Healthcare // Electronic Health Records
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Lessons Learned From The Largest Civilian EHR System

Implementation can costs hundreds of thousands of dollars, so it's critical to make wise decisions.

Commitment Required

As EHR systems become more sophisticated and get populated with ever-expanding patient information, data storage emerges as a major challenge, especially when you consider the data volume associated with medical images. Kaiser Permanente continues to expand its use of picture archiving and communications systems. To put it into perspective, our storage systems handle more information than can be found in the volumes of the Library of Congress. We are engaging IT professionals on how to further compress data and store it while maintaining information access.

Our electronic health record systems need to be built and accessed in a way that improves patient-centered care. Tools that support electronic records must enhance the convenience, efficiency, and transparency of our interactions; let clinicians analyze the data and help them identify needed care; and provide computer simulation models that can be customized based on individuals' health histories and other factors. Think of these as "business intelligence" tools that can enhance patient health.

It must be easy to access and use these tools, and to retrieve information from and add information to the EHR without excessive delay or administrative burden. Much of the progress Kaiser Permanente has made in recent years in population care and care registries is a direct result of fluid information exchange among providers--and between providers and patients.

Any EHR system is only as good as the ecosystem of technologies surrounding it. Integrating dozens, even hundreds, of adjacent applications and systems is paramount. When choosing an EHR system, consider ease of integration in addition to best-of-breed functionality.

EHR systems, like every other part of care, will continue to evolve, so remember that systems must be flexible and adaptable to address the future needs of both clinical and IT staff.

Phil Fasano is the executive VP and CIO at Kaiser Permanente. Write to us at

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