The police are investigating whether a Kaiser surgeon hastened a man's death to get his kidney. I don't even know what to say to that.
Kaiser whistleblower Justen Deal has published an article about patient safety at Kaiser in The News is Now Public. If you think these issues are important vote for the article on Digg here.
I'd like to shout out a thank you to Matthew Holt for his recent help. I look forward to meeting him at the Healthcare Blogging Summit.
ROTFLMAO Update! Should I apply for this Kaiser job? Leave it to Kaiser to stomp on and priggishly ignore their critics while creating a new bureaucratic position to pretend like they're taking action. What Kaiser doesn't get is that Doing the Right Thing starts with...actually Doing the Right Thing. Further Update: Kaiser blocked and email-bounced my application for Culture Change Leader. Should I interpret this as Kaiser symbolically blocking culture change? :D
Here is the text from some recent Kaiser memos attempting to shape public perceptions of their EMR project. Is it possible to overdose on Koolaid? I'm not posting pdfs of the originals because I received them as text.
Important Announcement from George Halvorson, CEO Chief Information Officer (CIO) Appointment
February 26, 2007
I am pleased to announce that Philip (Phil) Fasano has joined Kaiser Permanente as Senior Vice President and Chief Information Officer, effective immediately. As the leader of KP-IT, he will focus on the service, products and people essential to the success of KP’s technology agenda. Phil will be a member of the National Leadership Team and will report directly to me.
Sincere Thanks to Bruce Turkstra
I want to thank Bruce Turkstra for his excellent leadership during his tenure as interim CIO. As you know, Bruce also did a wonderful job overseeing the KP HealthConnect roll-out and advancing our electronic health record to where it is today. His valued contributions throughout the KP HealthConnect project and during his recent work in IT are greatly appreciated. Bruce will be working with me to develop and execute a transition plan.
Phil Comes to KP With an Impressive Background
Throughout his career, Phil has managed teams and organizations whose scope and complexity are very similar to our IT organization. His proven ability in a number of settings to interrelate system support and the overall strategy of the organization will be of great value to us. Kaiser Permanente will benefit from his business acumen, strategic approach and deep technical skills.
Phil has more than 20 years of corporate experience as a business leader and has successfully served as CIO for several companies including Deutsche Financial Services, JP Morgan Chase and Capital One. With each opportunity, he brought a transformational vision that was key to the evolution of the company’s business strategy and success.
Most recently, Phil was President and CEO of Capital Sourcing Group, Inc., in McLean, Virginia, where he provided advice, consulting and services to Fortune 500 companies and the U.S. Department of Homeland Security.
Phil received an M.B.A. from Long Island University, and a B.S. in Computer Science from the New York Institute of Technology. He and his wife, Judy, have five children. They will relocate to the SF Bay area in the near future.
Please join me in welcoming Phil to KP, and in thanking Bruce for his strong performance. I am confident that we will all support Phil in our ongoing efforts to drive an effective technology agenda that enables optimal care for our members.
This is a broadly distributed message. Please do not reply.
Please share this message broadly with your peers.
A message to KPSC managers and physician leaders from
Benjamin K. Chu, MD, president KFHP/H, Southern California, and
Jeffrey A. Weisz, MD, executive medical director, SCPMG
The February 15 edition of the Los Angeles Times reported on concerns with the implementation of our Kaiser Permanente HealthConnect TM system, and questioned its safety.
Many of you have wondered where the reporter from the L.A Times received his information. He interviewed numerous people within KP including CEO George Halvorson and other national leaders. We also hosted him for a full day at Baldwin Park Medical Center, where he spoke with two of our physicians closely involved with KP HealthConnect. He also talked with nurses and other staff, and we gave him unrestricted access to our hospital and clinics with KP HealthConnect. While many spoke candidly of some of the earlier challenges, nearly everyone commented on the benefits the system provides to enhance care for our members.
We know, and the article acknowledges, that Kaiser Permanente has already improved the care for our members because of KP HealthConnect. After mastering the system, the overwhelming majority of our doctors and nurses agree that KP HealthConnect has improved their ability to deliver the highest quality of care.
No comparable scale electronic health record has ever been deployed so rapidly. With a project this large and an organization as diverse as Kaiser Permanente, we have had to overcome our share of obstacles. For the first time, all eight of our regions are operating on a common technology platform through KP HealthConnect. A change of this magnitude required significant IT infrastructure upgrades, as well as a level of cross-regional collaboration that had not been required to date.
This conversion also has had a profound impact on the day-to-day work of our physicians, clinicians, and staff. More than moving from paper to electronic processes, we did extensive examinations of workflows and care practices to optimize the care our members receive throughout our system. This has required significant training and support.
We have always been forthcoming regarding the challenges we have faced and overcome, as well as the success. We expected these challenges in infrastructure, deployment, and adoption given the size and scope of our implementation and we are pleased with our progress to date.
We thank all employees and physicians whose tremendous work has advanced us to this point in our system’s implementation. Your efforts, professionalism, and results make the difference in our ability to deliver and meet our members’ and patients’ needs in the 21st century.
Because you may receive questions about the article from members, family and friends we have provided a brief overview and a link to a Q & A regarding questions about KP HealthConnect below.
Sincerely,
Benjamin K. Chu, MD, MHA Jeffrey A Weisz, MD
President, Kaiser Foundation Health Plan, Hospitals Executive Medical Director, SCPMG
KP HealthConnect Facts
KP HealthConnect is Improving Care Delivery
KP HealthConnect's built-in treatment guidelines are helping us improve the management of common/chronic conditions such as diabetes and hypertension. We are also improving patient safety by increasing the accessibility of the patient medical record. Industry studies show that a paper medical record is missing up to 30 percent of the time for an office visit and paper medical records are almost never available for patient care in an emergency room. With KP HealthConnect, the electronic health record is available when and where it is needed.
Because KP HealthConnect includes more comprehensive patient information, it is helping caregivers address multiple problems or the provision of multiple services in a single visit. This reduces the need for additional follow-up appointments.
Our new online features, such as secure e-mail to your doctor’s office, will bring our members unprecedented access to Kaiser Permanente care.
By logging on to kp.org, members now have the ability to address some of their needs online, instead of coming in for an office visit or spending time playing phone tag. Preliminary surveys show high satisfaction with these opportunities to save both time.
System Availability is Close to Our Goal
Our goal is to have KP HealthConnect available for use everywhere and every time it is needed to provide care and service to our members. Our goal for system availability is 99.7 percent. We currently average 99.2 percent and we are aggressively working to meet our ultimate availability goal.
We’re Continuing to Move Forward
The world recognizes the KP HealthConnect project as a groundbreaking tool that will allow us to set ever higher standards of health care. The dedication of our many outstanding professionals who deploy, support, or use it every single day ensures that we will meet the challenges ahead of us, and distinguish Kaiser Permanente as the best place to receive quality and compassionate care.
For Answers to Additional Questions
Go to the KP HealthConnect Web site for answers to additional questions.
How to Get Kaiser Permanente’s Side of the Story
Ever wish you could go online to get Kaiser Permanente’s side of the story when KP appears in the news? Kaiser Permanente’s Brand Strategy, Communications and Public Relations Department launched an external Web site accessible from KP.org on February 1 so that you can do just that.
The new Web site, KP News Center, highlights the latest news and commentary from across the Program and provides a channel for Kaiser Permanente leadership to tell KP’s side of stories that appear. For example, the feature story on the site today responds to an LA Timesnews article that describes KP’s electronic health record efforts.
The site is designed to inform audiences such as KP members and potential members, KP employees, legislators, purchasers and customers, and the media with facts and information. We are working to identify the best way to make the public aware of the news Web site.
The site also features stories on a variety of topics including Health Research, KP HealthConnect™, Community Benefit and Clinical Excellence. In addition to our own news features, the site includes links to other news sources, health resources on KP.org and Kaiser Permanente podcasts. Readers can also subscribe to news and receive regular updates through an RSS feed. Bookmark it now: http://xnet.kp.org/newscenter/index.html
Please be sure to check this site regularly for ongoing updates and information.
Thank you,
Diane Gage Lofgren
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Over the last week I've toured the health care blogosphere to express my concerns about the recent Healthcare Blogging Summit. My chief concern was that the Summit reinforced the credibility of PR bloggers and other professionals (physicians, lawyers, consultants, etc.) who already enjoy the advantage of being backed by corporate resources and favored by the mainstream media - while helping to further marginalize and suppress bloggers who are trying to criticize corporate heavyweights. The focus of blog-inclusive news aggregators like Memeorandum and Tailrank on A-List blogs has further served to magnify the blogs blessed by the business world while reducing the potential of the blogosphere as a whole of serving as a vehicle for alternative points of view.
To my surprise, several of the organizers of the Healthcare Blogging Summit responded to my concerns thoughtfully, and they had actually hoped for more representation of alternative and critical viewpoints on the panels. One organizer, Fard Johnmar, interviewed me.
Fard also points out Kaiser's recent foray into "blogger relations":
Kaiser is very interested in working with bloggers and may even deploy its own public facing blog in the future. As a result, they are very interested in working with bloggers to communicate their position on the Deal e-mail and other issues.
Kaiser employees have also been attending blogging and social media conferences. This is part of my complaint: Kaiser is trying to hijack the platform for communication and block or swamp criticism instead of addressing it. Kaiser can throw money and hordes of employees at this endeavor: the people with the technical skills and willingness to put in herculean amounts of unpaid work to hold onto a place for alternative points of view are very, very few. Kaiser already gets to push their story through canned news. They should leave the blogosphere alone.
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In other news, Matthew Holt has started to cover Kaiser's health care plan for California. Strangely, this is not the money-grubbing plan that Kaiser CEO Halvorson proposed last month in his capacity as chairman of America’s Health Insurance Plans (AHIP). Perhaps it's more geared to reinforce the proposal that Don Perata, the Dem leader of the CA Senate who also represents Oakland (re: Kaiser's HQ). Honestly, I can't tell from either article. Maybe everyone is just trying to get on the health care bandwagon, and speed of soundbyte is more important than actually making sense.
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LOL! Kaiser wants to get into the "Web 3.0 killer app" couples counselling business....?
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More Kaiser EMR outages are detailed in this article. After asserting that Kaiser physicians don't care about improving the EMR as much as he does, Kaiser's Interim CIO Turkstra lowers his goal for EMR uptime to 99.7% (in the talking points document Kaiser circulated about Justen, the goal is held to be 99.9%). 99.7% is actually pretty low - remember, incidents don't "average out" - an average of 4 minutes a day could mean half an hour during the week.
The article describes several "critical patient issues", including a baby endangered in the NICU (neonatal intensive care unit), but Turkstra dismisses the wording of the incident report as "dramatic". Yep, those tech support folk are some of the most drama-prone people in the working world. Every time someone loses an email at Kaiser, 15 guys run in little circles, screaming and tearing their hair out. ;-)
In other news, a doctor describes frustrations with the Kaiser system from the patient point of view:
Dr. Min Su said he found it hard to believe when patients expressed frustrations in dealing with the health system for which he worked. This week, the Modestan found himself in those patients' shoes, battling the system after an insurance flap caused his premature twins to be split between two hospitals [Kaiser wanted the weaker of two twins to be moved to a Kaiser hospital]....The Kaiser health system did not literally "require" the transfer, but a case manager said the parents would have to pay for the charges [if one of the twins remained at an outside hospital]...
..."I heard a lot of patient complaints about Kaiser," Su said. "Now, I realize they provide good care for the healthy patients, but when the big one comes, they don't care. They just care about saving money."
...As a former physician for Kaiser, Su said, he was able to appeal to officials in Kaiser management to resolve the issue, something that is rarely possible for regular patients...."I got nowhere going through normal channels," he said. "I can see it is frustrating for people who are looking for help and don't know where to go."
Lastly, has anyone been reading the story of Abu Ghraib whistleblower Joe Darby? This poor guy can't even go back to his own hometown because everyone thinks he's a rat who betrayed his buddies for handing over PICTURES OF PEOPLE BEING TORTURED FOR KICKS. What is wrong with this country? Silencing whistleblowers (including discouraging them through loud humiliation and abuse) and hiding such atrocities helps perpetuate them. And this isn't just about a few people who were unluckily subjected to torture - though that should be reason enough in a civilized society - it's about whether we want the respect and admiration of the rest of the world. That respect and admiration has to be earned: the world is not a high school where Americans automatically get the privileges of being pretty and popular just because they can afford a nose job and a new car.
Update: A little birdy pointed out that the Business Times included a wonderful wrap-up of the mystery of the phony press release on Friday.
If it turns out to be a complete con job, it's a darn good one: Not only did the writer capture PR-speak perfectly -- he/she also knows an awful lot about Kaiser. All of the names and titles check out. Korn/Ferry, the search firm listed, is the one Kaiser used last time its top job was open. The media contact number listed is the real one. And Kaiser frequently uses PR Newswire to pump out its actual news releases.
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The rise of social media has been a powerful tool for whistleblowers. One video on YouTube can be heard around the world, getting the concerns of the whistleblower out before corporate PR departments can shape public perceptions. This means the public is in an unprecedented position to help whistleblowers.
Whistleblowers make a terrible sacrifice when they take their concerns public. While corporations have the PR and legal resources to punish whistleblowers for stepping out of line, the public rarely steps up to protect whistleblowers because they have mixed feelings about anything that shakes the status quo.
Whistleblowers internalize the public ambivalence: I, for one, never promoted this blog for my own case - it was mainly just here for interested parties, and it gave me a way to respond when the mainstream media was propagating Kaiser PR. However, for the sake of another Kaiser whistleblower, I've made more of an effort recently. As part of that effort, I thought it might help to be explicit about what readers of this blog can do to help.
First, here's WHY you should help:
1) Are you against letting corporations destroy, re-arrange, and manufacture evidence to "manage" a favorable outcome to a situation?
2) Do you believe that whistleblowers should be able to rely on basic protections from corporate retaliation?
3) Do you want government oversight agencies to expedite acting on whistleblower complaints, quickly apply whistleblower protections, and remedy any initial mistakes they made that harmed the whistleblower?
4) Do you think whistleblowers should be able to freely express their concerns without needing a lawyer?
5) Do you believe the media should report on matters of public concern instead of helping corporate PR abuse or frame whistleblowers?
6) Do you believe the media should rapidly correct of matters of fact, even if the whistleblower is a person of no power or influence?
7) Do you want to prevent corporations from intimidating whistleblowers through filing fake lawsuits?
Now here are seven tips on HOW you can help:
1) For my own case, I posted a list of people to contact. This same list can be used to help other whistleblowers in California, and I welcome suggestions about what I should add to it. Contact political representatives to make sure they quickly activate the appropriate whistleblower protection measures (and, more importantly, so they know that the public doesn't want them to villify the whistleblower: otherwise political representatives go with how the media is reporting it). Contact the media so they will know the readers are interested in exposing corporate shenanigans more than slamming the whistleblower.
2) If you have a web site or blog, it helps to blogroll and/or link to sources that offer the whistleblower's point of view. This is especially important if the mainstream media is already being dominated by corporate PR. For all the skepticism about the media in general, bloggers often rely on rehashing mainstream media content: that means they can easily end up as vehicles for corporate PR. A couple of weeks ago I caught a prominent blogger rehearsing falsehoods about Justen Deal. It took several comments to get her to consider where her assumptions had come from. This week she's on a panel of a blogger's conference, acting as an expert on blogger credibility and influence. But her sort of "credibility" is based on shunning independent blogs like mine in favor of citing mainstream media sources: i.e., her credibility is derived from the *reputation* of the mainstream media, not any gauge of the truth.
3) Of course if you're a blogger, it would really help if you blogged on the whistleblower's story. You might even be able to get an interview with the whistleblower. Do a podcast. See if you can get video.
4) If you don't own a blog, but you comment on them, you can help by offering a counterpoint every time you see a gross error in how a blogger has represented the whistleblower's situation or wherever you see comments obviously planted by corporate PR. I'm pretty good at tracking these, but I'm not omnipotent and I don't have the resources that corporate PR departments do. Justen at least has me - no one was there to help me with this when I was under Kaiser siege.
5) If you participate in social networking or social media sites where you can share blogs, news stories, and links, post the whistleblower's story. If there's video or podcast, post those on YouTube, etc. If the whistleblower has a podcast or video, add it to your public playlists. If you know of some forum frequented by people with the professional skills/resources to advocate for someone going up against a big corporation, point them to the whistleblower's story.
6) If you're a recruiter, HR representative, or hiring manager, you can take action to counter the public belief that whistleblowers will never be hired again. Corporations are only able to use that as a threat against whistleblowers because HR gurus have been harping on the dangers of digital dirt when they could be promising people that there's *nothing* corporate "issues managers" can do to destroy their chances for future employment. How about vowing not to Google prospective employees? How about making a public statement to the effect that you welcome job applications from people of integrity, including whistleblowers? At the very least, don't perpetuate the intimidation of whistleblowers through your own actions. Don't, for instance, decline hiring someone right after visiting their blog, lie about the reason, and then visit their blog several times a day every day thereafter (which not only emphasizes the role you've played in punishing whistleblowers, it shows you're a hypocrite since you actually love what they're doing).
7) Some people compulsively rip on whistleblowers without even reading their point of view. If the whistleblower has a blog or web site, please at least read what they have to say before tearing into them. Whistleblowers who have taken their concerns public are also often willing to answer questions, too. Try to avoid making assumptions based on whistleblower stereotypes: whistleblowers are individuals, with a variety of reasons for taking their problem public. Remember, a whistleblower who has gone public needs your help. Right now, the whistleblower experience is like crying "Rape" near a busy street - and then watching everyone cross the street away from you in order to gossip about your character and scalp tickets.
Many of the people who read this blog are filled with good will, and I hope at least some of you will be willing to convert that good will into action.
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