In the pavement cracks.

The gist: Diminishing the seriousness of the work that is done at Kaiser Permanente may seem fine to George Halvorson, but it’s another example of his misleadership of an organization that once was led by a man, Dr. Sidney Garfield, who would have been horrified at the thought of a non-physician nonchalantly excusing medical errors. This remarkably embarrassing message has to make it absolutely clear to every Kaiser Foundation Health Plan director and every Permanente physician that George Halvorson has no right and no ability to lead the foremost healthcare institution in America.

The whole story: George Halvorson is so pleased to be celebrating five troubled years at Kaiser Permanente that he decided to send a message to all 162,000 of his employees, congratulating himself on his anniversary. (See Kaiser Thrive Exposed for the whole story.)

I don’t have much to say about the message, except that I found it to be completely bizarre, and somewhat defeatist. Mr. Halvorson points out that Kaiser Permanente has tens of millions of patient encounters each year, so things have to go wrong somewhat regularly. Umm. Uhh… (Hearing the crickets yet?)

If the message was meant to boost morale, well, the good news didn’t stop there. Mr. Halvorson says HealthConnect is beating the socks off the electronic systems at the Mayo Clinic. Oh, wait. Actually, he said it will beat their socks off in a few years. Maybe by 2009 or so. Maybe.

George Halvorson started out as a newspaper writer, but his anniversary note really could have used the touch of a good editor (or, perhaps, a whole team of them). I’m no big fan of George Halvorson (as you might have guessed), but reading his blathering, blabbering email was painful even for me.

Mr. Halvorson called his email message “good news,” but the bad news this week didn’t stop there for Kaiser Permanente. According to Tim, the ongoing hemorrhaging of senior leadership at KP-IT has now seen Adrienne Edens out the door. She was most recently vice president and information officer, heading up the Business Partnership Group. She’s apparently being replaced by Diane Comer, who was CTO at the Fireman’s Fund.

After Phil Fasano, and then Carol Rizzo, you probably won’t be surprised to know that Ms. Comer has built her reputation on outsourcing IT jobs. If the strategic direction KP-IT is heading in wasn’t obvious to anybody before, I really don’t know how much crystal clearer it’s going to get. The buck doesn’t stop anywhere at Kaiser Permanente, but you know where the fish rots from… The lack of ethical leadership at Kaiser Permanente, combined with the lack of competency (and stability) at the head of KP-IT left most folks to do their jobs as best as they could with the resources they had. Now, it looks more and more like the people fixing Kaiser Permanente’s ailing IT infrastructure won’t be Kaiser Permanente employees at all.

I gave up thinking, a while ago, that positive change was coming anytime soon to Kaiser Permanente or HealthConnect. The board is completely out of touch and unaccountable. George Halvorson is running the organization into the ground. And the kids are now in charge of the candy store over at KP-IT. (Seriously, Fasano, Rizzo, and now Comer have about as much healthcare experience, combined, as Zach Braff.) Until KP starts to run even further off the rails, there’s not going to be enough momentum to dislodge the ridiculously callous, careless, and incompetent board and chairman of Kaiser Foundation Heath Plan.

There was public outcry over the horrific kidney transplant nightmare. There was public outcry (and criminal charges) over the shocking mistreatment of indigent patients. But until Kaiser Permanente has an accountable board, or processes to hold its board and its executives accountable, this will not stop.

George Halvorson’s message was saying just that, almost excusing that, or perhaps preparing us for another round of Kaiser Permanente patient nightmares. He knew the kidney transplant scandal was coming long before the Los Angeles Times broke the story. He knew the tragic story of Carol Reyes was coming before the video footage of her stumbling down skid row in nothing more than a hospital gown made national news. He probably even knew of the heinous accusations against Dr. Hootan Roozrokh before the sad story of Ruben Navarro made headlines.

After five years of his “leadership” at Kaiser Permanente, it’s time for George Halvorson to go.