Dr. David Brailer, appointed by the president a year ago to deploy health information technology, spoke to about 200 physicians, IT experts and other Kaiser staff at a conference on health IT in Oakland on Tuesday.
"The way Kaiser has gone about doing this is a great learning experience for other providers," Brailer said. "They've brought consumers into the process and made sure they are designed into the system."
Kaiser's new medical information system, called HealthConnect, is a $3.3 billion, decade-long initiative that integrates patient data into a single format for quick and secure access. It is already up and running in Colorado Kaiser facilities.
As part of HealthConnect, Kaiser members and medical staff will be able to track medications, allergies, lab results and other information online through Kaiser's Web site. If a Kaiser member is admitted to a nonaffiliated emergency room, all that information can be accessed instantly once the ER physician gets security clearance to view it.
HealthConnect is rolling out now in Northern California, with Bay Area outpatient services in Pleasanton, Hayward and Fremont going online in September. All regional facilities, including inpatient and outpatient, will be using it by 2007. And starting in October, the
3.2 million Kaiser members in Northern California will be able to e-mail their physicians on a secure network.
The Bush administration is watching Kaiser closely as it develops a 10-year strategy to get all health care providers including hospitals, doctors' offices, nursing homes, labs and clinics to go digital with medical records and other health information.
The initiative, announced in 2003, could cost the government and the private sector as much as $200 billion to initially build and operate, according to a report by health IT experts published Tuesday in the Annals of Internal Medicine.
Brailer, who was a senior fellow at the nonprofit Health Technology Center in San Francisco before his appointment last year, said the administration is taking a market-based approach to the project.
Hospitals and doctors' offices would purchase and implement the new technology using their own funds, as Kaiser has, while the federal government would give its seal of approval to technology that offers the best security and privacy and works across platforms. The government would also use its clout as a major health care provider through the Veterans Administration and health care purchaser to leverage the market, Brailer said.
"Our job is to make it really, really simple and easy for consumers and providers to access," he said.
On Oct. 1, Brailer's team will select six developers to put together prototypes on medical information sharing, privacy and security. The best ideas will be fostered for development.
The private sector would bear most of the cost. Hospitals could pay about $53 billion nationwide, largely to implement new systems and train staff, while physician practices could invest about $50 billion, according to the study released Tuesday, which was funded by the Commonwealth Fund and the Harvard Program for Health Systems Improvement.
Brailer said he thought the cost figures were high but that it was a "good study."
He said small physician practices probably would not be able to support a comprehensive electronic medical records system like Kaiser's, but can replicate some of its practices.
Implementing health IT could reap savings in other areas, such as reducing medical errors and streamlining paperwork. But in a time of rising health care costs, adding more expenses seems daunting, Brailer said.
"I'm often asked, 'Can you really fix the roof while it's raining?'" he said. "This is a one-time chance. If we don't do it today, while there's a low level of adoption, we'll lose the opportunity."
Kaiser officials, whose members are paying to make the switch, believe HealthConnect will improve patient safety.
"This can change the signal-to-noise ratio," said Dr. Andrew Wiesenthal, who is co-leading the HealthConnect effort.
For instance, medical staff can catch subtle problem signs in patients if they have full access to their records, Wiesenthal said.
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