justen

With governance at Kaiser Permanente in shambles, it is sad but not surprising to hear that the respected musical chair method of reorganization is now in full swing at KP-IT, under Phil Fasano. The new orgchart has been drawn up and distributed. The only trouble? Well, there aren’t any names. Simple math says there are now fewer positions than there were a few days ago, but nobody knows who’s out just yet.

The details of the brilliant reorganization plan don’t end there. Every year or so, KP hires an outside firm to gather opinions about KP-IT from a sampling of top executives from across the organization. Needless to say, last year’s results painted a bleak picture for KP-IT. In particular, concerns have reached the boiling point with regard to the amount of money being wasted by KP-IT: it’s killing the regions outside California. The solution? Put a new middleman between head CIO Fasano and the itty-bitty CIOs in each of the other regions. I’d hate to be that middleman. (His name is Garry Hurlbut. Pray for him, won’t you?) Just so you’re following me… Dodd: centralize everything! (Pendulum swinging…) Fasano: regionalize everything! (Sad inside joke: somewhere, off in the distance, I hear a Boeing crashing.)

Needless to say, all stop at KP-IT is about how things are going right now. Uptime has held fairly steady these past few months (after doubling every few months last year), but the amount of lost productivity by physicians, nurses, and pharmacists as the result of unavailable and malfunctioning systems is still an enormous (and growing) drain on Kaiser Permanente.

The cash spigot is being tightened to KP-IT, as the organization as a whole is beginning to feel the painful results of poor financial (mis)management. Fasano is bracing KP-IT for job cuts, but so far is coy about whether there will be net losses of positions.

It’s sad to see the wheels coming off the wagon. You know this organization can do better, you know these people, if given the right resources, can do more (well, except one or two of them).

I gave up, long ago, thinking the Kaiser Foundation Health Plan Board of Directors would do something about all of this. (There’s a reason, after all, that Halvorson felt such a strong need to defend his “rubber stamp” board, a term he chose himself, and an accusation I had never made.) But, when Halvorson is finally forced out, the pieces will not be easy to put back together. What a mess. What an unnecessary mess.