While many providers are working on their first full-blown electronic health record system, Kaiser Permanente has been through the process several times, starting back in the 1990s. Some of its facilities had EHRs long before others; its eight different regions tried out different systems at various times. Every time the organizational information technology strategy changed directions, it required full technological and operational overhauls.

Now, there's one EHR across the entire organization, encompassing 36 hospitals, 430 medical offices, more than 14,000 physicians, and 8.6 million members. Kaiser accounts for more than half the hospitals that have achieved HIMSS Analytics' Stage 7 EMR adoption--a complete paperless system with advanced use of integrated data. Kaiser recently introduced a mobile phone app to allow its members to access their medical records, make appointments, e-mail their physicians, and refill prescriptions.

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