How Kaiser Permanente consolidated 12 EHRs into 2

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 transfers – which involved approximately 40 million patient records – were each completed in less than three hours, without a single canceled appointment or delayed procedure.

Kaiser’s EHR consolidation shows that large-scale integrations can be achieved without compromising patient care, noted Neil Cowles, the health system’s chief information and technology officer.

Kaiser found itself operating six EHR instances in Northern California and six in Southern California due to scalability limitations when the systems were initially deployed, he explained.

“These instances had different configurations, workflows and patient data to fit their local service areas, which created complexity for physicians and care teams,” Cowles said.

During the transition, hospitalized patients were virtually discharged and then readmitted to the new EHR instance. It was purely a technical workflow: Patients did not need to physically leave the facility, change rooms or experience any interruption in care, Cowles emphasized.

By consolidating into just two instances, Kaiser has made tasks easier for clinicians, improved data consistency and enabled more transparent access to patient records across all facilities, he noted. Patient records are centralized, allowing healthcare teams to quickly retrieve a complete medical history, regardless of where the patient received care.

Now, workflows are consistent, Cowles added. Clinicians use the same interface and processes across all locations 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 said.

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, these same updates are only deployed twice, which Cowles says reduces complexity, risk, ongoing maintenance efforts and additional IT costs.

The project also helped simplify scheduling, as patients can more easily schedule their appointments at hospitals and doctor’s offices, and staff can manage those appointments more efficiently, he noted.

He attributes the success of this consolidation project to the close alignment between Kaiser’s clinicians, business teams and technology experts.

“The program team put a plan of more than 600 steps into practice more than 25 times. Many teams repeated multiple handoffs and quality checks to ensure the event itself ran flawlessly. This achievement was only possible because our entire system worked collaboratively, identifying and agreeing on critical measures of success,” Cowles noted.

He also highlighted that automation plays a vital role in accelerating the data migration process. It automated repetitive tasks, such as transferring personalization settings and validating data integrity, reducing Kaiser’s planned downtime by more than 30 minutes.

When planning the project, Cowles said Kaiser’s guiding principle was simple: protect patient care and avoid operational disruptions.

To do this, the health system has invested massively in preserving the experience of each user. Kaiser migrated individual data and personalization preferences so seamlessly that most staff required minimal training and light change management support, Cowles said.

“We delivered targeted online training and real-time outreach on the night of the changeover, but the real measure of success came afterward. When leaders visited the clinics after the launch, several staff members asked, ‘What changeover?’ That’s exactly the outcome we were aiming for,” he said.

Photo: Thomas Barwick, Getty Images