Diagnosis: more technology: systems meet some resistance.

Continuing education has always been an integral part of a doctor's career, whether it be to learn about new treatments, surgical techniques, drugs, devices or other medical advancements, but Kaiser Permanente physicians can now add basic typing and computer skills classes to their to-do lists as the non-profit company is leading the Valley in converting its medical information systems to an electronic infrastructure.

Kaiser is making sure that its staff members, including doctors, nurses, technicians and other providers as well as receptionists and other administrative staff are familiar enough with the company's computer systems to begin using its KP HealthConnect features. KP HealthConnect is a multi-billion dollar project that will be implemented over the next several years.

In the Valley, Kaiser is making progress in its system that will soon allow medical providers to look up charts, admit patients, order drugs and manage every other aspect of a patient's care from a computer terminal. The system is staggered in its deployment, but Mike Bruce, site implementation manager for Kaiser's Woodland Hills hospital, said that system is already changing medical care for its members.

"Receptionists can look up patient demographics, insurance coverage or Medicare information," said Bruce. "Before, we had a series of mainframe systems, so you could get the information, but it would take a few steps. Now it's all contained within a set of windows similar to something you would see with Microsoft Word."

Doctors at Kaiser's Woodland Hills and Panorama City can also use what the organization is calling Chart View.

"What they can see in the exam room is information about allergies, any type of medication that has been prescribed, previous visits and who the patient saw on the visit," said Bruce.

Doctors can also easily pull information on chronic conditions that a patient may be at risk of developing, like diabetes or chronic kidney disease, and create graphs displaying cholesterol levels or other information.

Bruce said the technology's users have given somewhat varied reactions.

"I've been hearing a lot from physicians and the nursing staff," said Bruce. "There are doctors who are very excited about this and feel that it's the best thing that's ever happened and there are physicians who have some fears or concerns.

Some doctors are worried that the system will "affect their ability to provide good care and slow them down in the examination room," Bruce said.

Bruce said that Kaiser has launched training programs that staff members can take in groups or individually in order to become more familiar with the systems. He said that as KP HealthConnect becomes more ingrained within Kaiser, reluctant staff members will join the majority that sees the system as a benefit. As the system is fully deployed, the system will be used for everything from admitting and discharge, inpatient pharmacy orders, billing, online medical records access for members and clinical support for physicians.

Kaiser is at a distinct advantage because of the nature of its organization; doctors are employees rather than independent business people, and don't have to worry about making sure that their systems are compatible with other hospitals.

James Barber, president of the Southern California Hospital Association, said that other hospitals have been slower to implement their own technologically sophisticated systems.

"I can't say that many hospitals have been widely successful in implementing systems," Barber said. "It's not a technology issue, it has to do with acceptance on the part of users. Doctors can find the best system and it can be installed, but it goes unused by physicians if it inhibits their practice."

Barber said that hospitals and doctors disagree over technological requirements and that most doctors will stick to handwriting notes and orders unless, like with Kaiser Permanente, they're forced to adopt a new system.

"It takes time to learn a new system and become proficient in it before it becomes second nature," said Barber. "Doctors are afraid they're going to make mistakes, but ironically there are a lower number of mistakes when the systems are being used and the equipment is not rusting."

Hospitals that aren't rushing to implement electronic records are finding that they still have to invest tens of millions of dollars on state of the art medical equipment or risk losing staff physicians.

Patrick Petre, administrator at Providence St. Joseph hospital in Burbank, said staying ahead of medical technology is a constant struggle as it is getting more expensive and progressing faster every year.