Kaiser Plans Ambitious High-Tech Records Revamp

Throughout Kaiser Permanente’s Southern California hospitals, doctors and patients are experiencing a transition into the future of medical records and information. As part of a nationwide project linking all of the company’s hospitals and doctors, the company will be keeping records of every patient’s doctor visits, medical tests and prescriptions ordered. The data will then be accessible to anybody in the company’s computer systems. Matthew Gerlach, senior vice president of business development for Kaiser, is heading up the project in Southern California. He said the company sees itself to be excelling in almost every area, with the notable exception of electronic records. “We consider ourselves to be one of the most integrated health care delivery systems in the country, yet our information systems weren’t really paralleling that,” Gerlach said. When the new system is in place, Gerlach said, patients and doctors will have appointments based less upon patients trying to recall their medical history, since everything will be available on a computer, regardless of how many doctors a patients has seen. “Patients tend to forget,” said Gerlach. “You go to a doctor, and you don’t know exact specific information. That information will be in the system. Instead of a doctor having a patient come in and starting to ask questions, it will become a situation of confirming the information that’s already in there.” Since Kaiser’s system will allow for doctors to have patient information available during a visit, it can help safeguard against costly and dangerous errors, Gerlach said. For instance, if a doctor orders a test that was recently ordered by another doctor, the computer will show a warning. The computer system will also keep track of every prescription drug that a patient is using, so if a doctor adds a drug that carries a risk of dangerous interaction, another warning will flash on the computer screen. Gerlach calls the safeguards a “built-in level of patient safety.” Taking a step further from safety and efficiency concerns, Gerlach said that Kaiser’s new system will also include a way for patients to access their records test results from their home computers via the World Wide Web. “The system will eventually allow members to do one-stop shopping via the Web,” Gerlach said. “They can get information about their last visit, get lab results, order medication and reorder prescriptions. They can book their own appointments, and designate which doctor they want to see.” Web sites will also prompt patients to schedule important tests and appointments, something that Gerlach, who has two sons with diabetes, can appreciate. Largest of its kind The $3 billion company-wide program is called KP HealthConnect. It is, according to the company, the largest electronic medical record system of its kind in the country. The company has about 8.2 million members in 9 states and the District of Columbia, and has over 12,000 physicians. The program was launched in May in Hawaii, and will eventually link clinical information with scheduling, billing and registration data. Internet access for Kaiser members is scheduled to be available in early 2005 at www.kp.org. Health information technology has been a hot topic of discussion within medical and political circles for years. In January, President Bush made computerizing health records a priority in his State of the Union Address. The president’s health information technology plan claims that while the American health care systems dispenses some of the best care in the world with cutting edge technology, hospitals are using outdated methods when it comes to keeping records of the medical information. The plan claims that “The Institute of Medicine estimates that between 44,000 and 98,000 Americans die each year from medical errors. Many more die or have permanent disability because of inappropriate treatments, mistreatments, or missed treatments in ambulatory setting. Studies have found that as much as $300 billion is spent each year on health care that does not improve patient outcome treatment that is unnecessary, inappropriate, inefficient or ineffective.” The president set a goal that seeks to assure that most Americans have electronic health records within the next 10 years, and notes that within the last several years, the Department of Health and Human Services has directed the private sector and other federal agencies to work to develop voluntary standards which make it easier to transmit medical information. Setting standards The collaboration, according to White House reports, has yielded standards for sending X-rays over the Internet, electronically transmitting lab results to physicians’ offices and sending electronic prescription orders from doctors’ offices to pharmacists. The federal government has also envisioned a system that would allow people to carry medical records on them at all times, on a credit card or in a key chain. The problem, according to Gerlach, is that there is no standard electronic format for health care companies to use. Patients may find themselves in an emergency room not run by their HMO, which has no way to read the information. Gerlach said that Kaiser has systems in place so that the company, using encryption and firewall technology, can send medical information to other hospitals over the Web safely. In order to ensure that medical documents are as safe as possible, federal health records privacy laws include specific security rules for electronic files. The Department of Health Services designed the standards, and health plans, doctors hospitals and other health entities are required to be in compliance with the standards by April of 2005. Paul Adams, spokesperson for San Francisco-based McKesson Corporation, which develops integrated technologies for health care companies, said that the first step for many hospitals is digitizing its paper records. “We have over 300 facilities across the country where our customers have done that,” said Adams. “We have a hospital here in Atlanta, which is probably comparable to many in Southern California, that scans million and half pages a month, which is a huge amount of paper.” Adams said that while many hospitals and health care companies are developing electronic records, smaller doctors offices sometimes can’t afford to implement a high tech system, or their system is too out of date to work with hospitals computer systems. To rectify the situation, Adams said, three groups: the American College of Physicians, the National Alliance for Health Information Technology and the Healthcare Information and Management Systems Society are working together to develop the “holy grail” of medical records, a universal standard to transmit all the medical records anyone could ask for.