EMRs, KP HealthConnect and Research - George Halvorson Letter

Dear KP colleagues,

More than 2,500 media outlets –- newspapers, magazines, and radio and TV stations -- ran stories last week about the Kaiser Permanente research done about miscarriages and caffeine consumption.

The story ran on the front pages of over thirty major newspapers –- including the New York Times, Boston Globe, San Francisco Chronicle, Sacramento Bee, Cleveland Plain Dealer, and Dallas Morning News.

That piece of Kaiser Permanente research will have an impact all over the world. It’s impossible to estimate how many miscarriages will be avoided as a result of that research -- but there is no doubt that the number will be large –- and the effect will last a very long time.

This weekly celebration letter is not about that very solid piece of research. It is about the specific role we play in world health care –- and that story illustrates a piece of that role.

We have a very special status in the world of health care. We are almost alone in our role as both the provider of health care coverage and the hands-on provider of actual care. Our new data base uniquely has all of the data about the provision of care and about the cost of care.

Everyone else has a splintered and incomplete data base. Even the very best of the other large multi-specialty caregivers -- like the Mayo Clinic or the Geisinger Clinic or the Cleveland Clinic –- who also have implemented electronic medical record systems –- can’t match our data base. Why is that? Because even Geisinger, as a leader in electronic medical record support, only has the portion of the data that relates to the pieces of care delivered directly by Geisinger doctors and the Geisinger hospitals. So if a patient goes to Geisinger for some care and to other caregivers for the rest of their care -- which many Geisinger patients do -- the Geisinger data base is incomplete for that patient.

Geisinger is a great and talented care system. But they don’t have their patients “enrolled.” So they only have part of the data about the care of each patient.

Most other care systems and independent, solo-practice caregivers have a lot less data than Mayo or Geisinger or the Cleveland Clinic.

Why is that important? Because medical care delivery is sadly very incomplete in its data base.

Real research on patient care in most settings today involves tiny patient samples –- with each data element laboriously hand-collected. Those research projects are very small, very time limited, and very un-computerized.

We have the wonderful opportunity to computerize our care data and then use it to do some of the best medical research in the world.

We are building that overall data base through KP HealthConnect.

Our new system will not only give us excellent research data, the total system will also give our caregivers special support in the care of individual patients. I will write about that support in another weekly letter fairly soon.

For now, let's celebrate the fact that we have an opportunity that almost no one else in the world has –- the chance to use the computer to study populations of patients and to do research projects electronically that advance the science of caregiving and track the progression of the new science over time.

Because we have this great opportunity, we have a great obligation –- the obligation to truly use this new tool kit to both improve care and teach the rest of the world how to improve care.

The 2,500 news articles and stories that were printed about Kaiser Permanente research just this week were an indication of ways the world needs us to perform. The researchers for that study used our old data base -- and did excellent work. The follow-up studies that we will be able to do with the new data base will be exceptional.

Have a great week and be well.

George