Kaiser makes move to automated records
Electronic records keep caregivers connected
One day soon in a Kaiser Permanente facility near you, Kaiser patients will no longer be able to take a peek in the chart that the nurse leaves behind on the desk. No, it’s not because of the Health Insurance Portability and Accountability Act (HIPAA); Kaiser is going all digital, all the time.
Earlier this year, Kaiser began what will be a three-year process of moving from the traditional paper chart to an electronic record of patient visits, progress notes, lab results, and hospital care.
"Our major impetus was to make sure that no person is ever cared for with information missing," says Andrew Wiesenthal, MD, associate executive director of the Permanente Foundation. Wiesenthal, along with Louise Liang, MD, senior vice president of Kaiser Foundation Health Plan, is taking point on the conversion. "Take the emergency room, for example: The sickest people in America go to the ER, and generally speaking, ER physicians have no information on the people they are seeing," Wiesenthal notes. Electronic records will give Kaiser docs access to Kaiser patients’ medical history, regardless of the patient’s home base, he explains.
The move to electronic patient records is not a new idea to the health care system. Ancillary providers such as laboratories and radiology are already using electronic records, as is Kaiser’s Colorado facility, which has been on-line for six years, and its Northwest facilities, which have used electronic health records for nine years.
The conversion will transition the balance of Kaiser patients, some 7.5 million, to an automated system.
The electronic footprints will start at the check-in desk. "There will be computers in all treatment rooms, nurses will record vital signs via computer, and physicians will input progress notes on computer," says Wiesenthal.
The electronic conversion is not going to be easy or cheap. The cost of outfitting all 423 medical offices and 29 medical centers over 10 years — which includes software licenses and maintenance, equipment, training, and lost productivity while learning — is around $1.8 billion.
The backbone of the system was developed by Epic Systems of Madison, WI, which specializes in electronic information technology. The system allows Kaiser to schedule patient appointments, record patient information and clinician diagnoses, order and view lab tests/results, place prescription orders from the treatment room, and bill patients and co-insurers.
Training will take many forms, including classroom, computer-based, and one-on-one.
Clinicians from any part of the United States will be able to access patient records. "If non-Permanente physicians require access, they could be granted a view into the patient record via the Internet as needed for care," says Wiesenthal.
Kaiser patients can already schedule appointments and refill prescriptions via the Internet. The migration to electronic record-keeping will allow them to view test results, review advice their doctor or nurse gave them, communicate with their care team, and receive reminders regarding preventive care and care for chronic illness via the internet.
The system is HIPAA-compliant, Wiesenthal notes. "The system controls what you can see and do based on your professional role," he explains. "There’s also an audit trail so we know who did what and who looked at what."
Not only is information safe from prying eyes, it’s also safeguarded from electronic disasters. "There are several levels of redundancy. Copies will be made of the data every night to mitigate against loss," Wiesenthal says.
One day soon in a Kaiser Permanente facility near you, Kaiser patients will no longer be able to take a peek in the chart that the nurse leaves behind on the desk. No, its not because of the Health Insurance Portability and Accountability Act (HIPAA); Kaiser is going all digital, all the time.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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