back to article Computer glitches harmed 'nearly 150' patients after Oracle Cerner system go-live

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 …

  1. Yet Another Anonymous coward Silver badge

    Unknown problems

    To be fair, storing fixed format records on a small number of humans, retrieving them, updating them and ultimately deleting them - is a famous unsolved problem in computer science.

    Perhaps a young agile upstart like Oracle can make a breakthrough in Fifth-generation AI powered quantum computing to enable this

    1. David 132 Silver badge
      Trollface

      Re: Unknown problems

      It definitely sounds like an ideal use case for blockchain and/or AI, doesn’t it? Perhaps Oracle will be brave enough to bring us the first health records system that uses GANs to generate realistic-looking treatment plans.

      1. Martin Gregorie

        Re: Unknown problems

        One would hope that a well designed medical system would be rather careful to check that the person or organisation who is being asked to carry out the procedure or provide the requested medication is capable of carrying out the request in a timely fashion and *not* simply send it to a waste basket.

        Dunno why you'd think either block chain or AI would fix this problem when any competent project team should be capable of designing a data structure and supporting process stream to carry out something like that.

        Task specific specialist knowledge requirement? Easily fixed: just be sure to add a team member who has SUCCESSFULLY done a very similar task in a related specialty. Been there, used that approach several times. Never failed, unlike certain other projects I've been on that were managed by know-it-all MBAs and similar 'universal experts'.

        1. Anonymous Coward
          Anonymous Coward

          Re: Unknown problems

          "Dunno why you'd think either block chain or AI would fix this problem"

          WHOOSH*

          * just in case: https://www.howtogeek.com/783229/what-does-whoosh-mean-on-the-internet/

        2. FIA Silver badge

          Re: Unknown problems

          Dunno why you'd think either block chain or AI would fix this problem when any competent project team should be capable of designing a data structure and supporting process stream to carry out something like that.

          Well, they tried microservices and XML first but they didn't work either. :(

        3. fandom

          Re: Unknown problems

          I guess you are on the spectrum, since your hardware can't detect sarcasm you have to keep in mind that it exists.

          1. heyrick Silver badge

            Re: Unknown problems

            Hmmm, I'm probably on the spectrum, but that sarcasm was so bleedin' obvious that it shouldn't have needed sarcasm tags.

            I'm just a little upset that David didn't wiggle NFTs in there too, but HildyJ below has covered that, thanks. ;)

      2. Anonymous Coward
        Anonymous Coward

        Re: Unknown problems

        Just make each record an NFT.

    2. Mike 125

      Re: Unknown problems

      > storing fixed format records on a small number of humans, retrieving them, updating them and ultimately deleting them - is a famous unsolved problem in computer science.

      Henceforth known as the 'Oracle-Cerner Unknown Queue Paradox'.

      1. englishr
        Facepalm

        Re: Unknown problems

        > Henceforth known as the 'Oracle-Cerner Unknown Queue Paradox'.

        Or perhaps, Cerner-Oracle Queue Unknown Paradox (COQ UP).

  2. Mike 137 Silver badge

    Not a unique issue

    I once worked with a UK hospital trust with an emergency admissions system that demanded a mandatory post code (zip code) before an admission could be registered. If a patient was unable to provide a post code, in order to proceed with the admission staff took to entering a standard dummy post code. Consequently there were large numbers of patients apparently residing at the same (non-existent) address and if they had common names (e.g. Smith) their records could become completely corrupted. All because the system designers didn't see fit to include a "don't know" option for that field in the form.

    1. Yet Another Anonymous coward Silver badge

      Re: Not a unique issue

      There is a small farmhouse at the geographic center of the USA which is constantly raided by various squads of law enforcement for similar reasons.

      No location for cyber attack? Default to default USA location

      1. Phil O'Sophical Silver badge

        Re: Not a unique issue

        I'd have half-expected that to be Schenectady NY, which has ZIP code 12345.

        1. that one in the corner Silver badge

          Re: Not a unique issue

          That is the same code as my luggage!

    2. Yet Another Anonymous coward Silver badge

      Re: Not a unique issue

      I did a medical imaging system once where we were told we couldn't display sex/dob/address/ssn on screen to identify patient. Only minimally identifying information is initial+surname

      This is a city where Huang / Lee / Singh identify a majority of the population.

      1. Anonymous Coward
        Anonymous Coward

        Re: Not a unique issue

        I went into a bank in Fiji once, and the filing cabinets were labelled

        A,B,C..I,J,Kumar,Kumar,Kumar,Kumar

        I'm easily amused.

        1. Phil O'Sophical Silver badge

          Re: Not a unique issue

          A bit like my school in N.Ireland. The four first form classes were divided according to alphabetical order of names: A-E, F-M, Mc, N-Z.

          1. katrinab Silver badge
            Alien

            Re: Not a unique issue

            I guess the lack of a separate O' cabinet tells me what sort of school you went to.

        2. David 132 Silver badge
          Coat

          Re: Not a unique issue

          > Kumar,Kumar,Kumar,Kumar

          …Kameleon?

          (And for that 80’s earworm, you’re welcome.)

    3. Scene it all

      Re: Not a unique issue

      There is a scene in the 1971 film "The Hospital" (starring George C. Scott and Diana Rigg) in which a hospital administrator is badgering a comatose patient in the Emergency Room for his insurance information. In fact, the person in the bed was a doctor on staff at that very hospital. He later died, but would have survived had the hospital staff not been incompetent (which was the point of the movie).

    4. tokai

      Re: Not a unique issue

      Also homeless people and tourists sometimes need admissions…

    5. Anonymous Coward
      Anonymous Coward

      Re: Not a unique issue

      I came across a similar problem with a Social care system, its important that we understand if a client is homeless but there was no way to do this so a valid but dummy post code was used.

      The systems really do not handle people who have complex lives terribly well. They are ironically predicated to supporting a care pathway from home - hospital then discharged to home or a care home. Randomly wandering between living on the street, rehab, sofa surfing among a group of friends, returning to parents then back on the street or any possible location at any time isn't coped with at all

  3. Anonymous Coward
    Anonymous Coward

    I've done integration with Cerner

    It's not the worst, and certainly hasn't harmed as many patients in the UK as some of the alternatives. But all this category of software is shockingly bad, held in semi-monopolistic place by far too many regulations, endless numbers, to the point of anti-competitive, of processes (looking at you, GCloud) and "strategic relationships".

  4. DJV Silver badge

    fraught with problems

    "Fraught with problems" and "Oracle" - all too frequent bedfellows.

  5. WolfFan Silver badge

    Umm…

    Why, oh why, didn’t the software flag this kind of thing with something like “I don’t know what that is” and give the user a chance to fix it? I seem to have been taught about sanitizing my inputs back when I first learned programming, in FORTRAN IV and 77, and Pascal, mumbly decades ago. When 16 kB was a lot of RAM. (Hell, _4 kB_ was a lot of RAM) Just dumping input to trash without telling anyone was a Major No-No.

    1. Vometia has insomnia. Again. Silver badge

      Re: Umm…

      I'm still astonished that there's so much software that doesn't do even the most basic stuff, like online banking that'll go "argh, you've put a trailing space in the number field, I don't know what to do!" because you copy-and-pasted a value from the same page. As you say, doing this stuff was standard when tiny amounts of memory (and tiny memory maps) were what was available, and as often practised by professionals and hobbyists alike; why can't supposedly professional multinational computing boutiques manage it? Okay, rhetorical question, it just sucks.

      1. Yet Another Anonymous coward Silver badge

        Re: Umm…

        I love the: please re-enter the credit card number without spaces.

        1. logicalextreme

          Re: Umm…

          Back before contactless was a thing, at self-service checkouts you could usually whack your card straight into the chip & PIN reader and the till would detect it and switch into "card payment" mode (i.e. you didn't have to select a payment type on the main screen after scanning your items). There were a few of them, though, that when you put your card in, the main screen would indignantly demand that you remove your card and select "debit/credit card" as a payment method before reinserting it.

          Would love to have gotten a peek at that particular codebase.

          1. dvd

            Re: Umm…

            Well, having worked on, not these but similar systems I have a lot of sympathy for the developers.

            They are made up of a bunch of obscure peripheral devices like scales, bar code readers, touch screens, line printers, and payment devices. They will have been selected not on suitability or quality but on price or the size of the kickback to the purchasing department. They will have badly specified and conflicting interfaces. Nevertheless the programmers will cobble them together into a somewhat working system.

            When finally sold the pain really starts as the system will need changed to comply with some obscure local 18th century banking regulation that has never been repealed plus one of the peripherals will need to be changed to an obsolete one that the buyer has 10,000 of in the basement of their head office for some reason. And it all needs done in a fortnight or a deadline will be missed and the salesman won't be able to afford his second yacht.

            It always amazes me that these things work at all.

        2. Ken Shabby

          Re: Umm…

          Radio buttons that require more than one item to be selected.

  6. This post has been deleted by its author

  7. JWLong

    Dead Vets

    I'm a vet and happen to live in the city in question.

    This software is a bad joke, and for 4 months vets couldn't get service (care,test,surgery,or meds) untill they rolled back to the old system. Then the VA had to play catch up to begin services again.

    During this catch up period, the VA had to use actual paper processes to get things done. And it worked (paper that is).

    40 Billion over cost estimates is fucking ridiculous. How many trees have to be cut down and how many Vets have to die waiting for services that they are entitled to, to justify this shit.

    Maybe the VA should invest 49 billion in basic services, care, pencils and paper, and dump the "New and Improved" clusterFuck.

    One can only hope and pray.....

    1. BOFH in Training

      Re: Dead Vets

      I would have assumed that when a new system is put in place, it will be running concurrently with the older system, just to make sure everything works before removing the older system.

      Guess not.

      1. This post has been deleted by its author

      2. JWLong

        Re: Dead Vets

        NOPE, they should have but they rolled it out and said "lots of luck".

  8. Jan K.

    "Oracle would migrate the Cerner solution to an Oracle second-generation cloud infrastructure datacenter at no extra cost, he said..."

    No extra cost?

    From same article: "...the project could bulge to $49 billion, $40 billion over early cost estimates,"

    Didn't Oracle offer to handle *all* data records for *everyone* in the entire States? And the UK too iirc?

    By all means, go ahead. Seems to be in good hands.

  9. Kevin McMurtrie Silver badge

    $9 billion ... $49 billion

    It would have cost a fraction of that to form a new company and set aside 10 years worth of operating costs. The bean counters must have been working on commission.

  10. Auntie Dix
    Terminator

    In Other Words

    "...we plan to flub it first and work out the clusterf#ck later. Patients and providers will always die first. We won't let contract-wrangling get in the way of our gouging."

  11. Bump in the night
    Mushroom

    It goes to the unknown queue

    Employee:

    But we weren't told about the unknown queue.

    Kafka:

    How long haven't you been told about the unknown queue?

    1. eswan

      Re: It goes to the unknown queue

      Catch-22:

      We've always haven't been told about the unknown queue.

  12. Anonymous Coward
    Anonymous Coward

    Unknown queue

    Was it a known unknown queue (designed but not documented) or an unknown unknown queue (an exciting new unplanned feature)?

    1. heyrick Silver badge

      Re: Unknown queue

      I suppose in this day and age we should be glad that it went into an "unknown queue" instead of simply going "I don't know what to do with this, I'll just ignore it" (effectively erasing it).

      I guess this is some form of progress...

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