The Commonwealth Fund published a series of case studies this week that reviewed the ‘best practices’ of several health communities and their efforts to integrate care, reduce cost and improve outcomes. With respect to health care information technology, Kaiser Permanente, the largest not-for-profit integrated health care delivery system in the US serving over 8 million members, stands out as an example of how health care technology may positively affect the provision of care over the long term. The case study was drawn from Kaiser sites in North Carolina and Colorado.

The case study lists “information continuity” as an attribute that is vital to overall health care delivery success. According to findings from the study sites, the criteria necessary to achieve information continuity include electronic health records that integrate physician order entry, clinical decision support, population and patient management tools, appointment, registration and billing systems. Additionally, Kaiser views the EHR as a double-sided entity, with patient access on the flipside offering online access to resources, visit history, appointment scheduling, prescriptions, lab test results and secure messaging with providers. Wow—that is quite an agenda. So, does it work?

While electronic health records are a new and exciting prospective market for patients, providers and policy analysts, Kaiser is an experienced healthcare IT user. Having implemented an EHR system in the early 1990s, Kaiser is now a decade plus into the use of EHR technology as a vehicle to improve care and reduce costs. In 2003, it launched a $4 billion dollar effort to connect all of their sites nationwide, aiming for an interoperable platform that enabled all of their providers to share information despite their physical location. This system is called KP HealthConnect.

By 2008 most outpatient clinics were operational, having implemented most aspects of the new system. According to the report, studies show that the ‘patient’ participation piece of the EHR has a significant impact—for example, in Kaiser’s northwest region, patients that use online tools connected to the EHR system made 10 percent fewer visits than those who were not, on average. In Hawaii, the drop was 26 percent. This translates into cost savings and more attentiveness on the part of patients to preventative health care regiments.

Physicians too, are on the EHR love boat, praising electronic records as an important tool in reminding physicians of evidenced based protocols.

This is what the Obama Administration is dreaming of… ”greater access to information leads to better decision making, more evidenced-based care protocols, reduced visits to docs and yes, yes, yes, a slower rate of growth in health care spending!!” But alas, Kaiser is unique. Kaiser is a test tube case that has a differing physician payment structure to most health care settings (they salary their physicians), have years of experience in health information technology, and have spent years studying and implementing evidenced based care—no question, they are on the cutting edge. Meanwhile, the average health care setting has to wrestle with antiquated technology, lack of capital, and luddites. So while Kaiser can show us the way—they lack some of the baggage that the rest of the health care system carries. Nonetheless, they are a shining star that deserves kudos. From the rest of us, time to put a best foot forward in emulating their performance.

More on EHRs:

[+] GE offers no-interest loans to promote EHR software

[+] EHRs and national security-is the government snooping?

[+] Choose your electronic health record carefully

[+] Doctors aided by emerging offshoot of EHR software

[+] DOD and the VA stumble toward shared EHR system