Kaiser Permanente launches patient-accessible EMR

Some say giving patients online access to their health information makes practical and financial sense.

By Tyler Chin, amednews staff. March 10, 2003.

Will letting patients view their records online improve physicians' relationship with patients, workflow and the bottom line?

During the next three years, the industry will be looking to Kaiser Permanente for some answers as the huge Oakland, Calif.-based group shells out $1.8 billion to roll out paperless and patient-physician communication systems and make medical records accessible to patients over a secure Web site.

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Earlier about Kaiser

Kaiser will use a system developed by Epic Systems Corp., scrapping a homegrown system it had developed.

Kaiser, which has yet to determine what information patients will be able to access online, began testing the application last December in Oregon.

Kaiser Permanente, which employs 11,350 doctors and has 8.4 million patients nationwide, also plans to create a database containing anonymous patient data and to mine the data for best practices, said Francis J. Crosson, MD, executive director of The Permanente Federation.

"The most important piece of this [project] is that this is a tool that enables the doctor to care better for the patient," he said.

The system is costing $1.8 billion.

A handful of organizations, including CareGroup in Boston, already have done what Kaiser is planning. But none is investing as much or is as large as Kaiser. Thus, industry players will be keeping a close tab on what happens at Kaiser as they consider or roll out similar initiatives.

As patients are able to view their records online, they inevitably will have questions and become more active and engaged in their care, predicted Michael J. Barrett, senior analyst at Forrester Research.

"Doctors are going to get to know their patients better -- something they have always said they wanted," Barrett said. "They complained that ... the patient load required under managed care interfered with their ability to have an intimate relationship with the patient. Now they are going to get what they asked for."

CareGroup, a health system which has six hospitals in the Boston area, has let patients access their records over a secure site since 1998 without reporting any problems.

Patients also can request prescription refills, appointments or referrals. In addition, patients can e-mail questions to their doctor through the site.

A major lesson CareGroup has learned is that "exposing" the record online hasn't resulted in "cyberchondria" on the part of the 10,000 patients who are accessing their records. "You're not going to get overwhelmed with e-mail," said John Halamka, MD, who is CIO of CareGroup and the developer of the application the health system is using. Doctors and patients have found the experience positive, the emergency physician said.

Richard A. Parker, MD, an internist at CareGroup, agreed, saying that patients had not barraged him with irrelevant questions nor asked him to correct their records.

"In general, patients are respectful of my time, and they usually don't bother me for trivial stuff," Dr. Parker said. Regardless of whether records are online or offline, "the patients who are going to bother me for trivial stuff are going to bother me for trivial stuff [anyway]."

Dr. Parker believes that giving patients the ability to electronically review their records and communicate with him online has reduced phone calls to his office and improved patient satisfaction and loyalty. "It allows me to be more efficient with my time and since time in some sense is money, I'm benefiting," he said.

Dr. Parker is one of about 150 to 200 primary care doctors at CareGroup whose patients are accessing their records online.

The online patient access and Web site, which cost $250,000 to develop and another $250,000 for annual support, already has paid for itself by reducing potential medication errors, Dr. Halamka said. Doctors, for example, have been able to avoid adverse drug interactions after patients electronically informed them about over-the-counter medications they were taking.