Systems Integration in Information Technology - Research Paper Example

Submitted too: Kaiser Permanente: System Implementation Breakdown 2006-2008 Integrated Practice and Group Accountability in Health Information Technology.:A PAPER SUBMITTED by::Author’s NoteAbstract:Kaiser Permanente, comprising the Kaiser Foundation Health Plan, Kaiser Foundation Hospitals, and Permanente Medical Groups is the largest nonprofit integrated health care delivery system in the United States. Kaiser Permanente has pioneering experience in information technology in health care for more than 40 years to improve clinical and administrative functions.

Its use of electronic health records (EHRs) dates back to the 1990s. Kaiser Permanente in 2003 launched a $4 billion health information system called KP Health Connect that links its facilities nationwide and represents the largest civilian installation of EHRs in the United States. Shortly after the system wide integration, in 2006, problems within the system architecture resulted in a dangerous breach of patient care. The system breakdown as described by Kaiser Permanente executives and industry leaders was a direct result of integration of an information technology (IT) component of the KP Health Connect system.

Introduction: Kaiser Permanente envisioned the KP Health Connect system as a seamless integration of resources that in theory would electronically connect members to their health care team, to their personal health information, and to all relevant medical knowledge available to promote integrated health care.(Cochran, 2009) Ideally Kaiser Permanente members would complete an annual online health risk assessment, then receive customized feedback on behavioral interventions, start pro-active health behavior change programs, and choose whether to send results to KP Health Connect to facilitate communication and information sharing with their with their physician.

(Montalbano, 2008) In reality Kaiser Permanente was abandoning a very costly attempt made in the late 1990’s and early parts of this decade to build its own clinical information system with IBM. Kaisers approach shifted to "buy, not build," (Montalbano, 2008) after the earlier failure with the IBM system. The project’s expansive scope was unprecedented for a civilian company. To purchase an “off-the-shelf system” (Montalbano, 2008), Kaiser studied two medical software vendors, Cerner and Epic Systems, ultimately selecting Epic as the primary vendor for a new system that would eventually become KP Health Connect. .(Cochran, 2009) Kaiser Permanente attempted with the “off-shelf” system to fully integrate the company’s previous EHR’s and collect all their data into one system.

(Cochran, 2009) The resulting loss of access and availability of patient records and billing histories has been described as a “catastrophic information technology failure” (Montalbano, 2008) caused by a “misunderstanding of technology”(Cochran, 2009) that led to a major break down in the organizations ability to route all patient records. The circumstances and systemic failures with the KP Health Connect system are directly attributable to a failure of integration between IT systems.II. Problem Analysis: The fundamental “misunderstanding of technology”(Cochran, 2009) made by Kaiser Permanente is the fact that not all IT systems are created in the same fashion.

By nomenclature alone IT systems possess different and dissimilar data structures and architecture that result in an incompatibility at a very structural level.(Aarts, Berg, 2004) Kaiser Permanente Managers failed miserably to comprehend the dissimilarities within the existing company IT base and the new “off the shelf” system from Epic. (Montalbano, 2008) The resultant was a quirky sometimes incomprehensible integration program that effectively created the foundation for a massive IT disaster.

What was originally conceived as a 45 day integration turned into a two year system re-boot that cost Kaiser Permanente almost 480 million dollars.(Cochran, 2009)IV-System Integration Failure: Although the inappropriate choice of technologies was ultimately the responsibility of poor management the complete lack of a cohesive integration plan across the existing and selected technologies was a dominant factor in the failure of Kaiser Permanente to realize the full potential of innovations offered by the Epic system.

The very nature of the extant research preformed on the “off the shelf” software did not pay enough attention to technology integration and its relationship to performance as a specification of selection.(Ash,Berg, 2004). The most significant obstacle to the successful system integration was the absence of a universal definition of an EHR (Barki, 2005) by Kaiser Permanente Managers. Health care providers must have a specific and concrete definition of what the EHR is and what it must consist of.

(Ash,Berg, 2004) Empirical studies in health care have sufficiently demonstrated that basic system nomenclature too often dictate the ease or degree of difficulty encountered in wide spread system integrations. (Barki, 2005) Ultimately managers based their software selection on future projected requirements for the EHR’s instead of focusing on near term system realities of how the systems would co-exist and integrate. The different technology platform offered by Epic was an advanced integrated system; unfortunately, the IT vendor did not exactly know what to supply Kaiser Permanente in regards to how to manage the integration with the existing EHR system.

(Montalbano, 2008)V-Conclusion: The circumstances and systemic failures with the KP Health Connect system are numerous and describe a system integration gone terribly wrong. Most industry groups point directly at the human error created by management.(Cochran, 2009) However , in the defense of Kaiser Permanente the integration between the IT systems was in fact a great unknown derivative. Neither Epic nor Kaiser Permanente managed to ask or answer any of the correct questions concerning exactly how KP Health Connect would function within the entire data management network.

Both Epic and Kaiser Permanente assumed the other party had the answers, when in fact neither did. The resultant failure was an EPIC disaster in IT system integration.VI-Bibliography:E. Montalbano, 2008 Microsoft, Kaiser Pilot Integration of E-health Systems, ABC News/IDG News Service, June 9, 2008, http://abcnews.go.com/Technology/PCWorld/story?id=5030248.J. H. Cochran, 2009, Statement on Behalf of the Kaiser Permanente Medical Care Program Before the Committee on Health, Education, Labor, and Pensions (Washington, D.C.: United States Senate, Jan. 15, 2009).Aarts, J. Berg, E. 2004. Understanding Implementation: The Case of a Computerized Order Entry System in a Large Dutch University Medical Center. J. Amer. Med. Inform. Assoc. 11(3) 207-216.Ash, J. S., M. Berg, E. 2004. Some Unintended Consequences of Information Technology in Health care: The Nature of patient Care Information System-related Errors. J. Am Med Inform Assoc 11(2) 104-112.Barki H., 2005.

A Model of Organizational Integration, Implementation Effort, and Performance. Organization Science 16(2) 165-179.