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March 11, 2005

HEALTH PLANS: Kaiser's Gadfly hits the big time

Those of you with memories that stretch back to the dog days of summer last year may remember the somewhat curious incident of the Kaiser Permanente Thrive campaign coming up in THCB. If you missed it, here's a brief recap.

KP has been running a $40m advertising campaign in California and elsewhere under the tag line "Thrive". By the way, the voiceover is done by everyone's favorites Presidential spokesperson (No, not Fitzwater, Myers or McLellan--CJ Cregg!)  Quite what the campaign has to do with the delivery of health care I have no idea, but that's why I was thrown out of advertising finishing school. It seems to me no better or worse than any other corporate makeover campaign, and as KP is in general on the side of the angels it didn't worry me too much.

However, there are a bunch of people who do have reasons rightly or wrongly for disliking Kaiser, and this small group of dissidents discovered quite a treasure trove of base sloppiness. For example, the URL KaiserThrive was never reserved by KP, so the dissidents took it and launched a parody campaign called "Thieves" on it. Then they discovered some of the strategy documents linked with the campaign on an openly available web site, and copied and posted them on their website. Finally, they discovered a KP web site (or possibly one of its contractor's sites) that had reams of KP's diagrams and blue prints for its HealthConnect EMR project--which are all presumably proprietary and at least somewhat confidential. This site was also mirrored by a couple of KP gadflys (long after it was put up on the web originally).

I posted about this on August 30, 2004 and lo and behold a few days later that KP site with the wiring diagrams was taken down. None of this in my view contained damaging internal documents of the "Dodgeball"  style that Merck was exposed for earlier this year. But apparently I didn't look hard enough.  Somewhere buried in all the wiring diagrams was some patient information, which the anti-KP Gadfly had assumed was test data.  Apparently not. According to KP, there are some 140 identifiable patient records in there somewhere. This week Kaiser sent a cease and desist notice to the Gadfly (which was sent on to me) asking for the removal of all web pages, and stating that the Gadfly had broken the employment agreement signed when joining KP. The letter also threatened prison time, huge fines et al.

It's a bit ironic that KP has pulled out the big legal guns on this. and got The story is the SJ Mercury News today, (correction posted roughtly 4.15pm PST Friday after I was contacted by Barbar Feder, the SJ Merc journo who wrote the story) amazingly enough not because Kaiser leaked it to put pressure on the gadfly, but because one of the 140 patients they called was a member of the Merc staff and got a call about it! Barbara thereafter contacted the KP public relations people and extracted the story out of them as well as finding the Gadfly's blog and getting some comments from her. It is still nonetheless ironic for Kaiser to be calling out the legal big guns because the when you consider that the patients they are panicking by telling them that their information is on the web have had it sitting there since at least 2002. There is clear evidence at this URL that the site was publicly up as of 2002, and I know it was available to be looked at on the web until at least August 30, 2003 2004 (typo corrected), because I went to look at it then. I must stress that I didn't know that there was any patient data in it, and in wandering around the mirror site (you'll have to go to the Corporate Ethics blog to discover the link as THCB is too lilly-livered to link directly!) I never found any patient data. But presumably I was looking in the wrong place.

According to the Corporate Ethics site, the Gadfly in one of her attempts to get at Kaiser tried to get them for a HIPAA privacy violation because of this posting, but apparently they were cleared of this. It's quite amusing really that they are now coming after her for the same thing for which they apparently were not guilty.

When you dig a little deeper, this is a typical story of a lack of common sense in corporate policy. Like the McLibel trial in the UK when McDondald's stupidly went after two penniless anarchists for passing out leaflets about their food being inedible and blew $10m in legal fees and all its goodwill in Europe in the process, or a recent case of a friend of mine whose job offer at Carly's HP was withdrawn because of a one word discrepancy on a background check from Choicepoint (yeah, that trustworthy bunch)  with NO-ONE at HP's human resources group having the nous to investigate and find out the truth, Kaiser is not stopping to think about how to resolve this issue sensibly. The Gadfly is an ex-employee who was fired and has since seen her financial life go into cataclsym.

The Gadfly is flat broke, and said in a private email to me that she'd welcome jail time as it would get her health care coverage!  So why did Kaiser fire her? Obviously there are two sides to that story, but is there no way that they can make it up to her and come to a reasonable settlement without pushing her and themselves to all these extremes? This is not good PR for what's generally a noble organization, and some of the grown-ups there need to get hold of this whole issue pretty quickly. Perhaps if a senior KP person took it upon themselves to have a fair review of the case, and figure out a way to make a reasonable settlement, their organization's own sloppiness wouldn't have to become a major fiasco.  At the least presumably they can get her some of the health care coverage she needs at a price they can afford!. Right now the Gadfly is finally welcoming the attention, and if KP keeps pushing this way it's likely to get much worse for them before it gets better.

March 11, 2005 in Health Plans | Permalink


Hi, Matt -

Thanks for your coverage of my ongoing struggle with Kaiser. I've been told that Kaiser's threats of HIPAA sanctions wouldn't apply to me because I'm neither a health plan or a health provider. I'm sure they are still trying to work other angles, though.

I just wanted to let you know I got a few hits from NBC on my Parody site. If NBC is indeed interested in looking into this, I have you to thank for speaking up for me.

Posted by: Gadfly | Mar 11, 2005 3:27:44 PM

Hmm, Who is this gadfly and why does she think that helping more people find Kaiser patient's private infromation is going to do anything for anyone but her? Are these patients better off for all of her stupidtity in posting their information over and over again?

And why does Kaiser owe her anything? Because they fired her and she can't get herself another job? And she has no health insurance? Well she could use COBRA like everyone else who has lost a job that provided health care. Just a thought, but apparently her revenge is better if she is portrayed as a pathetic person who was wronged by corporate America.

I have no problems with her fighting Kaiser, nor do I particularly think Kaiser is without blame, but her self serving diatribe against them is hurting many innocent people by posting very private information in a very public forum. At least Kaiser's post was not easy to find, as you were unable to find it. She will be continuing to hurt her case the more she whines about her poor life that Kaiser has destroyed, while all along taking the 140 patients down with her.

She needs to grow up and take responsiblity for her hurtful actions before anyone will ever take here seriously. The press and government agencies she contacted certainly did not find her credible, so why should anyone else? And calling for some of the adults at Kaiser to get ahold of this situation quickly? What about her childish revenge fantasy she is living out without any concern for anyone who may be hurt by having their private medical information so prominently posted for anyone to see? She needs to ba an adult and stop hertin other people in her desire to destroy her former employer.

Posted by: tim | Mar 12, 2005 3:08:29 PM

Who is this Tim, and why does he think he has a right to point fingers and make judgments about someone else's life? Must be a Kaiser shill, or worse (if there is anything worse), a bureaucrat.

Kaiser falsifies records and lies to regulators in employment disputes and privacy complaints, just as it does in the courtroom in med-mal cases. This does not in any way reflect on the credibility of the person complaining.

I know because it happened to me. I require no further proof other than my own personal experience. Let's hope you never find yourself in a similar position.

Posted by: Chen | Mar 12, 2005 7:08:53 PM

Hi, Tim -

I don't see how I'm hurting my cause. As long as I'm not speaking up, no one will do anything at all. I quietly went through proper channels with Kaiser and DFEH for over a year before I turned to trying to fight for myself. And I only started to fight after Kaiser tried to scare me into dropping my complaint by sending someone to lurk outside my house. What Kaiser did to me was outrageous, but no one cares enough to help unless your problem is part of some larger one. The larger problem here is that Kaiser lies and destroys evidence in order to escape responsibility for mistakes.

It's true the public has no way of judging whether I was justly terminated or not. Kaiser is the only one who can choose to investigate that issue. I will do everything I can to get them to investigate.

As for COBRA - it's expensive for people on unemployment. It's impossible for people who have NO income. I have no income, and I haven't had any since December 2003.

As for the 140 patients - I don't know where Kaiser got that number. I only saw three that I thought might be real people. My belief is that Kaiser created the 140 people so they could call a bunch of people and scare them with the idea that some hacker was posting their data. In doing this, Kaiser failed to mention that a Kaiser insider originally posted the data and that Kaiser didn't feel the need to announce it when I pointed out *their* site last August. Kaiser is trying to manipulate the media and the public to do their bidding. They already have all the corporate lawyers on their side. I'm just a normal person who had to work really hard to get the entry level job I had at Kaiser. Kaiser thinks it can just steamroll over me: and your response shows that that they can count on part of the general public to help them.

The political figures I have mentioned in my blog have attempted to help me. They have been blockaded by various bureaucratic things. DFEH, for example, lied to Don Perata by telling him my Right to Sue timeframe had expired. It took me months to get the request to be made again. By then DFEH said they didn't have enough time left to build a case. The problem here is that the various channels of recourse take too long.

Kaiser has performed many hurtful actions here. No one has called them to be accountable. No one will call them to be accountable as long as I am quiet. As far as I can see, I'm not hurting anyone done. The information for those 3 (or 140, as Kaiser claims) people had been online for over a year. The damage has been done. If you have another suggestion for how I can bring attention to the way Kaiser lies and covers up mistakes instead of taking responsibility for the things it does wrong, please let me know. I'll listen to any suggestion that sounds like it will actually work.

Posted by: gadfly | Mar 12, 2005 7:11:33 PM

Hi, Chen -

I'm sorry to hear you had an experience similar to mine. I know it's one of the most horrible things that can happen in a person's life - to be deliberately harmed, to know the truth of what happened, but to find out that corporate juggernauts can rewrite reality to whatever suits them best.

My greatest hope is that Kaiser will look into their internal processes and make a genuine attempt to find out what is driving people to lie, destroy evidence, and cover up problems. It is not in the interest of the leadership or the organization in general to maintain or encourage unethical practices. The truth will out eventually.

At the risk of sounding like a New Age mystic, I think the universe has been trying to tell Kaiser something here. First I stumble across the specs for Kaiser's upcoming $40 million dollar ad online, leading to the discovery of their Intranet leak. Then I stumble across Systems Diagrams that only someone with my former job experience would be able to recognize, *and* with my ex-manager's name on at least one of the files(!) And now one of the 140 patients Kaiser calls to turn me into a Scary Person turns out to be a reporter? What are the chances of all this? Probably a zillion to one for any of the above. Kaiser should have a bad conscience, but if they don't, they should at least be wondering how they earned all the bad karma. :-)

Posted by: gadfly | Mar 12, 2005 7:31:24 PM

It's all very well for Tim to criticize the Gadfly, but the Gadfly is going to do what she does until somehow her case is dealt with. Getting her case dealt with outside of the newspapers should be the object of Kaiser's management here. The best way for them to do that is to reach an amicable settlement.

Posted by: Matthew Holt | Mar 14, 2005 9:39:46 AM

You have just hung yourself in my opinion. You admit this:

As for the 140 patients - I don't know where Kaiser got that number. I only saw three that I thought might be real people

You only THOUGHT that three of these people MIGHT be real? Where is your proof? Without proof either way you had no right to post this information. What if those 3 people were real? Did you contact them and let them decided if their information should be made much more public in order to protect their privacy? If not, you acted unethically.

You also claim that this information was NOT readily available to the general public with this statement:

Then I stumble across Systems Diagrams that only someone with my former job experience would be able to recognize,

Like it or not, you are a Kaiser insider. This is the first time I have heard you say that this information was only able to be recognized by someone who worked for Kaiser. Only someone with your training by Kaiser could find and recognize this information, which means that it was NOT available to the general public, but only to Kaiser insiders, which by your own admissions includes you. If you are really trying to make Kaiser take responsibility, you need to understand how you are coming across in all of this, and to be honest, you are not looking good. I was outraged when I heard this story on the news, not at you, but at Kaiser. There is very little available out there about this story other than your postings and statements though, and you are not making your case. In fact the more I find out from you, the more outraged I am at your actions.

Oh, and by the way, I am only affiliated with Kaiser in that I am a patient at Kaiser. My concern is that you will continue to find and post more peoples private information using your insider knowledge of Kaiser.

I am sorry that you and Chen have had problems with Kaiser, and I hope you can get some resolution to your problems, but not by stepping all over other peoples rights. I have been fighting against corporate greed for over 20 years, yet I have never considered hurting innocent people in this pursuit. As I said before, this is unethical. If you are fighting the ethical fight, you fight it ethically, otherwise you hurt your credibility.

Posted by: Tim | Mar 14, 2005 11:29:16 AM

Sorry, but what is all this about a settlement? I thought this was about the posting of information on the internet. That just makes this whole thing worse. Gadfly admits in her postings here that she only THOUGHT THAT THREE OF THE PEOPLE MIGHT BE REAL. What proof is there? She has offered none. She also admits that this information was not recognizable to anyone other than Kaiser insiders, which she was herself when she learned how to recognize this information. And yet she continues to post it? Without regard for any of the patients involved? Why does she feel she has this right? Becaues she wants money from her former employer? And you support this Matthew Holt? Good lord have neither of you ever looked up the word ethics? This is no way to fight coporate greed. Fighting greed with greed? The more I learn from Gadfly's own postings about this case, the more she looks just as bad as the people she is claiming to fight. More power to her if she can get what she feels is owed her from Kaiser, but she is not allowed to hurt other people by posting their information without their consent. Even if that information was posted by Kaiser, which she even admits was unrecognizable to anyone other than Kaiser insider, she had no right to repost that information. All for a settlement. Good for you Gadfly, you prove that the enemy is not just corporations. Now focus on your lawsuit that you want a settlement on and leave innocent people out of your fight.

Posted by: tim | Mar 14, 2005 11:52:26 AM

Should the gadfly allow Kaiser to get away with blaming her for its security breach? That's exactly what is happening, and she has every right to tell her side of the story. The problem is that nobody wanted to listen until Kaiser made those calls to the patients and Barbara Feder got wind of it. Why was it any less of a violation (or media event) when gadfly reported the privacy breach last summer?

Let's all remember that Kaiser would never have made those calls if it wasn't forced into it. Kaiser quietly had the site taken down in September without so much as a peep to the patients whose private information had been on the internet for over a year-and-a-half.

Posted by: Thrive | Mar 14, 2005 12:45:55 PM

To clarify: only previous Kaiser employee working in the Northern California area would have recognized the technical significance of the Systems Diagrams and their relation to Kaiser's EMR (or AMR) system. This security leak is a separate issue from the HIPAA issue.

While most of the diagrams are images, some are html documents. Those pages were indexed in Google, and any of the patients with their information listed on those pages could have found themselves listed there. While they might not have recognized what the System Diagrams were, they might have have been concerned that their information had been published amongst all those strange technical diagrams. I original found the System Diagrams through a Google search: they were available to anybody for over a year.

I have no proof whether the names I saw were patients or not: I thought they were probably test data. I knew the physicians listed were real people, though, and that was enough to raise a question for me. Kaiser's recent press releases were the first confirmation I had that real patient information had been placed online.

I contacted political representatives, departments of government, and journalists every step of the way. If I had been able to get a serious investigation from any of them, I would not be continuing to wave the System Diagrams in the air now. Kaiser has a reputation for hiding and destroying evidence before it can be investigated: ask anyone who has ever been through a Kaiser arbitration. I have direct experience of Kaiser destroying evidence. I agree that my approach here isn't optimal, and I do ask myself a lot of ethical questions about it - but I don't see any other way to bring Kaiser's unethical corporate behavior to light. This is an issue that has ramifications not just for those 140 patients, but every person who has agreed to Kaiser arbitration or other "dispute resolution" processes. I'm not sure which constituency carries the most weight here. I would have preferred it if Kaiser had handled all these issues when they had the chance, but they didn't. I welcome suggestions as to what I should do next, and I do want to do the right thing.

Posted by: gadfly | Mar 14, 2005 12:46:26 PM

I'm not supporting anything here, least of all the Gadfly violating patient privacy. However, she is posting the information whatever I say, and as she has pointed out she has little to lose by doing that. What I am suggesting is that the self-interested motivation of Kaiser here was NOT to let this thing get into the press. But apparently they don't seem to care and are pursuing this the legalistic way. Given that the Gadfly is right about the facts--that someone connected with Kaiser (not her) posted this information where it was findable online for the better part of 2 years, I don't see how Kaiser can come out of this looking blameless. And, as I said in my piece, with a little common sense they should have been able to settle the Gadfly's dispute with them amicably, but they apparently haven't tried to do so.

Posted by: Matthew Holt | Mar 15, 2005 1:16:56 PM

Tim -

It seems to me that Gadfly was in a perfect storm. It's easy for people to second quess with hindsight. She tried all the acceptable avenues and was rebuffed. They terrorized her at her home. Under the circumstances I think she was remarkably judicious. Far better than others would have been under similar circumstances.

The good people of Kaiser have an integrity deficiency. They were the ones who posted the information two years prior - those are the facts. Gadfly is not the enemy. She is merely a convenient scapegoat to conceal their malfeasance. We in the public should rally to Gadfly's cause against unchecked corporate power.

Posted by: Citizen | Mar 26, 2005 11:17:12 AM

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