Computer errors following the go-live of a new Oracle Cerner electronic health records system harmed nearly 150 patients at a Washington hospital, as revealed during a hearing in the US.
Four days after Mann-Grandstaff VA Medical Center in Spokane switched over to its new Cerner software, staff became aware of an "unknown queue" problem which had the potential to cause harm to patients, a US Senate Committee on Veterans' Affairs heard last week.
Oracle acquired Cerner — a specialist developer of electronic health records systems used throughout the world — for $28.3 billion in June.
With the acquisition, Oracle inherited a 10-year, $10 billion contract with the Department for Veterans' Affairs signed in 2018. The deal was to design a health records system for VA hospitals and communicate with an EHR system that Cerner was installing for the US Department of Defense, replacing legacy systems, some of which were 40 years old.
The committee heard the total budget for the project could bulge to $49 billion, $40 billion over early cost estimates, according to Senator Jerry Moran, (R-Kan), who was citing an Institute for Defense Analysis report.
Witnesses described how the early rollout at five hospitals had been fraught with problems.
Speaking at the hearing, David Case, deputy inspector general, Office of Inspector General, Department of Veterans Affairs, said (1:31:00) that the so-called "unknown queue" problem was among the top three.
He explained the Oracle Cerner EHR system requires a healthcare provider writing a medical order for tests or other services to match the order to a certain delivery location. If a provider's selected option does not match the order to the correct delivery location, then the order would go to the unknown queue. Healthcare providers were unaware that their orders were not being acted upon.
"Cerner leaders told us they had no knowledge that VA was told about the unknown queue before go-live. We were provided with exit documents noting a VA leader had approved of its use, but that official told us they had no awareness of it," Case said, adding, "This is reinforced by the fact that there was no training on the unknown queue, no planning for it and its existence was unknown at Mann-Grandstaff (hospital). As one VA clinician put it, 'We stumbled on the unknown queue'."
In 2021, Veterans Health Administration patient safety experts found 60 safety concerns with the new software: the unknown queue being among the top three highest risks.
The same experts identified "nearly 150 veterans at Mann-Grandstaff who suffered harm due to the unknown queue from go-live through to June 2021", Case testified.
Although Cerner and VA took action to minimize the problem during 2021 and 2022, every facility that uses the software would need to monitor and manage their unknown queue, Case said.
"We have concerns about the adequacy of the current mitigation plan," he said.
Other VA hospitals already using the Cerner system are Walla Walla (Washington), Columbus (Ohio), Roseburg (Oregon), and White City (Oregon). The VA plans for another 25 hospitals and medical facilities to go live with the system between now and the end of next year.
While the unknown queue problem lies in design and user training, the Cerner system has also hit stability problems. The EHR system in Walla Walla, Washington, went down for about 127 minutes in April.
Dr Gerard Cox, assistant under secretary for health for quality and patient safety, Veterans Health Administration, agreed that the unknown queue feature in the Oracle Cerner EHR was not working well and created instances of patient harm.
He said that since the first hospital went live on the system, technology and clinical teams had tried to mitigate the effects of the problem.
"There have been strategies put in place to monitor that queue and make sure that the orders that were lost for several months are now identified and dealt with on a daily basis. I don't think I would say that a permanent fix is in place," he said.
Speaking to senators, Terry Adirim, program executive director, Electronic Health Record Modernization Integration Office, Department of Veterans Affairs, said: "The unknown queue is not something really to be fixed. It's a feature of the Cerner software. It is the way it is designed and people can talk about whether it is a good or bad design. What happened during the deployment was poor communication, nobody was trained in using this feature and a process was not put in place."
She also said that clinicians coping during height of the pandemic affected the implementation, adding patient safety was a top priority.
"Due to concerns in the first deployment, patient safety and risk reduction activities have been incorporated into every aspect of [further] deployments," she said.
Speaking before senators, Mike Sicilia, executive vice president at Oracle said Cerner and the VA had already implemented system changes to reduce the number of orders going into the unknown queue and to better address those orders that were sent into it.
Oracle planned to increase automation and alerts, as well as Excellerate workflow designed largely to "prevent orders from ever entering the unknown in the first place," he added.
During the next six to nine months, with the approval of the VA and the DoD, Oracle would migrate the Cerner solution to an Oracle second-generation cloud infrastructure datacenter at no extra cost, he said.
"If something isn't working for caregivers or patients, we plan to fix it first and work out the economics later. Patients and providers will always come first. We won't let contract wrangling get in the way," he said. ®
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Accelalpha, a portfolio company of Century Park Capital Partners, announced today that is has completed the acquisition of Frontera Consulting, a leader in implementation and management of Oracle Cloud applications. The combination expands the geographic reach of both firms’ consulting services and managed services, while broadening their solution delivery capabilities and industry expertise.
Founded in 2008, Frontera was one of the first Oracle Partners to focus on Oracle Cloud applications, implementing the first ever Fusion Financials client in North America. Since then, Frontera has developed capabilities and certifications in ERP, EPM, PPM, HCM, and SCM, as well as Oracle Integration Cloud. Frontera has grown to develop deep expertise and a strong reputation within the Financial Services, Professional Services, Public Sector, Telecommunications, and Media & Entertainment industry verticals and has a strong presence in the U.S. and U.K.
The Frontera transaction marks the seventh acquisition by Century Park in the Technology Services sector and the fourth acquisition for Accelalpha. Tony Trevino, Principal at Century Park Capital Partners, commented, “We’re delighted to join forces with the Frontera team as we continue to expand our geographic reach and capabilities around mission critical applications for our enterprise customer base. We look forward to seeing what Frontera and Accelalpha can accomplish together.”
Also Read: Artificial Intelligence: Strategies to Leverage it to Stay Competitive
Kevin Beyer, Managing Partner at Frontera, will continue to lead the Frontera operating unit within the Accelalpha family. Beyer said, “The combined organization of Frontera and Accelalpha creates a leading global consulting service provider with the ability to deliver a broader set of Oracle Cloud solutions and a depth of targeted industry knowledge. The two companies are an outstanding fit, geographically, technically, and culturally.”
Nat Ganesh, Accelalpha CEO, concluded, “I have admired Frontera’s capabilities and reputation for a long time and we are excited to finally join forces with a great organization. The combination of Accelalpha and Frontera will bolster our market leadership as an organization that can implement, integrate, and manage all of the Oracle Cloud applications end-to-end to deliver comprehensive digital transformation solutions for our clients across the globe.”
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The rollout of the Department of Veterans Affairs’ new electronic health records system has been a “total mess” from which IT vendor Oracle Cerner has been able to profit, according to a senior Republican.
Rep. Matt Rosendale, R-MT., said that VA Secretary Denis McDonough should take responsibility for major flaws and ongoing risks to veterans associated with the platform.
“It’s a s*** show. They’ve made a total mess out of it,” the lawmaker told FedScoop. “Meanwhile Cerner is profiting off this debacle. They’re profiting from it. This is unacceptable. It’s a little game of disaster.”
Rosendale, who is the House VA Subcommittee on Technology Modernization Ranking Member, added that it was incumbent on McDonough to hold everyone involved in the EHR program accountable.
“At the end of the day Secretary McDonough has to take responsibility for it because he’s in charge of the VA. So it’s up to him to hold everyone else accountable,” he told this publication outside a House hearing Wednesday on the issue.
The senior Republican’s trenchant criticism came after lawmakers from both parties aggressively called out rampant issues with the cost, transparency and reliability of the VA’s electronic health record (EHR) system rollout during the House hearing. They were speaking at a House committee on Veterans’ Affairs hearing Wednesday on patient safety and the electronic health record modernization program.
Multiple Congressmen speaking at the hearing were angry that despite internal VA reports from October 2021 showing that the EHR system had major flaws and ongoing risks that could harm veterans, Secretary Denis McDonough and the VA continued to launch the system in medical facilities in multiple states.
Rosendale also accused the VA’s Executive Director of the EHR Modernization Integration Office at the VA Terry Adirim, and her staff, of contradicting themselves during their interactions with him and during hearings in Congress.
The implementation of the VA’s new EHR system on an Oracle Cerner developed platform to medical centers around the country will be delayed from its original estimates by at least one to two years and the system rollout is far behind where it was expected to be at the moment, a top VA executive said during a Senate hearing last week.
The EHR system rollout issues have in some instances, including at the center in Spokane, Washington, caused major harm in which a veteran at risk for suicide did not receive treatment because records disappeared in the computer system. This system error occurred due to technical issues with what’s known as an “unknown queue,” that has caused nearly 150 instances of patient harm, according to the VA’s Office of Inspector General (OIG).
The Institute for Defense Analyses, a nonprofit research entity, puts the life cycle cost of the EHR system at $50.8 billion over 28 years, while the VA’s original rollout implementation tag was about $10 billion over 10 years, but some Congressmen are even skeptical of these estimates.
“The new [IDA] estimate says the cost could be as high as $63 billion if everything goes wrong, and I see a lot of things going wrong,” said Rep. Mike Bost, R-IL, a member of the House VA Subcommittee on Technology Modernization.
“Cerner says the rollout would be 13 years instead of 10, but even 13 years seems like a best case scenario given all the issues,” said Bost.
Oracle-Cerner said during the House hearing Wednesday that problems with the VA’s current cost estimates are due to the federal government assuming the EHR technology stands still. However, the company took responsibility for the VA EHR software being too complicated and cumbersome, requiring extensive staff training which typically shouldn’t be the case.
Adirim from the VA during the House hearing Wednesday attributed some of the increased EHR rollout costs to Oracle-Cerner contract modifications regarding pharmacy enhancements that went above and beyond the baseline of the original contract because they were “technically considered enhancements,” not fixes to the system, Adirim said.
Rep. Rosendale, however, said that Oracle Cerner was getting paid more money for their contract while veterans continued to get poor service at medical facilities where the EHR system has been rolled out without permanently solving latent issues with reliability and stability.
Former VA leaders who have experience with EHR systems have also observed deep entrenched issues with the agencies ongoing rollout and its ballooning costs.
“If you don’t have discipline, if you don’t control costs tightly and if you don’t even know what your costs are, you’ll get sucked for every dollar the government has. Like with Cerner. That’s how this game works,” said Roger Baker, chief information officer (CIO) and assistant secretary for information and technology for the Veterans Affairs Department from 2009 to 2013.
“The VA doesn’t know how much things cost and it has no clue how to do so, it would be like me trying to estimate what it could cost to build the Empire State Building,” he said.
Baker added that the VA had repeatedly shown management and execution issues with the EHR rollout due to their lack of prioritization on the day-to-day experience of doctors and staff within VA hospitals while instead focusing on trying to expand the rollout to as many medical facilities as quickly as possible.
Adirim declined to comment further after the hearing.
The MarketWatch News Department was not involved in the creation of this content.
Aug 02, 2022 (Alliance News via COMTEX) -- Manufacturer Detail, Oracle, Koenig Solutions Pvt. Ltd., Learning Tree International, itcast, UrbanPro, testkingreal.com
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The latest version of Oracle’s Fusion Sales customer relationship management (CRM) application wants to automate the most repetitive sales tasks by providing users with automated recommendations to increase productivity and close more deals.
The new look Fusion Sales tool looks to build on the data Oracle has collected for over 40 years and remove several manual steps in the B2B sales process.
“Traditional CRM systems were designed to be a system of record for planning and forecasting, versus a tool to help sellers sell more," said Rob Tarkoff, executive vice president for Oracle Fusion Cloud Customer Experience. "As a result, sellers spend countless hours on data entry and administration that stunts sales productivity."
The updated sales application already comes bundled with Oracle’s Cloud Customer Experience CRM suite, which also includes marketing, customer service, finance, and HR modules.
Fusion Sales could turn marketing leads into opportunities
The updated sales application offers a step-by-step guide that helps sellers onboard faster. These steps can be based on the custom recommended practices of an individual enterprise, as well as helping to automate the process of qualifying and converting marketing leads into opportunities.
“When connected to Oracle Fusion Marketing, Fusion Sales automatically creates highly qualified leads and then passes them to sellers for follow-up,” the company said in a statement.
Sellers will be able to see quotes, proposals, and implementation schedules once new opportunities are created inside the CX cloud.
These quotes are automatically updated throughout the sales process as a deal progresses and are enriched with historical data that includes prior successful deals, the customer’s industry sector, and other key account attributes.
The application can also surface intelligent content recommendations for sellers that can be fed in from the marketing team. These approved pieces of information, such as commonly asked questions, can be used to quickly answer buyer or customer queries, easing the time taken to complete the sales process.
New app lets users create personalised mircosites
The updated version of Fusion Sales also includes a new Digital Sales Room, where an enterprise can create personalised microsites for its customers.
These sites can include resources such as quotes, past contracts, reference stories, and details of past or upcoming Zoom meetings to help move buyers closer to a purchasing decision.
These sites can also track certain customer signals or behavioural patterns based on their interaction with the website, and these signals can be used as further sales insights for training and future deal-making strategies.
Competition continues to be strong in the CRM market
With these product moves, Oracle is looking to keep pace in what is becoming an even more competitive cloud CRM space, alongside the likes of Microsoft, Salesforce, and SugarCRM.
Salesforce has been looking to leverage AI to make recommendations to users since it launched its Einstein product back in 2016, and Microsoft has added its own Sales Insights for Dynamics CRM.
“In 2021, many companies continued to pivot toward the more digital world that we now live in, including the procurement of technologies that would help them Excellerate their level of engagement with their customers and the experience that customers receive,” said Alan Webber, program vice president for customer experience management strategies at the analyst firm IDC.
Java 7 certainly had its time, but it’s time to prepare for the future. Oracle has been trying to implement Java 8 and 11 and make it the norm, however, there are always developers that keep using Java 7, and 8. Therefore, the company is ceasing its support for the old version. The company has announced that Java 7 will reach the end of its life cycle. So, the company will cease the extended support for this particular version.
According to the official statement, when the life cycle is over, the product will enter continuous support mode. No further patch updates will be provided, no bug fixes, security fixes, or feature implementation, and only limited support will be provided. Furthermore, the company is ceasing its support for Java SE 7. Therefore, some older versions of various Oracle Fusion Middleware products will no longer provide certified JDKs.
“Community support will end when Java 7 reaches the end of service on July 29, 2022. All applications running on 7 will continue to run, but 7 itself will not receive updates or security patches. To minimize risk and potential security vulnerabilities, upgrade your applications to 8 or 11 depending on your workload requirements.
The canonical guide to follow is the Oracle JDK Migration Guide. The migration guide addresses all Java specification incompatibilities and JDK implementation incompatibilities. Most of these incompatibilities are edge cases. You should make an investigation when a warning or error occurs.”
“Most applications should run on 8 without modification. The first thing to try is running on 8 without recompiling the code. The point of just executing is to see what warnings and errors are coming from the execution. This approach gets an application to run faster on 8 for the least amount of effort required.”
Oracle is recommending its users upgrade to a new Java SE version that has support. Currently, the company is offering support for Java SE 8 and Java SE 11. Users opting for these versions will get full support for their Java runtime.
It’s a common behavior for companies to cease existing services to focus on new ones. Amazon, for example, is shutting down Amazon Cloud Drive to focus on Amazon Photos. Google last year, changed the Google Photos policies.
BELLEVUE, Wash.--(BUSINESS WIRE)--Aug 4, 2022--
Accelalpha, a portfolio company of Century Park Capital Partners, announced today that is has completed the acquisition of Frontera Consulting, a leader in implementation and management of Oracle Cloud applications. The combination expands the geographic reach of both firms’ consulting services and managed services, while broadening their solution delivery capabilities and industry expertise.
Founded in 2008, Frontera was one of the first Oracle Partners to focus on Oracle Cloud applications, implementing the first ever Fusion Financials client in North America. Since then, Frontera has developed capabilities and certifications in ERP, EPM, PPM, HCM, and SCM, as well as Oracle Integration Cloud. Frontera has grown to develop deep expertise and a strong reputation within the Financial Services, Professional Services, Public Sector, Telecommunications, and Media & Entertainment industry verticals and has a strong presence in the U.S. and U.K.
The Frontera transaction marks the seventh acquisition by Century Park in the Technology Services sector and the fourth acquisition for Accelalpha. Tony Trevino, Principal at Century Park Capital Partners, commented, “We’re delighted to join forces with the Frontera team as we continue to expand our geographic reach and capabilities around mission critical applications for our enterprise customer base. We look forward to seeing what Frontera and Accelalpha can accomplish together.”
Kevin Beyer, Managing Partner at Frontera, will continue to lead the Frontera operating unit within the Accelalpha family. Beyer said, “The combined organization of Frontera and Accelalpha creates a leading global consulting service provider with the ability to deliver a broader set of Oracle Cloud solutions and a depth of targeted industry knowledge. The two companies are an outstanding fit, geographically, technically, and culturally.”
Nat Ganesh, Accelalpha CEO, concluded, “I have admired Frontera’s capabilities and reputation for a long time and we are excited to finally join forces with a great organization. The combination of Accelalpha and Frontera will bolster our market leadership as an organization that can implement, integrate, and manage all of the Oracle Cloud applications end-to-end to deliver comprehensive digital transformation solutions for our clients across the globe.”
About Accelalpha:
Accelalpha is a leader in solving critical business challenges through a unique combination of industry insight, technology depth, and a world-class team with an unmatched level of experience and domain expertise. Accelalpha leverages its expertise in end-to-end enterprise solution implementations to help companies build integrated logistic capabilities, optimize sales processes, modernize the supply chain, and realize benefits of the cloud. Our rigorous, result-oriented approach to developing solutions allows us to deliver tangible results in a shorter time frame. Accelalpha is recognized by Fortune as a best small and medium workplace and certified as a great place to work. For more information on Accelalpha, please visit www.accelalpha.com.
About Frontera:
Frontera Consulting is a leading provider of business and technology consulting services to global organizations. Collaborating closely with our clients, we create transformational solutions to meet business needs and drive performance. Our mission is to create long-lasting value for our clients through the innovative use of technology and process expertise, earning the role of trusted advisor. Frontera is headquartered in New York, with operations in London and Hong Kong, and a development center in India. For more information on Frontera, please visit www.fronteraconsulting.net.
About Century Park:
Century Park Capital Partners is a Los Angeles-based private equity group established in 2000 that invests in family businesses, owner-operated firms and corporate divestitures with the purpose of accelerating growth and transforming these companies into leading industry players. We specialize in acquiring strategically well-positioned yet under-resourced middle market companies with identifiable potential for value creation. We leverage our C-level executive partners (“Century Leaders”) in targeted sectors to build an investment thesis, evaluate opportunities, and lead portfolio companies through the value creation process. We further support our investments with proven operational and best practice initiatives, led by our Operating Team, including buy-and-build acquisition integration programs and infrastructure additions. For more information on Century Park, please visit www.centuryparkcapital.com.
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