Short takes: Oracle Cerner still has major hurdles, says VA, Congress; One Medical adds Hackensack Meridian to specialist network, HTA to employer benefits; NHS trialing AI tracking of home behavioral patterns for at-risk patients

November 17, 2023 | by

VA’s All Quiet on the EHR Front doesn’t mean nothing is happening. With the House hard at work with a new speaker, negotiating budget extensions, and generally trying to get work done before the Christmas-New Year recess, the work of subcommittees goes on. Rep. Matt Rosendale (R-Montana), chairman of the House Committee on Veterans’ Affairs’ Subcommittee on Technology Modernization, yesterday (15 Nov) in what was titled “Electronic Health Record Modernization Deep Dive: System Uptime” got an update on the status of Oracle Cerner from Kurt DelBene, the VA’s chief information officer. His testimony wasn’t exactly reassuring. “Overall we still think there’s a ways to go. I don’t want to present the system as all set and ready to go.” In a rare show of bipartisanship, ranking member Rep. Sheila Cherfilus-McCormick, D-Florida, said that “[Oracle] training and change management are still woefully inadequate and user satisfaction is still critically low.” And despite being invited by Chairman Rosendale, Oracle’s Mike Sicilia didn’t show up or send regrets, which made Rep. Cherfilus-McCormick a little livid. FedScoop  HISTalk in its recap also pointed out that Rep.Rosendale “cited a report saying that it will take Oracle Health 15 more years to match VistA’s functionality. [VA deputy CIO Laura Prietula] responded that she doesn’t think it will take that long.” Oracle Cerner, in the few VA locations where it is operative, has not had a complete system outage in six months. Hearing and 1 hour 46 min. video (YouTube), hearing documents

Amazon continues to build out One Medical to, perhaps, ubiquity. On the East Coast, Amazon’s One Medical adds a major New Jersey health system relationship, Hackensack Meridian Health. Like its newly inked relationship with CommonSpirit Health, it will add integrated specialty providers to One Medical’s primary care focus. Specific locations based on patient needs are not specified yet nor financials. Implementation timing is unusually long–by the end of 2024. On a faster track may be One Medical’s deal with Health Transformation Alliance (HTA), a consortium of large US employers comprising 67 employers including Coca-Cola, Intel, Boeing, and many others totaling nearly 5 million employees. Timing and financials were not disclosed. This adds to One Medical’s current contracts with 8,500 companies that offer its primary care services as an employee health benefit. Becker’s, FierceHealthcare

NHS experiments with predictive health indicators and AI modeling for at-risk patients to prevent unnecessary admissions. Four GP practices in Somerset will be using an AI system that will flag registered patients who have complex health needs first, and are most at risk of hospital admission or who rarely contact their GP. Monitored in Buckinghamshire, the most interesting part of this is that the AI is linked to electronic sensors on kettles and fridges that spot changes in Somerset patients’ eating and drinking habits, obviously as an indicator of changes in health. (Does this remind anyone of 3rings or QuietCare?) Changes are reported to an Onward Care team of health coaches, nurses, and GPs who speak to patients and ask about any health or living issues. They can provide, based on patient input, deliveries of food parcels, arranging for cleaning or shopping services, home alterations to help to avoid falls, or to link them up with local voluntary groups to reconnect them with community resources or simply to help avoid loneliness. Clinical care can also be scheduled including specialist care. The NHS reports that GP practices can use this system to solve 95% of their issues or escalate anything clinical. Why this is important: hard winter and isolation, even with the holidays, loom after an autumn of wild weather and the persistent shortage of hospital beds and GP capacity/timeliness of appointments.  DigitalHealth.net

Keeping up with KeepUs

July 22, 2014 | by

Updated 25 July

Last October we profiled a UK-developed mobile app in beta called KeepUs. We said at the time that it “when installed on an older person’s or a child’s Android smartphone, (it) allows a family member to monitor that person’s both indoor and outdoor activity. Using geolocation, the family member can see that person’s visits (locations can be labeled), level of activity on any given day, alerts (being idle for too long), how much time was spent at each named location over the past two weeks and trends over two months.” For this Editor, it has the potential to supersede PERS of both the traditional and mobile types since it is free/low cost and also fits into an accepted form factor (phone) which increasingly PERS is not. It’s now well out of beta and with some “commercial care institutions” (we are following up). Founder Tom Doris is now inviting 10,000 volunteers to download a free version of the app by going to keepus.com and following the instructions (see at the top ‘go ahead and install the app’ which will take you to Google Play). PDF release.

Update: A follow up with Mr Doris confirms that KeepUs has users in the US, UK, Ireland, India, Turkey, Australia and even Cambodia (!). He explains, “It works the same as you’d expect any normal app and website to work: as long as you have access, KeepUs works fine. It doesn’t need any special hardware, nor does it need any special support from the cellphone network operators.”

Depressed? A woman? There’s an app for that.

November 12, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/11/T47screen-166×300.png” thumb_width=”130″ /]A new app still under development, Thrive 4-7 (the 7 is the seven dimensions of health) is meant to be used as a supplement to traditional therapy (and presumably medication). The app ‘thrives’ on constant interaction and uses gamification (!), behavioral psychology and influential design to modify the user’s behavior, for instance by sending special messages at times of daily stress. The developers want to connect the app with wearables and peer support groups as well. However, the time of their in-market–best case scenario is a debut at the end of 2014– is dependent on FDA clearance if it’s required–yet to be determined. The business plans, depending on this, may be direct to consumer or sold through health plans, hospitals and employer groups. The therapist you sleep with (MedCityNews) does seem like encouraging an unhealthy behavior, though.

KeepUs–smartphone-based senior activity monitoring and telecare

October 4, 2013 | by

KeepUs is a new, free app developed in the UK that when installed on an older person’s or a child’s Android smartphone, allows a family member to monitor that person’s both indoor and outdoor activity. Using geolocation, the family member can see that person’s visits (locations can be labeled), level of activity on any given day, alerts (being idle for too long), how much time was spent at each named location over the past two weeks (if Uncle Ted is spending three hours every day at the pub), and trends over two months. It requires no action from the person being tracked other than to carry the smartphone (certainly less obtrusive than a bulky non-removable watch). The family member/carer installs the app on both phones and controls permissions to view the other person’s activity. The app is in beta, free for individual use in the UK. (more…)