The state of California is investigating Kaiser Permanente's three call centers, responding to concerns that the health plan may be letting unlicensed staffers effectively make medical decisions by letting them triage patients using scripts.
The state's Department of Managed Health Care acted after a nurse contacted the agency to complain that calls are being mishandled and could be putting patients in jeopardy. She contends that at least one patient died of a systemic infection partly because a call center staffer didn't respond appropriately to his symptom description. She told investigators that she's also heard clerks use the wrong script for illnesses, something that could potentially be very dangerous.
According to the DMHC, Kaiser is barred by a 2003 state law from using systems that let people with no medical training decide how quickly patients should be seen. Kaiser, for its part, contends that employees have so little control that they aren't making decisions. Instead, it says, they just follow scripts written by physicians.
DMHC would now like a copy of Kaiser's scripts, but to date the health plan has refused to supply them, saying that the records are proprietary.
To learn more about the dispute:
- read this article from The Sacramento Bee