Earlier this year, Kaiser Permanente completed one of the largest IT projects in the health system’s 80-year history.
The health system consolidated 12 separate instances of its EHR system across the state of California into just two: one for Northern California and one for Southern California. These two major changes, involving around 40 million patient records, were each completed in less than three hours, without a single canceled appointment or procedural delay.
Kaiser’s EHR consolidation shows that large-scale integrations can be achieved without compromising patient care, said Neil Cowles, the health system’s chief information and technology officer.
Kaiser had found itself operating six EHR instances in Northern California and six in Southern California due to scalability limitations at the time the systems were originally implemented, he explained.
“These instances had different configurations, workflows, and patient data to fit their local service areas, creating complexity for clinicians and care teams,” Cowles said.
During the transition, inpatients were essentially discharged and then readmitted to the new EHR instance. It was purely a technical workflow: Patients did not have to physically leave the facility, change rooms or experience any interruptions in care, Cowles said.
By consolidating into just two instances, Kaiser made things easier for doctors, improved data consistency and enabled more seamless access to patient records across facilities, he said. Patient records are centralized, allowing care teams to quickly retrieve complete medical histories, regardless of where the patient received care.
Now, workflows are consistent, Cowles added. Clinicians use the same interface and processes across facilities in their region, reducing staff confusion and training time.
“Ultimately, this consolidation allows our care teams to focus more on patient care and less on navigating complex systems,” Cowles stated.
In the past, when Kaiser had 12 separate EHR instances, any configuration changes or code updates had to be deployed 12 times and then carefully synchronized to avoid inconsistencies or downtime. With newly consolidated systems, those same updates are deployed only twice, which Cowles says reduces complexity, risk, ongoing maintenance effort and additional IT costs.
The project has also resulted in simplified scheduling, as patients can more easily schedule appointments at hospitals and doctors’ offices, and staff can manage those appointments more efficiently, he said.
He attributes the success of this consolidation project to the close alignment between Kaiser’s physicians, commercial teams and technology experts.
“The program team practiced a 600+ step plan more than 25 times. Many teams rehearsed multiple handoffs and quality checks to ensure the actual event went smoothly. This accomplishment was only possible because our entire system worked collaboratively, identifying and agreeing on critical measures of success,” Cowles said.
He also noted that automation played a key role in accelerating the data migration process. It automated repetitive tasks, such as transferring customization settings and validating data integrity, which helped reduce Kaiser’s planned downtime by more than 30 minutes.
In planning the project, Cowles said Kaiser’s guiding principle was simple: protect patient care and avoid operational disruptions.
To do this, the health system invested heavily in preserving the experience of each user. Kaiser migrated individual data and customization preferences so seamlessly that most staff only needed minimal training and light change management support, Cowles said.
“We provided targeted online training and real-time awareness the night of the transition, but the true measure of success came afterwards. When leaders visited the clinics after the go-live, several staff members asked, ‘What transition?’ “That is exactly the result we were looking for,” he declared.
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