Thanks, appreciate these insights. I've been contemplating VA's Oracle / Cerner implementation and wondered if implementing the same systems across…
Monday Morning Update 5/13/24
Top News
Ascension’s 140 hospitals in 19 states remain offline following a ransomware attack on Thursday. An unstated number of the facilities are diverting ambulances.
The health system says restoring the systems “will take some time to complete,” adding, “we will be utilizing downtime procedures for some time.”
Ascension advises patients to bring in their own appointment notes and prescription information. A hospital family nurse said, “Patients are getting harmed. No one can tell you otherwise.”
A patient who was hospitalized when the attacked started reports, “It was like 1980. Everyone’s running to get pieces of paper, charts, clipboards. They have no computers whatsoever. It was chaos.” The patient, a colon cancer survivor who was vomiting blood, left the hospital two days after admission because he still hadn’t been seen by a doctor.
CNN reports that the Russia-linked ransomware group Black Basta was responsible for the attack. The federal government issued a warning about its ransomware variant on Friday.
HIStalk Announcements and Requests
Here are the results from last week’s poll. For me, the convenience of co-locating a medical and dental practice with a big-box store doesn’t hold value since plenty of doctors and dentists have offices in easily accessible locations. Some respondent comments that I’m paraphrasing:
- Walmart shut it down because they can generate higher margins elsewhere. The company benefits only from bringing in more dollars per square foot, not from supporting “healthier communities.”
- Health systems know that primary care and pediatrics are loss leaders, but Walmart missed that fact. They can’t sell enough groceries and TV sets to make up the cost.
- Walmart didn’t differentiate its services. It was just a bigger box with more expensive executives who were disconnected from any kind of healthcare transformation. Still, the company probably isn’t done with healthcare and an acquisition is likely.
New poll to your right or here: Should the federal government issue a national patient identifier?
I was pondering another poll: which platform’s users have the apparent lowest IQ or technical capability, Facebook or Nextdoor?
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Three members of the Senate Veterans’ Affairs Committee call for the VA to take advantage of its recently renegotiated contract with Oracle Health – which changed the contract’s five-year term to five, one-year terms – to strengthen accountability and oversight terms. They note that poor service delivery in the previous five-year period resulted in just a few hundred thousands of dollars in credits being extended toward the $10 billion contract.
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Pen and paper is not the downtime system a health system should be using in 2024.
A local non internet based electronic forms system is a far better solution. Both from a patient care perspective and labor required.
Now that’s an interesting idea. Seems to me you could have a backup copy of a segment of the patient EHR (say for all current inpatients plus any one seen as OP in last month?) stored locally, say updated each night. And on the local server a subset of the code need to do just basic functions. Like orders /results, etc.
Question is: Why hasn’t any of the big 5 vendors already done this??? and why hasn’t CIOs demanded it??
Epic has had a product called BCA Web for at least a decade, and it’s fairly similar to what you described. It even allows you to add new patients and encounters, which can be more easily reconciled back into the EHR when that’s up versus taking everything from paper.
Kind of obvious to say, but these ransomware attacks are getting ridiculous, and so is our national lack of response. If a foreign power bombed a hospital power plant or data center, we’d be thinking about war. With this, there’s a collective shrug and the Feds put out some tepid advisories. Not saying war is the correct response, but something more than advisories is needed. Maybe something behind the scenes is happening, but sure doesn’t appear like much.
Adding to the comment from Bob:
We are living in a world where our enemies are just beyond the screen. The space between our safe borders is no longer an ocean away. It’s just a millimeter away. We cannot say it’s up to the hospital system to protect us…although we do need to say stop collecting so much information and putting it in harm’s way. We do need to treat these threats as fundamental attacks on our citizens, our nation, and our borders. It’s not about building a wall. It’s about building an air gap. And it’s time to put our nation’s defenders on the front line and give them the mandate and authority to protect us.