Given big tech’s dubious track record in healthcare, Oracle’s nearly $30 billion acquisition of electronic health records company Cerner is already subject to skepticism. What is at stake now far exceeds shareholder expectations and lofty visions for transforming healthcare.
Oracle has committed itself to fixing data management challenges at the U.S. Department of Veterans Affairs and its nine million patients. If Oracle fails, patients may be harmed and the VA will ultimately have to revert back to a legacy system for managing health records that dates back to the 1980′s.
Cerner has been struggling with the VA, which oversees the nation’s largest integrated healthcare system, on a massive data implementation contract. Oracle now owns the problem — literally — and more is at stake than transforming healthcare as the companies touted in a scripted presentation last month.
Oracle’s corporate reputation and its success in healthcare faces a test: can it deliver for millions of veterans?This question came to a head last month when an investigative reporter’s article about problems with Cerner software at a VA hospital ran in the Spokesman-Review newspaper in Washington.
The findings have since reverberated in several healthcare industry trade publications. A government audit’s preliminary findings, according to the newspaper, finds Cerner software is putting patients into what amounts to a black hole where appointments, lab work, refilling prescriptions and other routine follow-up procedures get lost. In all, nearly 150 patients were said to be harmed at the VA’s Spokane hospital due to Cerner software.
Credit Oracle’s senior leadership for not ducking the issue. Oracle had a number of ways to avoid addressing the media and the resulting accountability. For one, the reporter obtained a draft report from his own sources on problems implementing Cerner software at Spokane’s Mann-Grandstaff VA Medical Center.
As a draft report, a common tactic would be to defer commenting until a final report is released later this summer. Yet Oracle Vice President Deborah Hellinger made a statement. Oracle software engineers were already working on technical and operational changes with the goal of “exceeding the expectations of providers, patients and the VA,” she said, adding that her company has ”a moral obligation to deliver the best technology possible for our nation’s veterans, and we intend to do so.”
This statement creates a sense of urgency while inspiring confidence that Oracle is up to the job. Invoking a moral obligation to developing effective technology for the nation’s veterans elevates the mundane debugging of software and resolving help desk tickets into a patriotic duty.
To be sure, Oracle stopped short of pledging to solve specific issues, which pre-dates the company’s acquisition of Cerner. In 2018, the VA signed a $10 billion contract with Cerner to migrate health records from a 1980′s – era legacy system. The deployment in 2020 at Mann-Grandstaff is the first part of what is envisioned as a nationwide rollout over several years.
It is not going smoothly.
Since 2020, the VA’s Office of Inspector General issued seven critical reports about problems related to Cerner software. Meanwhile, the GAO, the auditing arm of Congress, recommended delaying the deployment of the software to other VA facilities until further testing is completed.
Such audits invite additional scrutiny. President Joe Biden recently signed legislation that requires the VA to issue quarterly reports on progress with its Cerner EHR rollout.
“For more than a year, Cerner and VA leadership have avoided accountability, withheld key findings and information, and put the lives of our nation’s heroes at risk,” said U.S. Rep. Cathy McMorris Rodgers. The Washington state lawmaker has likewise called for a delay in rolling out Cerner to other VA facilities.
The bottom line is the track record of Big Tech in healthcare is dubious at best. Amazon, Apple, Google, IBM and Microsoft have either struggled or outright failed at bold new health initiatives. Kyle Silvestro, a healthcare IT analyst, attributes some of these failures to underestimating the difficulty of data acquisition and the”fluidity” of medical information. He’s right about that.
Many of the issues plaguing Cerner and the VA is the migration of data from the old EHR system, a process that is always easier said than done. Oracle has big plans to develop a nationwide patient database that will be leveraged into artificial intelligence, telemedicine and automated clinical trials. If Oracle can solve the thorny problems with Veterans Affairs, they can get there.
As Oracle founder Larry Ellison said, “better information will fundamentally transform healthcare.” He’s right and now must focus on veteran’s healthcare and rally the software troops to make medical data work for nine million patients who served the country.
Dr. Shravani Durbhakula is a board certified interventional pain physician and anesthesiologist with nationally recognized media projects. She joined the faculty of the Johns Hopkins School of Medicine in 2017.
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