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Kaiser to Put Patient Records Online

Kaiser Permanente, the nation's largest non-profit health maintenance organization, Tuesday said it is embarking on a three-year plan to put 8.5 million of its members' patient records online.

The Oakland, Calif.-based HMO said it will spend upwards of $1.8 billion on its revised Automated Medical Records (AMR) platform to make what it claims is the "largest ever transition to a paperless medical record system."

When finished, patients, physicians and other authorized health care staff will have access to up-to-the-minute medical records, including test results. Kaiser said patients would also be able to schedule appointments, request medication refills, and ask for referrals with a few short clicks of the mouse.

"People are starting to realize how automated medical systems enhance the quality of patient care, but until now, no one has implemented them so thoroughly on such a large scale," said Kaiser Foundation chairman and CEO George Halvorson said in a statement. "Creating secure 24/7 access to up-to-date patient records will mean improved patient care -- whether patients visit their personal physician or any provider in our medical groups across the country."

The HMO covers members in 9 states and the District of Columbia. Its network of hospitals and physician practices operating under the Kaiser Permanente name. Kaiser also sponsors the Permanente Medical Groups, associations consisting of more than 11,000 doctors.

Kaiser said it has been trying for 40 years to come up with a way to fully automate its patient files. After a few false starts, Kaiser resumed its quest for an AMR through a series of local clinical information systems initiatives. By the late 1980s and through the 1990s, virtually every Kaiser Permanente region was working on the development or implementation of some form of an automated medical record. In 1999, the HMO decided to move again towards an AMR system based on a new Clinical Information System (CIS) already deployed in Kaiser's Colorado hospitals.

This time around, Kaiser said it is turning to Madison, Wis.-based Epic Systems Corp. to provide its software including its eHealth systems. The system will allow for patient and hospital staff access to scheduling and pharmacy; administration of emergency room and operating rooms; as well as billing for patients and professionals. The system is expected to be phased in over the next three years.

U.S. Department of Health and Human Services Secretary Tommy Thompson has called the use of information technology to improve the quality and efficiency of health care services a "major priority," however, the move to put patient records online is also stirring the privacy debate.

Kaiser said the new system could be used for large-scale research such as trying to gage the health of a population or spot epidemics, but the HMO said the system will comply with Health Insurance Portability and Accountability Act (HIPAA) for privacy and security protocols. Kaiser said the software has a built-in "Minimum Necessary" system, so that sensitive medical information, such as psychiatric visits or HIV tests, is only available to the health care provider and the patient.

The HMO said patient records would not be accessible to outside researchers or employers. The physician or the parent in select cases could only view the personal files of children.

As for hacker attacks, Kaiser said the AMR uses tools to protect against unauthorized remote access, with security checks and audits within multiple layers of the system.

"We are committed to protecting our patients' privacy and fully complying with government privacy provisions. That is why we selected a system with state-of-the-art security, with many levels of password protection," said Permanente Federation executive director Francis J. Crosson, M.D.