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 large cutovers — which involved about 40 million patient records — were each completed in under three hours, without a single canceled appointment or delayed procedure.

Kaiser’s EHR consolidation shows that large-scale integrations can be accomplished without compromising patient care, noted 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 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 stated.

During the cutover, inpatients were virtually discharged and then readmitted into the new EHR instance. This was a technical workflow only — patients did not have to physically leave the facility, change rooms or experience any interruption in care, Cowles pointed out. 

By consolidating into just two instances, Kaiser made tasks easier for clinicians, improved data consistency and enabled more seamless access to patient records across facilities, he noted. Patient records are centralized, which allows 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 all facilities in their region, reducing staff confusion and training time. 

“Ultimately, this consolidation empowers our care teams to focus more on patient care and less on navigating complex systems,” Cowles declared.

In the past, when Kaiser had 12 separate EHR instances, any configuration change or code update had to be rolled out 12 times and then carefully synchronized to avoid inconsistencies or downtime. With the newly consolidated systems, those same updates are deployed only twice — which Cowles said reduces complexity, risks, ongoing maintenance effort and additional IT costs.

The project has also resulted in simplified scheduling, as patients can more easily schedule appointments across hospitals and medical offices, and staff can manage those appointments more efficiently, he pointed out.

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

“The program team practiced an over 600-step plan over 25 times. Many teams rehearsed multiple hand-offs and quality checks to make sure the actual event went flawlessly. This achievement was only possible because our entire system worked collaboratively, identifying and agreeing on the critical measures of success,” Cowles remarked.

He also noted that automation played a critical role in accelerating the data migration process. It automated repetitive tasks, such as transferring personalization settings and validating data integrity, which helped reduce Kaiser’s planned downtime by more than 30 minutes.

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

To do that, the health system invested heavily in preserving each users’ experience. Kaiser migrated individual data and personalization preferences so seamlessly that most staff needed only minimal training and light change-management support, Cowles stated.

“We provided targeted online training and real-time awareness the night of the cutover, but the true measure of success came afterward. When leaders rounded on clinics post–go-live, several staff members asked, ‘What cutover?’ That’s exactly the outcome we aimed for,” he declared. 

Photo: Thomas Barwick, Getty Images