Probably the biggest misconception about Kaiser critics in general, and this web site in particular, is the belief that we have the unrealistic goal to “bring Kaiser down” (typical accusation from the occasional hate mail we receive). That couldn’t be further from the truth. Our only purpose is, and always has been, to shine a spotlight on the numerous internal problems at Kaiser so that positive changes would occur, and we believe that has indeed been happening.
For example, we believe Phil Fasano is sincere in his goals for HealthConnect, as related in the following article from East Bay Business Times, and we wish him nothing but success in achieving them. We are here to advocate for the patients, and anything that benefits Kaiser members is okay with us.
What is not okay is the constant lying and cover ups that ensue when something does go wrong; with HealthConnect, in patient and employee disputes, or in any other area of Kaiser operations. As a not-for-profit public benefit corporation, Kaiser has a responsibility to the public to operate at all times in transparency and with integrity, and so far that simply has not been happening. Kaiser has been paying a lot of lip service to issues of transparency and culture change recently. If we ever see any real evidence that they are doing anything more than talking about it, it will be our pleasure to report it here. But we won’t be holding our breath.
Before reading the full article, we recommend that you check out Justen Deal’s blog for some interesting analysis of these latest revelations about HealthConnect by new Kaiser CIO Phil Fasano.
From East Bay Business Times:
New exec to solve IT woes at Kaiser
by Marie-Anne Hogarth
Kaiser Permanente, reeling from a succession of computer system troubles, is betting its third information executive in six months, a former banker, can set things right.
Philip Fasano, former CEO of Capital Sourcing Group Inc., takes the helm as vice president and chief information officer from Bruce Turkstra, who served in an interim capacity for only a few months after the sudden resignation of Cliff Dodd last November.
Fasano is promising to make Kaiser’s computers and call centers, which more than 12,000 physicians and 8.7 million members rely on to access sometimes life-altering data, work reliably and full time.
Dodd’s departure came days after an e-mail from a now-former employee calling attention to cost overruns and problems with Kaiser’s 3.2 billion electronic health records program, KP HealthConnect. Kaiser, which has declined to state why Dodd left, said it was unrelated to the e-mail.
Availability of IT systems will be a top priority especially as Kaiser proceeds with a number of related strategic initiatives.
The HMO giant looks to technology to capture lost revenue from problems with billing, develop new insurance products for the world of consumer-driven health care and execute on its mission of preventive medicine.
Fasano worked a succession of executive jobs over two decades with Capital One Financial Group, JPMorgan Chase, Deutsche Financial Services Corp. and others.
He says he’s well positioned for this role coming from an industry that more than two decades ago stopped treating IT as a back-office function. Financial services quickly evolved into one where being “real time” was a competitive advantage, a transition that the health care industry is only making now.
“What I would love to deliver is ‘always available,’ ‘always on’ and ‘regardless of your setting,’ ’24-by-7,’ ‘365,’” Fasano told the East Bay Business Times in one of his first interviews in the new job. “That is the industry I came from. We spent the last 20 years in that industry developing the capabilities to allow us to deliver on that promise, particularly in our critical areas, like global trading.”
In particular, Fasano said that in the next 12, 24 or 36 months, Kaiser will be coming out with a suite of products allowing doctors to follow patients more closely. Patients in their homes could step on a scale – for instance – and their weight would be automatically uploaded electronically onto their electronic charts for doctor to see.
“Every bit of information that we expect to gather, we expect members to have access to what is appropriate for them,” Fasano said. “And do that in any format that they will like.”
The first goal, Fasano says, is to get KP HealthConnect up and running at least “five nines” – 99.999 percent of the time.
“(Kaiser CEO) George Halvorson and I have come together on that and believe very, very passionately that has got to be our goal,” Fasano said.
That’s a different message from what Turkstra related to East Bay Business Times in an interview in December, when he said the goal was an up-time of 99.7 percent. That would mean the system would be down about four minutes a day.
In the first quarter of 2007 – according to Fasano – the system has been up 99.57 percent of the time.
“If we are delivering real time health care, you have to be available all of the time,” he said. “Our clinicians require it. Our members require it and so do our customers.”
Toward his goal of “real-time health care,” Fasano says he’s developing a new five-year infrastructure investment program that is conditional on some board approvals, and he’s recruited a new chief technology officer, Carol Rizzo, formerly CTO at American International Group Inc., who will support the clinical applications.
He’s also restructuring his department to give more authority to regional business information officers. There may be some lost jobs, he admitted, although he characterized them as nothing out of the ordinary.
“We may make some staff changes that happen as a result of the larger re-org over time,” Fasano said. “But not material numbers. My staff is 5,500 to 6,000 people, plus consulting resources. So if you add them up all across the company, if we lose 50, 100 people, that I would look at as normal attrition for an organization our size.”
Outsiders who know Kaiser say this is a tune they’ve heard before.
“Kaiser has gone through in the last 10 years three different cycles of this, where there has been this pull and this gravity toward complete centralization … to let’s loosen up,” said Joseph DeLuca, the managing practice director of IT Optimizers, an Oakland health care consulting firm. “You centralize for control – budget control – and you decentralize when you are profitable and you want to expand market share.”
Fasano is calling for a shift from a bureaucracy he says was 20 percent “internal customer facing” – meaning clinicians and Kaiser employees in the eight regions – and 80 percent shared services. Under the new structure, the organization is 60 percent internal customer facing and 40 percent central.
This means that service staff members who assist clinicians with computers and IT, as well as staff who develop new applications, would be managed at the regional level. Fasano is a giving a dozen business information officers – eight of them over the different regions – more budget, autonomy and accountability.
“Historically, the resources that many of them needed to execute were elsewhere in the IT organization, making it very challenging for them to consistently execute at a very high level,” Fasano said. “These changes are really intended to drive results on behalf of the eight regions in a very specific way, and to empower these individuals to have the authority to do that, as well as to ask those individuals that they perform a national role with me.”
Fasano hopes to spend an additional $100 million to $200 million on top of his budget next year on infrastructure investment. The annual budget for IT in 2006 was $1.7 billion and in 2007 it is $1.6 billion, a change Kaiser says results from KP Health Connect implementation costs coming down.
Kaiser, which earlier this month completed the KP HealthConnect rollout of two more hospitals in California – West Los Angeles Medical Center and Santa Rosa Medical Center – hopes to have Northern California hospitals online by 2010.
“We’ve been very methodical about bringing up hospitals one at a time and in a very careful manner so that we do not put anything at risk in that setting,” Fasano said. “The two most recent hospitals came online so well and had no problems whatsoever with the implementation.”
With regards to his infrastructure-improvement program, Fasano says he wants to upgrade data centers so that if one data centers fails, another can take over. He also wants to improve function of Kaiser’s 45 call centers around the country, serving members and clinicians.
Fasano also talked about making “continuous upgrades” to its Citrix farm, the programs that allow for central control of all of Kaiser’s computers and desktops.
Deluca, who says that some of Kaiser’s problems with up-time and system availability appear to be linked to the Citrix architecture, agrees this investment will be “crucial.”
“If I can think of anything comparable,” Deluca said, of the health care IT system’s complexity, “it is the airlines.”
You hear sincerity in his voice but it sounds more like inexperience. How much does he know about Kaiser-or health care in general? They have many problems to fix and he is talking about wireless weight scales-instead of network gear, data centers or application delivery. Worrying. Will he last a year?
Wanting to achieve “five nines” and actually doing so are two completely different things, aren’t they?
Halvorson’s decision to hire someone from the financial sector, rather than health care, speaks to what has always been ol’ George’s top priority…achieving fame and fortune for himself and Kaiser, with little regard for the effect his decisions have on employees and Kaiser members. I’m sure that any improvements in care delivery were secondary considerations for Mr. Halvorson, except for how the improvements might apply to the primary objective.
Neither one of them wants to fail, and if Mr. Fasano is a good leader it’s not necessarily a requirement that he have experience in health care. It’s a matter of hiring the right people, and most importantly, listening to them (hint! hint!).
I don’t really have an opinion about whether he can pull it off or not. I just hope someone does!
Has anyone heard of any kind of news about the class action suits against Kaiser in regards to the kidney transplant mess?
Sorry Mark, haven’t heard anything.
I read the new CTO made her name by sending IT jobs overseas at the bank she worked for before Kaiser. Is that the only solution they can come up with????
I can’t wait for the employees to start coming here to tell us all about what’s really going on behind the press releases. Remember Kaiser IT people: use discretion, and don’t post or email from a Kaiser computer! Here’s our privacy policy. 😆
All kidding aside, I do hope they get the problems sorted out for the sake of the patients and providers. I am willing to give all of the new execs the benefit of the doubt until they prove they don’t deserve it.
I can’t remember all of the details, but I believe Halvorson got caught in a lie for claiming Kaiser doesn’t outsource medical transcription (I could be wrong about the job) to India, when it turned out that he knew damn well that the contractor they had hired most certainly did. He was trying to weasel around the truth on a technicality like he always does.
There are also a couple of articles by David Lazarus (linked in our sidebar) about Kaiser outsourcing tech support jobs to India. This scares the crap out of me. Has anyone ever tried to get actual tech support from a call center in India? I have, and the nicest thing I have to say about them is that they are less than supportive. I try to avoid companies without American tech support whenever possible.
Me too. I’m tired of trying to book domestic flights on United through a call center in India with a language barrier and crackling phone lines. It really gets on my nerves. Imagine what already bad health care would be like with even more of a barrier and crackling phone lines. I won’t use United anymore because of it. They don’t give 2 hoots about their customers and Kaiser is already well beyond not giving any hoots.
People are unbelievable. You do your best to bring someone in to do a good job and you guys just slam them. It doesn’t matter if he has a health care background he is working with computers not providing patient care. Do you people not get this. The brought him in for his ability to get systems to run as the should and that’s what he will be working on. For those of you who think that Kaiser is the only company outsourcing to India wake up. Most large corporation do this. It allows them to continue to compete with their competitors who are also doing it. You people have no business sense at all. And I know what you will say: Its not a business is Health Care. Well is you can’t afford the machines, supplies, and personnel you need then you have no Health Care. It’s a NON-Profit organization. Do you even know what it means to be one, or, what the stipulations are behind getting that status. It just seems to me that people on this site are only here to complain and nothing else. They are either ignorant or just too lazy to do much research and they quote the 1st website they can find. News flash everyone. Not everything you read on the internet is real or true. Another thing; do you really think that Kaisers PR staff sits around and tries to think up ways to plant false information about themselves to deflect the spot light from another area. Again, you people don’t know the first thing about running a company much less a HealthCare organization. You all oppose the options given or taken, yet you do not propose and solution. For that you would be removed from my meetings and not invited back because you bring nothing to the table other that your bad attitudes.
Now, now, Mr. Cruise. Before you go around hurling accusations perhaps you should re-read what we said. Did you miss the part where we wrote that we believe Fasano is sincere? How about the part where we say that as long as he is a good leader, experience in health care isn’t necessarily a requirement. Or this: “I am willing to give all of the new execs the benefit of the doubt until they prove they don’t deserve it.”
You misrepresent what we said, then you go on to tell us you know what we’re “going to say,” and you’re wrong about that too. Moreover, accusing others of ranting in a rant of your own comes across as just a little bit hypocritical.
A few points:
1. Kaiser is non-profit in name only, and this we know for a fact. Read the CNA’s report on Kaiser for a more detailed discussion on the “distinction without a difference” between Kaiser and for-profit health plans. Yes, we know it’s several years old, and some of the details have changed, but the important points are the same.
2. Most of what we post is from legitimate news sources, and not “the first website we can find.”
3. And yes, Kaiser’s PR staff does sit around trying to think up ways to manipulate public perception. That’s what PR departments do.
I’m sure you believe what you said here today, Tom, but unfortunately that doesn’t make it true.
Have a nice day 😀
Now, Now, Mr. Admin, LOVE THE NAME!
You are correct. Some of you do but for the most part you fit in a back handed statement about his experience or some other statement meant to give the appearance of a good hearted statement until you get to the end of it. I know that some people on this site do hope it enacts change for the better of Kaiser as a whole but for the most part this is simply a place for disgruntled employee’s or former employees to air their personal issues with Kaiser when they are most likely the ones that brought it on themselves. I do not argue any reports of malpractice since I do not know enough about them to dispute them. However, being one that works for Kaiser, the people on this site are generally, but not always the people who were fired for one reason or another and they feel wronged even though THEY are the idiots who stole something, defrauded the company in one way or another, had major attendance issues and don’t see a problem with arriving late to work on a regular basis, or just have a bad attitude in general so they were no like or wanted in the clinic. It is indeed sad but very very true.
In dispute of your points:
1. If Kaiser was a non-profit in name only that would mean they would have share holders who get paid out. Since that doesn’t happen, I guess your point isn’t relevant. They reinvest the money into the company making it a not-for-profit organization.
2. That your opinion and since you have no supplied any facts to dispute it, I will continue to believe what I know. The first negative source is used whether hear say or fact. I know very controversial postings on here are driven off of hearsay since I have been present for several of the instances stated and taken out of context. Some good, hard working, extremely competent people have had their name slandered on her for no reason other than that person’s jealousy.
3. Your 3rd statement proves all my points about the common posted on this site. Do you work for a PR firm? Have you ever? Do you know anyone who does? Why don’t you find someone who does and ask them the best way to look good in the eyes of people. Is it making up lies and covering up controversy? Probably not.
I appreciate the banter.
Have a good evening. :o)
I can’t speak for everyone who comments here, just myself as the site admin (thus the name). No one speaks for the site officially but me.
Let’s continue numbering our points, shall we?
1. You didn’t read the CNA report, did you? And Kaiser does have shareholders. 1/3 of the Kaiser Permanente Medical Care Program is the for-profit Permanente Medical Groups, and the doctor partners are the shareholders. Half of the non-profit arms’ “not for profits” go back to the for-profit medical groups, which creates a conflict of interest and implied incentive to deny care. Kaiser’s organizational structure is deliberately misleading, and the “health plan and health care provider in one” model breeds all kinds of corruption.
2. Again, I can only speak for what we post on the blog, and my own personal comments, but all you have to do to verify what I said about legitimate news sources is to browse through our archives. Everything is linked to its source. Opinion stuff, and personal web sites are easily identifiable as such.
3. Yes I have worked in a PR department as a matter of fact. I have also personally seen Kaiser’s issues management team twist the facts from incidents that I have personally witnessed. I’m sorry, but you really are wrong about this.
Tom, Kaiser was just fined $3 million for poor handling of patient complaints, and according to all reports the problems are systemic. People who have been put through that wringer are angry, and justifiably so. I try to understand where Kaiser employees such as yourself are coming from, and I don’t think it’s too much to ask that you spend a few minutes putting yourself in the other side’s shoes. A little empathy goes a long way.
I’m not an unreasonable person, and I honestly do welcome the dialog.
Best regards,
One more thing.
Regarding the HealthConnect posts, which is what I assume you’re referring to as hearsay: we did receive multiple confirming complaints from independent sources, some of which were unimpeachable. Even so, it’s pretty obvious there are differing opinions and experiences within the project. People aren’t dumb, they know to take that kind of thing with a grain of salt.
Sometimes it takes something shocking like that before management will make the necessary changes, and Kaiser is well known for not addressing problems until they become public knowledge and affect its precious image (just ask the kidney patients).
As a gesture of good faith, I will go in and shorten all of the last names to initials. I might not be able to get to it until the weekend though.
Great Site Please Keep up the Good Work Expose Kaiser
Thanks
Quoted from Tom Cruise…
“It just seems to me that people on this site are only here to complain and nothing else. They are either ignorant or just too lazy” You might complain too if Kaiser allowed your Baby to die.
hmmmm, I most certainly WISH it had been this simple. That I was just ignorant and lazy and this is why Kaiser killed my Baby and then destroyed and tampered with my medical records so the case could not be arbitrated.
By the way Tommy C., I am a DISGRUNTLED VICTIM of Kaiser and I have spent 21 years working in the PR, Advertising and Marketing industries. I know all about hype. From my own personal experience, Kaiser is at the complete opposite end of the spectrum when it comes to doing what they promise in their advertising. This is about as false as false advertising can get.
Dear Admin.,
Excellent site and please keep up the good work. Kaiser victims everywhere are counting on you!
In case anyone has paid attention, Mr. Fasano has recently outsourced 700 IT jobs to IBM Global Services and laid off an additional 160. These jobs are connected to Data Center Operations, and include areas such as system administration, etc.
IBM hired back just over 300 of those outsourced, after ‘interviewing’ all 700. Rumor is that in some areas, IBM way underestimated the amount of work to be done. Furthermore, IBM will have to compensate Kaiser for missed goals in their Service Level Agreement.
So it’s a win/win for Kaiser. Shed the jobs and corresponding salaries and benefits, and when IBM can’t meet the service level agreements because they were sold a bill of goods, Kaiser will get some money back on the contract they signed ($700 million over 5 years).
But this is billed as ‘not about the money’.
Oh well…. Considering what’s coming down the pike in healthcare refrom, maybe Phil and company will be part of the 10% of those in the unemployment line.
In case anyone is still wondering, the outsourcing deal with IBM is failing miserably. Service to members is a disaster and outages are through the roof. People are wondering what exactly Kaiser is still doing in this contract. They need to abandon IBM just like the State of Texas, Disney, and many others have. Oh, and Fasano should be fired as well!!!