The poem: Well, it's not it's not the usual doggerel you see with this sort of thing. It's a quatrain…
Morning Headlines 4/27/23
UK’s TympaHealth sounds out $23M to expand its hearing diagnostics startup
London-based TympaHealth will use $23 million in new funding to begin marketing its digital ear and hearing healthcare platform to primary care providers, retailers, and pharmacies in the US.
VA’s new EHR hits another outage, as agency reconsiders FY 2024 request for project
The VA’s Oracle Cerner system experiences a nearly four-hour outage when one of its databases became unresponsive due to a failed background process.
Amazon closing Halo health division, lays off staff while offering hardware refunds
Amazon announces that it will shut down its Halo health wearables division at the end of July.
So VA’s options are:
1) fix cerner
2) flip to Epic
3) make Vista interoperable with the world besides VHA and especially DHA
Fixing Cerner meand VA learning or contracting with people who understand how to implement big systems.
Flipping to Epic is expensive (but so is status quo)
Stick to Vista means building Mumps expertise (that’s what VA tells me) but VHA may have better luck teaching Mumps than teaching implementation
So what have I missed?
What you’re missing is that the same government contractors who make their money implementing the new system also make their money from maintaining the old system. They have no desire to “get it done” or “get it right”.
Cerner isn’t the best but it also isn’t likely the core problem here. Cerner doesn’t really even control these issues as the headlines would make you believe.
As long as the contractors can double up on their earnings you’ll continue to see problem after problem and delay after delay.
Re: Government contractors – I thought that was the case for the DoD – Leidos managing both the Cerner install and the legacy system. For the VA, there is no government contractor, Cerner is paid to manage the install. Am I missing something?
Some comments:
– Every option is expensive, so pick your poison. In some cases you are trading up-front costs for ongoing costs, but you’re gonna pay, one way or another;
– Most of the VA’s struggles implementing 3rd party software? They’d face those exact same struggles implementing Epic;
– Have we all forgotten how the NHS dramatically failed to implement a nation-wide EHR 20 years ago? They spent ~$20 billion and got essentially nothing out of it;
– There is an iron-clad rule in IT. The larger the project, the greater the project risks. It’s not just the monetary exposure either. Statistically speaking, more large IT projects wind up with either a Failed or Challenged outcome;
If all that sounds grim, that’s not what my intention is. Lots of organizations attempt extremely large projects regardless. There are easily enough success stories to justify this.
Since the computer age started, there are vast numbers of case studies you can find. Stories that end with people saying, “It’s amazing how much this new system changed things for the better! I can’t believe we didn’t do this years ago.”
Apocryphal Winston Churchill: “Success is not final, failure is not fatal: it is the courage to continue that counts.”