More Oracle-Cerner VA/DOD EHR misery with 4 hour+ outage; 51% of VA iPads unused for video appointments

Oracle-Cerner’s VA and DOD systems were down for 4+ hours on 4 August. The culprit was a corrupted patient database that needed to be fixed and reprogrammed. The problem was likely not minor. An insider source claimed to FedScoop that it could be an indexing problem that could mean that “one patients files could point to a different patients data” (sic) which could be disastrous. The VA statement is verbatim from FedScoop.

VA spokesperson Terrence Hayes said: ““VA experienced a system outage of its electronic health Record system on August 4, 2022, which also affected VA, Department of Defense and U.S. Coast Guard sites using the Oracle-Cerner EHR. At 12:07 p.m. EDT, Oracle-Cerner received monitoring alerts indicating an issue with one of its databases. The system was taken offline to execute recovery of the database, during which time the sites switched to standard downtime procedures.

He added: “During downtime of the EHR, medical personnel could still care for patients, but documentation occurred on paper. The system was fully restored for all end-users at 4:23 p.m. EDT, for a total downtime of 4 hours and 16 minutes. No data corruption or data loss occurred.”

The VA’s Office of the Inspector General has been busy indeed, in this case tracking down usage of Veterans Health Administration-distributed iPads. These, along with internet service, were distributed to 41,000 qualifying patients during FY 2021 for the VA Video Connect program–to connect Veterans to care during the pandemic when facilities were fully or partially closed. The OIG audit issued 4 August indicates is that less than half were used in the way intended. 

  • Consults were created for over 56,000 patients. Devices were sent to 41,000 patients.
  • 49% of patients–20,300 patients–completed a video appointment
  • Over 10,000 patients had a video appointment scheduled, but did not complete the visit for various reasons, such as technical issues or canceled. They did not schedule another virtual appointment.
  • If unused in 90 days after issue, the devices were supposed to be taken back. This did not happen with 11,000 devices.
  • Going back to November 2021, VHA’s tablet dashboard showed patients did not use nearly 8,300 of those 11,000 devices.

The value of the 8,300 unused devices was $6.3 million with cellular fees of about $78,000. Even more interesting, VHA’s data showed 3,119 patients had multiple devices. In August 2021, VHA ordered 9,720 additional new devices at a cost of $8.1 million, but as of January this year, there was a backlog of 14,800 returned devices that needed refurbishment–not at all atypical given this Editor’s experience years back with the VA and RPM devices.

Recommendations for the program include clarifying the number of days from consult initiation to device order, adding procedures to prevent and retrieve duplicate devices, tracking device packages, creating detailed refurbishment reporting, and using that information to guide new device purchases. Federal News Network

AARP/Intel’s simplified tablet–insulting to 50+?

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]Earlier this month, AARP announced its marketing of the RealPad, a simplified 7.85″ tablet. Its positioning is clearly aiming at the less tech-savvy cohort over 50. With much fanfare, AARP is touting its partnership with Intel in this ” intuitive, easy-to-use software interface for RealPad” on Android KitKat 4.4. It will be available at Walmart this fall at $189 (preorder via AARP) and it has the requisite big icons, front and back cameras and free 24/7 customer service. Release.

The Eye Rolls. We know that the AARP bread ‘n’ butter is creating loyalty for their products by catering to those who pay for their association’s services, but a press release headline like this sounds tinny to many of the younger and not-so-young people in this age group:

AARP ANNOUNCES REALPAD, FIRST OF ITS KIND TABLET DESIGNED FOR AMERICANS 50+ APPREHENSIVE ABOUT TECHNOLOGY

Powered by Intel, RealPad to Serve as Digital Gateway to Over 70 Million Americans 50+ (more…)

Yesterday’s Apple intros and implications for health monitoring

A knockout or a catch up? Now that the Hype Dust is settling (along with Apple’s stock price), let’s take a look at what we know today about the new, larger iPhones and the Apple Watch regarding health monitoring.

Where it was a catch up:

  • Size and screen in phones. Apple got the message: squinting at tiny type and swiping to enlarge is rapidly becoming yesterday’s pain. As smartphones and larger screens knocked out the Blackberry, Samsung led the way in sizing up and higher resolution–and others followed suit. The awful fact is that the smartphone market is aging, both in users and who’s left in the market to grow it, and we want to see, not squint.
  • [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/09/apple-watch-beauty-shot.png” thumb_width=”150″ /]Finally (drum roll), a sleeker smartwatch with fitness tracking, out sometime next year–and not just a sports model. The basic model is a rubbery Sport watch, the mid-line has a sapphire crystal, stainless steel case and (proprietary) swappable bands. The beauty is the upmarket version in gold with a leather band (left, courtesy re/Code).
    • Here Apple is up against multiple in-market competition from Fitbit to Moto to Withings to Samsung Gear–whose pricing is well below the starter Apple Watch at $349 in the $200 and below range.
    • The Apple Watch looks seriously great, distinctively thinner and it’ll be a prestige item. But does it track more and better? No. According to reports (updated today) this is what it has: heart rate monitor, pulse, daily activity for which you need the phone. No sleep monitoring. It also has to be charged every night. There may be other features from developers, but they are under wraps for now and will likely require phone tethering. (re/Code) It’s not a comprehensive lifestyle watch–yet.

Where it could be a knockout in healthcare:

  • Finally, a compelling reason for health care providers to ditch the old iPhone and not go Android. Healthcare providers in the US are heavily wedded to iOS: (more…)

Apple purchasing 3D gesture control developer PrimeSense

Breaking News

Based on the report you read, the deal is done or nearly done, but it is highly likely that Apple will be acquiring Tel Aviv-based PrimeSense for an amount in or around $345 million. PrimeSense developed the original 3D gesture control behind Microsoft Kinect (replaced by their in-house version); the company currently works with Asus and probably Apple. The purchase will enable Apple to add controls with body movements and hand gestures to its smartphone, tablet and TV products, as well as more closely defend its own patents in 3D gesture control lined out in Apple-ology blog 9to5Mac. Nothing in this or other reports about the Apple foray into smartwatches or wearables, but the capability fits. Watch 9to5Mac, TheNextWeb and TechCrunch for updates.

Tablets as ‘socializers’ for older adults

Long-time reader and now guest contributor John Boden of ElderIssues LLC and developer of the LifeLedger, reasons that if young children can use tablets fairly meaningfully, so can older adults at home or in senior communities. This is adapted from one of his series of ‘Caregiver Tips’ available via opt-in at caregivertips@elderissues.com.

Socialize With Technology: Tablets and iPads

If babies can use iPads, so can the very old.

Tablets and iPads are everywhere – EXCEPT – with nursing home patients.

This must be the season for me to have “aha!” moments. Last month it was while reading “Still Alice” and this month it was while visiting a nursing home where Sue told me she liked playing Scrabble but it was hard to find people to play with.

I am sure it is hard in a nursing home where you have to find another patient (more…)

Sanitizing iPads: study

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/iPad-wash-me.jpg” thumb_width=”150″ /]It was inevitable–that the increased mobilization of in-hospital healthcare would lead to a study about reduction of microbial surface contamination leading to increased risk of nosocomial infection transmission. (Editor Steve and I were flagging this up in 2011 for both clinical devices and the patients!) Here’s the first study this Editor has seen on reducing the microbial load on iPads, and it’s out of Germany. Using a standard disinfectant–isopropanol tinted blue, otherwise known as alcohol, applied on the front, back and sides of the iPad in a six-step process–the procedure achieved a 98 percent + reduction compared to non-disinfected iPads. However this may violate the warranty, as the study warns! Study looks into standard disinfection of iPads in clinical setting (iMedicalApps)

Apple’s tarnished luster predicted, interestingly

At the point where doctors and their children use iPhones routinely, iPad is the elite tablet and Apple’s balance sheet is deep in cash, University of Southern California business professor and management consultant Dave Logan is warning that the magic is waning. He uses a bit of communication analysis called ‘wordmapping’ that he’s developed to parse the remarks of Apple’s management, notably CEO Tim Cook, and concludes that Apple is losing its way. There is no longer a revolutionary-in-residence imagining something from nothing…none on the horizon, either. Apple-ologists have been tap dancing around this for awhile, but the protracted development of the Apple smartwatch is pinging all sorts of alarms, despite the flurry of activity in and around health ‘n’ fitness [TTA 20 July] We’ve been to this movie before when Blackberry was a must-have and dubbed ‘Crackberry.’ A rather cheeky headline that’s made a few AppleFans upset. Why Apple is a dead company walking (CBS MoneyWatch)

Related: Want to try wordmapping for yourself as a tool for ‘instant rapport’? Mr. Logan dishes on the fascinating pointers here.

Doctors wild about…what works

In the first half of the following blog item the author makes some valid points about doctors being quick to adopt mobile devices but that they were also quick to discover that the available apps are not much use in their work. The second half turns into a ‘knock Apple and big-up Windows 8 on tablets’ session. But then, as the author is Bill Crounse, MD, Senior Director, Worldwide Health at Microsoft, it would be surprising if he didn’t take that opportunity. Doctors wild about….. what works Hat tip to Bob Pyke.

UPDATE: related item, thanks to Toni Bunting: Health apps won’t reach core NHS patients (The Guardian). An NHS commissioner, writing under a pseudonym, also bemoans the lack of focus on appropriate apps and/or their use in the NHS. What the author focuses on is that the majority of NHS users are “the elderly, deprived and poorly-educated” and these people are less likely than most to be wielding and using smartphones.

Microsoft Surface dives into mHealth, telehealth tablet market

“Not only Lync but Skype as well are becoming fairly predominant platforms for what I call ‘commodity’ telemedicine and telehealth services,” Dr. Bill Crounse, Microsoft’s senior director for worldwide health, told Pulse IT Magazine during a promotional visit to Australia. “We are seeing amazing progress at an institutional level, with people understanding and mapping out where are their patients coming from and how far are they travelling. How can we leverage this technology to better serve that population [of] patients who are being asked to travel three hours across town for a snippet of information or reassurance, when in fact this technology can be applied.”

It’s a good point, but as EHR Intelligence goes on to point out: ‘In contrast to the iPad mini, which fits neatly into lab coat pockets and has the advantage of millions of apps in the mature Apple ecosystem, the Surface Pro is a bulkier product, weighing in at two pounds and saddled with an $899 price tag. In the era of bring your own device (BYOD) healthcare, Microsoft faces an uphill battle when it comes to attracting individual physicians looking to pick up a supplementary device for their office work.’ EHR Intelligence item: Microsoft Surface dives into mHealth, telehealth tablet market.