Chapter $24$ discusses how the private sector has contributed to the adoption and implementation of EHR. The chapter also provides two examples using Kaiser Permanente and Duke University Health System. Locate one or more local to your area, additional examples of instances where the private sector has led the way in demonstrating how electronic health records can be successfully conceived and implemented. Put your examples in the form of a report.Kaiser Permanente's business structure provides health plans and delivers managed health care across the continuum, including the hospital, medical group professionals, the laboratory, and the pharmacy. The Kaiser Permanente Information Technology group is also part of the organization. ${?}^{42}$

Kaiser Permanente $($KP$)$ is believed to have the largest private sector electronic health record system in the world and has received multiple awards for leadership in electronic health record implementation. ${?}^{43}KP$ has implemented $"$My Health Manager," an electronic personal health record application that presently contains five elements as follows:

My Medical Record $($connected to the individual's electronic medical record$)$

My Message Center $($exchange secure email with the doctor's office$)$

Appointment Center $($book visits and$/$or consult the interactive symptom checker$)$

Pharmacy Center $($manage prescriptions and$/$or consult the drug encyclopedia feature$)$

Manage My Plan and Coverage $($obtain facts about the individual's plan and benefits and download forms$){?}^{44}$

KP has nearly nine million members, so heavy usage of the electronic personal health record can be expected. In the first half of $2011,$ for example, KP reported that members $"...$ have securely viewed $34\mathrm{.}8$ million laboratory results, exchanged $6\mathrm{.}2$ million emails with their KP caregivers and refilled $4\mathrm{.}6$ million prescriptions online." ${?}^{45}$ Furthermore, at the time of this writing KP has released a mobile$-$optimized website and app. In the first month after the new application was released, KP reported that it was used more than a million times by members and patients. ${?}^{46}$

Unified Ehr Adoption At Duke University Health System

Duke University Health System $($Duke$)$ includes three hospitals along with physician practices and other services such as home care and hospice, all based in North Carolina. ${?}^{47}$ In July $2012,$ Duke began a multi$-$year information systems project to unify electronic medical records across the health system. The project, titled "Maestro Care," has a "tag line" motto: "One Patient, One Record, One Health System." Duke expects to implement the new technology in three phases as follows:

Phase $1(2012)$: $33$ primary care practices Phase $2(2013)$: Duke University Hospital plus all ambulatory clinics Phase $3(2014)$: The $2$ remaining hospitals $($Durham Regional and Duke Raleigh$)48$