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

August 10, 2022 | by

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

VA expands telehealth services again with T-Mobile’s 70,000 lines

December 13, 2018 | by

The US Department of Veterans Affairs and T-Mobile announced on Monday that T-Mobile would be adding 70,000 lines of wireless service to increase telehealth services in the VA network and expand services to veterans, especially those in rural areas. The expanding network will connect veterans at home and at VA facilities, such as community-based outpatient clinics (CBOCs), with VA clinicians within the VA network.

This adds to VA’s push this year to extend telehealth to distant veterans in rural areas through initiatives such as with T-Mobile and the Spok Health – Standard Communications partnership to expand the Spok Care Connect messaging service to more VA healthcare systems. The VHA (Veterans Health Administration) has long been the largest user of telehealth services in the US. Until recently, their emphasis has been on store-and-forward and clinic-based patient consults, but finally Home Telehealth (HT) is being supported. Reportedly, only 1 percent veterans used Home Telehealth, while 12 percent used other forms of telehealth [TTA 24 May]. Yet the VA was among the earliest users of remote patient monitoring/home telehealth, dating back to 2003 and even earlier, with companies such as Viterion and Cardiocom.

While most of the news about VA has been about their leadership changes and their difficulties around EHRs, their ‘Anywhere to Anywhere’ program was finalized in May. This allows VA practitioners to provide virtual care across state lines to veterans, regardless of local telehealth regulations.

T-Mobile is already the lead wireless provider to the VA. The 70K line addition is part of the carrier’s $993.5 million five year contract with the US Navy.  Business Wire, Mobihealthnews

VA’s moves spell the end of the homegrown EHR

August 12, 2016 | by

The Veterans Health Administration (VHA) is formally reaching out to the private sector to explore switching from its current, pioneering EHR system, VistA (also referred to as CPRS, Computerized Patient Record System) to a commercial system. Their ‘feeler’ is an August 5 and 8 notice in FedBizOpps.gov titled 99–TAC-16-37877 * RFI – VHA supporting COTS EHR REQUEST FOR INFORMATION (RFI), Solicitation Number: VA11816N1486. This requests information on business support for transitioning to a commercial-off-the-shelf system (COTS–don’t governments love acronyms?–Ed.) and closes 26 August, which is not a lot of time even for an RFI.

VHA has been under extreme pressure from Congress to modernize its EHR, lately in July hearings before the Senate Appropriations Committee. EHR replacement is also in line with the Congressionally-mandated, now concluded Commission on Care’s recently published recommendations on a total, top-down reorganization of VHA, including a sweeping reorg of their HIT management. The VHA strategy appears to be that while they are walking down the road to replace VistA and have already spent to assess where they are with KLAS and other EHR consultancies (spending $160,000+ on surveys), they are essentially ‘kicking the can down the road’ to the next administration (POLITICO’s Morning eHealth, 14 July).

Current state is to continue to upgrade VistA through late 2018, though the closely related Department of Defense’s Military Health System is in the long process of cutting its homegrown AHLTA over to Cerner-Leidos as MHS Genesis, awarded last August, with a first trial in the Pacific Northwest later this year (HealthcareITNews, Ed. emphasis). Of course, it will take the VHA years to roll it out; there are close to 9 million veterans enrolled in the closed system that is the VHA.  FCW, Morning eHealth 10 August

Love EHRs or hate them, the sheer size of the VHA and its growing concession that VistA won’t do in caring for American veterans makes it clear that the future of EHRs is in private systems from major developers–a field which is winnowing out to The Few (take that, GE).  (more…)

Flo and ANNIE: text messaging with a personality to improve health (UK/US)

December 2, 2015 | by

Flo–the Florence Simple Telehealth text messaging system–is well known to our UK Readers as a successful initiative of the NHS. Over the past five years, starting from a test with NHS Stoke on Trent, it has been used by more than 30,000 people in over 70 health and social care organizations to help them monitor their health in areas as diverse as managing diabetes, living with COPD and managing breast feeding. Flo is customized by the clinician for the individual patient on questions, information, and speaks to the patient with a sometimes sassy ‘voice’ to help keep him or her on track. The Health Foundation has spotlighted Flo (named after Florence Nightingale) in ‘The Power of People’ with an overview page here and the video ‘Telehealth with a human touch’.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/12/1109151630.jpg” thumb_width=”150″ /]nhssimple, a Social Enterprise is now tasked with developing the Flo program and since 2013 has partnered with the Veterans Health Administration in the US to develop a counterpart. Named ANNIE after Lt. Annie G. Fox, Army Nurse Corps, who was the first woman awarded the Purple Heart for her actions at Pearl Harbor, the VA is shortly testing it at four sites with intent to roll out nationally in 2016. This Editor has seen two presentations by Neil Evans, co-director of VHA connected health, in 2014 and this year at mHealth Summit (HIMSS Connected Health–see left). The Health Foundation video also includes an interview with Dr Wyatt Smith, prior Deputy CIO of the US Military Health System, and mentions the VHA. Hat tip to Phil O’Connell, Global Lead of nhssimple, for the update.

VA calls IBM Watson for decision making, PTSD assistance (US)

December 16, 2014 | by

The US Department of Veterans Affairs (VA) Veterans Health Administration (VHA) area is working with IBM Watson to develop and pilot a Clinical Reasoning System to assist and accelerate decision making by primary care physicians. The $6.8 million, two-year project will concentrate on acquiring and analyzing the data generated by hundreds of thousands of VHA documents, medical records, EMRs and research papers. The second focus of the VA-Watson relationship will also include mental health–supporting veterans with PTSD who constitute 12-20 percent of US veterans from Vietnam to present. The pilot phase, interestingly, will use simulated, not real, patients.

(more…)