As EHR installation nears completion, Kaiser recommends 'big bang'

Believe it or not, Kaiser Permanente is nearing the end of its long effort to implement comprehensive, interoperable EHRs at all of its 431 physician offices and 35 hospitals, the largest such project ever attempted in the private sector. The cost and timeline have more than doubled from initial estimates of three years and $1.8 billion to seven years and $4.2 billion, but Kaiser widened the scope from the original, 2003 plan that only included ambulatory installations--back when lead vendor Epic Systems still had an unproven inpatient system.

Dr. Andrew Wiesenthal, associate executive director of the Permanente Foundation and co-leader of the massive EHR effort, said the organization has learned many valuable--and expensive--lessons over the last six-plus years, not the least of which was that training and productivity losses related to training and installation account for more than half the cost of a project this large. Other organizations may quibble with the strategy, but Kaiser says it has learned that a "big bang"-style rollout is more effective than a unit-by-unit installation, as long as providers had received on-the-job training.

And Kaiser has learned that EHR implementation never really ends. Once everything is in place, the focus turns to optimization and transformation of patient care, according to Wiesenthal.

To learn more about the evolution of the Kaiser EHR and the lessons learned:
- read this Health Data Management story