The Kaiser Permanente Electronic Health Record: Transforming And Streamlining Modalities Of Care

Abstract

We examined the impact of implementing a comprehensive electronic health record (EHR) system on ambulatory care use in an integrated health care delivery system with more than 225,000 members. Between 2004 and 2007, the annual age/sex-adjusted total office visit rate decreased 26.2 percent, the adjusted primary care office visit rate decreased 25.3 percent, and the adjusted specialty care office visit rate decreased 21.5 percent. Scheduled telephone visits increased more than eightfold, and secure e-mail messaging, which began in late 2005, increased nearly sixfold by 2007. Introducing an EHR creates operational efficiencies by offering nontraditional, patient-centered ways of providing care.

Variation in Electronic Health Record Adoption and Readiness for Meaningful Use: 2008–2011

“…Our findings show that between 2009 and 2011, physicians working in practices that were larger, multi-specialty or owned by entities other than physicians, especially HMOs, were more likely to have adopted EHRs than physicians working in smaller practices. Physicians in smaller practices continued to lag behind larger practices 4,7 and those working in closed health systems, 31 as found in earlier studies. Monitoring these trends to assess whether this gap diminishes through the provision of the MU financial incentives and assistance through the regional extension center program will be important.…”

Hospital Computing and the Costs and Quality of Care: A National Study

“…At Kaiser Permanente in Hawaii, implementation of an electronic medical record increased operational efficiency, defined as a decrease in outpatient visits and increase in phone and e-mail consultations. 23 In other settings, computerization has yielded mixed results. 24 In a national study, electronic medical records were not associated with better quality ambulatory care.…”

If You Build It, Will They Come? The Kaiser Permanente Model Of Online Health Care

“…However, emerging research conducted by others at KP and elsewhere is beginning to chronicle the major impact that usage of online health services is having on number of office visits, and scheduled phone appointments. 10 Our research agenda includes further evaluation of these first-order effects as well as the second-order consequences of the shift to Web-based delivery of health services.…”