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Big HMO Jolted By Email, System Failures

Posted by Zonk on from the so-proud-to-have-epic-systems-in-madison dept.

JoanofAlaska writes "The Wall Street Journal is running a front page story about the internal mass e-mail that exposed the failing $4 billion dollar electronic medical record system at Kaiser Permanente, the biggest non-profit HMO in the country. When word of the system's meltdown quickly spread back in November, one reporter obtained a 722 page internal document that showed patient safety lapses as a result of the system's problems. Then in February, the Los Angeles Times had a front page story in which a systems analyst who worked on the project called it 'the worst [technology] project I have seen in my 25 years in the business.' They've created a website to try to rebuild confidence in the project, and they say their goal for system availability is 99.7% (they're currently at 99.2%)."

7 of 171 comments (clear)

  1. Smoke, meet fire... by Anonymous Coward · · Score: 5, Informative

    Here's the first e-mail. Their CEO sent out an e-mail response to all their employees the next day (the same day it looks like the CIO suddenly resigned effective immediately).

    I don't know what to say about the first e-mail until I see more but the CEO sounds like a real jack ass in the second one. And if that 99.2% number is right then they got bigger problems than some email - that's all I can say!

    ac

    1. Re:Smoke, meet fire... by arth1 · · Score: 3, Informative

      To put the 99.2% figure in perspective, it amounts to almost 3 full 24-hour days of downtime a year.

    2. Re:Smoke, meet fire... by networkBoy · · Score: 4, Informative

      but say you can't get antibiotics for a day to treat an infection due to system downtime That would not happen. As a kaiser member I can tell you three things:
      • The patient owns their care. If you don't keep track of things then you will not get the care you need. (this is not malice, but rather I suspect kaiser is a victim of their size)
      • The doctors and nursing staff want to do their best for the most part, but are overworked, again leading to "you own your own care"
      • even when there is an outage, if an ER doc wants meds for a patient, they can get them. The computer system does all the record keeping, the humans still do the medicine, they have paper forms for everything, and when the computer is being an ass, they simply fill out the form like the "old days"

      In all reality they are not the great evil. They certainly could do better, but by no means are they horrid (this assumes that you, as a patient, know what you need, and press for a second opinion &&|| a specialist when the initial diagnosis doesn't seem quite right).
      -nB
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    3. Re:Smoke, meet fire... by R2.0 · · Score: 3, Informative

      What's wrong with N+1 redundancy? While I agree it requires an attentive response from Facilities to replace the failed unit quickly, my experience with facilities departments is that, if there is greater redundancy, they tend to rely on it to stretch out response and replacement intervals.

      For instance, we stated having failures of refrigeration units in a new facility I helped build. Everything was going fine, until we stated getting calls regarding multiple equipment failures and risk to the product inside the unit? We were perplexed - we had built in multiple levels of 100% redundancy (double sized, 2 refrigeration systems per unit, and twice as many units as required for the plant capacity). It turns out that various components had been failing for weeks, but the Facilities department was ignoring them because the backup systems had taken over immediately and there was no imminent risk. It was when the backup systems started failing that we got the frantic calls. There was a systemic problem with the fan motors (didn't use low temperature grease), which the manufacturer fixed promptly, but now the replacements were on an emergency basis instead of planned. When asked why they didn't report the initial failures, the maintenance staff just said "we always run on backups until we can get around to it - what's the use of redundancy if you can't utilize it?"

      Like Ron White said, you can't fix stupid.

      --
      "As God is my witness, I thought turkeys could fly." A. Carlson
  2. Long-term Kaiser patient disputes wild claims by msblack · · Score: 4, Informative

    This 45-year old lifetime Kaiser patient believes the media frenzy has blown this out of proportion. Kaiser Permanente undertook the monumental task of converting its patient records system into an electronic information system. Converting the hundreds of paper records for each of millions of patients is truly a monumental task and some problems will occur.

    Let me tell you of my experience visiting my doctor yesterday (Thursday). During my visit, my doctor pulled up recent lab results on the exam room console. He was able to prescribe new medication and schedule follow-up lab test through the system (no paper). I went down the hall to get a tetanus booster, then walk downstairs to pick up my prescription. All with no paperwork. I believe their system is phenomenally successful. I won't dispute the cost of this project.

    I've undergone a number of procedures and consumed considerable medical resources during the past year. All of my records are computerized and information is easily shared among their medical professionals. The doctors, nurses, lab technicians have access to information required to deliver quality medical care to me.

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  3. Re:Epic Systems? No wonder... by Mumpsman · · Score: 4, Informative

    Oh, Epic Systems? No wonder. Dude, you're f****ed.

    *sigh* - too true. Epic requires a monumental effort just to get the off-the-shelf product to work properly. Kaiser is doing a massive amount of internal development in addition to trying to implement as Epics biggest customer.

    Part of me wants to think that Justin is just fresh meat who hasn't put in the time to become as jaded as the rest of us in HIS. The other part of me thinks he might be right and that Kaiser has bitten off way more than it can chew. Failure to understand the effort involved is just as pervasive as the massive waste he's critiquing, and just as harmful.

    --
    No battles to the death are recalled. Mumpsman can hit to attack and cause brainsmashing.
  4. Percentages and Marketing speak by WarlockD · · Score: 3, Informative

    Dell offers contracts for 99.9% system availability. This means that if you pay the service contract, your within 30 miles of a depot, they guarantee the system won't go down because of hardware for 8.76 hours out of the year. In training we were calculating all that. Technically, it calculates to two "no post" service calls out of the year. So it looks really good when you market 99.9% reliability.

    It's also why many companies can say 99% uptime as that's close to 88 hours of downtime out of a year.

    Hours in a year 8760
    99% = 87.6 hours
    99.2% = 70.08 hours
    99.7% = 26.28 hours

    If they are at 99.2% right now, I wonder how the heck they are going to get that extra 0.5% percentage points with all the problems they have now.