T. Shih, K. Davis, S. Schoenbaum, A. Gauthier,
R. Nuzum, and D. McCarthy, Organizing the U.S.
Health Care Delivery System for High Performance
(New York: The Commonwealth Fund Commission on a High Performance Health System, Aug. 2008).
2 Information about Kaiser Permanente was synthesized in part from a presentation by CEO George
Halvorson to a Commonwealth Fund Commission on a High Performance Health Care System meeting in San Francisco, and from the Commission’s site visit to the Kaiser Permanente San Francisco Medical
Center in March 2007. Additional information was obtained from presentations, telephone interviews, or e-mail communications with the individuals named in the acknowledgments; from information and documents available on the organization’s
Web site (www.kp.org) and from regulatory filings; and from other presentations and publications cited below. 3 A summary of findings from all case studies in the series can be found in D. McCarthy and K. Mueller,
Organizing for Higher Performance: Case Studies of Organized Delivery Systems. Series Overview,
Findings, and Methods (New York: The Commonwealth
Fund, 2009).
4 For examples, see A. C. Enthoven and L. A. Tollen,
“Epilogue,” in Toward a 21st Century Health System, edited by A. C. Enthoven and L. A. Tollen (San
Francisco: Jossey-Bass, 2004).
5 The Colorado region developed an EHR in collaboration with IBM Corporation that was fully functional by 1997. Physicians in the Northwest region had access to an EHR (from Epic Systems
Corp.) starting in 1994; exam room computers were installed in 2001. Kaiser began rolling out the
Colorado EHR to other regions early in the decade but reevaluated that decision and, through a process that actively involved clinicians, selected the Epic system as a better fit for its needs. For more on this topic, see C. Kenney, “Kaiser Permanente