Thursday, November 09, 2006

Is an inquiry in order for the IT revelations at Kaiser Permanente?

In "Kaiser Healthcare IT Meltdown?" I wrote:

From my experiences in health IT, I place my bets on the whistleblower's account.

In the East Bay Business Times article "Kaiser reports good results, but CIO quits as problems loom" I read with frank shock this statement by the whistleblower Justin Deal:

"My concerns are the financials," Deal said. "So far we have spent in the
neighborhood of $4 billion to implement HealthConnect, which is an astronomical figure."

Incredible. $4 billion? If that is true, that is indeed an astronomical-sounding figure for health IT, perhaps paralleling the spending of the "Connecting for Health" national EMR project in the UK. (Also see my earlier posting "$70 million for an EMR system?")

Where did $4 billion go, exactly?

Is an inquiry in order? I believe if the details of the Deal letter hold any water, questions need to be asked about this level of expenditure. In fact, perhaps a neutral third-party audit is called for in any case.

On an added note, I find this story of another former IT person at Kaiser Permante that I became aware of in correspondence about my earlier post quite unsettling. It concerns HIPAA issues and the attempts of this person to call possible security breaches to the attention of the authorities, and the resultant misfortunes visited upon her. This tale is reminiscent of some of my own personal experiences in bureaucratic settings.

I would advise Mr. Deal to get himself a top lawyer fast if this example of corporate use of power for warfare with the "little guy" is any indication of what awaits him.


kaiserfraud said...

I had some brief correspondence with Justen before this happened and directly after. My impression is he honestly didn't realize this could happen. He was relying on the truth to be his shield. I do think he at least has a chance now, because people are watching Kaiser to see what they do.

My impression is the "administrative leave" is all about Kaiser trying to wait it out - they figure they can do whatever they want as soon as the "media cycle" is over. Anyone who believes that employees should be able to express a dissenting opinion for the good of their organization without having to fear instant retaliation should keep watching Kaiser. Don't let the media cycle end until Justen is safe!

InformaticsMD said...

Unfortunately, sending an email to 100,000+ people via company assets (IT) will likely be construed, and not entirely unreasonably, as a misuse of corporate resources no matter what the reason; he will likely be in for a rough ride. He has probably not been fired already as a result of the negative publicity his actions raised.

Only politicians and the well-connected can get away with breaking the rules in that spectacular a fashion, I'm afraid, and not always even for them.

My position in all this remains that further investigation is warranted, as is a re-thinking of the leadership and management models for clinical IT initiatives.

kaiserfraud said...

I'm willing to bet there was no such policy, at least not in a place that Justen would see it. When I was hired, I didn't even get a hard copy of the employee handbook. The Intranet version was incomplete, always in flux, and forever changing its url.

On the other hand, Kaiser has distributed notices urging people to destroy their email communications - and I believe the "after the legal requirements have expired" proviso is essentially small print that encourages people to "mistakenly" destroy communications that should be saved. I have these policies for California and Colorado - I'll repost them tonight or tomorrow.

Actually, I should point out that I hunted down these documents: neither was ever actually given to me or discussed with me.

So can a policy be enforced if the organizations expect employees to learn it through the amazing power of ESP?

Are you familiar with Ken Hamidi vs. Intel? His appeal established that using Intel's pipes for a blast email is free speech in the Paul Revere tradition.

Anonymous said...

Justin is going to loose his job. My attorney wife, who works as an administrator in a state office, was put in an office with no assigned duties during a large computer project. She was bluntly told she was not wanted. The reason being, as an attorney, she would raise questions regarding the legality of the actions taken by the contract administrators, along with the kickbacks.

Later several top level people were allowed to resign. The project was grossly over budget, but nobody was prosecuted. I have learned that a small group of companies handled this government mandated contract for a number of states and they all had similar results.

The reality is, when you have large amounts of money involved, greed and the thirst for power take over. This is not a medical problem, but a social problem. We have lost all sense of responsibility to everyone but ourselves and we will use a corporations assets to quell dissent.

Steve Lucas

Anonymous said...

Justen’s action, as an employee, may not be defensible. He may have some rights as a KP member, however. Assuming he’s covered by a KP plan, and if it’s an ERISA plan, there are rules governing fiduciary responsibility.

Any thoughts? Opinions?

kaiserfraud said...

That's an interesting thought. Could retaliating against an employee be illegal if the employee was standing up for his rights as a health care consumer?

I'm just about to post some interesting comments on KP finances at

Anonymous said...

The really intersting question about all this comes down to governance of a non-profit organization which is in some ways controlled by the government. Similarly Cuck Hagle has been making noises about excessive profits at non-profut hospital chains.

I assume the member tack and the "public interst" tack are the only ways to save Justen's job. However, he's clearly wasted in a low level KP job and should gto to law school and aim for politics...

Anonymous said...

I am fueled by all of the negativity of posters like "Kaiser Fraud". Honestly I think that Justin was trying to save his butt in light of an upcoming Reduction in Force, and overspending by Kaiser IT. Cliff Dodd was on his way out like the execs he fired a few months back.

kaiserfraud said...

More KaiserTurf above - *sigh*. When a colossal organization has to push its key messages at the expense of relatively powerless but principled people like Justen, it's pathetic.

InformaticsMD said...

Anonymous said...
I am fueled by all of the negativity of posters like "Kaiser Fraud".

Ad-hominem attacks on "negativity" are to be discouraged. I prefer people to address the issues, not their views of the messenger.