Kaiser Permanente's CIO Aims to Make Healthcare More Delightful

CIO —

In this latest installment of our CIO Interview Series, Fasano spoke with IDG Enterprise Chief Content Officer John Gallant about how the electronic records 'bet' has paid off for Kaiser Permanente and its roughly 9 million customers and patients, and how social and mobile technologies will advance the effort. He offers hard-won advice on making big tech projects successful and talks about what it means for CIOs to be the 'CEO' of their organizations.

Fasano is a member of the CIO Executive Council, IDG Enterprise's peer-based global community of leading CIOs. Click here for more information on the Council.

CIO —

In this latest installment of our CIO Interview Series, Fasano spoke with IDG Enterprise Chief Content Officer John Gallant about how the electronic records 'bet' has paid off for Kaiser Permanente and its roughly 9 million customers and patients, and how social and mobile technologies will advance the effort. He offers hard-won advice on making big tech projects successful and talks about what it means for CIOs to be the 'CEO' of their organizations.

Fasano is a member of the CIO Executive Council, IDG Enterprise's peer-based global community of leading CIOs. Click here for more information on the Council.

Tech Titans Talk: The IDG Enterprise Interview Series

Q: I want to give readers a clear understanding of the size and scope of Kaiser Permanente, so that people have a sense of just how big a responsibility IT has not only in supporting the company but also helping to drive innovation.

A: I'll give you that perspective from a couple of points. We're approximately a $50 billion by revenue institution, so if we were a public company we'd probably be in the Fortune 50. We're not a public company. We're not-for-profit and have a particular mission around that. The organization covers all aspects of the healthcare industry. We're larger than the health systems of 140 countries. So if you think of us as a country health system, we have primary care physicians, we have specialists and specialties, we have all the facilities that would be necessary to operate such a system, including medical buildings that are quite comprehensive. We have hospitals, 36 of them across the program, mostly in California and the northwest part of the United States, as well as out in Hawaii.

Though we don't operate in all 50 states, we do operate from the mid-Atlantic, on the East Coast, in Georgia, all the way out to Hawaii. We are a very large part of California healthcare, treating almost half the state's population. About 9 million Americans get their healthcare from Kaiser Permanente every day, and they certainly expect a lot of us and we expect a lot of ourselves in terms of the capabilities and services we have to offer them. We're also a health insurance company. We're a health plan, although we're an integrated health plan. Our health plan and our care delivery organizations are integrated in the sense that they work very closely together to deliver the high-quality care, as well as the products and services people need to ensure their health.

Our organization has over 200,000 people in it. Our IT organization has a little less than 6,000 employees as well as additional support people that would actually bring that number somewhat higher, probably a couple thousand higher than that. It's a large group of people who are focused on delivering what we call life-critical systems, and having all aspects of technology in place to support all our care delivery operations.

All of the systems to support our health plan and health insurance operations are part of my responsibilities, as well as the infrastructure to support a business of delivering life-critical capabilities to its members, either over the Internet when our members access our Website KP.org, or via a mobile phone, via mobile apps, or if it's when they come into see us in our care delivery settings. The technology supports every aspect of their care and every aspect of their insurance needs on the health plan side of the business. Our electronic medical records system is the largest implementation in the private sector anywhere in the world.

Q: I also want to touch on the scope of your role because you have a unique set of responsibilities that go well beyond just IT.

A: I am one of three executive vice presidents at Kaiser Permanente. My colleagues and I have responsibility on what we call a National Leadership Team and the Operational Leadership Group, which [oversees] day-to-day operations of the businesses of Kaiser Permanente. The National Leadership Team is the equivalent in a public company of an executive committee. We work with the CEO on everything from strategy and strategic development of the business, to quality and service and affordability around all of the programs we provide.

We work in partnership with another leadership group we call our Kaiser Permanente Partner Group, effectively the medical group leaders and our health plan, health hospital operations leaders, all partner together on that group. We go across all of our medical groups, all of our care capabilities, and all of our health plan operations, working together for the benefit of all of our members. We also have an additional goal, and that's to work for the benefit of the communities we serve, because we are not-for-profit and our not-for-profit capabilities are quite significant. We work with community outreach and many community based programs to support people who have challenges getting healthcare access, due to financial or other reasons.

Q: What spawned that significant bet on the medical records initiative? You have talked about your CEO's goal to turn healthcare on its ear. What does that mean?

A: I wasn't here when our CEO came to the company, but I've been here with him for the past five years, and I know that when he came to the organization one of the things that he brought with him was that he understood the value of information technology. In fact, he had implemented, on a smaller scale, electronic medical records in other organizations and, as a consequence, came with an expectation that having those tools was foundational to improvements in healthcare quality, healthcare affordability. And, frankly, levels of service to patients and physicians that were just beyond anything that was occurring broadly in the United States.

Bringing that foundation with him, he decided to effectively bet the future of the institution -- because of the size, scope and complexity of the project -- on implementing an electronic medical record system end-to-end. That meant in every one of our operations, effectively having every patient in this institution be on our electronic medical record system so that every care provider, every physician, every specialist had complete access to the entire medical record every time they treated that patient.

We started to say that patients should look at having an electronic medical record as a right not a privilege in this country. In our organization, it's become a right. Every patient at Kaiser Permanente now has that system. It allowed us to build on top of many preventive care capabilities, in the form of advanced analytics that look through your medical record for conditions or issues that could be as simple as you haven't renewed your prescription to noticing that your physician was attempting to prescribe a particular pharmaceutical that you have an allergy to, which gets noted to avoid having that happen again going forward.

The capability is extensive, it's widespread, and it's very significant. He was betting $4 billion of this company's cash flow on the future implementation of a system that he was hopeful we'd be able to get done, but of course, wasn't assured. I can tell you the bet has paid off in an enormous way and it's given us capabilities that should be expected of every healthcare system.