Matthew Holt

Andy Wiesenthal, Kaiser Permanente

Those of you with really long memories may remember that Kaiser had a little kerfuffle with a guy named Justen Deal. As part of that incident, I did a rather unorthodox interview with Andy Wiesenthal from The Permanente Group in 2006 which is still a hell of a read—mostly about the history of how KP got to the Epic decision and where it was in the middle of the installation process.

Fast forward the better part of 5 years. HealthConnect is done. And the pain and not inconsiderable expense is somewhat forgotten. But now it is done, what happens next? A long and somewhat philosophical interview. But a very interesting discussion.

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  2. Just a comment on the now “fully” implemented HealthConnect. It is being used in both in-patient and out-patient settings, but there are some serious limitations. For one thing, all the pharmacy and lab data has not been loaded. KP cut some corners and just went ahead and implemented without a full mapping of their data because they were pressed to “finish” it ASAP. The med groups have also insisted that the alerts for features such as adverse drug reaction be turned off. Just why that happened isn’t clear, but the fact that not all the pharmacy data is not loaded would be one of many possible reasons. There have been two meetings with data managers over the past 18 months at the Garfield Center to address this problem, and specifically to determine whether they need to build a new data mart which would include a complete data set. The decision was to not build one because of the expense–remember HealthConnect has already cost $6 Billion although the official price is $4 Billion. What they did decide was to require that all data elements in the future conform to a standardized format to make it easier to do the mapping at some point in the future. So, HealthConnect’s greatest value for now and well into the future is as a marketing tool. It is being used throughout the organization but in a very limited capacity.

  3. 2 hidden kiosks in Walnut Creek for check in but TPMG and the unions are pushing back against wide implementation. they haven’t been user tested very well and need some work.

  4. Kaiser’s successful implementationn of HealthConnect is certainly a significant accomplishment and I hate to nit pick but Dr. Wisenthal’s assertion that the system has been installed in “every nook and cranny” of the organization leaves me scratching my head. For example, I am enrolled in Kaiser’s Northern California region and I still can’t make appointments with my allergist online and every time I get an allergy shot I notice that the nursing staff is still recording shot reactions on paper. I’ve also noticed that certain tasks are begging to be automated but are still done the old fashioned way. For example, I am still waiting for electronic self-service kiosks to be installed in Kaiser’s Northern California clinics so I won’t have to wait up to 10 minutes in line to get checked in to an appointment by an overworked clerk (whom I suspect costs much more than a kiosk, probably $40,000 or more a year including fringe benefits). Seriously, if a bankrupt airline (e.g., Delta) can justify the capital expenditure to install self-service kiosks at its major airports to expedite the customer check-in process, why can’t Kaiser with its deep pockets do the same at its clinics? (I’ve been told that Kaiser has installed kiosks in Southern California—if anybody knows if its been done anywhere in Northern California, please chime in.)

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