Earlier this year, Kaiser Permanente completed one of the largest IT projects in the health system's 80-year history.
The health system consolidated 12 separate EHR systems in California into two, one for Northern California and one for Southern California. These two large conversions, involving approximately 40 million patient records, were completed within three hours each time without any canceled appointments or delayed surgeries.
Neil Cowles, the health system's chief information and technology officer, noted that Kaiser's EHR integration shows that large-scale integration can be accomplished without impacting patient care.
He explained that due to scalability limitations when the system was initially deployed, Kaiser found itself operating six EHR instances in Northern California and six EHR instances in Southern California.
“These instances have different configurations, workflows and patient data to suit local service areas, which creates complexity for physicians and care teams,” Cowles said.
During the cutover, the inpatient is actually discharged and then re-entered into the new EHR instance. Cowles noted that this is just a technical workflow—patients do not have to physically leave the facility, change rooms, or experience any interruptions in care.
By consolidating into two instances, Kaiser makes the clinician's task easier, improves data consistency and enables more seamless access to patient records across facilities, he noted. Patient records are centralized, allowing care teams to quickly retrieve complete medical histories—no matter where the patient receives care.
Cowles added that the workflow is now consistent. Clinicians use the same interface and processes across all facilities in their region, reducing staff confusion and training time.
“Ultimately, this integration allows our care teams to focus more on patient care and less on complex systems,” Cowles declared.
In the past, when Kaiser had 12 independent EHR instances, any configuration changes or code updates had to be rolled out 12 times and then carefully synchronized to avoid inconsistencies or downtime. With the newly integrated system, these same updates only need to be deployed twice, which Cowles said reduces complexity, risk, ongoing maintenance efforts and additional IT costs.
The program also streamlines scheduling, he noted, as patients can schedule hospital and medical office appointments more easily and staff can manage those appointments more efficiently.
He attributes the success of this integration project to the close collaboration between Kaiser clinicians, business teams and technical experts.
“The project team rehearsed the over 600-step plan more than 25 times. Many teams rehearsed multiple handoffs and quality checks to ensure the actual activities were flawless. This achievement was only possible if our entire system worked together to identify and agree on key measures of success,” said Cowles.
He also noted that automation plays a key role in accelerating the data migration process. It automates repetitive tasks, such as transferring personalization settings and verifying data integrity, which helps reduce Kaiser's planned downtime by more than 30 minutes.
In planning the project, Cowles said Kaiser's guiding principles were simple: protect patient care and avoid operational disruptions.
To this end, health systems invest heavily in protecting each user’s experience. Cowles said Kaiser migrated personal data and personalization preferences seamlessly, requiring minimal training and minimal change management support for most employees.
“We provided targeted online training and real-time awareness on the night of the switch, but the true measure of success was afterward. As leaders toured the post-go-live clinics, several staff members asked, ‘What switch?’ That was exactly the outcome we wanted,” he declared.
Photo: Thomas Barwick, Getty Images
