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 Strengthen 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. ®

Hangzhou, China, Aug. 8, 2022 — EMQ Technologies, a global provider of open-source IoT data infrastructure solutions, today announced that it had officially joined the Oracle PartnerNetwork (OPN). Through OPN, EMQ will work together with Oracle to better pair their respective IoT solutions, explore joint use cases and dive deeper into specialized technical knowledge to build successful, cloud-based IoT connectivity services.

Oracle PartnerNetwork (OPN) is a channel partner program that offers members access to partner-specific training, global industry expertise, go-to-market tools, valuable resources and support. These valuable benefits enable partners to accelerate their own transition to the cloud as well as drive superior customer experiences and business outcomes.

Since its start in 2017, EMQ has been on a mission to serve the future of human society through state-of-the-art open source IoT data infrastructure.

Over 20,000 enterprise workers use EMQ’s massively scalable cloud-native MQTT messaging platform, EMQX, which is the first open-source platform to provide scaling capability up to 100M connections per cluster. EMQ can deploy its mission-critical IoT infrastructure to major cloud providers such as Oracle Cloud, AWS, Google Cloud, Microsoft Azure, and hybrid clouds, all in a secure and reliable manner.

From the world’s #1 database to enterprise cloud applications, Oracle has a long-standing reputation for technology innovation along with its cloud-first, customer-centric strategy that empowers organizations to address demanding business issues.

Oracle Cloud infrastructure platforms are consistently rated as industry-leading and innovative by customers, delivering a truly differentiated enterprise-level cloud platform with complete, full-stack offerings that offer unmatched reliability and performance.

EMQ’s commitment to IoT data connectivity, combined with the efficiency of Oracle Cloud infrastructure, will deliver a higher level of resilience, security, and scalability for critical IoT business processes.

“Becoming an OPN member is the starting point of a robust, long-term relationship with Oracle,” said Feng Lee, founder and CEO of EMQ. “EMQ will join forces with Oracle to introduce more co-created, seamless, cloud-based IoT solutions for our mutual customers, accelerating their cloud journey and digital transformation. We are looking forward to bringing our shared vision to uncharted heights.”

EMQ will enhance its offerings through the Oracle ecosystem and work closely with Oracle’s experts to validate their joint IoT connectivity solutions.

Discover EMQ’s powerful IoT connectivity solutions. Built to accelerate success in the IoT era.

The City of Cape Town promotes and applies the principles of employment equity. People with disabilities are encouraged to apply.

CORPORATE SERVICES ? INFORMATION SYSTEMS AND TECHNOLOGY (IS & T)

SENIOR PROFESSIONAL OFFICER: DATABASE ADMINISTRATOR

TCOE SALARY COMMENCING FROM R912 661 PER ANNUM ? REF NO: CS 190/22

Requirements:

• National Diploma supported by industry specific/related qualification and relevant experience
• Oracle certification and SAP HANA experience will be advantageous
• Applicants with higher tertiary qualifications (e.g. B degree) will be given preference
• Five years’ relevant experience.

Key performance areas:

• Apply a substantial body of professional knowledge of database administration, installation and maintenance
• Develop and implement a full range of database management solutions within the framework of the City’s IT architecture, policies and practices
• Deal with a variety of professional issues relating to databases and database administration, performance tuning, database indexing
• Make recommendations and facilitate the development and implementation of long- and short-term objectives for data and database management
• Manage the DBA team members.

Please apply online at [URL Removed] (external applicants) or via the SAP Portal (internal applicants) unless otherwise stated.

By submitting your application for a position at the City of Cape Town, you are consenting that the personal information submitted as part of your application may be used for the purposes of the Recruitment and Selection process.

Closing date: 12 August 2022

• Please quote the reference number of the vacancy in all communications.
• Certified copies of qualifications must be available on request.
• Copies of supporting documents will not be returned.
• Kindly note that applications will not be acknowledged in writing.
• Visit our website at [URL Removed]
• No late applications will be considered.
• If no notification of appointment is received within three (3) months of the closing date, please accept that your application was unsuccessful.

Desired Skills:

• SAP
• Database Administrator
• Database Administration
• Database

Learn more/Apply for this position

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.”

Check Out The New Enterprisetalk Podcast. For more such updates follow us on Google News Enterprisetalk News.

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 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.