HIStalk Quotes
Internal E-Mail Criticizing Kaiser's HealthConnect Lands Employee in Hot Water; CIO Quits
Justen Deal, a 25-year-old employee of HMO giant Kaiser Permanente, was placed on administrative leave yesterday after criticizing the company's $3 billion information technology investment and some of its providers, including Epic Systems, in an e-mail he sent to all Kaiser employees and later to the company's board of directors. The San Francisco Chronicle picked up the story, using internal financial information contained in Deal's e-mail that projected a $7 billion loss for the company over the next two years if expenses aren't better controlled. "Kaiser's loss projections came to light after an employee sent an e-mail to 180,000 employees on Friday. In the e-mail, Justen Deal, a project supervisor who has worked for the company for two years, detailed his frustration with Kaiser's electronic health record system, which he considers inefficient and unreliable. Deal was placed on administrative leave Monday. 'What I'm doing is working to ensure the waste and abuse stops,' said Deal, who lives in Los Angeles. 'That's not something you get fired for.'"
I'll have more details later, but here is the full text of the e-mail he sent.
UPDATE: Kaiser CIO Cliff Dodd resigned last night. I have the memo and will post it later.
Dear Colleague,
Three weeks ago, George Halvorson, our CEO, wrote to tell us that Health Plan and Hospitals are facing significant financial challenges. What Mr. Halvorson did not mention was the magnitude of the financial losses we could see: our internal projections show that we could lose as much as $7 billion dollars in total over the next two fiscal years. Losses of even a fraction of that total will be a threatening blow to our organization and what we stand for, and will significantly compromise our ability to care for our members.
There are many things that are triggering these losses. Among them are accelerating changes to our membership base as more member move towards higher deductible plans, reductions in Medicare reimbursements, and our capital outlays for rebuilding. But the truth is, these issues are only exposing our real financial problem: we're spending recklessly, to the tune of over $1.5 billion in waste every year, primarily on HealthConnect, but also on other inefficient and ineffective information technology projects.
A History of Problems
On George Halvorson's first day here, he cancelled KP’s existing project to implement electronic health records. He wrote off the $442 million KP-CIS system that we had built with IBM. Instead of continuing to build on KP-CIS, Mr. Halvorson selected a company he was quite familiar with, Epic Systems of Wisconsin. Mr. Halvorson had also pushed through the selection of Epic at the health plan he previously had led, in Minnesota.
Despite internal resistance to this unusual and significant change of course, Cliff Dodd, our CIO, embraced Mr. Halvorson's decision, and both began working to convince key KP leaders that KP-CIS would eventually fail and that Epic was our only option.
What was particularly disconcerting about abandoning KP-CIS was the significant investment we had already made in the system. It was functioning reliably in Hawaii, had been in use in Colorado for years, and was on track for deployment in our Southern and Northern California regions. In fact, only days before Mr. Halvorson was hired, the Kaiser Permanente Partnership Group had reaffirmed its unequivocal support for KP-CIS. Comprehensive plans and agreements were even in place to continue building on KP-CIS.
But Mr. Halvorson was determined that KP would give its business to Epic. Several respected KP executives, who had supported or were directly involved with KP-CIS, saw the writing on the wall and quickly left the organization entirely. Others converted to supporting Epic after extensive ballyhooing from Mr. Halvorson and Mr. Dodd. All the while, our CEO and CIO ignored internal engineering reports which said Epic software would be unreliable for our size and difficult to adapt to our scope.
Instead of heeding those engineering reports, Mr. Dodd brought in a company called Tanning Technology to give an opinion on the viability of Epic within an organization as large as Kaiser Permanente. Mr. Dodd, while serving as an officer of Health Plan, also simultaneously served as a director for Tanning. Ignoring this significant conflict of interest, Mr. Dodd paid nearly $1 million dollars for Tanning Technology to give a favorable report on his and Mr. Halvorson’s predetermined plan to shift KP’s business to Epic. Tanning Technology, shortly thereafter, went belly up.
Despite the fact that Mr. Halvorson was hired for what we believed was his experience in implementing electronic health records, the truth turned out to not be quite so convincing. Mr. Halvorson was previously CEO at a health plan called HealthPartners, in Minnesota. HealthPartners is a little less than a tenth of the size of KP. Although George Halvorson had signed HealthPartners to an expensive contract with Epic Systems just before he left, HealthPartners still hasn't seen the results that Mr. Halvorson had promised. In fact, HealthPartners has faced significant problems with its Epic project, and, so far, the Epic software has only been able to completely cover about half of HealthPartners members.
Unfortunately, the story gets worse. When George Halvorson abandoned HealthPartners to come to KP, that (also not-for-profit) health plan was in the midst of being investigated by the Minnesota Attorney General for high-level financial waste and abuse. Mr. Halvorson left HealthPartners before the Attorney General could release the condemning report that laid blame for significant waste and abuse directly at George Halvorson’s feet. By that point, Mr. Halvorson had been in place as CEO at KP for about a year, and the scandal failed to get much coverage outside of Minnesota.
That the Minnesota waste and abuse report slid under the radar in the California media doesn’t change the fact that it has serious and direct implications relating to the judgment and decision-making ability of our CEO.
And the report only seems even more alarming now that KP is dealing with huge sums of financial waste, not unlike the financial waste and abuse that led Mr. Halvorson to give "no comment" to the Minnesota press.
A Lack of Accountability
When I first began to uncover this information, I almost could not believe what I was reading. As the impact to Kaiser Permanente became more and more obvious, and when I learned of the sheer magnitude of the potential losses, I knew I had to do something.
I was certainly concerned about jobs being eliminated, even mine. I thought about the poor people at Enron and WorldCom who lost their pensions. But, most of all, I worried about the millions of people who depend on us every single day for healthcare. For me, this isn't just an issue of saving money, it could very well become an issue of making sure our physicians and nurses have the tools they need to save lives.
So, I gathered all of the information I had collected: the news articles, the SEC filings, the engineering reports, and the Attorney General’s allegations. I put it all in a package, and I sent it, along with a letter explaining what I had found, to Dan Garcia, our chief compliance officer. That was in August. I also sent an identical packet to each member of the Health Plan Board.
I was worried by the seriousness of the issues, but I was heartened by many of the responses I received. Several Board members told me privately how shocked they were to see such terrible evidence and how alarmed they were to see the very negative financial projections. They thanked me for bringing the important information to their attention, and said they would be meeting with Mr. Garcia soon to make a decision on an appropriate course of action.
In putting all these pieces together, though, I missed one key fact that would lead me to seriously question Mr. Garcia’s ability to handle the situation. After sending the information to Mr. Garcia, I learned that Mr. Garcia had also served on the Health Plan Board of Directors for several years, even before he became our CCO. The key piece I missed was significant: Mr. Garcia is the very man who hired George Halvorson, back in 2002.
That presented a serious conflict of interest that I don't believe Mr. Garcia disclosed to the Board when they asked him to investigate, on their behalf, the issues that I had uncovered and report back to them.
I trusted Dan Garcia and his staff. I didn't question his integrity or honesty until he directly instructed me to have no further contact with any Board member. I found his order unusual: several directors had personally told me how concerned they were with these issues, and how thankful they were that this evidence had been brought to their attention. Why would Dan Garcia, who reports to the Board, try to create distance between the Board and me, and try so hard to keep the Board in the dark?
When I found a KP press release from 2001 that pointed out that Mr. Garcia headed the small committee that selected Mr. Halvorson, Mr. Garcia’s strange, and incredibly defensive behavior began to make sense.
Having Their Way
For some reason, Mr. Halvorson and Mr. Dodd were determined to make sure KP switched its business to Epic, regardless of the potentially catastrophic financial impact. Mr. Garcia chose to not stand in their way. And to make sure nobody else objected, Mr. Halvorson began replacing each and every director with handpicked candidates, who I believe he thought he could control.
The fact is, in an interview about a year ago, Mr. Dodd made a statement that puts everything into perspective. He said:
"We had a whole executive committee that was quite committed to [[KP- CIS]]... The board... all the medical directors...each had to be unwound and reset."
And “unwind” and “reset” Mr. Halvorson and Mr. Garcia did. Today, only one person remains on the Board from before 2002. That's an unprecedented turnover in our history, that, I believe, has allowed Mr. Halvorson and Mr. Dodd, with Mr. Garcia's compliance, to mislead Kaiser Permanente into a multi-billion dollar spending spree benefitting Epic Systems, that Wisconsin company that Mr. Halvorson is so familiar with.
Misleadership
Unfortunately, in this process, many of us have been misled, and no matter what happens to Mr. Halvorson, Mr. Dodd, and Mr. Garcia, we will be the ones left to deal with these problems. We put our faith in each of them. Other KP leaders trusted them, and depended on the integrity and accuracy information they provided. Dr. Jay Crosson, the leader of The Permanente Federation, and one of the most respected physician leaders in the country, recently wrote that downtime with Epic's systems has been getting better and better. The truth is, over the past several months, Epic outages have increased from just over 9,000 user hours per month in June to over 59,000 last month. Dr. Crosson, and each of us, have all been told how reliable and wonderful Epic is going to be. Sadly, it’s just not true.
Epic simply cannot scale to meet the size and needs of Kaiser Permanente. And we're wasting billions of dollars trying to make it.
Time to Fix These Problems
It's time we hold George Halvorson and Cliff Dodd accountable for their mistakes. It's time Dan Garcia stopped covering up these problems.
Most importantly, it is time the Health Plan and Hospitals Board of Directors take action to right these wrongs. Mr. Halvorson may have picked each Board member because he thought they would stand back and let him do whatever he wanted at Kaiser Permanente. But, if you look at our Board, knowledgeable, respected, and experienced men and women hold each independent seat.
If you recognize, as I do, how serious the stakes are here, please ask Victoria Zatkin to share with the Board your concern that these issues be dealt with immediately. Ms. Zatkin is senior counsel for Health Plan and Hospitals, and she serves as secretary to the Board. You can reach Ms. Zatkin via email at victoria.zatkin@kp.org.
If you're a Permanente physician, please tell Dr. Crosson, Dr. Pearl, Dr. Weisz, and our other national, regional, and local physician leaders that you continue to support their efforts to make sure Kaiser Permanente physicians, nurses, and pharmacists have access to the most reliable, most advanced, and most effective tools available. Dr. Crosson, Dr. Pearl, and Dr. Weisz are all exemplary leaders to us here in California, strong leaders who have set an example for each of us.
We all know that we have to make sure every dollar is spent wisely, so that we can focus our resources on providing the quality care our members deserve. It's time Mr. Halvorson, Mr. Dodd, and Mr. Garcia stop jeopardizing our ability to do that.
Please, help me fight to protect the future of our organization, the future of Kaiser Permanente, the future of America's foremost healthcare leader.
If you would like to stay up to date, I will try to update a website I have set up, fixkp.org, with the latest information.
Sincerely, and most respectfully,
Justen Deal
Kaiser Permanente
Mr. Deal, while articulate, suddenly finds himself quite unemployable at
the wise old age of 25. "Would you like fries with that?"
I don't know which I'm more shocked about - the contents of the story, or
the fact that a 25 year old did so much research and articulated his case
so passionately and so well.
I'm not sure what made Mr. Deal think he could post something like this,
(as well done as the piece is) and still be employed the next morning.?
Hey - don't I get credit for <a
href="http://corphq.livejournal.com">breaking the memos</a>?
What's going to be really embarrassing for Kaiser is that Justen is no
"malcontent" - he's been one of their most vocal "brand ambassadors". I've
called him a "Kaiser stooge" and a "hack" on more than one occasion because
I assumed anyone pushing that much propaganda must be getting paid. But no,
apparently he's just a True Believer. Too bad Kaiser decided to show poor
Justen just how wrong he was about the honorability of his employer.
This person needs to back up his claim that the existing solution can't
scale to meet the size and needs of KP. Can he propose a better solution,
or is he just screaming "fire" in a crowded room and running out the back
door, without helping the situation?
Why do you think Enoch Choi shut down comments on this?
I have a feeling that Mr. Deal will find himself much more employable than
the coward who took a shot at him with the comment;"Would you like fries
with that?" We can use more courageous people like Justin Deal and far, far
fewer cowards like the one that posted the message above. But you get a
chance to see how diverse people are in the IT arena. I'd go with someone
like Justin Deal over the also ran coward any day. Unfortunately, these
days we seem to have more business leaders and politicians like the coward
than we have like Mr. Deal.
This email from Mr. Deal is great. It is about time someone said what is
really wrong with a lot of hospital decisions on CIS that are made at a
high level with no regard to usability, user input, realistic goals set on
both sides of the table, consultant bias and especially executives like
this that have a hidden agenda that is so obvious. Bravo to you Mr. Deal,
on actually saying what many of us want to say about how this industry and
hospitals make their decisions. Good luck on your next job though, you
will probably need it.
Justen was courageous to post his story. As a Kaiser member and person who
has spent a career in technology, I could not understand why Kaiser picked
Epic Systems. Thank you Justen for filling us in. The story about Cliff
Dodd and "Tanning Technology" is too bizarre to be true..and too bizarre to
be fabricated. How could Kaiser let this happen?
As with any health care endeavor you must be diligent in your pursuit of
technology and check with current users of the solution you are pursuing so
fiascos such as what is happening at KP can be avoided. I also wondered
how KP could embrace such a large implementation of Epic without doing a
phased rollout to insure they are succeeding as planned. KP could be
headed toward breakup as the only way to survive in the health care arena.
Within 30 seconds, after somebody started explaining the Epic/Healthconnect
architecture to me a few years ago, I started laughing, and have not really
stopped since. If it wasn't so sad.
Justen Deal has the courage that many of us do not. He is trying to do the
right thing while risking his career and credibility. How can the rest of
us help him attain the integrity he is asking for in a big corporation?
Big corporations have clout and employees who will toe the line in order to
keep their jobs. These corporations have the luxury of knowing how to spin
their actions, lawyers who can wordsmith anything. Papershredders work
pretty well, too.
Thank you Justen. These are the same guys who lead the Kaiser IT
outsourcing effort. They believe that one computer person is as good as
the next one and ran out many of Kaiser's best, most knowledgeable computer
workers. As I recall, J. Clifford Dodd was soon discovered to be on the
board of directors of one of the companies he was outsourcing to. He first
resigned from Kaiser (in an email) and then said that he really meant to
resign from his outsourcing company. What a blow-it this guy was for
Kaiser.
I, too, was fired from Kaiser Permanente for daring to speak the truth
about management decisions (regulatory violations, etc.). I salute young
Mr. Deal for his bravery in telling the world what he knows. People need
to stop covering up the truth about this self-proclaimed "employer of
choice."
I congratulate you for having the courage to sacrifice yourself in order to
expose what many of the employees in the trenches at Kaiser already know.
I was employed as a consultant at the Kaiser SCAL regional office and the
disorganization and waste I experienced while there was gross. The expense
process is a "Carte Blanche" system and the leadership there is so
disorganized and out of touch, that someone could disappear for hours at a
time and nobody would ever know. Although I did not take advantage of
this, I know many that did. When I told my company that there was no work
to do and asked to be reassigned, the message I received was loud and
clear; shut up, show up, and remain billable.
Enough of the Kaiser/Epic bashing. The scale of the Kaiser project is
unprecedented, and the successes have been significant. I'd like to hear
from anyone at Kaiser who disagrees with all of Justen's ranting.
Halvorson and Dodd could not have conceived and executed such a massive and
ill-advised IT master plan without the consent and complicity of TPMG's
(The Permanente Medical Group) physician leadership. Every KP insider
knows who "really" controls the money flow and purchasing decisions for the
KP Health Plan and Hospital Foundation (regardless of the insistence by the
for-profit TPMG that it is legally separate from KP). The failure to
disclose Halvorson's misdeeds in Minnesota, clandestine actions to silence
all critics (Board members, IT engineers, employees, etc) via termination
and the revelation regarding Mr. Garcia's role in hiring Halvorson create a
perfect storm for a cover-up. With a KP Board filled with Halvorson hacks,
there is no higher authority to contain the power and control Halvorson has
amassed or to challenge the acquiescence (whether passive or intentional)
of Drs. Crosson & Pearl in the face of fact-based evidence that KP-CIS was
on track to meet the IT needs of KP and that their own internal IT
engineering reports indicated that EPIC was not adequate for an
organization the size of KP.
Thanks for your effort to make change where it was needed.
I am a per diem ICU nurse for Kaiser Richmond. I was a traveling critical
care nurse for nearly 7 years (an RN for nearly 14) and have worked for 22
different hospitals from Maine to Washington, Florida to California. I am
the author of a recently published book, Bottom Line Medicine: a Layman's
Guide to Evidence Based Medicine, which is very critical of the health care
industry. I worked as a molecular biologist for 14 year, seven for the drug
company Eli Lilly. I am generally very critical of most medical practices
and would probably have much in common with Mr. Deal, however, I strongly
reject his methods and challenge his claims. I ACTUALLY work with these
computer systems. I generally hate them because I believe health care
workers spend way too much time inputting questionable data for the benefit
of administrators and managers who make corporate decisions upon this data.
I am not convinced these systems result in better medical outcomes than
existing paper systems. I wonder why Kaiser is placing any emphasis at all
on these digital systems except for their potential to provide easy access
for data mining. I worry that Mr. Deal's comments may result in throwing
out the baby with the bathwater. I work for Kaiser because I believe they
do have a excellent health care model, they emphasize prevention. I can't
blame them for trying to curtail costs, medicine is expensive. I just wish
the health care industry was more honest about how little return you get
for your investment in insurance.
I welcome all those who wish to help me and those like me in our quest to
provide safer and better medical care, however, we do not need alarmists.
Research is best shared on an open forum, massive emailing to many in fear
because they are sick and dependent on the medical systems merely increases
their anxiety. Discourse improves our knowledge of why others believe the
way they do and potentially uncovers common ground. The rantings of a
disgruntled employee on a massive scale smacks of spam only and it has the
potential to cause more damage to those already in need of care. If you
insist upon a functioning computer charting system then look no futher than
your local Veterans Administation hospital. Although it is bare bones, it
minimizes the amount of time healthcare workers have to spend on data entry
while still providing the basic information need in patient care. Forget
all this ballyhoo about what charting system is better and find agreement
that Kaiser is saving lives and surviving in a very hostile environment.
True cost containment is obtained only by improving wellness, this is the
cornerstone of Kaiser Permanente. If you think I am a hack for the medical
community then just click on this link: http://www.amazon.com/Bottom-Line-L
aymans-Guide-Medicine/dp/0875864554/sr=1-2/qid=1163021020/ref=pd_bbs_2/103-
1818105-2232608?ie=UTF8&s=books
Kaiser's extreme lack of business sense, shown glaringly by the young
principled Justen is an example of lack of planning.
If the current management can't get the budget in line, fire them and hire new. If the current board isn't cooperating, replace them. In two years the grandiose promises either happen or they are gone, as well. Unfortunately for the KP IT people who have seen all the hardware become obsolete and disappear, the software has become a contract up for grabs and their jobs have eliminated - their boss was replaced by someone with a sociology degree (BS)and those who were duped into staying until the company could come up with the money for their severence were let go. The rest? Well, let's just say that Mr. Halverson's view of Epic is one of numbers game that no one else is privy to play. Hell, we aren't even allowed to send him an email directly. The 80/20 rule? Not good odds in any health care industry or anything else involving life or death. Oh sure, we can cover stuff up G! Is that what we are supposed to be doing?
Actually, Epic was a really smart decision for Kaiser. A home-grown system
wouldn't do it (and wasn't getting close) and Epic has a lot of the right
things to offer (which Kaiser just can't build). Implementation
challenges? Absolutely. But I think this is just uninformed cynicism from
a loose cannon employee.
I believe that there is both truth and speculation in anything. One, as a
former IT Consultant who has been on several large scale implementations of
EMR (Electronic Medical Record) systems, there are challenges and costs.
Nothing is free in this world and Kaiser was losing valuable time and money
in getting insurance reimbursement because many of their costs were not
properly or adequately captured to truly reflect the cost of providing care
for patients.
Things like insurance codes for diagnoses, procedures ( and supplies and equipment were not recorded and often given away without accountability. EMR systems like Epic provide a vehicle for accountability and more accurate recording of patient medical care. However, I have also seen waste during implementations because some Project Managers did not understand what they were supposedly helping to implement.
One of the most scary aspects of being involved in a large scale implementation is the way budgets are not adequately projected. On one occassion, most of the money for this particular project was spent for a big bang go-live that used up most of the money set aside for the entire implementation and the solution was to bring a temporary workers from a employment agency who had little or no experience in healthcare or training to be support specialists during one of the Go-Live rollouts. The results were disasterous to say the least and I ended up having to fired many of these temporary workers because they either did not show up for work or were habitually late.
EMR systems can be a boon to an organization if the costs associated with their implementation are controlled in a reasonably organized and well-thought out plan that looks at all the variables involved. It is kind of like creating a business plan that incoporates all your operating costs for the first five years of existence. Perhaps Kaiser did not plan in greater detail when embracing Epic as their EMR system of choice. I have used Epic and believe that it is a good choice for Kaiser but like any software, is good as long as the users embrace it and use it fully. Who knows if Mr. Deal has all the facts in this case? It does give food for thought.
I think all of the employees of Kaiser should take note. They should hear
from the Board directly at this point. We have no proof Mr. Deal is a
"loose cannon," nor proof that the Board is asleep at the wheel. The story
certainly sounds compelling and deserves further factual review.
It Ain’t Necessarily So: The Electronic Health Record And The Unlikely
Prospect Of Reducing Health Care Costs
As an insider to KPIT I happen to know that Justin has his facts straight,
the responses from the Halvorsen guy fails to mention that after the
Internal Experts analized the Epic product and panned it...that Upper
Managment then went shopping for experts that would return a verdict that
they approved of...which leads up to the fact that Cliff Dodd has now left
the company as he was affiliated with those outside experts.
Give you an idea of the disconnect between KPIT Sr. Mgmt and staff:
Recently, Sr. Mgmt acknowledged to the staff that morale is low due to the
constant reorg churn. To address this, they announced a Halloween Party!
WhoooHooo! Complete with cubicle decorating and costume contests. Tells you
what they think of the staff - that we're just a bunch of children. Instead
of treating us like professionals with something valuable to say and
contribute, they view our input as simply whining. Their reaction is to
stick lollipops in our mouths and tell us, "trust us, everything will just
be fine." Needless to say the Halloween "Party" (potluck lunch plus greasy
chicken provided by management) went over like a big turd.
The kind of behind the scenes maneuvering and manipulation that Justen
details is sadly all too common in HIT. What is all too uncommon is
someone with the intestinal fortitude to risk career and reputation in the
name of doing the right thing.
Sure, the brashness of youth shows in some parts of his letter. But
remember, the politic letters enabled by the tincture of time often also
brings diminishment of passion and willingness to take a risk. .
Hats off to Justen. Clearly he is thoughtful, hard working, passionate and
willing to do the right thing. These are the makings of a true leader...
as opposed to the 'tow the line' attitude of the managers and the managed.
As an ex-Kaiser IT employee (by choice) I can tell you that the KP-CIS
project was just as ill advised as the current Epic project and probably
more likely to fail. The minimal functionality of the home-grown KPCIS
system was embarassing to anyone that had ever worked outside of Kaiser.
Replacing some of the Kaiser IT executives that had NEVER worked anywhere
else was also a great idea. However - in the end - it looks like the
stagnant and inept culture managed to survive. Trying to accomplish
anything at KPIT is like trying to turn the Titanic.
I have worked at a number of large Northern California businesses including
several KP business units.
The larger question for all employees and customers (both the willing and
the unwilling) is:
Why could I turn Justen's letter into a template where names and major
multimillion $ projects could be plugged in for each business and have the
letters all be true and accurate?
I am not even a Kaiser member, and I applaud Mr. Deal's attempt to expose
corporate waste and fraud. Of course, he is too young to realize that he
is in deep trouble for some years to come, and likely won't find a good
job, but what the heck? We live in a selfish society. As long as *he* did
it, no argument.
In the past years as I have worked for KP-IT, I had the chance to be part
of KP-CIS. Justen had some facts wrong: KP-CIS was not a 400 million
dollars loss for KP. It was much more. Somewhere in the range of 4 to 5
billion dollars. At some point in time, around 2000-2001, KP-CIS was
spending between 500K and 750K a day!!!!
Until more of Kaiser's upper management leaves, nothing is going to change.
How many reorgs does it take to fix the problem? After 11+ years of
employment, I left KPIT to change careers. I have no intention of every
going back into IT. In those 11 years, Kaiser went from being a great place
to work, to a lousy job with low morale and poor management. EPIC was like
the Titanic. Management kept spending millions on it to keep it working.
They were more concerned with making their big salaries and huge bonuses,
and never cared what the worker had to say or do. I just remember them
ordering us to work harder and longer with fewer resources. I wonder what
kind of severance package Cliff Dodd walked away with. He's probably
laughing all the way to the bank.
Let's put a real face to Mr Deal...His job was basically one of an entry
level project manager in training and communications at one of 12 hospitals
in southern california. While his focus was on upper management of KP and
KPIT, finances, etc., he missed the true mark. That mark was the fact a
decision was made to replace almost all of the KP home grown systems that
were functioning within the Kaiser, to one "intergrated" system. And do it
in 3 years time. The vision is grand. The problem was those making the
decision and put an agressive deadline to it, had no concept of the real
scope this project or the expertise of those that would have to do it. They
are using a good product, who's average client was no bigger that 2,500
users on one instance and retooled it to scale to 150,000 users and 20
instances - using the same building and configuring techinques as you would
do with the aveage client - which is basically manual building and
configuring again and again. Are using a network that now demands that it
grow and be maintained at a level it hadn't been in the past. Are using
managers whose project management skills and expertise on both the business
and IT sides have never been honed on past projects of this size. Using an
employee pool, both business and IT that are largely inexperienced in basic
IT or clinical knowledge and too small to do the work. With all that- its
getting done. Could they have done a better job? That's a resounding YES.
Could it be better now? Yes, at a larger cost: slowdown the rollouts so we
can do a better assessment of the problems we have run into, create a
better work environment so those knowledgable don't leave do to burnout.
Build good foundations and sound plans and stick to them.
My job at one of the So Cal Kaiser Foundation Hospitals/Med Centers is not
in nursing or other direct patient care - it is in Health Information
Management, formerly known as Hospital Medical Records. Not to be confused
with IT, medical record departments are also not just the dumping grounds
of paper charts that need to be pulled and filed... some of us are also
college educated, credentialed, registered and otherwise certified
healthcare technicians working as "coders and abstractors" of all hospital
inpatient and outpatient encounters. The EHR has been the HIM buzzword for
the past years and now my job (it was once an interesting and challenging
career) is more like DATA ENTRY ... I work in KPHealthConnect not just part
of my day, but every minute spent in a cramped, outdated work-room that
doesn't even have what you would call a real desk,let alone a typical
cubicle, or even an ergonomic workstation.I can't leave Kaiser, I need the
stable position, life-long medical benefits and can thankfully,
comfortably pay my mortgage as a single mother. But the unbelievable
arrogance and bureaucratic b.s. of the administrators and some of the
support staff who have no clue what the daily users of this system go
through has dragged down morale and productivity. I just call it HELL
CONNECT and pray for payday -
Dodd leaving in the aftermath of the Deal email is not necessarily proof of
Deal's allegations, but is very much proof of the inability of Halvorson to
understand and control the situation. This is plain ineptitude.
Let's have Justen Deal solve the Kennedy assisnation. Anyone that has
bought into his conspiracy theory story probably subscribes to the National
Enquirer too.
I am torn about Justen Deal, I applaud him and worry. As someone who was a
CIO and similarly blew the whistle. I find myself unemployed after
remedying the situation while suffering many personal attacks. I believe
Justen did the right thing (hope for the right reasons)as I believe I did
because we must honestly live with ourselves. But there is a high price to
pay.
The price is very high indeed - but I'm hoping I already paid part of it
for Justen. If nothing else, Kaiser will be confirming itself as the
epitome of an evil corporation every time it tries to stomp on him. If
Justen gets ongoing public support, then he may just prove to be the
rallying point for change that Kaiser has long needed.
I work with Justen and he is a STAND-UP guy. This whole thing started in
response to his web blog (a VERY pro-Kaiser blog).He received numerous
responses to his blog that 'dissed' Kaiser and the HealthConnect system
(the computerized record system). Justen did some research and found out
all the things listed on the website fixkp.org. He went through channels
(see fixkp.org under what's wrong) and did not get a response. His email
went out on a Friday in the afternoon. By 6:30pm, the legal dept and IT
were in our dept taking Justen's computer. They spent the next week trying
to located out wireless router, trying to figure out the XM radio antenna
(a bunch of genius') and getting into the computer of every employee in our
dept. Management sent inaccurate, belittling emails to the employees that
looked like serious 'save your a$&' kind of material. The CIO resigns on
Monday pm with NO stated reason. The CEO demanded Justen be terminated. I
have seen Justen several times since this retaliation has happened. I used
to teach Kaiser's non-retaliation policy (not anymore!). Everyone in the
department wishes we had the morale standards and balls that Justen has. We
love him and miss him. Our education computer system has been down for
days. The company we are paying to keep it running cant and with Justen out
(he usually repairs it pronto) no one can seem to get it running. Projects
are not being done. JUSTEN COME BACK. GEORGE HALVERSON and DAN GARCIA GET
OUT!!!!!
Question 'authority', but raise your hand FIRST.
