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Conflict Resolution at Kaiser Permanente

Kaiser PermanenteÆs Health Connect information system is as prone to generating conflicts as any other information systemùprobably more so, in fact. In the paperless world of KaiserÆs system, reliance upon the data in the system is virtually 100%, so the data needs to be 100% correct, or conflictsùand tragediesùcan ensue. Kaiser Permanente has incurred litigation for numerous wrongful death claims and was fined $500,000 in 2001 for not referring a 19-year-old patient with muscular dystrophy with muscular dystrophy to the UC Davis Medical Center for needed care; the boy died six days later (Robertson). Conflict in terms of inconsistent data and also in terms of Kaiser and patients is well documented. Kaiser needs strategies for preventing and/or resolving both.

The consistency and accuracy of data in the Health Connect system is dependent primarily on three variables: the integrity of the system, the accuracy with which doctors enter the data, and the accuracy with which patients provide the data. Conflicts due to the systemÆs lack of integrity can only be resolved by correcting the systemÆs inadequacies. Conflicts due to doctor accuracy are likely common, since the doctor types entries while talking to the patient. A couple of strategies for dealing with this would be to have the doctor print out the part of the information that the patient contributedùi.e., symptoms experiencedùand have the patient verify it, as well as having the system do checks for data consistency against previously entered data for that patient. The accuracy with which patients provide their data can really only be remedied by having the doctor question the patient closely to verify the information.

Conflicts between patients and Kaiser generally occur because of KaiserÆs medical mistakes, such as surgically removing the wrong body part. Strategies for preventing such errors must include multiple verifications prior to surger


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