy has been telling me that I’m MIA on the big Kaiser story, but luckily MrHISTalk has picked up the slack and has printed the Internal E-Mail Criticizing Kaiser’s HealthConnect Lands Employee in Hot Water. In addition in a presumably related move CIO Cliff Dodd has quit. Gadfly also tells me that the 25yr old malcontent Justen Deal (who I’d never heard of before yesterday) was previously a Kaiser cheerleader. Well nothing like a convert to preach a new religion. And his new faith is that Epic sucks, HealthConnect is a disaster responsible for a forthcoming financial crisis at KP, and that Halvorson is incompetent/a crook (take your pick)

I have no idea whether the Epic solution will or won’t work in the long run, but I suspect that it was rather better than the IBM/Colorado solution, given a conversation I had  a while back with some internal KP tech savvy docs about the state of that code. The truth is presumably somewhere in the middle. Unless Halvorson actually has secret stock in Epic or is being paid off into some Swiss bank account, something that’s rather unlikely given the way Judy Faulkner runs that private company, then there doesn’t seem to be any direct conflict of interest. Lots of big IT projects don’t work as advertised—in fact few do! And Kaiser is a highly fragmented and political organization (always has been, always will be), so betting the farm on a one-stop EMR solution probably did require getting most of the board to leave. I’m amazed Halvorson got it done at all.

And I cannot believe that HealthConnect is by itself responsible for all the anticipated losses—the move towards HDHPs is far more likely to hurt KP’s bottom line, as they are just not set up for that type of an environment (in which the risk pools is destroyed). It’s just not in their nature.

And at least the attempt behind HealthConnect is to improve care. Much more concerning is the organization’s reaction to the kidney transplant scandal, which as some of my commenters mentioned at the time called into question the financial ethics of TPMG.

But I guess this new little outburst doesn’t help! And I have heard quite a few KP docs bitching about the new system. Any more want to chime in pro or con or neutral?

….and of course much more from a not exactly neutral source at Gadfly’s blog

 

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4 replies »

  1. If the $7 billion dollars was just a scare tactic, do you think employees then had reason to fear for their jobs? Kaiser has had a series of “realignments” over the last few years, as well as the unnoticed stream of firing people for bringing up ethical/compliance/safety issues.
    As for Justen being on a “personal crusade” – just keep listening. I’m not a friend of Justen’s: in fact his constant high praise of Kaiser seriously turns my stomach. That in itself should say that Kaiser made a serious mistake in taking the smear-as-disgruntled-and-isolated approach with him. All the actual disgruntled people are going to do, “Huh? What the bejesus are you talking about?”
    The courts have also already reviewed the “clogging the email” stance in the case of Ken Hamidi’s appeal against Intel. Unless Kaiser can come up with some other reason to fire Justen (and in my experience they aren’t above making one up and falsifying the documentation), this will be a monument and emblem case of retaliation against mere criticism. And it would throw Kaiser’s every disputed termination into question.

  2. I cannot comment on whether Epic was the appropriate vendor to select or whether the project will ultimately be successful.
    However, I think it should be clear to everyone that the “$7 billion” Kaiser loss being discussed absurd.
    The projections shown in the CFO presentation are being misinterpretted by Justin and the press:
    * The run rate appears to be based on a continuation of expense trend from whatever the actual trend was at the time of the presentation.
    * This run rate implies earnings of $20 million in 2006 according to the presentation. Based on the press release yesterday af ACTUAL earnings, they look certain to earn $800 to $1,000 million this year – and earned $417 in Q3 alone.
    * It is likely in the interest of the CFO to rally operations leaders to aggressively reduce the expense trend by illustrating what could happen to the company if actions are not taken. That $7 billion is a worst case scenario, it seems, and is much worse than the PLANNED trends shown in the presentation
    * Based on documents posted on Justin’s website and elsewhere, it seems clear the organization is moving agressively to limit current and future expenses and ensure that $7 billion is not lost.
    * Justin’s email suggests a 2007 IT budget of $1.5 billion, and the CFO presentation of a run rate loss in 2007 is over $2 billion. So clearly to lose $2 billion there has to be bigger problems than just IT.
    * Here is an interesting article on the business savings expected from HealthConnect
    http://www.kpihp.org/publications/docs/business_case.pdf
    * Kaiser’s not perfect, and what they are attempting to do is ambitious. But I respect that vision and leadership. Its easy to sit on the sidelines and suggest sucess is impossible.
    * Justin seems on a highly PERSONAL crusade. And is short on solutions other than punishing / firing all those at the top. It is not clear that will earn the organization any money or fix any of the technical problems he thinks the organization faces.

  3. Hey, wait a minute – I was the one that broke those memos! Let the Girlz blog, too!
    And Justen isn’t a malcontent. He’s *still* a cheerleader from what I can tell. He thinks he’s saving the organization he loves from the top executives who seem to be steering the ship in the direction of Enron.
    As for HealthConnect, did you read the comment about the lack of paper backup? I’ll give you that this is more poor project planning than an IT issue, but let’s start considering that HealthConnect may not be the Salvation of American health care.

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