Kaiser Permanente isn't talking about an e-mail an employee sent to
approximately 180,000 other workers, but at times it seemed like the
rest of the health IT world was.
Justen Deal, a project manager who has been with Kaiser for two
years, sent the e-mail out Friday, and it warned of $7 billion in
losses for the company over the next two years and criticized Kaiser
Chief Executive Officer George Halvorson on his decision to install
Epic Systems as the chief vendor of the massive $3 billion KP
HealthConnect electronic medical-record implementation for Kaiser's
12,000 physicians, 431 medical offices and 30 medical centers.
On Tuesday, Kaiser did not respond publicly to Deal's e-mail, but it
did announce the resignation of J. Clifford Dodd, senior vice
president and chief information officer for Kaiser Foundation Health
Plan/Hospitals and the appointment of Bruce Turkstra, vice president,
KP HealthConnect, as his interim replacement. Kaiser also released
its third-quarter financial report, which showed a healthy financial
A Kaiser spokeswoman would not comment on Dodd's resignation except
to say it had nothing to do with Deal's e-mail.
Deal, who is on paid administrative leave and would not confirm
published reports that he's 25 years old, did not have many
supportive things to say about Dodd in his e-mail to co-workers, but
said it would be "a crying shame" if Dodd was forced out in an effort
to deflect criticism of Halvorson.
"He knew how the system worked, and now we don't have benefit of his
counsel," Deal said. "I'm terrified to think this was done to appease
Deal added that he intended his e-mail to be an internal document.
"I hoped it would stay that way, but it didn't," Deal said. "Quite a
few of my colleagues decided to forward it to the media and
anti-Kaiser Web sites."
Earlier in the week, he developed a Web site, www.fixkp.org, which is
devoted to like-minded employees seeking to solve the problems they
see within the Kaiser organization. Deal said it just started to
attract visitors after the critical e-mail was distributed.
Internal corporate responses to Deal's e-mail have also been
circulated on the Internet, although Kaiser has not publicly released
them itself. Those responses note that Deal first brought his
concerns to the company in August, and they were investigated and
determined to be inaccurate -- which Deal disputes.
"In the e-mail I sent, every single fact is based on a document that
is not from me," Deal said, adding that Halvorson himself has urged
employees to "bend the trend" and seek cost savings wherever
possible. "There is a big push to go after low-hanging fruit to show
some savings right away."
In an Oct. 5 visit to the office of Modern Healthcare, Kaiser
Senior Vice President for Quality and Clinical Systems Support Louise
Liang said the KP HealthConnect rollout was going well despite quiet
rumors to the contrary.
"All thing things are moving in the right direction, and waste is
disappearing from the system," she said. "Our organization has never
wavered in its resolve to do this."
Deal said his criticism of KP HealthConnect involves Halvorson's
decision to drop the existing IBM-supported KP-CIS system in favor of
Epic's product which he said lacks the ability to run efficiently on
the 180,000 desktop computers used by Kaiser employees.
"The issue with Epic and HealthConnect is scalability, plain and
simple," he explained. "It (KP-CIS) was certainly working, the
reliability was there. The issue was that it did not have a billing
module, which was obviously something we needed, but was it really
necessary to scrap the entire system -- a reliable system -- just
because it lacked one module?"
Epic officials could not be reached for immediate comment.
Deal said the new system does include more features, but lacks
"We're driving a Ferrari around when all we need is a multipassenger
van," he explained. "I'd say they (Kaiser physicians) are frustrated
-- they might have more severe words for it which are perhaps not so
Deal did note that Kaiser's finances showed short-term health -- with
a $855 million growth in operating revenue from the same quarter last
year ($8.7 billion compared with $7.8 billion) -- but he questioned
why the company felt the need to tout gains in net revenue of $112
million ($417 million compared with $305 million) that he said were
based on a one-time boost due to the reduction liabilities for
self-insured risk such as medical malpractice and workers' compensation.
Deal said his intent was not to do harm to KP HealthConnect, but to
save the company from an Enron-type collapse.
"I agree with Louise Liang that HealthConnect is a necessary project
and idea that we have to pursue -- not only because of the money and
lives we can save -- but because our physicians are demanding EMRs as
a tool they want and need," he said. "But this is threatening the
very stability of the organization, and I would not be able to live
with myself if I knew these issues were coming and I didn't do
anything about it."What do you think? Write us with your comments at
href="mailto:[email protected]">[email protected].
Please include your name, title and hometown.