"We're the largest Citrix deployment in the world," Deal said. "We're using it in a way that's quite different from the way most organizations are using it. A lot of users use it to allow remote users to connect to the network. But we actually use it from inside the network. For every user who connects to HealthConnect, they connect via Citrix, and we're running into monumental problems in scaling the Citrix servers."

"Epic simply cannot scale to meet the size and needs of Kaiser Permanente," Deal said. "And we're wasting billions of dollars trying to make it. The big issues for me are the financial repercussions of trying to launch such an ineffective and inefficient and unreliable system across the organization."

According to Deal, Kaiser is wasting more than $1.5 billion a year, primarily on HealthConnect as well as on other inefficient and ineffective IT projects. Kaiser declined to provide financial details of the HealthConnect system, which it has been working on since 2003. Kaiser expects the outpatient portion of the project to be fully implemented in 2008, with the in-patient portion done in 2009.

Another issue is with the Epic software and its adaptability, according to Deal and the IT employee. They said the software was written in MUMPS (Massachusetts General Hospital Utility Multi-Programming System) -- a health care programming language originally developed in the 1960s.

"Basically, the problems really do follow the entire scope of the platform in that we have these issues with the adaptability of Epic and we have these issues with the information security of Epic -- so we implemented Citrix to try and protect that, and we're facing the scalability issues with that," Deal said. "Using Citrix is something that defies common sense. It would be like trying to use a dial up modem for thousands of users. It's just not going to work, and it's not something anyone would tell you a dial-up modem should work for.