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How Kaiser Permanente consolidated its EHR in California
Kaiser Permanente underwent a massive EHR platform consolidation, reducing 12 EHR instances to two for its California operations.
Kaiser Permanente has completed a large-scale consolidation of its KP HealthConnect EHR platform, reducing 12 separate environments of the software down to two instances, the company has reported.
The not-for-profit integrated healthcare provider and health plan, which serves 12.6 million members in states that span from Hawaii and California to Georgia, previously operated six distinct EHR instances in Northern California and six in Southern California, according to Neil Cowles, chief information and technology officer at Kaiser Permanente (KP).
The health system wanted to consolidate after 20 years of disparate EHR instances. KP HealthConnect originally went live in 2005.
Scalability limitations had caused multiple EHR instances to be created during the initial deployment. Each instance had different configurations and workflows, and patient data varied according to local service areas, which resulted in complexity for clinicians.
"By consolidating into one instance for Northern California and one instance for Southern California, Kaiser Permanente simplified workflows, improved data consistency, and enabled seamless access to patient records across facilities," Cowles said.
KP began its EHR consolidation of 40 million patient records in early 2025 with two system cutovers, moving records in Northern California and Southern California. During each cutover period, KP moved 20 million patient records without the system going down for more than three hours for each consolidation. KP then migrated to a single EHR for each California region.
After the Northern California migration, KP's Southern California facilities migrated to a single EHR instance 21 minutes faster than the Northern California switch.
The consolidation streamlined KP's operations by allowing care teams to access patient records more easily and coordinate care as well as reduce training time. It also simplified appointment scheduling for members across the health system's facilities.
Further, the project reduced maintenance on the platform, according to Cowles.
"Previously, configuration and code needed to be deployed six times in perfect coordination," Cowles said. "Now all of this is done once."
In addition, the consolidation reduced technical complexity on the platform involving custom code and complex routing, which previously led to additional IT costs, according to Cowles.
The consolidation required rigorous testing comprising 25 dress rehearsals, which allowed KP staff to fine-tune processes, spot potential issues and become confident in the execution plan, according to Cowles.
KP's consolidation of 12 EHR instances into two was part of the health system's strategy to "standardize, simplify and modernize its capabilities," Cowles said.
Minimizing downtime during EHR consolidation
The overarching goal of the EHR consolidation was to unify EHR instances in Northern and Southern California in the shortest amount of time possible, with no impact on patient care and minimal disruption to business operations. KP was able to complete the consolidation without any canceled appointments or delayed procedures because of close coordination among doctors, clinicians and business functions.
The health system also transferred EHR personalization for 18,000 physicians and tens of thousands of care delivery and administrative staff, according to the health system.
During the cutover of EHR instances, KP "virtually discharged" patients and then readmitted them, but this was just a technical step in the process. Patients did not leave or change rooms, Cowles said.
He explained that the virtual changeover was necessary because the new EHR platform was an aggregate clone of the existing six, allowing it to sync data perfectly.
"The purpose of this step was to ensure continuity of care and accurate recordkeeping as we made a clean transition between the old and new EHR instances," Cowles said. "[KP's] downtime procedures, which are regularly rehearsed, help ensure there is zero interruption to care during system transitions."
In fact, the KP team rehearsed the 600 steps in the consolidation process more than 25 times, he said.
A brief period of downtime allowed KP to move patient data from the existing six instances to a consolidated instance. Robotic process automation (RPA) helped reduce downtime to less than three hours for each instance.
"Automation played a critical role in accelerating the data migration process," Cowles said. "It automated repetitive tasks, such as transferring personalization settings and validating data integrity, which helped reduce planned downtime ... and ensured a smooth transition for clinicians and staff."
Tackling consolidation challenges
During the consolidation, KP needed to ensure data accuracy at scale for more than 20 million patient records. In addition, KP wanted to preserve EHR personalization settings during the transfer for 18,000 physicians and tens of thousands of staff.
"Ensuring that each user's preferences, workflows, and settings were retained helped avoid disruptions and supported a smooth return to work post-cutover," Cowles said.
Transferring EHR personalization meant transferring staff members' workflows and system settings seamlessly, he added. Settings included preferences for order sets, documentation templates, note shortcuts, favorites lists for medications and labs and personalized dashboard layouts.
"By preserving these personalizations during the cutover, Kaiser Permanente ensured that when clinicians and staff returned to work after the system cutover, they could immediately resume their daily tasks without interruption," Cowles said. "Maintaining these personalized configurations supported continuity and efficiency for our care teams and administrative staff across the organization."
Following the EHR consolidation in California, Cowles suggested that similar projects could be carried out in other states.
"While this project focuses on California, the success of this initiative demonstrates what's possible at scale and sets a strong foundation for future modernization efforts," Cowles said.
He added, "This achievement positions us well to explore similar opportunities in the future as part of our ongoing strategy to simplify, standardize, and transform our innovative use of technology across the organization."
Brian T. Horowitz started covering health IT news in 2010 and the tech beat overall in 1996.
