Generative AI is a known disruptor in healthcare today. Will this transformational technology be embraced by clinicians, patients, and healthcare organizations? Listen in as two experts from Accenture Healthcare and Oracle discuss the difference between traditional AI and GenAI, the opportunities that GenAI is presenting to the industry, and the need to lean in to utilize technology as an enabler and a change agent. Hear how care delivery can be reimagined with GenAI and how this technology has the potential to be applied to help reduce clinician burnout, augment the clinician-patient relationship, bridge workforce shortage gaps, reduce margin pressure, and more.

--------------------------------------------------------

Episode Transcript

00:00:00:17 - 00:00:22:10
Michelle
You're listening to Perspectives on Health and Tech, a podcast by Oracle with conversations about connecting people, data and technology to improve health for everyone. Hi, I'm Michelle Flemings. I'm the industry executive director for Health Care for North America Cloud Infrastructure at Oracle. Glad that you're here. We're in the age of artificial intelligence.

00:00:22:12 - 00:00:41:29
Michelle
The opportunities that we're presented with using A.I. as an industry are truly groundbreaking. And to be honest, I think we're just getting started. I want to focus today on a subset of traditional AI and want to talk a little bit about generative AI, some of the ramifications, some of the risks, benefits and what does it mean to health care.

00:00:42:01 - 00:00:47:29
Michelle
I am delighted to sit across today from Tej Shah and I'll have him introduce himself.

00:00:48:01 - 00:01:08:00
Tej
Thanks, Michelle Tej Shah I'm an emergency medicine doctor, a managing director, and Accenture's global health care practice. I've got a ton of experience working across different parts of health care as a consultant, obviously, but also as a venture capitalist, investing in companies and most recently starting a company in the health tech space.

00:01:08:00 - 00:01:16:07
Michelle
We're talking about AI and we always have to start with what is the comparison between traditional versus generative AI?

00:01:16:09 - 00:01:17:21
Michelle
How would you put that?

00:01:17:23 - 00:01:41:11
Tej
We've been talking about AI for 50 plus years. This is not a new thing. We've been talking about how we can leverage data to get insights going from analytics to AI to  GenAI. Really the difference is, you know, before with AI we were able to extract data and insights from data so we could figure out what the next obvious data point was going to be.

00:01:41:13 - 00:02:19:03
Tej
And in 2017 there was an article that was published by Googlers around attention is all that matters, right? And what happened with that papers is we came up with a completely new framework where we're now able through  GenAI to not just predict what's the next data point, but understand what's the next word that we can generate. And it's taking into consideration the context of the sentence to be able to make that prediction so that it's actually appropriate and it's opened up a whole bunch of opportunities that we're going to talk about today that is really transformative.

00:02:19:05 - 00:02:30:03
Michelle
Let's get into some of those opportunities. I think it's fascinating that it's been as  long ago that A.I. came about and the general public really doesn't know.

00:02:30:03 - 00:02:35:14
Michelle
let's talk about some of the opportunities in patient care that exists because of where we are now.

00:02:35:14 - 00:02:40:28
Michelle
With A.I.. We do a lot around documentation. Where else should we be going?

00:02:41:00 - 00:03:08:03
Tej
Back in 1996, you know, we started using search engines and it wasn't really until early 2000 when Google came around and the search bot search box became our librarian and around that time there was an article that was published by Will Carr in The Atlantic called Is Google Making Us Stupid and what he really meant.

00:03:08:03 - 00:03:33:29
Tej
when you read the article was, are we thinking differently? Are we using our brains in the same way or reading as deeply as we did before? And obviously the answer is no. I think we continued to use our brains and we continue to, but we were using this tool as a librarian. We were using it to identify information quickly and be able to access it, you know, more readily.

00:03:34:01 - 00:04:04:19
Tej
And what GenAI has done for us is start to be an advisor. It's enabling this transformation from technology, being a librarian to an advisor and that's what we're using AI for now. And GenAI today, right? So this idea of documentation and this is all relevant because the next sort of wave of what we're going to do with GenAI is it's going to start to act as an agent.

00:04:04:21 - 00:04:30:28
Tej
It's going to start to enable us to take these tasks away from the from our day-to-day workflows and enable us to operate more efficiently. There is no reason, for instance, that a doctor like you or I should have to, you know, once we've submitted that a patient needs to do a specialist appointment, continue to follow up, make sure that that appointment was scheduled and have a bunch of people that are in that workflow follow up on it.

00:04:31:01 - 00:04:49:27
Tej
It should just happen. And I think that generative AI is going to create these agents and these agents are going to be linked to one another. We're going to chain them together and it's going to do that follow up. It's going to make that experience more seamless, really enabling clinicians to do the work that gives us joy.

00:04:49:29 - 00:05:07:07
Michelle
Let's drill down on that now, because you said something fascinating there being an agent. How I see it as being is now, I don't have that extra chaos and clutter to remember. As an ER doc, we're in the midst of the chaos we are in and we're trying our best to multitask. And there are fewer of us now.

00:05:07:10 - 00:05:25:16
Michelle
There are others that are doing an exit now and then. We also don't have as much of a pipeline because, as you know, some of our residency programs didn't fill out. So three years from now, we're talking a massive deficit. And across the board in health care, there has been an exodus and a shift out of health care to other careers.

00:05:25:19 - 00:05:45:23
Michelle
How do you see then us utilizing Gen AI to augment and maybe bridge some of those gaps with our shortages? The agent is great, but can we maybe think about a couple of other things that maybe might be even more magnificent? Like it's maybe front office, back office? Is there opportunity there, you think? Because we don't think about them a lot.

00:05:45:23 - 00:05:47:04
Michelle
I do believe, absolutely.

00:05:47:04 - 00:06:10:27
Tej
So let me just start. The clinician shortage is durable and it's secular. This is something that I say over and over again. You know, we have projected forward what we anticipate the workforce in health care is going to look like. We know there's going to be a shortage. But if you look at some of the research that's being published now, just at the end of last year, there was a study that published that looked at nurses and doctors that are in school today.

00:06:10:27 - 00:06:43:15
Tej
And, you know, you might know that of those surveyed students, between 20 and 30% of them said they're going to drop out. They don't see the future of health care as a promising career that they want to pursue. That's going to be fulfilling in the way that maybe when we were going to school, we saw. And I think that's really disheartening because truly I think that, you know, when the way I thought about health care and the way the reason I pursued a degree is because I wanted to take care of people.

00:06:43:18 - 00:07:05:18
Tej
And what's happened along the way is so many things get in the way of that, Right. That joy that we were talking about that I mentioned, that's gone because we've got so much administrative burden, so many distractions that sort of pull us away from that day to day care. It's actually started to deteriorate or continue to deteriorate.

00:07:05:18 - 00:07:28:18
Tej
That relationship between the doctor and the patient that I think is so sacrosanct. It's so important. And I think patients want it. Physicians want it that nurses want it back. And so when I think of front office and back office, it's not just agents that are going to be doing this work. What it's going to do is it's going to take those tasks away, but it's also going to start to transform.

00:07:28:25 - 00:07:55:11
Tej
What role, as a clinician, I play in the delivery of care, right, where maybe 30, 40% of my time I was it was taken up by doing that administrative work. Now I'm going to have it back to refocus on the patient. And it doesn't just drive productivity improvement, it drives greater engagement, it drives better experience for us as clinicians and for patients.

00:07:55:13 - 00:08:19:10
Michelle
So back on Joy, I would love to be back there as well, cause I remember that feeling my first, but the patients and I could do anything and everything and this was going to be magnificent. And then you're right. Little by little, the administrative stuff started to become a burden. With GenAI,, how do you see us being able then, in this world of technology, having unfortunately had that adverse effect?

00:08:19:10 - 00:08:45:15
Michelle
And I think it was an unexpected consequence of all of the information coming into the EHR and all of the information coming at us, period, whether it's on our phones, on our on our laptops and still faxes and message centers and inboxes. How do you see Gen AI as being able to be the thing that we can get providers to say, I trust this, I'm going to buy in, I will do this.

00:08:45:17 - 00:08:51:16
Michelle
Because the last time we petted the dog, that was technology, it bit us and we have a long memory.

00:08:51:19 - 00:09:23:16
Tej
Yeah, you know, the EMR is a beautiful thing, right? It actually transformed and improved the quality of care. It helped us, you know, document how we were taking care of our patients and enabled us to move patients seamlessly from one provider to another. But you're absolutely right. When you look at the data around the impact to productivity of the EMR, there's a 13% reduction in clinician productivity because of it.

00:09:23:18 - 00:09:51:05
Tej
And I think, as you said, clinicians have been burned by it. I think we feel as though we were betrayed. We feel as though, you know, it didn't help us do our jobs better. It didn't help us improve the relationships that we have with our patients. And I think as we think about deploying new technology into care delivery, we're going to have to do a much better job of articulating the value proposition of what the technology is.

00:09:51:07 - 00:10:07:24
Tej
And we're going to need to pull in clinicians to think about where it gets deployed, what part of the workflow should be addressed by technology and what should it take over. I think there's a lot of work for the industry to do. We're not good at it. We haven't been.

00:10:07:27 - 00:10:11:29
Michelle
So how does Accenture then take away that hesitation?

00:10:12:02 - 00:10:35:28
Tej
You know, so we're in the early innings of what GenAI is going to be able to do of where technology is going to be deployed. Truly, I think the organizations that are taking the leap forward and adopting and figuring out, you know, how technology is going to be integrated into care delivery, are taking some really basic steps. They need to have a policy on generative AI.

00:10:36:01 - 00:10:59:06
Tej
They need to have governance, they need to figure out what is their data architecture and what's that foundation going to look like so that they can access that data to enable their clinicians to deliver care. They're going to need to think about on the back end how they train their clinicians and, you know, when they actually eventually do deploy technology, what is it going to look like?

00:10:59:07 - 00:11:03:26
Tej
How is it going to transform the way that they work, the way that they deliver care.

00:11:03:29 - 00:11:25:28
Michelle
Wow, transforming the way that we do work? When you say that, I think to myself, gee whiz, it would be marvelous. And in my mind, I would love to be able to be the ER doc seeing the cardiac chest pain patient and the intuitiveness of the system being that it understands who I am, what I do, what's going on with my patient.

00:11:26:00 - 00:11:42:25
Michelle
It then brings in from the EHR what I need to know then, but then also helps me to go along with the best practice guidelines and recommendations while not forgetting that other stuff that you were speaking about before. With regard to referrals. Do you think that that's possible?

00:11:42:27 - 00:12:14:07
Tej
So when I built my company, the fundamental premise that I was going for is technology should always be in the background. It should not be the reason that we get up in the morning and do anything right. It should be the enabler, it should be the assistant, it should be that third year medical student or third year resident that just enables you to do your job and perform at your peak all the time and think somewhere along the way, you know, we didn't sort of catch on to that.

00:12:14:09 - 00:12:29:12
Tej
And I do think that with generative AI that we have the potential to drive that type of experience for clinicians who really are customers and clients of health systems. And we need to start thinking about them that way.

00:12:29:15 - 00:12:52:13
Michelle
So I have two questions on that. We also spoke about the P word productivity. And as physicians, especially ER, we know that that can be something of a double-edged sword. So a lot of us want to frame it, couch it, present it more so as efficiency and effectiveness. How do we bring that message across with trust?

00:12:52:13 - 00:12:54:22
Michelle
Because there is trust to be rebuilt.

00:12:54:24 - 00:13:20:08
Tej
Yeah, you know, it's a great question. I agree that it's a double-edged sword. I think, you know, we productivity is what the organization cares about, but it's not necessarily what a clinician cares about. You know, their schedules are full, they're overloaded already. They're seeing more patients than they want to, and they're stretched way beyond, you know, the schedules that they're supposed to be working.

00:13:20:10 - 00:13:40:09
Tej
And it's a lot a large part of why we're seeing the burnout that we're seeing amongst clinicians today. And so I think as we again, as part of how we think about technology and where it gets deployed and how it gets deployed, we have to bring the clinician along. And I think we have to think about what are the messages that are going to resonate.

00:13:40:09 - 00:14:04:12
Tej
Just like when you do any sort of change program at any organization, they care about taking care of that patient and how do we articulate it to them that this technology is going to enable that, that this technology is going to power the experience that they want? Again, going back to this idea of the clinician as a customer or a client of a hospital system.

00:14:04:19 - 00:14:27:22
Tej
Right. Because 75% of clinicians are employed now. Right. And if we think about them as customers that are, you know, they're producing the outputs that we want, which is units of care, we've got to figure out what resonates with them, what makes them tick, what's going to get them up in the morning and help them use the technologies that we're going to make available.

00:14:27:24 - 00:14:33:28
Michelle
What's going to get them back at the table to actually have that conversation right, Because they need to be there. We need to be there.

00:14:33:28 - 00:14:36:07
Michelle
So going back to burnout, burnout is not new.

00:14:36:07 - 00:14:52:20
Michelle
And the question I have for you there is with regard to burnout and AI, do you think that there is meaningful use in there that we can honestly really tackle that meaningfully and impactfully?

00:14:52:23 - 00:15:00:25
Michelle
Or do you believe it's going to take a long time, like decades worth of time to get there? Big questions.

00:15:00:25 - 00:15:24:22
Tej
Yeah. And you know what, Michel? I'm not sure I have the perfect answer to it. I think what I'd say is we have to try. I think this technology has the promise to change how we practice, to create the space for us to do the thing that we had intended to do and take away all of that distraction.

00:15:24:25 - 00:15:58:27
Tej
But I think we also need to think about ways that the technology can change the roles that we play as clinicians right. And you know, how it can augment us in different ways or automate some of the work that we're doing. And that's going to require real analysis of workflows. It's going to require real, you know, work and effort to rethink and rejigger the jobs for clinicians as a whole.

00:15:59:00 - 00:16:05:22
Michelle
So there's a receptiveness there to an acceptance there that we are going to have to change. And we're not known for being change agents now,

00:16:05:22 - 00:16:31:23
Tej
There's a lot of fear. I think there's,I want to keep doing things the way that I've done them, but I know that what I've been doing is not working and I think it's  going to be a very tricky sort of journey for health systems and for us as we work with them to help them navigate it, because every system is going to be different and you know, it's going to depend on the culture.

00:16:31:23 - 00:16:53:09
Tej
But I think we need to get to and this will take a little bit of time is for clinicians to start having the culture of being accepting of change because you know it, I know it. I think everyone that's going to be listening to this knows that this is not the end. This is really the beginning of real transformation.

00:16:53:11 - 00:17:10:01
Tej
And the change is going to come fast and furious. And what we need to do is prepare our clinicians and organizations to know and expect that and help them understand how to navigate that. And I think that's going to be a long and durable journey.

00:17:10:04 - 00:17:12:10
Michelle
It will be. And you say fear.

00:17:12:10 - 00:17:30:08
Michelle
how do we start working to allay some of those fears and trying to get to the point of balancing out even just being straight up facing Gen AI as a functionality that has so much opportunity and then proceeding to that lean in, how do we help people to do that?

00:17:30:10 - 00:17:34:02
Tej
I think we're never going to take humanity out of health care.

00:17:34:02 - 00:17:43:12
Tej
Health care is about, you know, the clinician and the patient in that relationship and navigating the health and staying and remaining healthy.

00:17:43:12 - 00:17:52:10
Te
In the short term and in the medium term, we're in this transition phase from technology being librarian to an advisor.

00:17:52:14 - 00:18:20:17
Tej
And it's going to be an advisor for a very long time. That transition to agent is going to happen, you know, very quickly on administrative work, but it won't become an agent on the clinical side because I think we still need to use our judgment. That's what we were trained for. We know what's right for that patient and getting that advice, getting that support being augmented by technology is not outside the realm of what should be possible today.

00:18:20:22 - 00:18:30:02
Tej
It's available right now, but that role is going to need to change. Right. What we do every day will change and will shift.

00:18:30:04 - 00:18:55:15
Michelle
I love, though, the vision of returning to being that empathetic partner who helps to guide the patient through this journey back to health or to maintaining wellness, that would be phenomenal as opposed to always having people fall into gaps and into holes. And with that, let's talk a little bit about what GenAI may or may not be able to do with regard to access and health equity.

00:18:55:17 - 00:18:57:07
Michelle
Let's  talk a little bit about that.

00:18:57:07 - 00:19:25:08
Tej
Yeah, You know, the shortage of clinicians that we're seeing around the world, it's not just the U.S., right. The projection is 10 million shortage over the next decade. And that disproportionately affects patients who don't have the means to access care. As an emergency medicine doctor, you appreciate the number of patients that come in as a site of last resort because they have no place else to go.

00:19:25:11 - 00:19:52:20
Tej
It actually is not very convenient because the wait times are just getting longer and longer. And so what we're seeing is the disproportionate impact of the clinician shortage on populations that, you know, have not historically had. The means to access care. And so what I think and what I believe is with technology, as we scale capacity and we retrain clinicians on what their role is going to be, we're going to create access.

00:19:52:20 - 00:20:03:28
Tej
We're going to start to address the health equity challenges and barriers and inequities, really that that we see as a society, not just in the U.S., but everywhere.

00:20:04:00 - 00:20:06:05
Michelle
Beautiful, beautiful.

00:20:06:05 - 00:20:25:16
Michelle
How do we introduce GenAI to patients and have them accept that sometimes they're not going to be able to talk to the nurse and ask the nurse when the pharmacy is open and understand why that's important and how this technology is also intended to serve them and to help them to do better.

00:20:25:16 - 00:20:43:19
Tej
there's really two things that are really important related to AI and how we make it available to patients. One is around having, you know, a framework around responsible AI. And when we make the technology available to patients and for what use cases, because you're not going to it's not general availability for everyone.

00:20:43:21 - 00:21:01:28
Tej
And then the second thing is, you know, we have to understand how we segment the patients that we serve, because your 91-year-old aunt may never want to interact with technology in the way that I do or that a 25 year old does. And I think we have to respect that and we have to appreciate it.

00:21:02:00 - 00:21:32:17
Michelle
So we've hit now patient, we've hit provider, let's hit the hospital organization. They're the decision makers ultimately as to what comes in, what gets implemented, what gets discarded or what what's put on by the backlog or the back burner or how do you see the conversation going with hospital decision makers about going forward with a roadmap that includes AI?

00:21:32:17 - 00:21:49:03
Michelle
Because a lot of the discussions that I'm having are we want to see somebody else dip their toe in, we want to see somebody else dive in and survive. How do you see that conversation going or how would maybe you approach that conversation with someone who is a bit hesitant and wants to stand back a little bit longer?

00:21:49:03 - 00:22:09:01
Tej
the truth is there is not a choice that health systems are going to have to make the investment in AI and GenAI, because we're all facing, you know, really critical workforce shortages. And we need to create capacity right now and we're going to need to do it in a durable, you know, long term way.

00:22:09:04 - 00:22:29:19
Tej
The truth is there's a billion different applications of GenAI and, you know, we don't need to explore all of them all at once. Right now. What we need to do is very simple things around the investments in AI. You know, we have to have a responsible framework and governance and a policy for how we're going to deploy it.

00:22:29:21 - 00:22:57:07
Tej
What's the oversight going to look like? We need to have that technology foundation and the data foundation to make sure that we're really leveraging all the data that we have. And truly we have to think about how we train clinicians and the rest of our workforce to adopt the technology so that when we get to scale, it's going to be used, it's going to create and have the type of impact and the ROI that we want.

00:22:57:09 - 00:23:17:26
Tej
I guess the last thing that I would say is right now,  GenAI touches so many different parts of a health care organization. It's not just the chief medical officer, it's not the chief nursing officer, it's not the Chief  HR Officer It's not the Chief Operating Officer. It's not the CFO, it's not the CIO, it's not the CTO.

00:23:17:28 - 00:23:43:23
Tej
And really figuring out in the context of, you know, an industry wide sort of, you know, crisis around margins, right? Where margins are in the low single digits, you know, and negative for more than half of the health care systems in the U.S.. How do you make this investment in the context of where a lot of other things are burning?

00:23:43:26 - 00:23:59:11
Tej
How do you prioritize it and who do you go to and who makes the decision? Who who's going to be accountable? Who's going to drive the transformation? Who's going to drive the training? Who's going to drive the change? I think health systems are trying to figure all of that out and they need help.

00:23:59:14 - 00:24:28:23
Michelle
They do. They do. They're going to need a partner who's going to be able to sit with them and understand where they are. More so, though, a lot of other discussions I'm having are people want to just kind of throw air out there as the panacea and the magic wand to fix everything. And there's a real struggle to contain it and say, let's pick one goal, something that is small yet impactful, that doesn't derail the ability to do care, doesn't disrupt your whole organization.

00:24:28:25 - 00:25:00:21
Michelle
And those are some of the most impactful and beautiful conversations. And then when you get it right and they have a win under their belt, maybe tomorrow, I in the way of provider satisfaction, retention, patient engagement is better. Those sorts of discussions and those sorts of wins are huge. So I think that it is incumbent upon us and our positions and others out listening to this and similar positions to be that selfless advocate slash partner to your customer and help them along this path because it is complicated.

00:25:00:21 - 00:25:16:00
Michelle
Let's talk a little bit then about health care, utilizing technology to catch up with other industries, because other industries are fairly far ahead of us when it comes to tech and efficiency and productivity, using technology.

00:25:16:00 - 00:25:41:12
Tej
A lot of us like to say that if you want to know what's coming next in health care, look at what happened in other industries 20 years ago. What's incredible to me is that generative AI is being contemplated and probably more advanced in health care than it is in several other industries today. And it's almost moving at pace.

00:25:41:15 - 00:26:03:14
Tej
And I'm not really sure exactly why that's happening. I think that, you know, maybe it's the shortage, maybe it's the margin pressure, maybe it's the potential, maybe it's, you know, some of these thought leaders that are really expounding on its use and its application, its potential in health care. Maybe it's just the burnout that's happening amongst clinicians.

00:26:03:14 - 00:26:17:14
Tej
None of my clients on the provider side can afford to wait for the perfect sort of, you know, what are all the use cases and how do I sequence them and everything that I'm going to do for as you said, for the next five or ten years?

00:26:17:17 - 00:26:52:29
Tej
I think we have to start now and there's a place to start right now. There are things to do to prepare yourself for that future and I think we're going to be astounded by the creativity of the clinicians that that you and I work with and that work for these organizations on how the technology can be deployed. And I think we have to just be open to it because I think we're going to see the potential and, you know, sitting behind a desk or sitting in a lab, you know, looking at the technology and thinking of use cases, that's going to get us only so far. We have to put it in the hands of

00:26:52:29 - 00:27:04:27
Tej
clinicians having the appropriate sort of governance and guardrails. But that's how we're going to learn what it can do and how it can help and how it's going to impact, you know, how we deliver care.

00:27:04:29 - 00:27:09:21
Michelle
That sounds like a great call to action. 'Come to the table, your seats waiting'. Let's do this.

00:27:09:21 - 00:27:13:05
Tej
Yeah, let's do it. I mean, ER doc, right? Like, let's go.

00:27:13:12 - 00:27:30:15
Michelle
I love it. I love it. Well, thanks for your time today, Tej. Thanks to our listeners. Be sure to subscribe to the Perspectives on Health and Tech podcast for more insights from industry experts, visit Oracle Dotcom Slash Health or follow Oracle Health on social media.

As society's focus on mental health intensifies, technology stands at the forefront of this evolving narrative. Listen in as this group of experts examines technology's paradoxical role in mental wellbeing: constant connectivity that reveals insights yet also increases burnout due to poor design, and social media, where overuse is linked to decreased mental health but provides a beacon of hope through innovation. Hear about the challenges and opportunities of using technology to enhance mental health, exploring how digital advancements can be harnessed for a healthier, more balanced future.    Featuring the following panel at SXSW Conference: Moderator: David Feinberg, M.D., Chairman, Oracle Health Danny Gladden, MBA, MSW, LCSW, Director, Behavioral Health and Social Care, Oracle Health Tracy Neal-Walden, Ph.D., Chief Clinical Officer, Cohen Veteran Network Michelle Patriquin, Ph.D., Director of Research, Associate Professor, Menninger    Listen as they discuss:

• The moment realized, that access to care needs to be fixed (0:40
• What is happening from a technological standpoint that is helping individuals, patients, families, and communities (4:33)
  • The use of iPads
  • Research assistance
  • The collection of outcomes data
• An example of something done based on data to change the way that care is delivered (6:20)
  • The role of sleep
  • Post-treatment and post-discharge risks
  • Q15 (15-minute patient safety) checks
• Example of the effectiveness of telehealth (9:15)
  • Prior and post-pandemic
  • Impacts on standard measures
    • Additional data insights
  • Impact on no-show appointments
• Using technology to tell a fuller story (12:45)
  • Wearable devices
  • Digital therapeutics and inputs
  • Research to practice gap and the potential of technology (15:38)
• Concerns with technology not helping or distracting from human connection (17:05)
  • Social media and the link to depression (17:50)
  • People who are left behind; technology access and literacy (19:00)
  • Psychologic safety of technologies (20:00)
  • Concerns from the clinician perspective (20:45)
    • Helping clinicians with documentation and proper training of tools
    • leveraging AI (21:44)
    • Clinician burnout (22:34)

Notable quotes:  "This is why I love wearables, and I've always loved wearables, psychophysiology, because it fills a tremendous gap in our ability to measure the dynamic fluctuations and the way our emotions and behaviors change." Michelle Patriquin, Ph.D., Director of Research, Associate Professor, Menninger (15:10)   Learn more about how Oracle behavioral health solutions combine real-time clinical data from across each patient's unique healthcare journey.   Watch on-demand and live webcasts by registering for Oracle Health Inside Access.   --------------------------------------------------------   Episode Transcript:

00:00:00

You're listening to Perspectives on Health and Tech, a podcast by Oracle with conversations about connecting people, data and technology to help improve health for everyone.

00:00:11

David
My name's David. I'm the chairman of Oracle Health. And before I introduce this esteemed panel, there's a few patients that I've cared for, and I'm a child psychiatrist that have just stuck with me. And for a lot of reasons. Well, I actually feel like for whatever long I've been in this 30 plus years, I'm just trying to make it better for these patients and their families.

00:00:34

David
So let me describe them. And I think it really sets the stage for the role of technology in mental health. Okay. This little girl in third grade at the local school where my kids actually went to school writes in her haiku poem that she wants to commit suicide. And this is pre cell phone guys pre technology. The teacher reads the haiku poem and tells the prince at home that night tells the principal.

00:01:01

David
The next morning, the principal then calls the mother at home. And then this is L.A. And because they knew people, they were able to get in to see me in three weeks. And I was like, my God, if my kid was suicidal, it doesn't matter who, you know, you got to be seen today, right? I didn't know this word, but I know.

00:01:22

David
And now I'm going to fix access. I mean, that's what we use is this term access to me is my kid is suicidal and I'm calling an 800 number and my insurance doesn't cover it or I got to pull strings and God forbid I'm from the other side of the tracks where I don't know anyone. I will never get it like.

00:01:40

David
So how can technology help there? Right now, I think what we're supposed to talk about, too, is the negative part of technology, right? I'm stuck on my phone. I'm not I'm not socializing. I'm, you know, we all go to dinner and we're like this instead of actually being together. So why don't we go down the line and introduce yourselves?

00:02:03

Michelle
Okay, everybody, I'm Michel Patrick Quinn, and I'm a psychologist and a child psychologist, and I'm director of research at the Menninger Clinic and an associate professor at Baylor College of Medicine. I'm excited for this conversation. The Menninger Clinic is really known for humane treatment of mental illness. We are historic, known as an inpatient psychiatric hospital and really revolutionary and something called the therapeutic milieu.

00:02:30

Michelle
And so kind of actively intervene and doing psychotherapy while someone is inpatient. So it's not a passive intervention. And it's really just remarkable. We still hold on to that kind of psychotherapy within an inpatient context.

00:02:47

Tracy
I am Tracy Neal Walden. I'm a clinical health psychologist. I work for I'm the chief clinical officer for Coimbatore and Network. We're a network of mental health clinics across the US. We have clinics in 16 states covering, supporting 25 states. So and that's because of telehealth. So we utilize we don't do solely telehealth, but we've been able to utilize telehealth in order to expand our reach across the US.

00:03:18

Tracy
I'm also a veteran of the United States Air Force. I served for 24 years and served as a psychologist during that time in the Air Force as well. We serve not only the veteran but the veteran's family members. As a veteran, myself, my family doesn't have access to care in the VA, and that's no fault of the VA.

00:03:37

Tracy
It's the way the system is set up. And so we're able to reach and provide those resources to families and in a much shorter time period, especially due to the advances that we're going to be talking about now with technology,

00:03:53

Danny
Thank you and so I'm Danny Gladden. I'm the director of behavioral health and social care for Oracle.

00:03:59

Danny
Happy to be the social worker on the stage. And I really proud to work with just a whole group of social workers in the delivery of mental health services and all the great work social workers do.

00:04:11

David
Today, what in your organizations is happening from a technological standpoint that you think is improving access, improving quality, democratizing care, making care more affordable, more culturally sensitive, helping with, you know, inequities that we know that are in care? What are you doing to harness technology that's actually helping individuals, patients, families, communities? Sorry, go for it.

00:04:34

Michelle
Yeah. So it's not really revolutionary in any way, but we use iPads and research assistants and collect outcomes data across our whole hospital and with inpatients in outpatients, outpatients, it's pretty standard. People are able to complete, you know, outcomes, measure, self-report, inpatient. It gets more complicated. And we have to we have to guide people, help people. Some good times, people resist, don't want to do it, and that's fine.

00:05:00

Michelle
They don't do it. But that to me is the foundation, right? So if you collect outcomes data that gives people a voice in their treatment, particularly on inpatient. So our inpatient units are locked units, you have reduced someone's on autonomy when you measure how they're doing, from their perspective, it gives them some control back. And I think that is one of the most powerful things that we can do is give people control back through data and measuring these things and measuring the change over time.

00:05:32

Michelle
Whether it's positive or negative. And technology allows us to do that. So many of our patients want to use the iPad, and then we visualized the data in graphs that are provided to the treatment team through our electronic health record. And so that gives data driven feedback that the treatment teams can actually provide to the patients at the patient level.

00:05:50

Michelle
We also use it for research to understand like aggregate results, what's working for who and what's not. But I think, you know, I'm biased, I'm director of research, so I love data. I'm the PI over our outcomes. But I think that's tremendous. And we can advocate for better inpatient environments, better inpatient care, better inpatient outcome.

00:06:12

David
Can you? I think it's a great example. First of all, the simplicity of it is sometimes to make things simple. It's really hard and so this is great. Can you give an example of something you've done based on the data to change how care is delivered?

00:06:23

Michelle
Yes. So well, something we're working on right now, all of our results are lining up really around the role of sleep. One thing we are constantly thinking about is suicide risk with inpatient, and particularly suicide risk post-discharge for those of you who may not know post-discharge from inpatient is the highest risk period for suicide. Over and above any other time in someone's life and also relapse.

00:06:52

Michelle
So post in our highest level of care. And to us that is incredibly concerning. So we have been really thinking about the role of sleep as well as other measures and look at longitudinally outcomes while someone's inpatient what is predicting suicide risk and we have a paper that we published, we showed it is sleep over and above everything else that you can put in the model.

00:07:16

David
And you measure using our rings and things like that or how are you.

00:07:18

Michelle
Not yet. We are now because it is so important and we've now designed our own like API and with wearables to replace things that we do in inpatient that actually disrupt sleep. So like you, 15 checks and these checks. So there's checks done on inpatient to ensure someone's safety and sound checks. And these are often pretty disruptive. We have data now from active Griffey that we've lined up with the checks in about 75% of those checks.

00:07:48

Michelle
So someone going in their room, usually a stranger that they do not know, opens the door, sometimes shines a flashlight in their face to make sure that they're breathing and that they're asleep. Or if they're not asleep, they'll ask them to raise their hand. And so and for us at our hospital, it's every 15 minutes that happens. That equals about 36 times a night.

00:08:06

Michelle
Someone comes in their room. So we've designed our own kind of in-house homegrown system to replace that. And that is one and it's just one thing that, like we always say, you know, when technology is, you know, going to take over and ruin people's privacy, things like that. But in that situation, it improves people's privacy. People can sleep and be and have intact sleep.

00:08:29

Michelle
Great. So it's that and that has just that's one of our favorite examples. Right. Just kind of generic outcomes data into a new intervention that leverages technology that improves some of these outcomes. Hopefully in the end we're still working on it, but so cool.

00:08:46

Tracy
Yeah. I think it's really interesting what Michelle just discussed in terms of outcomes because we do measurement based care for all of our clients. So we measure their, their symptoms at every session and we do that via iPad. If they come into the clinic or we push it out electronically for those who are being seen for via telehealth.

00:09:10

Tracy
And one thing that we found is that we actually we want to take a look at how effective is telehealth, because many people say it's not effective. You know, prior to the pandemic, people were very skeptical. And we actually use this data and we have a research institute that's part of our and veterans network. And within the institute, they reviewed the data recently and we found clinically significant change in Q nine scores is for depressed individuals and for those with PTSD, a clinically significant change in their PCL.

00:09:50

Tracy
So these are the measures that are the standard measures given for those populations. And not only did we find clinically significant change, but we also found that those individuals were in remission. That's one of the things that I love about technology. It allows us to get those additional data insights. We rolled out telehealth in 2018, so before the pandemic, and we did it to improve access and not just access due to long wait, but to decrease no shows in to improve that accessibility for clients who were already in care.

00:10:29

Tracy
I remember a few years ago I had a client and we would advertise in our clinic. We had rolling slides that would tell about the different things that we offered, and we had a slide that talked about telehealth and it said, Ask your clinician if you'd like to know more about it. And my client came in that day and said, Hey, would I be a candidate for telehealth because I fall asleep on the drive home from here and I was like, Yes, you being silly.

00:10:59

Tracy
And that's also the beauty of telehealth, because it also it allows you to oftentimes squeeze additional appointments in if someone knows shows and it helps to prevent no shows, too, because oftentimes some people like to come in, they will they like to come in and see their clinician face to face, which is great. But sometimes life gets in the way.

00:11:23

Tracy
And so if someone calls to say, hey, I'm going to be late, then we say, Would you like to convert that to a telehealth appointment so that they don't have to miss that appointment?

00:11:34

David
Okay, Danny, take us home on that wonders of technology. Yeah. Then we're going to flip it.

00:11:39

Danny
We're going to flip it. Okay, Well, so. So for Oracle, we build tools. We build tools to ensure that the work that providers are doing with consumers of care have what they need to sort of ensure that that, you know, the clinical experience checks the box so that, you know, the 15 minute check that Michelle was mentioning is something that happens in our tools and the screening and the screening that happens in our tools.

00:12:05

Danny
We've embedded in the workflow for nurses, for oncologists, for the ED attending. We've embedded in the workflow a suicide screening tools and, and then and then alerts so that if someone is at risk, it's not just one person who's aware, but the entire treatment team can have this ability face up to this type of information. And so we sort of want to help folks use digital tools to be able to track patient information, to be able to get folks get folks in quicker.

00:12:37

Danny
But I think beyond that, the beauty of technology in general is there's an opportunity to tell a fuller story, you know, through wearables, through some of the cognitive behavioral interventions, the digital therapeutics. It just really provides a variety of different types of modalities for consumers of care to be able to sort of deliver inputs about their experience.

00:13:02

Danny
You know, if I have to get in the car, drive to a clinic to see Michelle in person, I'm putting on a mask. And all you really know about this individual is probably what happened an hour or two before they got to you. Like it's the stress of the moment using wearables, using sort of digital inputs throughout the week in between sessions, I'm able to I'm able to sort of have a more holistic picture of what your week looked like.

00:13:31

Danny
And because you're doing the session in your own home, you don't have to put on a mask. It is more intimate. And I'm able to, as the provider, just have a more holistic picture of what I'm working with. Okay. 

00:13:45

Tracy
Can I add one more thing?

00:13:46

David
You could add ten more things.

00:13:47

Tracy
It gives you more accurate information. You know, as I was thinking about what you were saying, Danny, about the technology and you, Michelle, when you were talking about sleep, sleep is one of the number one concerns within mental health. People may come in with issues such as depression, anxiety, PTSD, but there's usually an underlying sleep problem. And as a health psychologist, I love to treat sleep, but clients history directly underrepresented the amount of sleep that they actually get.

00:14:19

Tracy
And by using something like a wearable, a watch or a ring, you get that accurate data that then you can immediately share with them or they can see it immediately themselves.

00:14:32

Michelle
I completely, completely agree with Tracy and Danny, and I think the beauty of the data when we talk about outcomes data, self-reported data, those data are collected, you know, every week. So you have huge gaps in the information that you are getting about somebody's experience. You know, our emotions can change within seconds. You know, there's a you know, can be a traumatic event happen or just a, you know, an argument with someone.

00:15:01

Michelle
So our lives and our emotions behaviors are very dynamic and our outcome measures and the data that we have now is why I love wearables. And I've always loved wearables, psycho physiology, because it fills a tremendous gap in our ability to measure the dynamic fluctuations and the way our emotions and behaviors change. That is so important, I think, for understanding the ultimate outcome and just that that the kind of higher temporal resolution of the data is something we don't have now in practice.

00:15:36

Michelle
There's such a research to practice gap there that I think technology will certainly fill in and also has the potential. And one reason I love the wearables, because it really demonstrates that it's not all in your head. Yes, too, when you do a self report, that is your perception, right, of how you feel in and with the wearables, too, it gives an objective marker for the first time in vivo in the situation to show, Hey, I'm really experiencing this, this is real, this is how I'm inside.

00:16:11

Danny
Yeah. And I think about this just real quick. Like in our.

00:16:14

David
Now we're cooking.

00:16:14

Danny
Yeah, I mean, well, in our discipline historically, you know, we don't we don't get access to labs, We don't get access to some, you know, some good radiology scan. We find out something about someone by asking a bunch of really nosy and intrusive questions by observation or someone has sort of engaged, you know, has had a crisis in their, you know, the courts or corrections or a probation and it is point in time, like, how many times do you start a session where, you know, how have you been since I saw you,fine, right.

00:16:49

Danny
I mean, and that's sort of the starting point. So the ability to have real time inputs, the seven or the 14 days in between the times of seeing each other it just enriches the clinical experience so much.

00:17:03

David
We're flipping gears. What are your concerns around tech not helping us, tech distracting us from human connection?

00:17:14

Danny
I'll start us here. And so, you know, I, I still see I still see a few clients from time to time. I particularly enjoy working with adolescents and sort of the narrative from adolescence in the stories they sort of come up with in their mind about the world around them is really quite distorted, you know, based on the stories they get from social media.

00:17:40

Danny
And I'm not talking about sort of what fake news, which is its own lane, but sort of the attitude that, you know, folks around me are just having a much better experience than I am. And what we all know is that there's likely all of it is inflated a little bit or a lot of it.

00:17:59

Danny
Right. And so we know this. We know that the data on sort of overuse of social media and the link to depression and anxiety in young people is real. What we are seeing, though, is that transition, you know, it's not. So if I'm down, I'm feeling bad about myself. I'm now starting to engage in, you know, in ways to numb that pain.

00:18:25

Danny
And that's, you know, through self-harm, through self-injury. It's, you know, through alcohol use or other substances or it's sort of engaging in relationships that are unhealthy. So I'm really I'm from the adolescents that I get to work with. I'm really concerned about that. On the other side, the part that concerns me about tech is, is I mean, we've just sat here and talked about all of the benefits that technology can bring, the access, the data, physio, bio physiology data.

00:18:55

Danny
But the problem is there are people left behind, there are people left behind in the in the most remote parts of Alaska. There are there are folks that are left behind within a, you know, a mile radius around here. And so, you know, we have to ensure that that the tools that are created impact and benefit all of the people.

00:19:19

Danny
And you know, so I think tech access, tech literacy, all are concerning to me as so much of our particular discipline moves into the tech space.

00:19:30

Michelle
I'll kind of jump off from there. You know, I think when, you know, I'm not in the tech space, but I love technology. But I think technology does such a good job with some of these data privacy issues, and they do a lot in terms of the technicalities of how things are going to work with the interface. Looks like is are there protections in place, right, that safety is built in?

00:19:54

Michelle
I think one thing that is forgotten, though, and, you know, I don't know if we even knew that was going to be a consequence is no one was testing the psychological safety of these technologies, especially when it comes to social media. Right. As we, you know, are kind of zooming forward with technology. There's all these, you know, kind of ethical safety guidelines, American Psychological Association.

00:20:18

Michelle
These are really good job at starting to think about the psychological safety. What are the psychological kind of safety parameters that we need to test as we develop new technologies? But also then how do we put the guardrails up on the things that are here now?

00:20:35

David
Tell me other things that concern you about technology and mental health.

00:20:39

Tracy
I actually have another thing, and I'm going to shift it a little bit. I get concerned from the clinician perspective because we've technology has really helped us. We instead of, you know, giving a and I remember when we gave out the paper and pencil measures to our clients when they came in to the door, you had to wait for them to finish it.

00:21:01

Tracy
But the good thing about that is when they did, then I immediately had it. I reviewed the scores. Now measures are sent to us, you know, automatically, and then they go into our system. And so you really have to train the clinicians to utilize that data and not just have the client submit their data without it being utilized.

00:21:29

Tracy
Someone could submit data that could indicate that their risk status has changed. And if it's not being looked at, that's a huge concern. We're also looking at ways to help clinicians with documentation. However, a concern that I have with that too, is that, you know, if you're using AI to do your documentation, there could potentially be errors. And so we have to train our clinicians to properly utilize these wonderful technologies so that they can use them effectively.

00:22:03

David
Yeah, we're working really hard on that. I think we've got good stuff coming out.

00:22:08

Danny
Well, yeah, and, and actually so big because we don't have labs and radiology scan to sort of show a paper. Here's the evidence for the diagnosis. Our word, our discipline is very narrative rich. And you know, just to be able to sort of either get a prior authorization for service or to be able to continue service. And so we have a clinician burnout issue because of the administrative burden, the documentation burden.

00:22:36

Danny
And, you know, so that's and the tech just facilitates that. But I do think is exciting, you know, ambient genitive AI and ambient for documentation. Our little our slice of the pie has been carved out and I'm so excited. And, you know, so Microsoft has gone there's some other startups out there that got Oracle's working on its tool that will really shift the burden away from documentation.

00:23:04

Danny
I think it's going to be a game changer.

00:23:06

David
Great gratitude to all of you folks, and thank you for participating. Thank you.

00:23:11

Be sure to subscribe to Perspectives on Health and Tech podcast for more insights from industry experts, visit Oracle dot com slash Health or follow Oracle Health on social media.

 

 

The very definition of healthcare communication has shifted over time. Today, fewer clinicians practicing at the bedside have highlighted the need for advanced communication tools and processes. 

Join Jason Schaffer, MD, vice president and chief medical information officer at Indiana University Health and Liz Harvey, MSN, chief nursing officer at Oracle Health, as they discuss the evolution of clinical care team communications and how increased demand for healthcare has made better collaboration tools both a necessity and an opportunity for innovation.

Hear them discuss:
• How have trends in healthcare communication changed? (1:20)
• What types of technology are now available for teams and what are the benefits for patients and caregivers? (3:21)
• Important points teammates should agree on regarding critical communications (8:04)
• Knowing your message responsibility and escalation paths in critical situations (12:35)
• How to create flexibility with communication when needed (15:20)
• How can a unified communication strategy help organizations proactively address system-wide challenges? (17:20)

Notable quotes:
"We should be separating technologies for the right speed and urgency of communication." – Jason Schaffer, MD

"We can't solely rely on technology. We have to engage our brains and use the years and years of school that we have all spent learning how to be clinicians as we start to look as some of these messages that we receive and talk about the criticality." – Liz Harvey, MSN

Learn more about Oracle clinical communication and collaboration tools.

The Federal Joint Health Information Exchange connects the health records of the Department of Defense, Department of Veterans Affairs, and Coast Guard by helping provide continuity of care from the time Veterans enter the service, throughout active duty, and the rest of their life.

Now that the Joint HIE has been live for more than two years, what successes are we seeing? How has it impacted Veterans and improved the care they receive?

Listen as Amanda Cournoyer, Interoperability Director of the Electronic Health Record Modernization Integration Office at U.S. Department of Veterans Affairs, talks about advocacy and interoperability at VA with Sam Lambson, Vice President of Interoperability at Oracle Health.

Hear them discuss:
• Amanda's personal journey from active military service to working in interoperability at VA (1:50)
• An overview of a few of the interoperability solutions VA is implementing to improve care for Veterans (7:53)
• Why interoperability is a big deal for Veterans' and active-duty service members' care (11:45)
• Why it's a benefit to VA providers and community care providers (14:10)
• What she is looking forward to improving in data exchange nationwide (15:11)

Notable quotes:
"One of the things I don't think people understand is that 60% of the health care DoD provides to their family members and active duty is actually provided outside in the community. And on the VA side, 30% of our care is [health care] purchased in the community." – Amanda Cournoyer

"It's not just about making sure our VA providers, our DoD providers or our patients have access to their data, we want to make sure the providers taking care of our patients have access agnostic to their location or their affiliation or their health IT platforms." – Amanda Cournoyer

"We're putting this data into the workflows for the first time. It's not just a view, review, maybe decide you want to copy and paste into your clinical notes and your encounters—we're using it for care coordination." – Amanda Cournoyer

"That's some exciting work that you've accomplished bringing so many points of a disparate network that was trying hard to get together for so many years finally integrated as one body to support Veterans and active [duty] service members. It's truly phenomenal." – Sam Lambson

With significant and ongoing changes in the health industry in recent years, healthcare leaders have had to rapidly adapt to new ways of thinking and doing in order to stay resilient in the face of change. Yet some leaders push past the status quo and view these opportunities as a chance to explore new avenues for patient care, new partnerships for growth, and new ways to ease provider burden and boost their workplace culture.

In this episode, Stephanie Trunzo, senior vice president and general manager of Oracle Health, shares her experiences within change management and how to instill enterprise-level thinking within one's team.

She discusses:

• Bringing entrepreneurial experience into larger organizations to become an intrapreneur (0:55) • How you need to think about the people first in transformation process (1:45)

• How to embrace and mitigate risk and create a safe space for your team to create change alongside you (3:54)

• How to avoid becoming stale and losing clarity and instead surrounding yourself with fresh ideas and people to stay sharp (6:58)

• Getting an entrenched workforce onboard with change (11:09)

• What we should be thinking about when trying to instigate long-term change (14:10)

• What they're excited about in bringing Oracle and Cerner together (16:50)

• Pandemic introduced change, but how healthcare can now bring consumers along (18:38)

Notable quotes:

"We don't work for org charts. We work for people we believe in. We work for the purpose that makes us get up and be excited about the work that we're doing. It's not different for the workforce you're trying to move forward – how do you connect them back to that purpose in the first place?" – Stephanie Trunzo

"Do you want to be right, or do you want to get it right? If you're on the path of 'be right' you're going to be blind to the kinds of changes that need to happen." – Stephanie Trunzo

"People sometimes fall in love with complexity. The very things that they want to change is what they derive their own value from … you want to help them see that by making this thing simpler they actually can show value in a much more important and different way." – Stephanie Trunzo

During the pandemic and social and economic unrest of the last few years, there was a dramatic increase in demand for mental health services. Stigma had already been on the decline, and now, available mental health services are on the rise. Some patients are now seeking treatment for the first time, while others are continuing decades-long treatment with better coordinated services. Many don't travel this journey alone. The help their family, friends and caregivers provide is critical—for some, a caregiver's records have provided the only continuity of care.

Travis Dalton, general manager of Oracle Health, and Danny Gladden, director of behavioral health for Oracle Health, talk about their personal experiences in this area and how Oracle Cerner and Oracle Health can work together with health systems and clinics to alleviate the administrative burdens of caregivers to provide better care for behavioral health patients.

Hear them discuss: 

• How do you think the last few years have changed how the general public talks about mental health and wellness? (3:30)

• Why is mental health and well-being a personal driver for you? Can you share more about your experience being a caregiver? (7:11)

• Recently, it's been estimated that 70% of behavioral health records are still on paper. And many patients don't have a personal advocate to help them keep track of their records and treatment plans. What are some of the biggest challenges that are still being addressed in behavioral health? (12:55)

• What are some ways health care systems and providers can help alleviate the burden for mental health caregivers and patients? (17:45)

Learn more about Oracle Inpatient and Outpatient Behavioral Health Solutions

It's estimated that 80% of an individual's health is determined by nonclinical factors, such as socioeconomic, behavioral and physical environments. Today more than 38 million people in the United States are facing hunger, including one in six children. Those struggling with food insecurity are at increased risk for chronic diseases such as diabetes and high blood pressure.

Hunger impacts their stress levels and ability to care for themselves and others. Hunger also impacts their performance at work and school; it's even been linked to suicide risk.

Yet some of the most vulnerable communities don't know how to take advantage of 
free food resources. In this episode, members of University Health, a safety net hospital in Kansas City, share how they've been working to increase access to resources for one of their most food-insecure communities—immigrants and refugees.

Guests:
• Gloria Diamond, Director of Health Network Product Market Strategy, Oracle Health
• Susan Oweti, Supervisor of Cultural Health Navigation / Arabic Interpreter and Director of UH One World Food Pantry, University Health
• Deborah Sisco, Manager, Patient Advocacy and Engagement – Quality Resources, University Health
• Alison Troutwine, Project Manager, University Health

Hear them discuss:
• How does your cultural health navigator program help identify patients as food insecure? (1:30)
• What feedback have you heard? (7:12)
• How are social determinants of health being addressed at the community level? (10:54)
• Tell us about how University Health formed a partnership with a local food bank? Why did you pursue that route instead of only doing referrals? (13:09)
• Since many recipients of your pantry come from different cultures, how have you provided foods that are tailored to your community's needs? (15:00)
• How do you build a food program that makes an impact and is sustainable for the long term? (20:10)

Notable quotes:
"Research shows by the time someone has made their home in the United States for five years, a lot of them aren't food insecure anymore. So we're really talking about helping people when they need it the most—when they're first getting here." – Deb Sisco

"You can hear the community saying, 'Thank you, thank you for doing this. This is what we really needed,' you know? 'Thank you for thinking about this—this is really appreciated.'" – Susan Oweti

"It's so important to build a team of passionate people that can work together to address the needs of our community." – Alison Troutwine

"That's beautiful: respecting people's culture, providing dignity, all very important work that you're doing." – Gloria Diamond

In general, 45% of individuals who die by suicide will have seen their primary healthcare provider within one month of their death, but only 20% will have seen a mental health professional.

During the last few years, there has been an increased awareness and focus on mental health. Despite the increased availability of mental health apps and virtual connections to providers, the demand for services is still high. Recently, a national three-digit crisis number, 988, was rolled out in the US to help connect anyone in need with suicide prevention and crisis resources. What can health systems and providers do on a larger scale to help prevent suicide?

In this episode, Danny Gladden, Director of Behavioral Health at Oracle Cerner, talks with Dr. Caitlin Thompson, Clinical Psychologist and Chief Clinical Officer at Red Duke Strategies, who formerly served as the National Director of Suicide Prevention at Veterans Affairs.

Hear them discuss:
• Demystifying crisis lines—what happens on the call, how it's utilized by patients and providers (2:34)
• With the increase in mental health screenings at non-behavioral appointments, the importance of training, and how to help your nonbehavioral staff feel comfortable talking about mental health and suicide with patients (6:47)
• How asking if someone is suicidal opens doors to conversation (9:30)
• The availability of training and safety plans to help staff (12:10)
• Non-behavioral staff mental health check-ins during appointments (15:10)
• Safer Communities Act and risk mitigation that has helped (17:00)
• New areas of research, interventions (18:25)

Notable quotes:
"I think that part of what needs to happen in talking about suicide, both with clients but with each other, is to get us get more comfortable in talking about it." - Dr. Caitlin Thompson

"Suicidal thoughts are very normal and they're not bad or good. They are, from a medical model, a symptom by which we want to focus then on intervention." - Danny Gladden

Learn more about Oracle Inpatient and Outpatient Behavioral Health Solutions.

In this episode – recorded at Oracle Cerner Middle East and Africa Collaboration Forum in 2022 – an expert panel, hosted by Dr. Mohamed AlRayyes, Oracle Cerner, addresses how recent advancements in data and technology, from the clinical level to the system level, have enabled health care innovation across the Middle East.

In this episode—recorded at Oracle Cerner Middle East and Africa Collaboration Forum 2022—Dr. Bashar Balish, Senior Director and Client Site Leader at Oracle Cerner, speaks with keynote speaker Himanshu Puri, Head of Information Technology, King's College Hospital London, UAE, about how the pandemic opened new opportunities for patient engagement and which innovations healthcare systems are utilizing to deliver better care.

In this episode – recorded at Oracle Cerner European Collaboration Forum 2022 – speakers from the UK, Canada, and Qatar consider where we currently are with the long-running challenge of interoperability and what we need to do to in the future to help achieve its key goals.

In this episode – recorded at Oracle Cerner European Collaboration Forum 2022 – an expert panel in the field of health and care disparities discuss their views on the opportunities to remove systemic barriers to health equality and thereby improve health equity through digital innovation.

Four women health care leaders discuss the value of connected health data, clinical studies at the point of care, neurodiversity considerations in data collection, and the importance of community care. This second episode on women's health continues the conversation on how health systems need to change to eliminate barriers and address the needs of women patients to provide whole-person care. 

Featuring:

• Moderator: Nasim Afsar M.D., MBA, chief health officer, Oracle Health
• Christy Dueck, Ph.D., global head of the Learning Health Network and Health System Activation, Oracle Health
• Esther Gathogo, M. Pharm., Ph.D., senior performance improvement leader, Oracle Health
• Sarah Matt, M.D., MBA, vice president, physician and healthcare technology executive, Oracle Health

Listen as they discuss:

• Many women prioritize others' care above their own needs. What are ways technology can partner with providers to ease this burden? (2:49)
  • Clinical trials
  • Patient engagement and automation
• When patients feel like they aren't being listened to, they might seek alternate options. How can patients and clinicians work better together to make sure they're bringing all of the data and modes of health and wellness together to really treat the whole person? (8:53)
  • Providers need to re-educate on other modalities
  • Patient education 
  • Social determinants of health data in the EHR 
• How can we bring data together to proactively help communities that are exposed to higher risks? (12:43)
  • Using data to identify populations preventatively
  • Digital therapeutics
• What are some other ways you've seen health organizations share info with their communities? (19:56)

"I think that it's really about how can we make these super busy people utilize the tools that work for them best … Because every data element I don't fill out as a patient is a data element a medical assistant, a nurse, a doctor is going to have to do instead, which means less time treating me like a patient." – Dr. Sarah Matt 

"Where you live has a tremendous impact on your health and well-being, not just at a country or state level, but down to the neighborhood level. And so when we can get that information in the EHR, then we're able to proactively engage based on transportation barriers, food insecurities." – Christy Dueck, Ph.D.

"How do we pull that data together to be able to proactively reach into those communities? When I think about women and historically vulnerable populations, I think those are some of the same type of thinking and methodology that we have to leverage in connecting the data together, using data from a variety of sources to proactively identify populations, and then reach out to them." – Dr. Nasim Afsar

"There are a lot of [technology] platforms I feel that have come on board, which just makes it more accessible for people. And then just thinking about different groups of people who may perhaps were not considered before, like neurodiverse, and are we thinking about them when we are designing the [technology] systems or thinking about their data and how to connect their data … How do they communicate with their healthcare provider? Do we have a lot of information about that? Neurodiversity covers quite a lot and there will be a lot of changes [to technological solutions] in terms of how we capture the information in a standardized way." – Esther Gathogo, M.Pharm., Ph.D. 

--------------------------------------------------------   Episode Transcript:  

00:00:00

You're listening to Perspectives on Health and Tech, a podcast by Oracle with conversations about connecting people, data and technology to help improve health for everyone. 

In the second episode on Women's Health Equity, we'll be talking about how the role many women play as caregivers can present a challenge for patient engagement. We'll talk about technology and patient data and how we can effectively unify our knowledge together to treat the whole person.

00:00:37

Hi, I'm Dr. Nasim Afsar, chief health officer at Oracle Health. And joining me today on the podcast are three of my colleagues from around the world. I'll ask them to introduce themselves and give a brief overview of what they do.

00:00:53

Sarah Matt
Thanks, Nasim. I'm Dr. Sarah Matt. I'm a surgeon by training my fellowships and burns, but I've been in product development all over the world for my entire career. That's building our electronic medical records, new mobile applications, patient engagement solutions, you name it. First, I came in to drive our OCI, the cloud side of our business for health care and life sciences. And now, after our acquisition of Cerner, I focus on new product development. 

Nasim Afsar
Thank you. Esther? 

00:01:20

Esther Gathogo 
Hi, I'm Dr. Esther Gathogo, and I'm a pharmacist with 18 years' experience working across different sectors: community, hospital, academia and clinical research. And I currently work as a senior performance improvement leader in international based in UK. And I also focus on health equity and AI.

00:01:40

Nasim
Christy?

Christy Dueck
Hi, everyone, I'm Dr. Christy Dueck. I'm the vice president and global head of our Learning Health Network and really have responsibilities around creating health system partnerships with life sciences industries to bring clinical research as an integrated component of clinical care. 

00:02:02

Nasim
Thank you, Christy. And my background is in internal medicine. I practiced as a hospitalist for over a decade in tertiary, quarternary academic medical centers.
I've been in health care administration on the health care delivery side for over sixteen years in roles, in quality roles, in health management, contracting and health care operations. My team is focused on how do we ensure that across the globe we have healthy people, healthy workforce and healthy businesses. Driving the best of products and services to ensure that we're improving the health of the world.

So thrilled to be here and thank you all for joining me today as we talk about women and health equity. 

00:02:49

Nasim Afsar
Many women prioritize the care of other people, their loved ones or family members above their own, and oftentimes may feel like they don't have time to take care of themselves or be able to do the extra research that's required or seek a second opinion. Some of the ways that technology can help partner with providers to ease that burden. Christy, what do you think about this?

00;03;17

Christy Dueck
Well, I'm going to hit it from that clinical trial perspective again, as we look at ped's trials. We know the number one driver of not enrolling enough kids onto those trials is because the appointments happen when parents are working. And really when moms are working. And so it's, again, something as simple as we're changing that behavior so that we can bring that clinical trial out of a clinical research organization or at a specialty clinic that's 4 hours away from where that kid lives, and actually make it available at the point of care within their community on a Saturday morning so that a mom can take her kid to be part of that trial.

00:04:00

And instead of trying to create processes where we're enabling health systems and caregivers to work at optimum times, we've got to also create processes that actually allow our community members to engage in the care that they need on the time systems that work for them. 

And so I think, Nasim, you know, exactly what you were saying is that if we're going to have moms engage in their own health and in the health of their kids, we've got to make it available for them at a time that works for them. And it can be something as simple as changing those appointment times, or the availability for them, that completely changes the outcome of a clinical trial. 

00:04:42

Nasim
Sarah, wondering about your thoughts on this. 

Sarah Matt
So for me it's really about options. So I'm here at my desk and on my desk I have this letter. They actually send me a letter from the doctor's office and it was about an upcoming appointment.

First of all, I'm in a generation that a letter is just not going to work. It's not going to cut it. But I was never given the opportunity to tell them how I communicate best. So if they would give me an option to use some other patient engagement tool, a portal email, a text message, literally anything else for me would be a better option.

00:05:20

But I think that's the trick, is that technology can allow for more options. So maybe Christy is a text person. Maybe Esther actually will listen to her phone messages. If someone calls me, they're never going to get a hold of me. But, you know, I think that it's really about how can we make these super busy people utilize the tools that work for them best.

And every health care organization uses patient engagement tools, whether they're using a third party for a kiosk in their office or a patient portal or other outreach mechanisms for population health. There's so many ways they can do this, and some populations are going to love that letter. Other populations, like me: please text me, please send me an email, because anything I can do by multitasking, anything I can do where I don't have to stay on hold and talk to an actual person is going to be better for me.

00:06:11

I think the second piece is really about the information in your medical record. Nothing is more frustrating than showing up to a doctor's office or for me with this letter, they sent me a whole packet of papers to fill out to bring with me to my appointment on paper. I know they're going to scan that. I know none of it will be discreet, structured information, which pains me because I know I'm going to have to fill it out again.

But if we can find ways to take a patient's record, to use it well, to send it to the next provider, to use HIEs, to use other mechanisms of interoperability well, then those patients don't have to get to the appointment or they don't have to worry about the information being they don't have to check it again and again.

00:06:54

Every time you write this information down, there's a chance I'm going to mess it up again. And I'm a highly educated patient. For patients that are really iffy about their health care, it can be even harder. I know for me, as I say, I have a ton of kids. When I am filling out paperwork for my four kids, I can barely remember all their birthdays.

You can tell it's going to be a mess. So any time that all that information can be instead sent to me to review and verify, I'm going to do a ton better than what I'm starting from scratch. And I'm probably not the only patient out there that's experiencing the same thing. 

So for me, when I think about how technology can really help patients and that patient provider burden, it's about being able to transport and use interoperability in a really robust fashion to make sure my records go from place to place and then give patients options.

00;07:50

Because every data element I don't fill out as a patient is a data element a medical assistant, a nurse, a doctor is going to have to do instead, which means less time treating me like a patient. 

00:08:02

Nasim

Sarah, I can promise you that you are not alone. And I look at the crazy amount of health care paper that lands in my mailbox. You know, your comment about options and preferences is ultimately an angle of precision medicine, right? It's getting health care the way that you want it, and you need it to be able to care for yourself. And I think we have we have a lot of work to do, too, to actually be able to get there. 

00:08:34

When patients feel like the medical establishment is no longer listening to them, they sometimes turn to alternative therapies.

How can patients and clinicians work better together to make sure they're bringing all of the data and modes of health and wellness together to really treat the whole person? 

00:08:53

Sarah Matt
So when I think about brining, health, medical, wellness all together, I think that in the past, and even today, we often keep them in silos. So medicine is this and there's a big fence post around it and we don't think about what does that mean to the patient. What is wellness, what is mental health?

What are these other areas of health and wellness that are not necessarily part of our electronic medical record or as a part of our normal scope of practice. So first, I think providers need to really think past their training, and that's hard. As a provider who is trained in the United States, I was trained to take care of patients in a pretty specific way.

00:09:35

Fortunately, I'm from the generation that's worked on paper and electronically, so I've seen the full gamut of craziness when it comes to how to take care of patients digitally and not. But how does that intersect with chiropractic care or traditional medicine for different cultures or herbal supplement 27? Whatever it is. I think that as medical professionals, sometimes we know what our scope of practice is, and we know what we know really well.

But when it comes to a new modality of care, whether it's a nontraditional type of therapy or a new medication, that is maybe not an FDA regulated medication, maybe it's something that's herbal, we don't know what to do with that. And a lot of providers, I think, often will put up that wall and say that's not a good idea.

00:10:26

That sounds kind of crazy. Maybe you shouldn't do that. But I think that if we look to ten years ago, 20 years ago, 30 years ago, that's how we thought about a lot of things. Chiropractic medicine is a good example. Some providers are really excited about it, some aren't. But time and time again, all literature will show that for some patients it decreases pain.

So as a provider, should I prescribe chiropractic care? Ah, maybe not, but there's no denying that for some patients it's decreasing pain, and that's real. So what I'd suggest is first, sometimes as providers, we need to educate ourselves in some other modalities of care. Sometimes we need to recognize when some therapies are helping our patients, whether we agree or not, with the medical validity of it.

00:11:15

And we can help our patients understand what risks might actually be able. Will this medication actually do something in a negative? It's helping this patient with pain, with depression, with this new thing. Is it going to cause harm in other ways? How can we help our patients do a risk analysis for themselves? 

And when it comes to mental health, again, a lot of providers, me included, we have our scope of practice that we feel really comfortable with, and then we tend to refer out for everything else. Which is not a bad way to practice medicine, but I think it prevents us from thinking about what are those important and engaging human questions that we should be asking during our encounter.

Again, what are those personable things that we can do to show that we care and to help make sure that our patient gets to the right place next? Whether it's understanding a little bit about their life, about their struggles, about how things are going in their lives, I think that's important.

00:12:15

We often are concerned about how healthy they are or are they taking their medications the way they're supposed to. But I think we forget sometimes and rarely ask, how are you as a person? Because whether they hit those marks on the depression screen scale that my nurses give them, I think a lot can be said about when they speak to me in the office, if I'm concerned about them as a human being, and then I can help get them to the right resource or help give them some information that will help them on their journey better. 

00:12:48

Nasim
There's such tremendous value, Sarah, in truly listening, understanding and empowering people to be able to take care of themselves. And then for us to having truly understood them, to help them in a different way. I really appreciate that perspective. Christy, I'm wondering about your thoughts on about how can we help patients and clinicians do better in bringing all of the data together? 

00:13:14

Christy 
I think it's a couple of things. I think that as I was listening to Sarah, I thought of, you know, there's the social determinants of health aspect and then there's certainly the prevention aspect, where we're not just focused on treatment of a known issue, but prevention of issues presenting in the first place. From that social determinants of health perspective, you know, we know that beyond clinical data, there's so much more that impacts your health and well-being.

00:13:43

Where you live has a tremendous impact on your health and well-being, not just at a country or state level, but down to the neighborhood level. And so when we can get that information in the EHR, then we're able to proactively engage based on transportation barriers, food insecurities. 

00:14:06

Nasim
You know, Christy, one of the things that we talked about was how our various data on patients are in lots of different places. So that even if you have data with one EHR company and you see another health care delivery system that has the exact same EHR, those two parts actually don't speak with each other.

And so when it comes to some very basic elements of care like colorectal cancer screening, we don't really have a good sense of what percentage of the population have been screened because we have data in all these different systems that don't really come together.

00:14:50

And really the strength of, and the privilege and the responsibility of, being part of a large data company that knows data and connectivity to look at how do we solve these problems, how do we really need a system where we can have a national, and then in every country across the globe, a way to be able to pull this data together, understand it?

And then there's another side of this where more data can be leveraged. Which is pulling data from lots of different sources and connecting it enables us to understand particular communities where there are, for example, food deserts: where we know patients are likely eating large amounts of highly processed foods, where the rates of alcohol consumption and smoking are much higher and those are going to be populations that are more predisposed for colorectal cancer.

00:15:49

How do we pull that data together to be able to proactively reach into those communities? And again, when I think about women and historically vulnerable populations, I think those are some of the same type of thinking and methodology that we have to leverage in connecting the data together, using data from a variety of sources to proactively identify populations, and then reach out to them.

00:16:14

Esther
Just picking up on what I guess you've all said, but also what Sarah mentioned on the mental health, it made me think about digital therapeutics, an area which is growing. And even in Europe you have some countries like Germany who are now having like digital therapeutics on prescription as an alternative to giving medicine. 

So I'm just imagining now in terms of how to connect some of this data from these newer applications where they've really started to show really good benefits when it comes to managing depression. And mental health is an area that I feel over the pandemic really changed the model of care and delivery and with a lot more people feeling comfortable to have their therapy virtually.

And so there's a lot platforms I feel, that have come on board in which just makes it more accessible for people. And then just thinking about different groups of people who may perhaps were not considered before, like in terms of thinking about neurodiversity and are we thinking about them and when we are designing the systems or thinking about the data and how to connect the data.

00:17:36

So if you think about someone with autism or a woman with autism and how do they describe or how do they experience, for example, I'm going to talk about menstrual cycle because I started with that, but how do they experience the menstrual cycle? How do they communicate that with a health care provider? And do we know a lot of information about that?

So in thinking, just because neurodiversity covers quite a lot and I think there will be changes, I think, over more incoming years, in terms of how we capture the information in a standardized way. Because then you can be able to connect the information across to be able to do research in certain groups. So I think it's quite an exciting point to be in, I guess this is this is like the pioneering stage of everything.

00:18:35

And just thinking about like we saw statistics in the UK, we have now reached 99% of households with Internet and there's more people even over the age of like 80 who've got mobile phones and they're learning to use smartphones. So I think and if you look at the smartphone and the way there's a lot of health apps on there—I think when you're talking about this whole trying to improve the physician and patient kind of relationship, this thinking about when I go home and I've been diagnosed with a condition and how to been instructed and how to manage it, how do I, what's my self-care looking like?

So when I go home and I download an app that's capturing information, it might improve on the follow-up care in terms of how you capture the information and share it with the physician in your next visit. And I think a lot of that is going to become more and more easier in terms of sharing information between systems so that you can be able to improve on just seeing that holistic view of your patient across. So I think it's quite exciting.

00:19:56

Nasim
Yeah, I think that's that's a great point. What are some other innovative ways you've seen health organizations share information with their communities? 

Esther
Yeah, So we saw just over the pandemic an increase in social media use, particularly in low to middle income countries just looking for answers really to understanding like COVID and also the vaccine itself.

So we've seen an increase and they saw it as a potential tool to access hard to reach communities in terms of educating people in low resource settings on health care. And one of the things, for example, we had and within ECF last year there was Dr. Khyati Bakhai who delivered a talk on this where she was saying that she translated some information around the COVID vaccine to another Indian dialect, and that increased the uptake of the COVID vaccine within that community.

So you're starting to see how social media platforms, particularly if there's a really high usage of it, particularly in low resource settings, as another avenue to reach out to those communities, just to help them on understanding more about their health and also sharing credible health information through those platforms. And also just thinking about how you can use it as well and in terms of thinking how to reach out to them if it was, for example, for research or for understanding more around even like barriers to health care for them or understanding their needs. 

00:21:56

Nasim
Well, thank you all for joining us for the thought-provoking conversation about women and health equity. I want to thank our panelists Christy Dueck, Sarah Matt and Esther Gathogo. Great conversation around the role of technology and how can we address some of these shortcomings and limitations that we have for women to receive better care.

But lots of areas identified where we really need to work together in partnership to address as we move forward. Looking forward to ongoing dialog around this, and more importantly, action around how we can impact better health for women across the globe. Thank you. 

Be sure to subscribe to Perspectives on Health and Tech podcast for more insights from industry experts, visit oracle.com/health or follow Oracle Health on social media.

Even before the COVID-19 global pandemic, consumers were asking providers for more autonomy and convenience with their healthcare. Given the pandemic, there has been a subsequent boost in healthcare consumerism, pushing patients to adopt the patient engagement technologies at a much faster rate. In this episode, Sue Martin, vice president, financial alignment at Cerner, and Rick Gundling, senior vice president, professional practice at HFMA, discuss the impact that COVID-19 has had on consumerism. Tune in to hear Sue and Rick discuss: • How the rapid increase in consumerism has impacted the healthcare industry (1:39) • The largest behavior differences between pre-pandemic patient behavior and today, and healthcare organizations' reactions to the change in patient behavior (3:25) • Helpful strategies that healthcare organizations can leverage to empower and support patients as they navigate a changing landscape (8:26) • Industry insight into consumer expectations moving forward (13:49)

In this episode, Dr. Lu de Souza, vice president and chief medical officer, is 
joined by Dr. Tania Tajirian, chief medical information officer, Centre for Addiction 
and Mental Health. They discuss the topic of clinician burnout, what factors play a
role in burnout, and lessons that have been learned in tackling this issue.

Notable quotes:

"EHRs are meant to be tools, not a burden. How you bring joy back to medicine is by reducing that burden. Less time at the terminal, more time at the bedside. That resonates with every clinician...also with patients." – Dr. Tajirian

"We have to get back to thinking about our care team holistically." – Dr. de Souza

Tune in to hear Dr. de Souza and Dr. Tajirian answer these questions:

• How are EHRs impacting clinician burnout? (02:17)
• Why taking a multi-prong approach is important in tackling this issue? (06:22)
• What are the top three or four things you [Dr. Tajirian] have learned through this process? (16:31)
• What is coming up in your strategy immediately, and what is coming in the next five years? (18:59)
• Share some wisdom that has helped you in your journey. (22:33)

In this episode, Josh Mast, director and product regulatory strategist, is joined by fellow associate, Hans Buitendijk, director of interoperability strategy, and special guest, Mariann Yeager, CEO of The Sequoia Project. Through their own experiences, they discuss TEFCA (Trusted Exchange Framework and Common Agreement), including what it is, how it impacts healthcare providers today, and how it can impact healthcare in the future, both locally and globally.

Notable quotes:
"…a trusted exchange framework where we can all share the data safely, securely, and with the right stakeholders." – Hans Buitendijk

"The ultimate goal is to make it much easier to have a standardized way to share information…" – Mariann Yeager

"I think that there is opportunity to leverage the capabilities and what we've been able to 
accomplish here in the US and learn from other countries to facilitate information exchange internationally, and I think it's closer than we think." – Mariann Yeager

Tune in to hear Josh, Hans, and Mariann answer these questions: 
• What is TEFCA? (01:39)
• Why is that such an important topic for users and healthcare providers? (03:02)
• What role is The Sequoia Project playing within this trusted exchange network? (04:44)
• What do you see as the ultimate goal in implementing TEFCA? (06:15)
• What do you think are the biggest challenge for achieving that goal? (07:55)
• What is the next big milestone for TEFCA? (08:47)
• What advice would you give healthcare organizations going forward? (10:13)
• What does healthcare data-sharing look like over the next five to 10 years? (11:48)
• Do you believe that US policies like TEFCA have a potential worldwide impact on healthcare exchange? (14:50)

In this episode, Dick Flanigan, senior vice president, Cerner, is joined by fellow associate Rob Helton, senior director of platform management. They discuss the upcoming bulk API requirement, stemming from the 2015 CEHRT Cures Update, on health systems as well as how this new functionality will help advance innovation in healthcare. Tune in to hear Dick and Rob answer these questions: • Why are APIs important for the industry? (2:00) • Why are APIs so exciting? (4:45) • What kind of value does Bulk API add to the future? (7:23) • What is FHIR? (8:41) • What is required of health systems when it comes to the January 2023 deadline? (10:40) • What challenges will organizations face, and how is Cerner helping address those challenges? (12:26) • What does the future hold for clients and consumers in an API enabled world? (13:52)

In this episode, Dick Flanigan, senior vice president, Cerner, is joined by fellow associates Sue Martin, vice president, financial alignment, and Josh Mast, director, regulatory strategy. They discuss the impact of the No Surprises Act (NSA) on health systems as well as how this new federal legislation may help patients avoid unexpected and potentially devastating medical bills. Tune in to hear Sue and Josh answer these questions: • What healthcare problems does the NSA help solve? (1:29) • Which healthcare players are expected to accomplish the goals of the NSA? (3:42) • How does the NSA impact surprise billing, balance billing and good faith estimates? (5:24) • What challenges are health systems facing as they work to comply with the NSA? (6:47) • What part of the healthcare process will see the greatest workload? (10:44) • What changes can consumers and health systems expect around price transparency? (12:09) • What's the burden on providers and how can Cerner help? (14:46) • What's next for the NSA? (19:25)

In this episode, Bob Robke, vice president, real-time health system and clinical products, Cerner, is joined by Lisa Gulker, senior director, health system operations and clinical surveillance, Cerner. They discuss COVID-19's impact on how health system leaders use real-time and predictive data and the challenges of managing scarce and expensive resources to address growing health needs. 

Notable quotes

"Health leaders don't want to go back to working off yesterday's data. They want to make real-time decisions with situational awareness based on what we predict will happen in the future." – Lisa Gulker

"The data in our clinical products and in the EHR is great for mining in real time and bringing up in a command center setting." – Lisa Gulker

"COVID-19 accelerated systemness in healthcare, and it's here to stay. Leaders have learned how to manage resources and supply chains across larger groups of organizations." – Lisa Gulker

Tune in to hear Lisa answer these questions:

• What are your key takeaways so far from your journey as a clinician and health system and informatics leader? (1:50)
• How has COVID-19 effected health system reliance on real-time and predictive analytics for decision-making? (4:45)
• How are command centers shifting the scope of capabilities for centralized clinical operations? (6:45)
• How is real-time situational awareness helping health systems address the staffing crisis? (9:39)
• Outside of the command center, is there a way to bring situational awareness to the point of service? (13:58)
• How are current market forces influencing health system leadership practices? (16:22)    

In this episode, Dick Flanigan, senior vice president and Cerner brand ambassador, is joined by Hans Buitendijk, director interoperability strategy, Cerner, for a conversation around the current and future state of data reconciliation, connectivity and usability.

In this episode, Jessica Herstek, MD, chief medical informatics officer, Children's National Hospital, joins Lu de Souza, MD, vice president & chief medical officer, Cerner, for a conversation around funding disparities in children's health innovation. Learn about the unique relationship between Children's National Hospital and the Bear Institute, which enables the health system to pursue a multifaceted approach to innovation — including a new pediatric accelerator challenge that invites start-ups, student teams, pediatric providers and administrators to collaborate on creative solutions aimed to help close the innovation gap in children's digital health.

In this episode, we're joined by Casey Sansale, senior director and product integration executive, Cerner, for a conversation around the future of ambulatory care and how organizations can optimize their outpatient efforts.

Notable quotes

"Making healthcare approachable is the fundamental challenge that we have as we digitize. Putting the patient at the center of all we do is likely the most prominent area of ambulatory growth." – Casey Sansale

"This decade is going to define the intersection of healthcare and technology." – Casey Sansale

"The pandemic is a catalytic change agent for healthcare and technology. It's fundamentally going to be the thing that propels us forward." – Casey Sansale

"The pandemic highlighted the importance of technology for rapidly solving problems." – Casey Sansale

Tune in to hear Casey answer these questions:

• What was happening in the ambulatory space before COVID-19, and how has the pandemic influenced those trends? (1:11)
  • Policy (1:28)
  • Defining decade (2:22)
  • Systemness (4:34)
  • Big tech, retail and insurance, direct care operators & startups (5:21)
  • Joint ventures (6:25)
  • Regulatory payment reform (7:52)
  • Venues of care (9:01)
  • Expanded care team (10:06)
  • Better together (10:26)

• What are the driving factors of ambulatory care post-pandemic? (11:39)
  • Provider/Payer/Patient interdependence (12:06)
  • Rebalancing the care team (13:01)
  • Hyperspecialization (14:00)
  • Gravity of data (16:05)
  • Precision medicine (16:37)
  • Real-world evidence & data activation (17:22)
  • Social medicine & U.S. healthcare (17:48)

• How has the rise in consumerism impacted ambulatory care strategies? (18:55)
  • Convenience & access (21:05)
  • Workforce health (21:26)
  • Communications (22:08)
  • Social determinants of health (22:35)
  • Data liquidity (22:53)

• What's top of mind for organizations that are focused on ambulatory as an area for growth? (24:04)
  • Direct patient care activities (24:39)
  • Clinician & staff wellness (25:19)
  • Digitizing the enterprise (26:54)
  • Enterprise-wide analytics (27:43)
  • Patient experience (28:05)

In this episode, David Harse, vice president and general manager, consumer engagement, Cerner, is joined by Allison Hess, vice president, health innovations, Geisinger, for a conversation around wellness and addressing inequities in healthcare.

In the last decade, a growing amount of research has increasingly exposed how a lack of funding for medical and pharmaceutical research around women's bodies has put both patients and clinicians at a disadvantage for treating even common illnesses. With a lack of knowledge and awareness on women's health, clinicians don't have the data with which they need to practice, and patients don't feel heard, some even experiencing bias at the bedside. How can AI and other technologies help address some of these challenges?

Listen in on this first episode of a two-part series.

Featuring:

• Moderator: Nasim Afsar M.D., MBA, chief health officer, Oracle Health
• Christy Dueck, Ph.D., global head of the Learning Health Network and Health System Activation, Oracle Health
• Esther Gathogo, M.Pharm., Ph.D., senior performance improvement leader, Oracle Health
• Sarah Matt, M.D., MBA, vice president, physician and healthcare technology executive, Oracle Health

Listen as they discuss:

The moment they realized, personally or professionally, there was a gap in women's health care (2:47)

• In practice for oncology patient
• Collegiate athlete performance
• Menstrual health care in school settings
• In practice, while pregnant

What is being done to address the lack of research on women and diversity amongst women (10:56)

• Representation in clinical trials
• Product development
• Expanding inclusivity in EHR data

What can be done to help address the lack of women and women of color in clinical studies (15:11)

The role of AI in care delivery (17:15)

• Tips for training AI algorithms
• Burnout, patient engagement, automation

Notable quotes:

"When we think about women's health in general, using more automation, using more AI/ML, could it help women in their ability to get care for themselves? It absolutely could … Because right now I think what we're finding is that the system's stressed, all the people are stressed, the patients are stressed. Everyone needs a break and we can't do more with less. We're going to have to do things differently." – Dr. Sarah Matt

"At the end of the day, we want to make, just like you said, those 15 minutes with the community members that you serve more impactful and with the option to bring more innovative things to your community than ever before." – Christy Dueck, Ph.D.

"And we know that if there's such a low representation of women in clinical trials, it means that products are being approved without the representation of these women. And it means that the real-world evidence then becomes really important. If we are then using these products, we have to understand the female body and the diversity—in terms of the genetic background as well—and that diversity means that they might respond differently to the approved medicines. It's also thinking about how to recruit and making it a lot simpler for women to understand the products." – Esther Gathogo, M.Pharm, Ph.D.

---------------------------------------------------------

Episode Transcript:

00:00:00

Nasim Afsar
You're listening to Perspectives on Health and Tech, a podcast by Oracle with conversations about connecting people, data and technology to help improve health for everyone. 

Today on the podcast, we're discussing women and health equity. From personal and professional experience, how we've become familiar with the lack of resources and research on women's health and how AI and other technologies can help address some of these challenges.

00:00:35

Hi, I'm Dr. Nasim Afsar, chief health officer at Oracle Health. And joining me today on the podcast are three of my colleagues from around the world. I'll ask them to introduce themselves and give a brief overview of what they do.

Sarah Matt

Thanks, Nasim. I'm Dr. Sarah Matt. I'm a surgeon by training my fellowships and burns, but I've been in product development all over the world for my entire career. That's building our electronic medical records, new mobile applications, patient engagement solutions, you name it. First, I came in to drive our OCI, the cloud side of our business for health care and life sciences. And now, after our acquisition of Cerner, I focus on new product development. 

Nasim Afsar
Thank you. Esther? 

Esther Gathogo 
Hi, I'm Dr. Esther Gathogo, and I'm a pharmacist with 18 years' experience working across different sectors: community, hospital, academia and clinical research. And I currently work as a senior performance improvement leader in international based in UK. And I also focus on health equity and AI.

00:1:37

Nasim
Thank you, Esther. Christy?

Christy Dueck
Hi, everyone, I'm Dr. Christy Dueck. I'm the vice president and global head of our Learning Health Network and really have responsibilities around creating health system partnerships with life sciences industries to bring clinical research as an integrated component of clinical care. 

Nasim
Thank you, Christy. And my background is in internal medicine. I practiced as a hospitalist for over a decade in tertiary quaternary academic medical centers.

I've been in health care administration on the health care delivery side for over sixteen years in roles, in quality roles, in health management, contracting and health care operations. My team is focused on how do we ensure that across the globe we have healthy people, healthy workforce and healthy businesses. Driving the best of products and services to ensure that we're improving the health of the world.

So thrilled to be here and thank you all for joining me today as we talk about women and health equity. 

00:02:47

To start us off, I want to talk about the moment that you all realize that there is a wide gap in women's care and that could be either personally and professionally. 

Nasim 
So, to kick us off all kind of share a story from my background. This really kind of hit me a number of years ago when I had the privilege of taking care of a 48-year-old woman with end-stage metastatic colon cancer during her final hospitalization. I learned during this hospitalization that leading up to her terminal diagnosis, for about a year, she had seen a number of providers with her symptoms.

Initially started off with fatigue. She then had some abdominal pains, some nausea, and this was continually attributed to stress, irritable bowel syndrome. And during those 12 months, she was really never provided the appropriate diagnostic interventions, like a colonoscopy, until it was too late. 

I also learned during that time that she was a phenomenally dedicated teacher. She was a caring mother. She was a spouse, a child, a sister, an incredible friend to many. It was absolutely heartbreaking to see that her voice was not heard as she didn't receive standard of care that really could have been lifesaving. And I wish I could say that this was a rare case. But cases like this happen every single day in the U.S. and across the globe.

00:04:22

Christy, I'm wondering if you can share with us when this really became real for you. 

Christy
Sure. A little bit different story for me, and mine's actually personal. So, when I was studying pre-med, I was an intercollegiate athlete in rowing with aspirations of competing at the national and elite level. And like so many female athletes' experience, I really got caught up in the cycle of being asked to lose a significant amount of weight by my coaches, because rowing, like other sports, has weight classifications.

So over the course of a summer, I dutifully lost 35 pounds and returned back in the fall at under 130 pounds, which is a light weight. And in about three months I had a full osteoporotic hip fracture at the age of 20. And it was really a peak milestone for me. I was in my junior year. I was pre-med at the time.

00:05:22

I was never given, obviously, any guidance around the impact that that weight loss would have on my health, my endocrine system. And so that was really a milestone of it ended my rowing career, unfortunately. But it was really a driver for my career. I went on and got my Ph.D. in reproductive endocrinology and did a whole lot of research around the female-athlete triad since I was sort of the poster child for it at that time.

00:05:50

Nasim 
What a challenging personal experience to go through. Christy, thank you so much for sharing that, Sarah. 

00:05:58

Sarah
So I think, you know, as I went through my medical training, you kind of see things, you hear things, if things don't seem quite right a lot of times. I think where it really hit me is when I started having my own children.

So, I have four kids, and my first, I was still doing surgery at the time. And when I think back to that time, there were so many assumptions made about what I, as a professional, might already know about women's health or might know about my own body, and that I didn't. And when I would ask caregivers, they would either be like, "Oh, well, you know, it's this or it's that."

And I think that having come from the medical field and having a baseline of information already, I still didn't have the answers I needed. And I was relying on my grandma or my mother or my sister or friends to ask advice when I couldn't get what I needed out of the medical system. And as a medical professional, I needed information like, "Hey, if I'm going to go into a vascular procedure, do I need to wear lead?"

00:06:57

"Hey, is this chemical okay for me? What if I get exposed to that?" And yes, sometimes there was a paper that I could Google and sometimes I could ask my doctor, but sometimes there just wasn't. And there wasn't the right people for me to ask within the medical community or otherwise. So I can really see how people just struggle, because I had, theoretically, all the resources I could possibly want available to me, and I still couldn't get the answers that I wanted.

00:07:27

Nasim
Thank you for sharing that, Sarah. It really brings out the part of the heart of the matter, which is even when you have resources and knowledge, it can be so incredibly challenging. And so many women across the globe don't have the resources and the knowledge. Esther? 

00:07:46

Esther
I'm just going to take us back to the early years of when you're probably a teenager and you had the reproductive health conversation. And I was in boarding school and we came back after having been given sanitary towels and shown tampons and everything else.

And I think at that point the main focus was on the menstrual cycle and what's normal. But no one really talked about how bad it can be, I think for most. And so I think what became very clear is when girls, you know, because that's the stage when the menstrual cycle is being regular, more regular, and you started to see serious, serious problems.

00:08:33

You know, we had one girl who had to be taken by ambulance and started on a drip for menstrual pain, you know, and it's something that hadn't obviously seen before. And then as we got older, the conversations where I've had friends who've had a hysterectomy before 40 for benign conditions. And when you listen as a group, particularly around the problems that people face with the menstrual cycle, you realize that there's not a lot of treatment options.

And this is after many years of many women coming in to the medical center and recognizing that 10, 15, 20 years down the line, we're still using hormonal treatments as the main treatment for most of the conditions. 

And I think when you listen to how, you know, it's impacting the mental health, you know, the life and social life and just their well-being, then you end up realizing that over time, more needs to be done with this. You know, because I think the medical community has somehow become just complacent because they have benign conditions and they can see that it's, you know, in terms of self-management or whatever it is that women do.

00:10:06

But I think thinking about now, especially as we are working women and, you know, how stress affects your system, it's something that I think and just thinking about needing more options. And like even getting down to understanding the basic understanding of why the disease happens, you know, some of those questions are still, you know, they're not there. So that's why.

00:10:35

Nasim
Thank you for that, Esther. I think you highlight the challenges of managing something that is as basic as it gets and it's biologic, and how much work and understanding still needs to happen for some of the most basic and biologic processes in women. So I really appreciate you sharing that. 

00:10:56

So, we know that a lot goes into these gaps of care from lack of understanding or honestly acknowledgment of biases in vulnerable populations to lack of medical and pharmaceutical research considering women's health, I think you all touched on different sides of this. So let's focus on representation of women and women of color in research. What has been done to address this gap in research and data? Esther, I'm going to ask you to kick us off. 

00:11:30

Esther
Yeah, and I was reading a bit around this and just throwing out some figures that, you know, women are representative of 22% of clinical trial research.

And for women of color, it's been reported even as low as 2%. It makes you think about the information in terms of the clinical research, whether it's truly representative of the diversity of women, you know, across even the globe, if I want to say it that way. And we know that if there's such a low representation of the of women in clinical trials, it means that products are being approved without, you know, the representation of these women.

And it means that the real-world evidence then becomes really important. Which is where I think if we are then using these products, we have to understand that the female body and the diversity of all of us in terms of the genetic background as well—and that diversity means that they might respond differently to the approved medicines—is also thinking about like how to recruit and making it a lot simpler for women in terms of understanding the products.

00:12:51

Because one of the biggest things would be how does this product affect my body? Most of the time people are concerned about fertility, you know, and a lot has been done over the years to try and just put women's minds at ease. But it is difficult. 

And this is where I find that the electronic health record and thinking about not just about that the information is within the record, but are you collecting information in the clinical care of women and representing it in that way and within if you're doing clinical observation studies, because if you've got a product and you're not, for example, collecting information on the impact on the menstrual cycle, but you're getting lots of reports from women saying they've had a few missed menstrual cycles and they don't understand why it could have been the product that they're taking. But if this information is not being captured, then it's not within the system, which means that you start you still can't glean the insights that you need from the electronic health care records.

00:14:03

So I feel that not only around and when you look at internationals looking at the numbers in terms of the proportion of women who are conducting clinical research as well, and that's quite low. So it can also then make you think about in the end, when are designing the clinical trials, is someone speaking up for the diversity of women to include them in the clinical trials or in the trial design?

Because then you are collecting the information that will be useful as well for women when it comes to evaluating whether or not they should take a product or they should be recruited into a trial. 

00:14:51

Nasim 
So there's a real multi multifaceted problem, right? It needs to really be tackled from multiple, multiple angles as you highlighted. So, Christy, Esther highlighted how low representation of women and minorities as has carried out in clinical research. What are we going to do to fix that?

00:15:11

Christy 
Oh, that's a big question, but I think, you know, we got to we got to start with working with what we have in the most effective way. And so, you know, from my angle of the world, I'm not a practicing clinician, but I've been engaged in clinical research my whole career.

And coming from Cerner, we had this realization of, oh my gosh, we're literally sitting on 40 years of digitized health care data. How do we turn that as a giant lever to help address some of these broad stroke issues, like women and access to clinical research?

And so in my world, one of the things that we did was create a partnership with health systems and an opportunity for them to share their data with other health systems so that we could create a searchable dataset, a real world data set that we could then work in partnership with health systems to bring clinical studies that address issues in women's health to the point of everyday health care, and use that data as the accelerant to get very prescriptive in finding women that are a match for the specific study criteria or enabling care teams to engage directly with their patient populations that may be a fit for a new, innovative trial in a rural community that would never have had that opportunity before. So right now we're sitting at this critical point in health care where we know we've got a whole bunch of data.

00:16:51

That's our quality problem. We've got more data than we know how to use. And to Esther's point, it's now making that data a lever we can pull to accelerate clinical research, to focus on the specialty groups where we've seen disparities in care given up until this point in time. 

00:17:11
Nasim
Agreed. Agreed. So, you know, we've talked a couple of times around the role of technology in helping address disparities.

I want to focus in on the role of AI in health care delivery. What's the potential and what are the downsides? 

00:17:30

Sarah
So, you know, when we think about AI/ML it's been the buzzword for how many years now? And I think during COVID, everyone recognized that we have to do things differently now than we did in the past.

And so everyone's heard about ChatGPT. It's been a huge buzz. Everyone wants to talk about AI/ML, but a lot of health care organizations, a lot of ministries of health, have been slow rolling in how they deal with AI/ML over the last couple of years. A lot of that has to do with trust and why would we be concerned about that for the same reasons that health care in general has had problems for decades and decades and decades.

00:18:04
So that means whether it's structured data coming from an electronic medical record, straight from a clinical trial database, wherever that data is coming from it, we have to make sure we're comparing apples to apples. And every single algorithm, every AI model that we build out, has to be trained.

So, when we think about women's health and how we can improve women's health, ultimately, there's going to be models that are trained on data that doesn't include women. Well, how is that going to impact us? 

If you think about all the different ways we treat people today, whether it's in nephrology and kidney health and the way African-Americans have been treated in the past, in terms of those algorithms, whether it's X, Y or Z, we have so many clinical rules that we use today that have their own inherent biases based on medical data from the past.

00:18:54

So if we're going to build out new algorithms, we have to make sure that we're training it properly. So things to think about for people developing these algos is: who is your set of patients that you're going to bring into this model? Are women included? Are people of color included? What other kinds of people should be included in this algorithm's data set to make it a great model?

When we think about women's health in general, using more automation, using more AI/ML, could it help women in their ability to get care for themselves? It absolutely could. When we think about the nursing shortages all over the world, when we think about how hard it is to make a doctor's appointment on a Monday, when you have a bunch of kids, when you have a job, when you think about how much time a provider is actually going to take with you … how can we automate things for the patient?

00:19:48

How can we automate things for the provider? How can we provide that small town doctor feeling in 15 minutes? How can we provide that care and engagement with less? Because right now I think what we're finding is that the system's stressed, all the people are stressed, the patients are stressed. Everyone needs a break and we can't do more with less. We're going to have to do things differently. 

00:20:18

Christy 
I love that. I'm just going to jump in right now and do a high-five to you on that one, because I think, right, fundamentally—and, Nasim, you and I've talked about this before as well is—at the end of the day, we have to change our behavior around health and care, regardless of what side of it you're on, whether you're a provider of it or a receiver of it.

And that behavior change is what's going to drive our ability to be able to actually leverage and receive the benefits of all the cool stuff, Sarah, you just talked about. But if we don't change the behavior around health care as the starting point, it doesn't matter what great tools we develop if people don't use them. And so in my world, you know, we're trying to engage critical-access hospitals who have never, ever participated in a clinical research study before.

00:21:14

And the first thought and the first line of defense is, "I don't know how to do that. We've never done that. No." And really, it's creating that opening of, "We're here to partner with you. We've got all of the tools and technology in place to enable you to do it." And at the end of the day, we want to make, just like you said, those 15 minutes with the community members that you serve more impactful and with the option to bring more innovative things to your community than ever before.

And on the patient side, or being a community member, you know, I love all the powerful stories that I get to hear of people who are busy, women who are really busy, and now they look at participating in a clinical trial as even a control patient, as a way to give back, as a way to serve. And most of those stories end with an, "Oh my gosh, I thought I was a control patient, and I actually got diagnosed as a result of my participation in that study because I haven't done anything in my health care over the last three years with COVID" because of all the reasons we all just talked about.

00:22:22

Nasim
I think you all highlighted how technology can really be used to facilitate receiving care, getting care, getting better care, facilitating your care at the time that we need. And there are barriers that we have to overcome. And I think that's kind of Christy, your point about that changing relationship. 

Esther, you were touching on this. I think those are the elements that we have that we have to work through as a society to be able to move things forward. 

00:22:56

Well, thank you all for joining us for this thought-provoking conversation about women and health equity. I want to thank our panelists Christy Dueck, Sarah Matt and Esther Gathogo.

Great conversation around the role of technology and how can we address some of these shortcomings and limitations that we have for women to receive better care. But lots of areas identified where we really need to work together in partnership to address this as we move forward. Looking forward to ongoing dialog around this, and more importantly, action around how we can impact better health for women across the globe. Thank you.

Be sure to subscribe to Perspectives on Health and Tech podcast for more insights from industry experts, visit oracle.com/health or follow Oracle Health on social media.

In this episode, we're joined by Cerner leaders David Bradshaw, senior vice president, consumer and employer solutions,  and Jessica Oveys, director, product market management, for a conversation around the future of healthcare in a post-pandemic world and the potential impact on consumerism and engagement. Read the show notes: https://www.cerner.com/perspectives/the-tipping-point-of-healthcare-consumerism-and-engagement

In this episode, Lu de Souza, MD, chief medical officer, Cerner, has a conversation around the importance of clinician wellness with Jennifer L. Bickel, MD, medical director for the Center for Professional Well-Being at Children's Mercy Hospital in Kansas City, Missouri. Read the show notes: https://www.cerner.com/perspectives/assessing-and-prioritizing-clinician-wellness

In this episode, Christy Dueck, vice president and general manager of research, Cerner, leads a conversation with John Potthoff, CEO, Elligo Health Research, and Scott Rogers, director of innovation, CoxHealth, around how diverse community-based hospitals are a lifeline to saving clinical research, and can help increase patient trust and reduce health disparities. Read the show notes here: https://www.cerner.com/perspectives/how-diverse-community-based-hospitals-are-a-lifeline-to-saving-clinical-research

Summary

It's essential to prioritize cybersecurity, particularly for healthcare organizations that handle sensitive patient information. With so much at stake, it's critical to recognize the importance of cybersecurity and take proactive measures to prevent potential breaches. In a recent discussion, two experts from Oracle emphasized the significance of areas such as ransomware resiliency, cyber-recovery, and other crucial aspects of cybersecurity.  

 

Featuring

• Waleed Ahmed, Senior Manager, Cloud Engineering, Oracle 
  
• Esteban Rubens, Field Chief Technology Officer, Oracle Cloud    

Hear Them Talk About:   

• What's going on with cybersecurity in healthcare today (0:42) 

• What Oracle Health is doing to address the cybersecurity situation (1:17) 

Areas of Focus 

What is the threat intelligence in the platform? (1:27) 

The need to continuously monitor and detect threats (1:50) 

How to allow the business to continue and provide care in the event of an attack (2:35) 

Ransomware resiliency and ransomware recovery (2:53) 

How to deliver a cyber-recovery (3:17) 

A recap of the three prongs that Oracle is focused on to deliver cybersecurity (3:47) 

How Oracle can support both clinical and non-clinical systems (4:08)   

Notable Quotes

"There's an incredible amount of scrutiny in understanding what the threat landscape is and it's becoming more prevalent in healthcare, where it's an opportunity for attackers to lock in and prevent businesses from occurring where it matters most." - Waleed Ahmed 

 

"You have to be able to say, not only is my architect resilient, but in the event I do have a cyberattack, can the business continue?" - Waleed Ahmed 

"Oracle is delivering in three different prongs. The ability to detect, the ability to assess, monitor, and also provide the capability of bringing the systems back up." - Waleed Ahmed 

Learn more about how Oracle is safeguarding operations with resilient architecture and military-grade security. 

Watch on-demand and live webcasts by registering for Oracle Health Inside Access.  

--------------------------------------------------------

Episode Transcript:

00:00:00:00 – 00:00:00:09
Perspectives introduction
You're listening to Perspectives on Health and Tech, a podcast by Oracle with conversations about connecting people, data, and technology to help improve health for everyone.

00:00:00:10 - 00:00:00:24
Esteban
Hi, I'm Esteban Rubens. I'm the Field Healthcare CTO at Oracle Cloud. And we're here to have a quick chat on cybersecurity and health care. I'm joined by Waleed Ahmed. He's a leader on the engineering and architecture side of Oracle Cloud. Welcome.

00:00:00:24 - 00:00:00:25
Waleed
Pleasure to be here, Esteban.

00:00:00:26 - 00:00:00:35
Esteban
What's going on in cybersecurity in health care today? We've seen so many headlines. There's a lot going on, very high profile attacks. There's a lot of flack everywhere. What's your take on it?

00:00:00:36 - 00:00:01:01
Waleed
There is there's an incredible amount of scrutiny in understanding what the threat landscape is, and it's becoming more and more prevalent where especially in health care, where it is an opportunity for attackers to lock in and prevent businesses from occurring where it matters the most, especially after the pandemic that we've come out of right now.

00:00:01:01 - 00:00:01:36
Waleed
And it has opened up a great amount of pressure on the organizations to do something about it. And in Oracle Health, what we're doing is we are addressing the situation in a manner of three areas. First of all, is understanding what the threat intelligence is in the platform, understanding threat intelligence and using capabilities from security scientists, and also third party vendors such as CrowdStrike to bring in and assess, assess and interpret what the possible threat areas are.

00:00:01:37 - 00:00:02:07
Waleed
Now, once you've assessed it, you need to be able to continuously monitor and while you're monitoring, being able to immediately detect it. So understanding these two capabilities need to exist in an architecture will allow, you know, security leaders within the health space to take a take a relaxing mode and saying understanding that, yes, I have the intelligence and I also have the constant detection and and and monitoring of our of of our architecture.

00:00:02:08 - 00:00:02:34
Waleed
So those two parts are there now. It's not really complete unless you think about in the event of an attack, how do I allow the business to continue? We cannot stop giving care, especially in a provider space. So in those type of settings, it's a it's a it's a life or death situation. Right. It's being able to provide critical emergent care immediately.

00:00:02:34 - 00:00:02:59
Waleed
Now, to be able to do that, you have to not only think about ransomware resiliency, but you have to think about ransomware recovery. You have to be able to say, not only is my architecture resilient, but in the event I do have a cyber attack, can I allow the business to continue as, as you all know, that a cyber attack, when it happens, there is a crime scene investigation put around it and there has to be scrutiny, investigation.

00:00:03:00 - 00:00:03:30
Waleed
So business can come to a halt. If you were able to address by delivering a clean room and at dynamically through the cloud capabilities of Oracle, rebuild a reliable, uninfected environment and provisioning it at a moment's notice, that's where you deliver a cyber recovery, a true cyber resilience that is able to recover in and with confidence and allow the business to continue.

00:00:03:31 - 00:00:03:43
Waleed
So Oracle is really delivering in three different prongs. It's the ability to detect, the ability to assess, monitor and also provide you provide the capability of of bringing bringing the systems back up.

00:00:03:44 - 00:00:04:03
Esteban
That's crucial, though, whether the rapid recovery so that you can continue operations regardless of what's going on. And what about tiering of the different kinds of systems or clinical non-clinical, things like the EHR, billing? We've heard about things happening around the billing system. We can help with all of those areas.

00:00:04:04 - 00:00:04:15
Waleed
Absolutely. I mean we have front line EHR that delivers into a backend payroll that pays critical resources to deliver the necessary needs.

00:00:04:16 - 00:00:05:04
Waleed
So with that, we we understand and deliver security in depth. That means we will start at where the data resides to secure that all the way out to the edge. So that that in itself is because we run our oracle help platform on oracle cloud infrastructure. Inherently, it delivers security at the data tier all the way up to data in motion and as well providing key capabilities such as web access, firewalls such as, such as cloud strike capability within a cloud guard, and also with the same tool monitoring and detecting issues on the front line too, all the way in the back end where you're having connectivity between provider and payer in that sense.

00:00:05:05 - 00:00:05:23
Esteban
Obviously, we could talk about this for hours and hours. We would love to talk to all of you about this. We are more than happy to have any of those discussions and expand upon them and give you very specific examples. So reach out to your Oracle resources and we can happily get engaged. So again, thank you, Waleed.

00:00:05:24 - 00:00:05:26
Esteban
Thank you all and we look forward to seeing you soon.

00:00:05:26 – 00:00:05:38
Perspectives outro
Be sure to subscribe to Perspectives on Health and Tech podcast. For more insights from industry experts, visit Oracle.com/health or follow Oracle Health on social media. 

Healthcare is ever evolving and new trends and tech capabilities are on the horizon for 2024 and beyond. What should healthcare organizations, clinicians, and patients be prepared for? How might healthcare delivery and operations be impacted? Listen in as two leaders from Oracle and Deloitte Consulting LLP dive in and share their perspectives from industry clouds and AI adoption to burnout, workforce shortages, rising costs, consumerism, and more.  

Featuring:  
Hashim Simjee, Principal, Global Oracle Healthcare Leader, Deloitte Consulting LLP 
Sarah Matt, M.D., MBA, Vice President of Oracle Health Product Strategy 

Hear them talk about: 

• Healthcare organizations adopting industry clouds (1:30) 

• Utilizing AI to improve operations, support caregivers, and make diagnoses (4:32) 

• How AI adoption can help free clinicians' time, improve clinician workflows, and decrease burnout (6:49) 

• A recent JAMA study comparing empathetic responses of physicians and chatbots and how AI, augmentation, and telemedicine could help offload clinician workload and address workforce shortages (9:02) 

• Consumerization of patient care and how tech can help (11:23) 

• Interoperability, and accurate and accessible patient data's potential to influence health outcomes for populations disproportionately affected by social determinants of health (14:15)  

• How to make use of IoT with data from wearables and hospital at home (16:54) 

• How tech innovation can make a difference in healthcare's biggest challenges this year (18:05) 

Notable quotes: 

"You can't replace the bedside manner, you can't replace the empathy for a clinician, but you can replace the components around pulling together information and coming back with a reasonable diagnostic that can be done and that has to be reasonable and validated."  – Hashim Simjee 

"So what we're really looking at is, as we think about AI and access—we really want to start to think about equitable access and using technology to drive easier access for consumers." - Hashim Simjee 

 

Learn more about how Oracle is connecting healthcare with cloud capabilities through products and solutions. 

Watch on-demand and live webcasts by registering for Oracle Health Inside Access. 

Check out Deloitte's 2024 Global Health Care Sector Outlook. 

---------------------------------------------------------

Episode Transcript:

     

00;00;00;11 - 00;00;23;18 
Sarah Matt 
You're listening to Perspectives on Health and Tech, a podcast by Oracle with conversations about connecting people, data and technology to help improve health for everyone. We're at the start of another new year, and I can't help but be curious about what's coming in the health care industry in 2024 and beyond. More specifically, the tech capabilities and trends that are ramping up to support health care delivery and operations. 

00;00;23;29 - 00;00;42;20 
Sarah 
Now, Deloitte published a 2020 for Global Health Care Sector Outlook report that shared several key trends that are anticipated to make quite a splash in the future of health care delivery. And I'm excited to dive in and hear more. So with that, I'll introduce our guest speaker with us today, Hashim Simjee. Hashim, introduce yourself a little bit. 

00;00;43;26 - 00;01;04;19 
Hashim 
Thanks, Dr. Matt. Great to be here with you. The way to help your practice, primarily focusing on technology and health in the intersection of health care. And I'm responsible for our global Oracle health care practice, including clinical plan analytics, HRA, HCM, ERP. So happy to be here with you today. 

00;01;05;03 - 00;01;23;05 
Sarah 
Nice. We're happy to have you. You know, in our last podcast, we discussed cloud tech for health care. And looking at this year's health care predictions, I was really excited to see that in a recent report published by the International Data Corp.. So I see that 70% of health care organizations are going to adopt industry clouds by 2025. 

Can you share with us a little bit about the emerging technology prediction and how it aligns with the Deloitte's 2024 outlook? 

00;01;29;18 - 00;01;58;08 
Hashim 
Yeah, it aligns very nicely with that. We expect to see AI cloud interoperability as kind of huge, huge upturns in the market with air driving potential savings of $300 billion through 2026 relative to the broader market and think that cloud is going to continue to drive adoption and continue to drive efficiency in the market as well as help to improve access and equity as well. 

00;01;59;16 - 00;02;21;06 
Sarah 
So you know, when I think about AI, just in the last year, we've had such a huge exponential increase in visibility use cases, you name it. You know, it was maybe last spring when chatbots really just kind of blew it out of the water. We think about AI to improve operations or support caregivers or do diagnostics, you know, Hash, where do you think it's really going to touch us the most? 

00;02;24;25 - 00;03;15;29 
Hashim 
So we see it in a few major areas right in. But think about it. It's really streamlining of administrative tasks, improving overall quality of care. Again, you mentioned access to expanding access to care and really around helping clinicians spend more time with patients. So looking at next-best outcomes, suggesting outcomes, looking at case histories and really being able to consolidate test results and whatnot and allow the physician to spend less time inputing all that information together where the clinician can pull all that information together, allowing for admin tasks such as clinical inventory, or to be able to say, you know what the stock levels are and using algorithmic components to really be able to drive that improving quality of care, really looking at time cost to outcomes, to being able to say, you know what the optimal procedure or so on and what location, as an example, to say, how do we pull some of that together and using all of that information that reside in the facilities today and being able to do that much more automated fashion in in a predictive fashion. And so we think those are probably going to be some of the biggest or option these out there that are going to help.  

00;03;48;03 - 00;04;20;09 
Sarah 
That's very interesting. Let's dig in a little bit. You know, IDC also shared some interesting stats around AI and Jenny AI and they estimated that 60% of health care organizations will see a 60% increase in AI solution adoption by 2025. And by that time, just like you mentioned, clinicians, time will free up 15% due to Gen AI. So these are pretty incredible stats considering health care organizations have realized the difficulties of rising costs and they're really trying to improve care, quality and clinician satisfaction. So when we think about improving clinician workflows, quality of life for providers, decreasing burnout. What are your thoughts on how we can really make an impact There. 

0;04;33;28 - 00;05;05;26 
Hashim 
Prior in the conversation, Sara, you're going to kill me for this is, you know, one of the one of the thoughts that I've had over the years and I've had this discussion with physician friends is physicians are really an amalgamation of a lot of data. So they are, you know, one of your quintessential as you can't replace the bedside manner, you can't replace the empathy for a clinician that you can replace the components around pulling together information and coming up with a reasonable diagnostic that can be done and that has to be verified and validated. 

00;05;06;08 - 00;05;26;08 
Hashim 
And so as I think about it, how do you free up the time for them to be able to pull that information together, being able to utilize that time to spend time with the patient and then being able to be much more in the moment with the patient and not have to do all of the routine things that they historically had to do around filling out notes, filling out paperwork. 

00;05;26;20 - 00;05;42;17 
Hashim 
How do you use ambient listening to be able to support that and do some of the other tools that are already in the market or coming to market to better describe the position on the clinician experience and then improve the overall patient experience. 

00;05;43;21 - 00;06;09;21 
Sarah 
So when it comes to decreasing paperwork as a provider, I am all for that. No problem. When it comes to helping you with diagnosis. Again, I'm not that concerned about that because we've been using clinical decision support tools for 100 years, whether it's a rules-based engine, whether it's a third party bringing in crisp data. I mean, just prescribing medications, especially in pediatrics, can be really difficult if you're just trying to do it off the top of your head. 

00;06;10;04 - 00;06;39;16 
Sarah 
I think where I'm the most concerned is really about the bedside care and the empathy piece. There was a recent JAMA article that was from last year that compared ChatGPT both on its ability to make diagnostic kind of inquiries and answer medical questions. It did great on that. Okay, no problem. Not surprised. But then it also showed that the answers it was giving were more empathetic than providers. Now that makes me a little anxious. What do you think about the empathy gap and how AI could cross that chasm at some point, and perhaps I'm going to be replaced? 

00;06;51;22 - 00;07;14;08 
Hashim 
I think, you know, I think the diagnostic element, you're spot on, right? I mean, we to your point, we have been using WebMD or whatnot for well over a decade in your self-diagnosing and now actually putting it into a clinical setting is interesting and important where I think the empathy gap is big cross. 

00;07;14;13 - 00;07;53;08 
Hashim 
I think the models are we're training the models to be empathetic and to actually listen. And I think part of it is the clinicians are so overwhelmed with so much when you look at what we had to do with COVID, where the decrease in the number of clinicians who are actually available to support the run through the need for more primary care physicians and whatnot, I think is as a interim step in that is going to be important because then you can start having the clinicians be in the spots we need done and then use at the more general questions and care and still have patients feel like they're being closed and then having that information recorded in in the notes and then using those notes to then further inform the clinician, you know, becomes that virtual loop that you want. 

00;08;02;16 - 00;08;27;06 
Sarah 
So I'm wondering if there might be additional ways to help with burnout, because when we think about this empathetic response from AI, now Dr. Matt, the surgeon, when I was working hundreds of hours a week, I admit I was a little cranky. I admit maybe I was living on Rock Star Energy drink and in a dream. But he doesn't get tired and doesn't get hangry. 

00;08;27;10 - 00;09;01;15 
Sarah
Dr. Matt absolutely does. So I'm wondering if I can offer clinicians, perhaps the rest that they need or the time for clinicians to offload some of those smaller tasks, again, that are patient centric, but perhaps the doctors need to do themselves. So I'm interested to see how we start utilizing either a AI-augmented telemed or other ways of doing it, not just for doctors, but for nurses, for other health care workers, or any of the workers, for that matter, within a health care system. How do you think this might address workforce shortages? 

00;09;05;00 - 00;09;35;03 
Hashim 
100%, last year at CVS one of the companies introduced a sensor for the toilet where you can actually pee and it would measure 300 metabolites. This year. There was another century introduced that was looking at breathing and kind of being able to look at what was coming from an oxygen intake standpoint. We look at being able to look at what's on your wrist from a whether it's a Garmin or an Apple or whatnot. 

00;09;35;03 - 00;09;56;26 
Hashim 
I mean those are those are devices that are starting to bring together information like nothing else. And all of a sudden you don't need to go to a lab, you don't need to go do different things. You can start pulling all that information together into clinical records and being able to then start offering diagnoses that presentation time, but also present clinician time and frees up lab time. 

00;09;56;26 - 00;10;22;08 
Hashim 
It frees up lots of other things when we're actually starting to have these devices embedded within the home in the air, I can start our models can start looking at consuming that data, especially in our models and coming up with a health record that you will never have access to and a much more complete health record. So from that standpoint, I think getting noticed in patient history and all of that becomes a background task which then allows for the commission to have significantly more time. 

00;10;23;26 - 00;10;51;14 
Sarah 
So when we think about the patient, we're truly consumers now. And I think that COVID-19, you know, it was a mass trauma for all of us, but it made patients really think about what they want for health care, whether that's comparing prices, self-selecting where they want to go, go get care, especially in the United States. But we think about the patient as a true consumer and we think about some of these nontraditional care models and the importance of patient convenience. 

00;10;51;25 - 00;11;24;13 
Sarah 
You know, I'm seeing a lot of focus really on how can we move things to different venues, whether that's my favorite truck that comes to my house every day with my packages not to be named, or if it's getting my care within a retail organization like a Costco or CVS or whatnot. You know, when we think about how this consumerization of patient care is really not just at the forefront, but it's now, what are your thoughts on how either I can help their patients and tech can help their what is Deloitte think. 

00;11;25;07 - 00;11;57;00 
Hashim 
So that aligns with our future of healthcare already. So we've seen a shift. And to your point, we don't we don't see them as patients anymore. We see them as consumers in healthcare. And much like anything else, they're looking at the lowest price for the best quality, just like you would with your favorite retailer online. What do you have the ability to start comparing now with price transparency in the US, you're starting to see the ability for a patient to go across multiple hospitals for elective procedures and say, Where am I going to get the best price? 

00;11;57;10 - 00;12;23;03 
Hashim 
Understanding the quality of care now that that needs a little bit more elucidation or elimination relative to quality of care versus price. But beyond that, you know, we're starting to see even states with Medicare being able to go out and start doing competitive bids. Now for the first time, Florida recently, as of I think two weeks ago, said they were going to start looking at importing drugs from Canada. 

00;12;23;14 - 00;12;50;25 
Hashim 
It was an article out today, I think, in the Journal or New York Times that said Ozempic is about 75% cheaper in Mexico and it is in the States. And so we continue to see kind of this massive proliferation of information and data that's coming out for services that are extremely useful for people. And from a retail perspective, you know, whether you Google or whatever other search engine we're using to go start shopping, we're going to see that significant through July here. 

00;12;51;08 - 00;13;21;14 
Hashim 
And it's going to be incumbent on providers to be able to say what differentiates me in the market as a quality of care, as a service, and what is it not offering multiple versions of service. The other thing that we're we've seen significant rise in is medical tourism for elective procedures. That there's a funny name that I recently saw around the backside of a of plane and there's a bunch of guys coming back from Turkey who are being managed up in the Carolinas, essentially said that they were all returning from heart transplants. 

00;13;22;05 - 00;13;39;01 
Hashim 
Right. And we're starting to see a lot more of them across the globe going for dental work in India or going to Southeast Asia for some of the medical care. It's a lot cheaper and doing a four-star resort than actually having a full service down here in the States. 

00;13;40;10 - 00;13;59;22 
Sarah 
When we think about getting care, whether it's in another country or even just in a different town or just down the street. You know, we're really speaking about the necessity of accurate and accessible patient data and interoperability is really another hot topic in which we've made great strides as an industry, but we still have a really long way to go. 

00;14;00;02 - 00;14;14;08 
Sarah 
So I know Deloitte highlights that committing to information sharing has the potential to influence health outcomes for populations disproportionately affected by social determinants of health in particular. Can you kind of expand on this and what you folks have mentioned in the outlook. 

00;14;16;01 - 00;14;45;08 
Hashim 
What we're really looking at is, you know, as we think about A.I. and access and just more generally where we see it as, you know, we really want to really start to think about equitable access and using technology to drive easier access for folks, for consumers. And as costs are continuing to drive higher, how do you continue to manage the access point on that? 

00;14;45;28 - 00;15;16;29 
Hashim 
Everybody's got a phone, right? Being able to automate a lot of the tasks that are on that are on a common device that everybody has is really helping. So access is really linked back to or portability is really going back to access. So how do you continue to drive access to information? Use your access to your point around telemedicine and the ability to get care in than during COVID, a lot of rules were suspended specifically around licensing across state. 

00;15;17;13 - 00;15;43;07 
Hashim 
We've seen a lot of mobility for workforce that people don't want to go back, people don't want to move back to where they were and their physicians didn't move in. They were still getting the same level of care, if not improved care, because it was easier to get telemedicine from that standpoint. So we continue to see we continue to see access to being able to afford being able to drive that, especially as the costs continue to drive up. 

00;15;43;07 - 00;15;47 
Hashim 
And then we're expecting to see the costs in inequality rise to well over $1 trillion. 

00;15;48 
Sarah 
That's a ton of money. I don't even know how to fathom that much, to be honest. You know, it's interesting when I think about some of the ways folks have been trying to take care of themselves with or without their doctor. And a lot of the new modern wearables are a very interesting example of that. I remember just a few years ago, having been in this industry for a long time, doctors were very hesitant to bring all that data into the electronic medical record because it was overwhelming at the time and there weren't really great ways to show it was, you know, out of normal to make sure that the right people were notified. 

00;16;28 
Sarah 
But I'm really thinking that with more advances in the AI, disability for wearables, which before were okay, now, even with the same data, I feel like we can do a lot more. What are your thoughts on wearables and more of the hospital at home and other ways of bringing patients, not to a doctor's office, but keeping them in their homes and utilizing more IoT? 

00;16;54 
Hashim 
So to me, it's where it's where the industry is headed, especially with labor shortages. And I mentioned this earlier with regards to whether it's Garmin or an Apple named in favor of product, that the amount of data that those devices are capturing is incredible and the ability to actually get a full view of the patient is much easier now for a position than before. 

00;17;19 
Hashim 
When you took patient history, natural poor technician often admitted they were eating all these sweets or they didn't do their work out or whatnot. But you can't hide from the Apple Watch that's counting your steps or the glucometer that's automatically measuring your blood glucose level every 30 seconds or so, and that you can scan at any time and get that from your Bluetooth. 

00;17;44 
Hashim 
And from that standpoint, it's I think it's a much better position because now you can actually make informed decisions, versus in the past where it was you were getting 50% of the information from the patient. And these devices have come down in cost and significantly cheaper to obtain an available library everywhere, frankly. 

00;18;05 
Sarah 
Well, I know we're almost out of time, Hash. So fast and furious. Let's think to what your predictions are for the next year. What do you think are healthcare's biggest challenges and how is tech innovation really moving the meter? Give me two examples. 

00;18;20 
Hashim 
I think Staffing and the ability to support staffing is going to be huge. We've seen inflation coming down and cost of care is continuing to still hold steady. If not, why so? And staffing is going to play a huge part in that. And then the other big challenge is continuing to access and how do you make the information more accessible to consumers to improve the overall patient experience. 

00;18;45 
Sarah 
All right, I'll take it. Well, Hash, thank you so much for joining us today from Deloitte. It has been an absolutely wonderful discussion. 

00;18;55 
Hashim 
Thank you. This is great. Really appreciate the time talking you as well. 

00;18;58 
Sarah 
Be sure to subscribe to Perspectives on Health and Tech podcast. For more insights from industry experts, visit Oracle Dotcom Slash Health or follow Oracle Health on social media. 

It's no secret: healthcare systems are overburdened—could cloud capabilities really provide some of the needed reprieve? Could the right data presented at the right time reduce costs and improve operations, ease the administrative burden on clinicians and payers, and help improve the patient experience? Two experts discuss use cases on cloud-enabled intuitive assistance, streamlining and vetting data, how cloud-enabled technologies are benefiting the whole patient experience, and more.

Featuring:  
Michelle Flemmings, M.D., industry executive director, Healthcare North America Cloud Infrastructure 

Sarah Matt, M.D., vice president of Oracle Health product strategy

Hear them talk about:  
•    What's going on in the healthcare industry right now (0:24)

•    Using cloud and other technologies to improve workplace experience and retain healthcare workers (1:15)

•    Challenges and concerns when moving from rules-based applications and tools to more predictive forecasting and AI (2:54)

•    Working with clients going through the transition of bringing together disparate data sources separated by geography, organization, privacy, and security (4:27)

•    Harnessing cloud capabilities for clinical trials (7:24)

•    How to build trust around privacy and security for cloud and AI—and how cloud can be a secure mechanism to bring forth that trust (10:05)

•    Opportunities in leveraging the cloud for healthcare (14:24)

Notable quotes:  

"I think that cloud has a great availability of information, but it also has the functionality whereby it can hopefully look at the system overall, if it's dialed in right, and then predict what's necessary and then take out the rest of the chaos. You know, taking in the signal and taking out the noise." – Michelle Flemmings

"Now with the potential of AI using thoughtful implementation to support our providers from burnout, empower our patients to lead their healthcare teams, make those right decisions using trusted information that's fit for purpose, it changes the entire landscape." – Michelle Flemmings

"We need to make certain that we're not replacing that trust that has been in the provider relationships so long and then got compromised when we did start going digital. There's an opportunity here to rebuild that, and magnify that, and still broaden our ability to care for more patients." – Michelle Flemmings

Learn more about how Oracle is connecting healthcare with cloud capabilities through products and solutions.

Watch on-demand and live webcasts by registering for Oracle Health Inside Access.

--------------------------------------------------------

Episode Transcript:

00:00:00 Dr. Sarah Matt
You're listening to Perspectives on Health and Tech, a podcast by Oracle where we have conversations on creating a connected healthcare world where everyone thrives. I'm Dr. Sarah Matt. I'm the VP of Oracle Health product strategy. And with me today, I have Dr. Michelle Flemmings from our OCI team. So, Michelle, I know we've been hearing a lot about cloud capabilities for healthcare. Can you get us a bit of an overview of what's really going on in the industry right now?

00:00:24 Dr. Michelle Flemmings
Well, Sarah, thank you for that question. I have had the pleasure of meeting with a lot of our clients and being at several events recently and top of mind is cost containment especially with the economy as it is, and the cost continuing to rise. Second, a very close second, is achieving and maintaining operational efficiency that will help support that cost containment.

00:00:44
Things around process improvement, throughput, driving patient outcomes, improving quality performance as well. And then I think, honestly, the one that really surprised me the most is road mapping around the implementation of AI and wanting to establish the right partnerships in order to know that they're doing it in the right way.

00:01:03 
You know, in a race not to be last, they got to be they're busy road mapping but they also have to assess the readiness for change. And I think that's where I'm having the best conversations.

00:01:15 Sarah Matt
Interesting. So we talk about cost containment as a start. I know that over the last couple of years, especially when COVID hit, we had huge issues with not just supply chain but the supply of our workers.
So we think about utilizing cloud and some of our technologies to improve not only the experience of our workers, but how do you keep and retain them? What have you seen as really effective mechanisms, especially in healthcare?

00:01:37 Michelle Flemmings
Oh goodness, that is a double-edged sword. Having worked with a lot of systems and in a lot of digital tools that support our care of patients, you have to be careful in the balance. You don't want to be very disruptive in the way of inset and alerts, but you also don't want to overload with minutia and tab hopping and logins and so forth.

00:02:01 
Where the sweet spot is is intuitive assistance and uplift for productivity as well as insight speaking specifically around things such as items that occur in the background. So I'm seeing a patient, they know that this patient has a hip fracture and automatically, based on the fact that the patient weighed 125 pounds and is, you know, five-feet-three, this patient will need this size of prosthesis and it automatically taps out two supply chain to identify the location and availability. Those sorts of items that are intuitive and in the background and I don't have to touch another tab are important.

00:02:38 
Additionally, clinical decision support—the right information at the right time that doesn't disrupt my brain processes and my thoughts, because anytime a provider is interrupted, an opportunity for omission and errors.

00:02:54 Sarah Matt
So I know when I see patients—I still do charity care on the side—it is a very difficult job for all providers to keep up with the latest and the greatest when it comes to new literature, new guidelines, and that most hospital systems are doing whatever they can within the application space, whether it's their electronic medical record or otherwise, to assist with some of those areas.

00:03:15 
When we think about moving from rules-based applications and tools to more predictive forecasting and AI, what do you think are some of the challenges and concerns that health organizations really need to think about?

00:03:31 Michelle Flemmings
Wow. Overload of information we have that now we need to prevent it. Especially when you start doing predictive. If we're going to do that, we need to be very dialed in on our resources, our sources of information and eliminate duplication. As well, make certain that it's not just raw data that you're bringing in, and then you leave it to be sorted by the individual.

00:03:54 
So any ability to bring in items that are useful that are already vetted somewhere in the system and provide the right-size solution is going to be key. It can't just be everything that you bring in. I think that cloud has a great availability of information, but it also has the functionality whereby it can hopefully look at the system overall, if it's dialed in right, and then predict what's necessary and then take out the rest of the chaos. You know, taking in the signal and taking out the noise.

00:04:27 Sarah Matt
When we think about large healthcare organizations or even small healthcare organizations, especially United States, cloud is becoming a lot more necessary, if you will, because we're moving from a lot of extremely siloed on-prem installations of whatever it might be into an extremely connected environment and the HIEs of the past and the present may not give you enough of what you're looking for from a connectivity perspective. What I'm seeing a lot, and I'm wondering what your thought process is, is that payers, providers, even pharma, are all moving to systems where they're actually utilizing PaaS (Platform as a Service) to bring together some of those disparate pieces, whether it's in a data lake, a data lake house, whatever you want to call it. But they have so many different systems that are either separated by geography, separated by organization and separated by privacy and security, and they're trying to figure out the best ways to bring that disparate data together. How are you assisting some of those clients that you've been seeing in moving through that transition?

00:05:27 Michelle Flemmings
Absolutely. We start with, for lack of a better word, an audit of their inventory. What do they have? What do they utilize and where does it sit? How is it connected? Is it connected in a manner that works for you now? If so, great, we won't mess with that. But if it's not connected and you need to go ahead and log into something else or open up another platform, that doesn't work.

00:04:49 
What we then go to is examine and evaluate in partnership with our clients. What else are you trying to achieve? What are the near misses that you have now that you're experiencing and are frustrated or struggling to capture? And what is your Nirvana?

00:06:06 
And then we make a path with them from those starting from that basis. It needs to be end-to-end, is honestly where I think that we need to take our clients and go with them for success. It needs to be everything that starts with the patient walking in the door. In the case of the provider and how do we do dispositions that makes sense and prevent readmission.

00:06:26 
In the case of payer, how do we get the first-time right rate for claim submission, but then also put automations that are thoughtful, meaningful, and impactful in that the prior authorization process and in the payment process. How do we help them to remove the, now primarily retrospective, review of claims for potential fraud, bring it into more contemporaneous—then in cases where possible, how do we bring it to being anticipatory? So we're identifying patterns that would be consistent with possible fraud? 

00:06:58 
And then for patients, how do we help our clients to provide for patients a whole health patient experience that empowers them with the right tools, helps them make the right decisions for themselves and help them to guide their care team to support those decisions so that they can have their best outcomes and they can live their lives and return back to life, as opposed to being sick and in the hospital?

00:07:24 Sarah Matt
You just mentioned a number of really interesting use cases. I think the most important thing I found is that every institution has to decide what is their priority, what is the most important use case they're going to focus on, because if they're focused on clinical trial access as opposed to retain providers or leveraging the cloud for patient insights, that would start perhaps in a different department with different data elements, etc.

00:07:49 
You know when you think about kind of the cloud capabilities making a huge difference for some of these areas, let's pick on clinical trial access for a second. You know, what are some really interesting ways you've seen folks really harness the cloud for those capabilities?

00:08:04 Michelle Flemmings
That's a great question. As a physician, my personal experience was that you can't know everything, and things change so much in that capability. So we have to be cognizant of the volume of data, but also the need to remember that these things exist and that's very difficult, especially when you're dealing with large numbers of patients and you have a huge workload.

00:08:30 
I believe, and there are ways of bringing in that information as the patient goes through the journey. My sister had breast cancer; ended up with bilateral mastectomy. The last thing on her mind when she was in the hospital was anything about clinical trials. She was so concerned about the possibility of passing away while in the hospital. I think it would be very important to, before she even gets admitted, we know when she's coming in, let's start putting out some of the information about clinical trials to our patients with instructions and opportunities to speak with a nurse navigator or physician to walk through the process. Let them know what's available when their mind is able to be settled and concentrate on this. Give them expectations for when they're in the hospital about helping to make some of these decisions and maybe even starting care while they're in that hospitalization, to not delay any further treatment.

00:09:24 
With the use of items such as conversational Gen AI, rather you could give instructions and more education, preparing them for the conversations in the hospital. As well, I think giving them some insights about what the capabilities are, even in a broader expanse than just their facility, maybe they through referral or maybe they through alternative care options bringing that technology to the patient is something I think that they deserve in a manner that meets them where they are. For their level of their level of understanding, but also gives them the opportunity then to connect back with their trusted source of care for questions.

00:10:05 Sarah Matt
In the healthcare space we have done a lot of things maybe not so great over the many decades and hundreds of years that have led up to today, and many groups are still leery of the healthcare system. Add on to that a layer of technology and AI that most people cannot even begin to grasp. Understand because it's kind of a black box in a lot of ways. 

00:10:27 
How do you think folks are thinking about cloud technology and AI? I know there's still lots of concerns about privacy and security. You know, when you think about those areas and how we can assist in building that trust, what are your thoughts on how cloud can actually be a secure mechanism to bring forth that trust?

00:10:47 Michelle Flemmings
First off, I think that we need to put more information out in the places where our patients and future patients are looking at data now. We need to make certain that the right information is out there on the most popular websites where people do their searches before coming into the hospital and then change their perspective. We need to talk about the security. We need to let them know that their information isn't going to end up on some social media channel or and also portray to them and let them know that we are deserving of their trust because we do this very well in other industries, especially in the financial industry with regard to security. I think that's first and foremost.

00:11:26 
We also, though importantly need to build the trust of the providers. There are several that are in fear of their jobs disappearing because they'll be replaced by the machine.

00:11:36 
Our patients sometimes believe that the machine is going to have some sort of a decision-making mode that is going to tell the physician you know I'm no longer worth taking care of. I'm a dead-end so no longer give any time to my care and instead devote your time to someone else.

00:11:54 
So starting with the right information about the security, especially your personal health information, securing and demonstrating capabilities along with the health information exchanges and platforms.
Pulling in that information into portals, driving patients to that portal with trust at the provider level and at the individual organizational level is going to be important as well because a lot of folks, it's going to be seeing and feeling and experiencing that's going to build the trust.

00:12:25 Sarah Matt
That's a great thought process there, Dr. Flemings. I know this has been a really interesting conversation. I want to ask one more question. Let's end this one on a positive note. So when we look forward, what are the opportunities that you're the most excited about in leveraging the cloud for healthcare?

00:12:41 Michelle Flemmings
Oh, wow. Oh, wow. Yeah, shame this is the last one. Truth is, I am most excited about all things AI. I am a child of the 60s. And for me, I remember when I had my first little calculator—I thought that was mind-blowing.

00:12:57
Now with the potential of AI using thoughtful implementation to support our providers from burnout, empower our patients to lead their healthcare teams, make those right decisions using trusted information that's fit for purpose, it changes the entire landscape.

00:13:15
Honestly, I do believe, especially when you talk about productivity and augmentation of workforce, that has to be top of mind. How do we put that into our workflow so that it helps and doesn't hinder and that it also doesn't overload with extra information?

00:13:32
I think that is really where it lies. Maybe it also considered tapping some of the information that's in pre-hospital systems. I believe as an ER physician that the bedside is where the care starts and that sometimes that bed side happens to be at the roadside. We need to use AI and our capabilities to bring in that information because sometimes that is key to decision-making for the physicians.

00:13:54 
Also, I live in a very, very rural area in southwest Colorado. I think that GenAI and virtual care should go hand in hand and that we can help better support our patients who live in areas distant from hospitals, especially at smaller hospitals that's closed—extend that care, improve outcomes, maybe bridge some of the gaps between healthcare and retail sources that are trying to now invest in healthcare. Make it better, fortify it with some clinical expertise from some of our organizations, but utilize the infrastructure that's already in place, maybe, especially if you want to consider this: primary care and behavioral health. I think we can make huge inroads in those and provide care, right where people live.

00:14:40 Sarah Matt
I can't agree with you more. I think for me, I feel like we're really at the precipice. We have so many tools that are at our disposal. The data is now becoming more clear. How can we bring things together and effective means throughout healthcare organizations to really gain that value. I think over the last decade or so, we've been inching along from a digital perspective, inching along, we'll say, journey to AI. Here we are, I think now every healthcare organization is going to have to decide how they want to interact with it, how they're going to prioritize it and how we're going to keep the focus on the patient.

00:15:17 Michelle Flemmings    
Totally. In closing, with focus on the patient, I would offer two recommendations. When it comes to AI, I believe that going slowly is actually going quickly. We need to be iterative like you said, about where we go and how we institute and how we implement, because sometimes those small and impactful wins will build the security and the belief in the system for the overall organization and also drive that to our patient.

00:15:46
Second, I think that we need to make certain about that, keeping the human in healthcare, in all portions of healthcare. We need to make certain that we're not replacing that trust that has been in the provider relationships so long and then got compromised when we did start going digital. There's an opportunity here to rebuild that, and magnify that, and still broaden our ability to care for more patients.

00:16:11 Sarah Matt
Doctor Flemings, thank you so much for joining us today.

00:16:14 Michelle Flemmings
Thank you, Sarah. It was my pleasure.

00:16:16 Sarah Matt
Thank you all for joining us on this very exciting podcast discussion. Please be sure to subscribe to Perspectives on Health and Tech podcast for more insights from industry experts, visit oracle.com/health or follow Oracle Health on social media.

Mental health remains a significant area of concern in healthcare, especially after the pandemic. Universal screening tools, such as suicide risk assessment, have become a vital resource. One of the best ways to normalize mental health screening is by integrating it into your clinical electronic health record (EHR) workflow. However, with the influx in risk assessments, is your staff confident and prepared to handle the needs that arise? And does your organization have the infrastructure required to support those needs?

While telehealth has alleviated part of the burden for providers, it has also exposed many ways technology can create barriers to care, especially for communities who are already at a disproportionate risk for suicide and addiction. So, how can we better coordinate care across the illness-wellness continuum? Join Danny Gladden and Dr. Sarah Matt as they discuss the progress and opportunities to support mental health and improve suicide prevention.

Guests:

Danny Gladden, director of behavioral health and social care, Oracle Health

Dr. Sarah Matt, vice president of product strategy, Oracle Health

Hear them talk about:

• Education and training for physicians regarding suicide assessment and prevention treatment (2:00)
• Suicide screening assessments and lack of staff resourcing and infrastructure to meet those needs (4:15)
• Crisis intervention training for first responders and the increased availability of mental health first aid (11:15)
• Telehealth doesn't solve access to care issues—there's still a gap in equity and barriers to care (13:00)
• Benefits of behavioral health data collected on digital record (15:15)
• Moving toward a consumer-focused patient experience (17:20)
• Suicide prevention resources (19:18)

Learn more about Oracle Inpatient and Outpatient Behavioral Health solutions

---------------------------------------------------------

Episode Transcript:

00;00;00;00 - 00;00;30;09

Danny Gladden:

You're listening to Perspectives on Health and Tech, a podcast by Oracle, where we have conversations on creating a connected healthcare world where everyone thrives. Hi there. I'm Danny Gladden, clinical social worker, director of behavioral health and social care here for Oracle. Dr. Matt, so glad you are here.

Dr. Sarah Matt:

Thank you, Danny. I'm so excited. You know, when it comes to suicide prevention, I think there's so many problems that we could talk about, but I think there's also solutions and things we can do next.

 

00;00;30;16 - 00;01;06;28

Danny:

So I'm excited that we're talking about this topic today. Yeah. And, you know, I think we've made some great progress. And I say we as the collective, we myself, I'm a clinical social worker that practices in mental health services. I've actually ran one of the National Suicide prevention lifelines, but suicide prevention takes all of us. And so, you know, I'm actually just curious, you know, you're a physician—think about your preparation into sort of medical school and residency.

 

00;01;06;28 - 00;01;26;15

And you know what does what did your preparation look like as a physician assessing for and treating suicide risk?

Sarah:

So I went to med school a long time ago, I will say, But when it comes to training, it was very traditional. So four years of med school. And then I did my residency in general surgery and my fellowship in Burns.

 

00;01;26;17 - 00;01;56;05

So I'd say that when you think about structured learning for mental illness, it was pretty scared. Most of it was around inpatient mental health services. So that's the rotations that we did in medical school. Now there was the small bits and pieces you may have gotten on your primary care rotation, but it really wasn't a focus. Now today are unclear how the clinical rotations are going and how the medical schools have changed their training.

 

00;01;56;12 - 00;02;19;17

But I would say that for the generations of doctors that are in my age category, it definitely wasn't something that was highly stressed.

Danny:

Yeah, you know, in the last couple of years, I get invited from time to time to come in and speak to first or second year medical students, particularly on the subject of suicide assessment, suicide prevention, collaborative safety planning.

 

00;02;19;17 - 00;02;58;19

And I, I think that structurally we've come a long way in normalizing the assessment of suicide risk. We have built it into much of our clinical workflows. The Joint Commission has guidance on how on how we assess for suicide risk. But I think even maybe where there is some competence that's been gained, there's still a gap in competence, particularly because of our own fears around, oh, if I ask someone about their suicide risk, what will I do with the information they provide me?

 

00;02;58;19 - 00;03;28;02

And particularly I think about our community access hospitals it at 2 a.m. who are sort of dealing with folks with limited resources, limited specialty consultations and whatnot. And so we celebrate universal screening tools such as the Columbia Suicide severity rating scale or many other really great evidence based, validated tools. But I know that we have a long, a long way to go.

 

00;03;28;02 - 00;03;54;21

And so as we think about September Suicide Prevention Awareness Month, we think about the physicians and the nurses and those and quality and compliance who are working to manage risk within a within a hospital health system. What are you seeing best practices from a technology perspective in how folks are leveraging technology to assess for and prevent suicide?

 

00;03;54;24 - 00;04;18;18

Sarah:

So it's hard to say best practices because I think we can still do a lot better. A lot of times everyone at the administrative level of a hospital system recognizes the importance from a regulatory perspective, from a compliance perspective for universal screening for suicide. And a lot of times this kind of shows up as an extra forum for the nursing staff on intake and things like that.

 

00;04;18;20 - 00;04;37;14

I think some of the things that are missing are the why and the importance. And so in a system where nurses, doctors and all the rest of the staff are highly strained, sometimes it's difficult to do another form. The other thing I had mentioned is that a lot of times this burden is put again on medical assistance and nurses.

 

00;04;37;21 - 00;05;02;21

The providers rarely do these screens themselves, and I think that oftentimes they might not know exactly what the screening is or how useful it can be. So for their patients, where they may have a potential and or a diagnosis to have some sort of depression, anxiety, etc., there's things that they can use. There's tools that are available and they may not have all of those at their disposal.

 

00;05;02;23 - 00;05;57;11

Danny:

Yeah, again, back to the community access hospital or the Alaska village that's using a health aide, for example. I think about that 2:00 in the morning assessment that the sort of mandatory requirement in policy to assess for suicide risk and the patient sort of reporting some level of suicidal thoughts and the provider, the nurse, the health aide in Nome, Alaska, wanting desiring to do what's best to keep the patient safe, but also have limited resources to be able to, you know, get that get that individual true specialty care.

 

00;05;57;13 - 00;06;47;01

And so, you know, celebrate universal screening. But also worry about actual the what happens on the other side of a positive screening. Is it possible that we are unintentionally over hospitalizing folks with the best of intentions or over incarcerating folks with the best of intentions to keep to keep patients safe and to keep the community safe because of lack of available responsiveness from trained mental health professionals who can a dig deeper into assess, assessing and understanding is there a true lethality risk or is this someone who has what we might call morbid ideation?

 

00;06;47;01 - 00;07;18;00

You know, if I didn't wake up tomorrow, that would be okay. But no, I'm not actually going to hurt myself. And then also the ability to build collaborative safety plans. Right. We don't get to draw blood or run an X-ray to know someone's risk, right? We get to ask a bunch of really intrusive questions and then the intervention is not is not often, particularly for suicide risk, medication in real time or a cast or another medical device.

 

00;07;18;02 - 00;07;47;26

It is a really intense creation of a collaborative safety plan that's a usable tool for the for the patient to leave the hospital to help them recognize their own triggers and to help them utilize their own resources, their own social network, for example, to mitigate that risk. And so I celebrate universal screening and I worry about the infrastructure that's behind it.

 

00;07;47;26 - 00;08;21;23

And let's just say, Dr. Matt, the you know, someone does have a risk of suicide or other psychiatric disorders that need to be treated. We have an infrastructure that doesn't have enough available beds and that folks often get housed in emergency departments, get housed in municipal jail cells. At times they get housed in med surge out of a desire to keep them safe.

 

00;08;21;23 - 00;08;42;24

Sarah:

I'm curious what thoughts you have kind of on the current state of mental health delivery. So I think that, you know, as we go past universal screening, we've just screened all these people, just like you mentioned. Now, what is the problem? And I think you're right. In a lot of environments, everything from primary care to pre-hospital to inpatient.

 

00;08;42;26 - 00;09;06;07

The next step is the hard part is the hard part for the patient who may need extensive therapeutics as well as medication. But from a provider perspective, what do you do next? If you are in a small rural hospital, you may not have access to a psychiatrist in the middle of the night. It might be that that personally comes every couple of days.

 

00;09;06;07 - 00;09;24;12

It might be that you do a televisit in the morning. What do you do for that patient in the meantime? And you may not have a lot of options. So I think you're stuck in a lot of ways. If you're in a primary care environment and you have a patient that has immediate needs, what are you going to do?

 

00;09;24;12 - 00;09;49;27

How do you help them? You have to send them to the hospital because there's nothing else you can do. It's outside of your scope. And then if you're on the streets, you know, from a pre-hospital perspective, having been an EMT in the past and still as a firefighter now in a volunteer situation, when people are on the streets having a crisis, it can be really hard for civilians to say this person is dangerous or this person is having a mental health crisis.

 

00;09;49;29 - 00;10;14;16

And I think that what we found is there's just not the resources to come and assist those folks. We have firefighters, EMTs and police officers. That's basically we have on the streets. We don't have an army of social workers like yourself, Danny, that I can deploy to help people who really need it. Now, I know there are some cities and some municipality that are doing more in that area, but we could do a ton more.

 

00;10;14;16 - 00;10;49;28

It's really hard, though. So what I'd say is I think that universal screening or again, providers, nurses all doing the best they can, they're seen issues, but they don't have a lot of options for the next step. And I think that's problematic.

 

Danny:

Yeah, for sure. You know, in many cities across the country, law enforcement, paramedics and EMTs, firefighters are are getting some really great training crisis intervention, training to help be able to sort of manage a mental health crisis and in real time.

 

00;10;50;00 - 00;11;17;12

But the scale of all of us need some variation of mental health first aid, which is available for free in most communities to be able to, you know, for getting CPR training and first aid training. Mental health first aid training is also an essential part of being able to being able to work with folks in real time and in our communities.

 

00;11;17;15 - 00;11;46;28

You mentioned telehealth visits, and I was, you know, drawing on my extensive experience in Alaska. And you know, we have sort of a paradigm shift through COVID by which much of behavioral health services that occurred within the four walls of a clinic or a hospital have now transitioned to the home. And that's so exciting. It was it was it was a big shift.

 

00;11;47;00 - 00;12;19;24

But I also think about folks living with severe mental illness, often who share other social vulnerabilities, such as such as housing insecurity, such as technology insecurity. And I'm wondering if you can talk a little bit about tech equity and sort of the division between the advancements in technology and the delivery of care and those who are also left behind?

 

00;12;19;26 - 00;12;43;28

Sarah:

Absolutely. So I think it's interesting, Alaska is a really good example of where telehealth has been immense in the ability to reach patients. But I think we take for granted that you can have, I'd say, health care deserts in a big city, health care deserts in the middle of the country, health care deserts, not just in a third world country per se, but right here in places that we go every day.

 

00;12;44;01 - 00;13;12;11

And a lot of that has to do with socioeconomic issues. But what does that mean from an access perspective? Do our patients have Internet? Do our patients have cell phones? Do they have smartphones? Do they have enough data on their data plan to utilize that smartphone for a television as an example? So when it comes to mental health, there's a whole slew of new commercial offerings for tele psychiatry where they even will prescribe medication.

 

00;13;12;11 - 00;13;33;28

And that's a really interesting option, especially when we think about the stigma around mental health services. And so getting more people to be served is wonderful, but it may be disproportionately serving certain populations. The populations that their only Internet is at the library are not going to be able to have a televisit in the middle of a public place.

 

00;13;34;01 - 00;13;58;24

Those folks that have a data plan that maybe isn't so large, are they really going to use our data plan to have a televisit? Hey, that's a tough one. And the other piece is really around different kinds of people. It's even harder for children and teens to get the services that they need because pediatric psychiatrists are far and few between at baseline.

 

00;13;58;27 - 00;14;28;07

And again, a lot of people, especially minors, but in teenagers need help. They need lots of different things, but they're not on their own insurance. They don't have the ability to do a lot of things someone who's not a minor can actually do. So I think it makes it even more difficult.

 

Danny:

Yeah, And I'm thinking on the other side of technology, I don't I don't know if you know this data point, but in the United States, only about 30% of behavioral health providers are using some sort of a digital record.

 

00;14;28;07 - 00;15;16;26

And so not only are we sort of pre info sharing and pre and are off, we there's really no consistent way in which mental health data is collected and shared. And so it means each time someone is having a mental health crisis or needs to present for a new mental health provider, they have to start from scratch and retell their entire story, answering intrusive questions from a provider who is a stranger to them. And I'm super excited about, you know, from a policy perspective, I think I think there's some there's some great work happening in the United States to sort of encourage and push providers towards a digital record.

 

00;15;16;26 - 00;15;54;00

And I'm sitting in London right now where the NHS has a mandated that mental health providers move that are part of the mental health trust move to use have a digital record. And I think the more we can sort of use what are now traditional technology tools in the delivery of mental health service says the better we'll be able to paint a true picture of a whole person as far as care is delivered and folk can be shared.

 

00;15;54;03 - 00;16;32;00

One treatment plan that covers hypertension and diabetes and depression and anxiety. And so I certainly am excited about the direction we're going. I'm wondering, as you know, we probably have a couple of minutes left here. If you see anything on the horizon that that's exciting from you or from you from a technology perspective.

 

Sarah:

So I think now, especially in a post-COVID world, consumers are demanding more and ultimately it means there's more solutions for folks to obtain mental health services, whether psychiatrist, counselors, you name it, in the palm of their hand.

 

00;16;32;03 - 00;16;56;16

Now, again, we mentioned there might be some equity issues there for sure, but at the same time, there's so many folks who may have access to a cell phone as an example that could really use that assistance. So I think that the advent of a more consumer focused, patient centered experience is helping there. And with these new digital consumer grade solutions, it means we're digitizing behavioral health, even if it's from the intake part.

 

00;16;56;16 - 00;17;28;07

For a patient that's half the battle. As a primary care provider now in chronic care management, it's really hard for me to have a new patient come in who might be an immigrant who does not have documentation, to have someone who lost their insurance. All these different problems at the charity clinic where I work to help them in their journey, because if I had documentation of what their issues had been and how they'd been treating the past, my scope of practice includes depression, so I could definitely help them with some therapy and some medications.

 

00;17;28;10 - 00;17;54;01

But my solo practice doesn't include things like bipolar as an example, so how can I get them to the right people? But if it's not documented, that's really difficult for primary care doctors in particular.

 

Danny:

Yeah, such a great point. No doubt we are moving into what I would call the techno, you know, the technology age for mental health and social care service delivery.

 

00;17;54;01 - 00;18;27;18

And that's, you know, from a from a consumer perspective and the quality of applications that are making their way into the market. But it's also from available free available community resources. And I think maybe we can just close with this for our US listeners, there's available 24/7, the National Suicide Lifeline in the last 12 months. It's gone from a gone from a 1-800 to a three-digit number that that all you have to do is remember that number is 988.

 

00;18;27;20 - 00;18;55;14

It's available for you in your community today. It's available 24/7/365. It's available for you to be anonymous if you so choose. It's also available for you if there's someone that you care about and you're trying to figure out how best to help this person out; the folks who answered the 988 number are happy to sort of talk through with you how best to help someone that you care about get connected to resources.

 

00;18;55;16 - 00;19;18;05

Unknown

When you dial 988, our veterans have a have a special have a special option to talk to someone who is understanding and committed to veterans-specific topics. And there's also Spanish speaking. There's also a Spanish-speaking prompt or a prompt for our LGBTQ+ listeners. And that's just in the United States. I know we have listeners from all over the world.

 

00;19;18;07 - 00;20;05;27

Most countries have some sort of a national Suicide Lifeline phone number. So September Suicide Prevention Month couldn't be more lucky to spend some time with you. Dr. Matt, thank you so much for sharing your expertise and experience with our listeners.

Sarah:

Absolutely. Thanks so much for having me.

Outro:

Be sure to subscribe, get Perspectives on Health and Tech podcast for more insights from industry experts, visit oracle.com/health or follow Oracle Health on social media.

As part of the No Surprises Act, healthcare systems must now provide comprehensive good-faith estimates for the cost of care—both from their own organization (relatively easy) and from outside providers (much harder). Listen to industry leaders Seth Katz, University Health, and Josh Mast, Oracle Health, discuss with Jodi Busch, Oracle Health, the impacts of good-faith estimates on health organizations and how to use this phase as an opportunity to streamline workflows and better prepare your teams for the next iteration of the No Surprises Act.

Featuring: 

Seth Katz, Vice President of HIM and Revenue Cycle, Finance, University Health  

Josh Mast, Director and Product Regulatory Strategist, Oracle Health  

Jodi Busch, Senior Director of Financial Alignment Organization, Oracle Health  

Hear them discuss: 

• An overview of this year's iteration of the No Surprises Act (1:16) 

• How have these changes impacted safety net hospitals/organizations? (3:36) 

• How are schedulers at hospitals/organizations handling the increased duties of working good-faith estimates? (5:05) 

• Was it difficult to gain internal buy-in from your staff for these changes? (6:57) 

• Have you had any issues sending the good-faith estimates back to patients in the allotted time? (9:39) 

• Are there penalties for non-compliance? (10:59) 

• How does the enforcement discretion potentially impact the overall process? (13:29) 

• Where are you at in terms of combining providers inside and outside of the organization? (15:06) 

• What has been the response back from patients regarding good-faith estimates? (16:10) 

• What's coming next? (17:29) 

Notable quotes: 

"We have to remember that we work in healthcare to help take care of people and make them better and that the No Surprises Act, price transparency, information blocking are good things for the patients." – Seth Katz 

"At the end of the day, this is about trying to get patients and consumers information prior to receiving care so that they are better informed." – Josh Mast 

In the US, big leaps have been made toward industry-wide interoperability in recent years. From establishing a standard set of health data that must be exchanged, to broadening the scope of the ban on information blocking—recent regulations have driven positive advancements to simplify health data sharing across vendors and venues of care.   On top of all that, the Office of the National Coordinator and The Sequoia Project, the Recognized Coordinating Entity for the Trusted Exchange Framework and Common Agreement (TEFCA) established under the 21st Century Cures Act, announced the first applications accepted for Qualified Health Information Networks (QHINs) under the TEFCA. That short list included CommonWell Health Alliance, of which Cerner,  now Oracle Health, was a founding member nearly a decade ago. 

This is a leap forward in achieving our vision for interoperability. Our shared goal with CommonWell joining TEFCA is to build a nationwide health information exchange,  leveraging a collaborative trade organization, that will help give patients access to their healthcare data regardless of where they receive care.    Listen in as we talk about the exciting progress toward nationwide interoperability and how it will benefit patients and providers.   Featuring: Paul Wilder, Executive Director, CommonWell Health Alliance Sam Lambson, Vice President of Interoperability, Oracle Health   Hear them discuss: • TEFCA and what it means for advancing interoperability (2:10)  • Benefits of better information exchange for providers and patients (3:49) • How a record-location service is more accurate, efficient and secure than geo-locating like many systems use today (6:45) • When does TEFCA start affecting patients and providers at the point of care? (13:04) •How does TEFCA impact gaps between care, translating care, and settings of care, like telehealth? How does it affect patient engagement and involvement? (17:00) • Ways to learn more and ask questions (19:20)    Notable quotes:  "Me having my data is not just a toy. It's not just I want the image because it's interesting … I want the report. It's that I want to manage my health, or that of my children, or my parents in a better way—which I think in the end is really going to benefit the provider." - Paul Wilder 
"And think of mental health—it gets even more robust as we're expanding services a lot right now. If we don't do it efficiently, it's going to get very expensive. And getting past all those administrative flows to get to the care you need at the level the person can do it in front of you—as opposed to what the data is allowing you to do—is, I think, really important." - Paul Wilder   Resources

• TEFCA: A leap toward achieving nationwide interoperability
• Sequoia Project
• CommonWell Health Alliance Reacts to QHIN Application Approval

Discover the Value of AI in Healthcare

Are you interested in using AI tools to drive operational efficiencies within your organization, but not sure where to start? Listen in as two industry experts from HIMSS and Oracle discuss how AI is helping to transform healthcare operations and how to consider implementing AI technology in a healthcare organization. Hear about how AI is being used in healthcare today, risk factors to consider before implementing AI tools, and how AI can be used to boost clinician satisfaction while helping to reduce operational waste.

Featuring:

Mary Ann Borer, Senior Copywriter, Strategic Marketing Services, HIMSS

Matt Patterson, Executive Director of Oracle Health AI, Oracle

Listen as they discuss:

-        How AI is being used in healthcare IT today and the impact it is having on the industry (1:00)

-        Key factors that are important to consider before implementing AI technology in healthcare systems (6:45)

-        Clinical and healthcare business workflows that may be best suited today for AI applications (8:20)

o   Automation vs augmentation

-        Key risk factors to consider when adopting AI in clinical practices (12:20)

-        Which aspects of AI may add the most value to help improve the efficiency of current processes (15:22)

-        What's to come for healthcare AI in the future (21:35)

Notable quotes:

"My number one area of opportunity in healthcare, that's best suited right now, today, for artificial intelligence is addressing physician and clinician burnout." – Matt Patterson (9:47)

CTA:

Learn how Oracle is working to reduce the documentation burden on physicians and elevate the patient experience with the Oracle Health Clinical AI Agent.

---------------------------------------------------------

Episode Transcript:

00:00:00:00 - 00:00:38:08

You're listening to Perspectives on Health and Tech. A podcast by Oracle with conversations about connecting people, data, and technology to help improve health for everyone. In this episode, you'll hear a conversation recorded by HIMSSCast where the host and guest speaker delve into unlocking the value of AI within healthcare. Your host for this session is Mary Ann Borer and the guest speaker is Matt Patterson.

 

00:00:38:10 - 00:01:05:11

Mary Ann

Hi, I'm Mary Ann Borer with HIMSS. Today I'm joined by Matt Patterson, executive Director of Oracle Health AI at Oracle, and we'll be talking about unlocking the value of AI within health care. Matt, thanks for joining us today.

Matt

Thanks for having me, Mariana. I'm excited to be here.

Mary Ann

Wonderful, Matt. Can you start off by telling us a little bit about how artificial intelligence is being used in healthcare IT today, and what impact does it have on the industry?

 

00:01:05:13 - 00:01:31:21

Matt

Yeah, absolutely. And I'll start just kind of a brief introduction of my, my experience here leading into, what's been one of the most exciting chapters in my career. But I've spent about 15 years in health care, serving in a variety of different health care entities across the globe to extract value from technology investments. So have had the opportunity to really work with some large scale players across the globe.

 

00:01:31:23 - 00:01:56:14

Matt

And that's enabled me to learn some from some of the most innovative, forward thinking leaders across the industry on a variety of use cases. So I really started, in the heat of the adoption of core EMR technology during the meaningful use era. And throughout that journey, you know, 15 years ago till today, standing up care management programs to support value based care, you know, revenue cycle optimization initiatives.

 

00:01:56:14 - 00:02:22:03

Matt

Most recently, I led a venture around, a lab is strategy to advance diagnostic capabilities, which is another topic, but one that I believe, you know, diagnostics has so much room for, for growth in the future. But that's often back of mind for health care organizations today. But again, as I noted, this AI initiative is really the most fun that I've had in my career.

 

00:02:22:05 - 00:02:54:01

Matt

Of really just the value that it's bringing to healthcare professionals. To start off, just, you know, backing up a little bit around AI and healthcare, it's obviously the buzz of the last, you know, 12 plus months. But AI has been in health care for nearly half a century, and I refer to it as classic AI. It's used to carry out a specific task that a human typically performs, recognizing patterns and data to predict and drive what might happen next, or summarize what's already happened.

 

00:02:54:03 - 00:03:28:13

Matt

Or making suggestions. What's really happened in the last 12 plus months is within healthcare is leveraging generative AI. That's the newest development in healthcare that leverages massive amounts of data and computing power to look at things in a much broader context and generate something completely new. So GenAI generate documents that can summarize existing information. It can translate a document and extract information and classify text based on a specific request.

 

00:03:28:15 - 00:04:07:01

Matt

ChatGPT is obviously if anybody has actually tested that, it's a really good example of ask a question and it will give you a very succinct, summarized answer that's structured better than a lot of what humans can do. And so that's really where we're seeing this substantial shift in the healthcare industry is this shift from classic AI, which is if this happens, then I can drive this result to generative AI that truly can create something completely new around automation of administrative tasks, looking at precision medicine, etc..

 

00:04:07:03 - 00:04:29:06

Matt

And as you think about just the impact on what generative AI can really bring to healthcare AI, I go back to what Bill gates, an article he wrote in 2023 after he really he had a meeting with OpenAI and it started to click for him around what AI is really going to mean foundationally for a variety of industries.

 

00:04:29:06 - 00:04:55:15

Matt

But, you know, in his article, he was kind of focusing on health care. And, and he said this "AI will become as fundamental as the creation of the personal computer. It's going to change the way people operate to face some of healthcare's most significant challenges and rising costs, lack of equitable access and aging populations, doctor, nurse burnouts and global pandemics."

 

00:04:55:17 - 00:05:37:22

Matt

We're already seeing a lot of those impacts at different levels, leveraging GenAI so, you know, rising he mentioned rising costs. Today we're, we're driving operational efficiencies across health care around more efficient scheduling, claims processing, supply chain management and eliminating waste of supplies through real time forecasting, timely interventions of care that can eliminate readmissions and higher acuity costs.

 

00:05:37:22 - 00:06:06:16

Matt

So we're impacting the cost curve already through AI, lack of equitable access to care. Social determinants of health is a big thing that we're embedding into a EMR today to provide an Uber access so somebody doesn't miss their appointment. And doctor nurse burnout. So I'm going to get into more of that today because that's where I'm spending a lot of my time within Oracle is addressing administrative tasks through leveraging AI.

 

00:06:06:18 - 00:06:32:07

Matt

In short, the integration of AI and healthcare. It truly is transforming the industry by improving accuracy and diagnostics and treatment, reducing costs, and ultimately leading to better patient outcomes. But we'll get into some of this today. It also raises important considerations regarding data privacy, like the ethical use of AI, how to put controls around it, and the need for regulatory oversight.

 

00:06:32:07 - 00:06:48:00

Matt

So overall, it's playing a crucial role around the evolution of health care. It's making it smarter, more patient, more efficient and more patient centered. But important to put controls in policy as organizations look to bring AI into your organizations,

00:06:48:03- 00:06:55:12

Mary Ann

What are some key factors that you consider important before implementing AI technology in health care systems?

00:06:55:14 - 00:07:28:12

Matt

It's one that I receive often. Where do we start? So the possibilities when you really dig into the technology of cloud hyper-scalers, the capabilities are endless, which is exciting. Yet it's also overwhelming when you really kind of dig in to what the possibilities are. So where to start is hard. And so a lot of clients and folks that I'm working with week in, week out, I give them this simple advice : start small and start now.

 

00:07:28:14 - 00:07:59:09

Matt

You can go address low risk use cases. Now to learn the technology, understand how to wrap your arms around it, and put controls and protocol around it before you get to those larger scale, higher risk use cases such as do I drive a diagnosis directly to a physician into their physician workflow, you're going to want to put a higher level of protocol controls and risk management around that type of larger AI.

 

00:07:59:11 - 00:08:15:00

Matt

We'll call it recommendation. In comparison to something like, how do I go create a draft note for a physician to have to review? So in short, my recommendation is always start small, but get going now.

00:08:15:02 – 00:08:25:09

Mary Ann

 Now that's an excellent point. And let me add to that a little bit and ask you which clinical and health care business operations do you feel are best suited for AI today?

 

00:08:25:11 - 00:08:52:24

Matt

So as I mentioned on the front end, I've been fortunate, to have a variety of experiences across, the healthcare entities I've worked with throughout my career. And, I'll tell you, from my experience, it's all of the functions of the healthcare system that need automation and really need to have the opportunity to eliminate manual process and waste, supply chain.

 

00:08:53:00 - 00:09:21:00

Matt

You know, I mentioned AI, more effective predictive analytics to eliminate waste, huge opportunity across our healthcare system, of, you know, things that aren't necessarily needed and are wasted on a daily basis, that if we had more effective ways to forecast what's needed and when we could eliminate cost, eliminate that waste within our supply chain management system. Revenue cycle, there is more manual process in rev cycle.

 

00:09:21:02 - 00:09:47:11

Matt

And there are more tools coming out to augment that. Those manual processes, leveraging AI. So the automation of coding and prior authorizations claims processing, denials, management, a variety of aspects of how we can automate manual process today, predictive analytics to reduce readmissions, health equity programs that I mentioned on the front end. There truly are countless opportunities across the functions of healthcare.

 

00:09:47:13 - 00:10:20:00

Matt

But my number one area of opportunity in healthcare that's best suited right now, today for artificial intelligence, is addressing physician and clinician burnout. So before I get too far into the why there, I just summarize the where to start through the evaluation of two different concepts. One is automation. The second is augmentation. So think of automation as the automation of a process.

 

00:10:20:02 - 00:10:56:18

Matt

Creating a note automatically driving a code within for an ICD ten coding. It's addressing an administrative task versus augmentation. Is the AI actually providing a recommendation directly to the end user? I personally believe that as you think about those two concepts, the nature of what health care serves myself, my mom, my dad, my kids, it's so personal that we really do need to be careful with AI.

 

00:10:56:20 - 00:11:30:24

Matt

And so starting with automation of process and the administrative burden, there is so much opportunity there. My recommendation is start with automate automation. As you as we continue to see the AI improve, which it will exponentially in the coming years, I think that's when we start to look at the augmentation of care. And there are a variety of organizations out there that are continuing to look at this augmentation concept, meaning I want to drive a recommendation of a diagnosis or a treatment plan directly into the clinician workflow.

 

00:11:31:01 - 00:12:02:20

Matt

But again, my $0.02 starting small. Start with automation of administrative process. And as AI improves, think about da Vinci three to chat GPT four. There has been so much improvement around AI hallucinations, and those hallucinations are real in artificial intelligence. The iterations of AI will just continue to improve. And so as the AI improves, I think that's where there will be our opportunity to get to the next level of that true augmentation of healthcare.

 

00:12:02:22 - 00:12:05:01

Matt

That will really take AI to the next level.

00:12:05:03 – 00:12:23:01

Mary Ann

That's such a great point, especially when you think about how some of those kind of cumbersome administrative processes that are really a big factor for clinician burnout, what are some key risk factors, not that you would consider when it comes to adoption of AI in clinical practices?

00:12:23:03 – 00:12:35:06

Matt

Regardless of the use case, small or big, there's an associated risk, and it's important that it's articulated to the end users.

 

00:12:35:06 - 00:13:12:10

Matt

And as organizations think about policy, AI is meant to support human functions or decisions. It is not meant to replace it. So I've spent a lot of time and, you know, in recent months, traveling with providers across the nation to adopt ambient listening technology to automate their documentation within any of our. And when you sit down with the providers, I'm always very clear that the AI generated note is a draft.

 

00:13:12:12 - 00:13:42:13

Matt

The actions that the AI will recommend are proposed. It's critical that on the front end of the adoption, you really talk to, in this case, the physicians, about what the AI is and what it is not. It is not a replacement of your responsibility as a licensed professional to sign that note or to sign off on that medication or that prescription.

 

00:13:42:15 - 00:14:17:14

Matt

Right. So from my perspective, as we continue to get to the next level, the education of what artificial intelligence really is meant to be - an assistant, but not a replacement - is critical as we move forward. It's impressive what it is doing. Yet it's also important that clinicians, and end users of the I understand their responsibility. It still lies on them to sign off on as the human and the owner on really the impact of patient care at the end of the day, right?

 

00:14:17:14 - 00:14:52:10

Matt

So it's about putting the right controls in place so that you can control the AI and wrap your arms around it. You know, AI will, as I've mentioned, fabricate. There was actually an example from my book that I read around, asking that in this case it was for Da Vinci Three about how they knew, how did they learn so much about Metformin and the at that time, Da Vinci three replied with, I received a master's in public health and personal experience with diabetes in my family.

 

00:14:52:10 - 00:15:14:16

Matt

Well, they I did not actually receive a master's in public health. And so we kind of laugh about it when, you know, you're playing around at home with the power of what, you know, ChatGPT is or in this example, Da Vinci three at the time, but at that is an a hallucination of, you know, what the artificial intelligence is.

 

00:15:14:16 - 00:15:21:02

Matt

And so it's just very careful that you treat, like you do anything else in life with caution.

00:15:21:04 – 00:15:30:06

Mary Ann

Fantastic. So, Matt, what aspects of AI do you see adding value to help current processes to help transform health care?

00:15:30:09 – 00:15:43:04

Matt

I'm going to go back to my earlier number one opportunity that I believe right now. Current state AI has the opportunity to go advance.

 

00:15:43:06 - 00:16:16:18

Matt

And it's really providing an intelligent assistant to doctors and nurses to decrease administrative burden and to give some background that everybody knows about. But I've been on the front lines experiencing it in the practices, not at the corporate level or in the C-suite office, but in the provider practices that are doing, you know, every single day serving 25 plus patients in primary care, various specialties, etc. physician burnout is real.

 

00:16:16:20 - 00:16:36:14

Matt

And, you know, the administrative workload that has been put on to physicians and nurses, it has increased dramatically over the last 20 years. And candidly, it's diminished the noble desire of having young students enter into various health care roles to just help people because there's too much day to day documentation and paperwork. I've got to create these notes and insurance claims and requesting prior offers for lab tests.

 

00:16:37:16 - 00:17:04:04

Matt

It takes up 49% of a working day for doctors and nurses. So the net of this is that we need strategies to reduce administrative work on doctors and nurses to get back to what they do, provide patient care. And so, again, back to some of the things I've hinted at today automation versus augmentation, precision medicine, and some of these neat things that I am very excited about what it will be.

 

00:17:05:15 - 00:17:30:11

Matt

But my focus today, right now at Oracle Health is how can we automate administrative tasks to enable physicians, nurses and clinicians alike to get back to patient care? That is where we're going to see outcomes improve there. If you ask any provider - and I had the opportunity down in Knoxville, I won't mention her name, but a physician looked me in the eyes.

 

00:17:30:13 - 00:17:56:09

Matt

She's adopted our technology. She actually, has a four year old and a six year old, and she was telling me how on Sundays, she will spend anywhere from 4 to 5 hours doing documentation so that on Monday, she's not behind before she goes into the office. And she's got a full patient load. You know, tremendous, patient bedside manner.

 

00:17:56:11 - 00:18:22:07

Matt

And so, you know, she's a busy physician, bottom line. But still, I'm allowing her to spend time on Sundays that that 4 to 5 hours has gone down to 30 minutes to 1 hour. So the technology that we're providing to her is enabling her to spend four more hours per weekend with her four year old and her six year old.

 

00:18:23:09 - 00:18:50:15

Matt

And as a mom, that matters. And so what she told me, and she looks me in the eye as I was walking out of her practice, is. Thank you for contributing to the quality of care for my patients. And we have talked about, you know, her four year old and her six year old earlier in our meeting. But the bottom line is that there's direct correlation around physician satisfaction, linking back to patient satisfaction, engagement, and improved outcomes.

 

00:18:51:17 - 00:19:25:09

Matt

So if the physician is looking me in the eye, as opposed to typing on their computer, I feel engages the patient, I'm going to be more likely to remember what was said during the visit. I'm going to be more likely to follow through with the instructions that the provider has given to me. So I see the most important aspect of who are leveraging AI today, right now, in the near future, is getting clinicians back to what they were, what they went to school to go do, provide patient care.

 

00:19:25:11 - 00:20:00:08

Matt

It extracts across the entirety of a practice the health care system, the unit, you know, of a given floor. It's about addressing administrative burden. And that will bring attractiveness for young students to enter into health care again. Again, back to that noble desire strictly to help people. So in the near term, that's my focus to really bring back the joy of practicing medicine, I've had the pleasure to hear from countless providers on what this AI technology can really bring from Oracle and, getting them back to their practice and their patients.

 

00:20:00:10 - 00:20:09:05

Matt

And so that's, that's really it. I think in the short term, where the core focus should be and the excitement that is, AI's bring it into health care.

00:20:10:08 – 00:20:16:20

Mary Ann

Wonderful. Now, Matt, on that note, what excites you the most for what AI can bring to health care in the future?

00:20:16:21 - 00:21:01:23

Matt

So this is the art of the possible, right? And it does. You know, again, as I mentioned, I've had the opportunity to learn quite a bit about the capabilities that exist within Oracle's cloud. And other hyper-scalers have similar capabilities. It really, truly is endless around and to my earlier comment, overwhelming on what it is that we could go do, but to just name, you know, a few examples of really where I think and I'll, I'll go back to that automation versus augmentation to really getting to that augmentation aspect of what we can do to assist health care holistically, leveraging AI.

 

00:21:02:00 - 00:21:26:10

Matt

What I'm most excited about, and some of this is already starting to come out, with various entities. I think the impact is still, TBD around adoption, etc., but things like personalized medicine, how you can leverage AI to tailor treatments to individual patients by analyzing genetic information. Again, you know, there's a lot of interest there.

 

00:21:27:12 - 00:22:01:06

Matt

I don't necessarily know that it's being adopted across healthcare systems throughout the globe yet, but it's a very exciting on what I can bring there. And we're just scratching the surface. Medical imaging. So AI can be utilized to analyze medical images, to detect anomalies and aid radiologists in a, in a diagnosis that is very exciting so that a radiologist doesn't miss something if they're doing a night shift. Hypothetically.

 

 

 

00:22:02:06 - 00:22:33:04

Matt

Clinical decision support. So actually getting to the point that the AI can assist a health care provider for evidence based recommendations of patient care, how do you how does the AI potentially, you know, remind a provider or a nurse or a clinician of something they might have missed, right. Drug discovery. I think there's tremendous opportunity around what I can do to accelerate the drug discovery process.

 

00:22:34:06 - 00:22:57:00

Matt

Going back to, you know, the Bill Gates quote that I opened up with, how do you get ahead of significant things like we just went through in the pandemic? Well, AI can assist us in that as we think about what it can bring to the future. And, the other one, you know, to wrap in a bow is patient engagement.

 

00:22:58:02 - 00:23:23:09

Matt

I think that we all have our own ways of how it is that we want to engage with, you know, our own bodies, our own health care and AI powered chat bots. It can really know who you are, understand who you are, and how it is best to engage with you to get the best result of the engagement.

 

00:23:24:09 - 00:23:47:03

Matt

For - Are you doing your walking for diabetes right? Are you filling your prescriptions or not? Have you gone in for your annual wellness check? Are you going and seeing getting your dental exam on an annual basis? Small things that ultimately lead to more healthy populations and preventative care. I think AI has tremendous opportunity just through, you know, the scale of how it can actually analyze data.

 

00:23:48:05 - 00:24:09:21

Matt

It will take some of the pop health strategies and patient engagement strategies that exist today to the next level. So that's more getting to the augmentation aspect that I mentioned earlier, as opposed to just I think, you know, the core focus of automation, a process that we're that is the more of the here and now today. So, exciting times, a lot more to come.

 

00:24:10:23 - 00:24:20:03

Matt

And, I truly do believe that we're just scratching the surface of what artificial intelligence will be able to bring to health care. As we look back ten years from today.

00:24:21:05 – 00:24:26:11

Mary Ann

 I'm sure looking forward to seeing what comes next. Matt, thank you so much for joining us today, and thanks for sharing your insights with us.

00:24:27:14 - 00:24:40:21

That's all for this episode. Be sure to subscribe to Perspectives on Health and Tech Podcast. For more insights from industry experts. Visit oracle.com/health or follow Oracle Health on social media.

 

In recent years, there's been a significant rise of AI technology and hyper-scalers entering the healthcare market. Listen in as two experts from Oracle Health discuss improving healthcare delivery through the integration of these technologies, particularly focusing on the role of AI and comprehensive data platforms on value-based care. Learn about improving care coordination and delivery, the shift to scalable platforms, and incorporating AI and cloud technology to continuously evolve with the needs of healthcare systems.

Featuring:

Bharat Sutariya, MD, Senior Vice President and Chief Health Officer, Oracle Health

Scott Wiesner, Go-to-Market Strategy and Operations, Oracle Health

Listen as they discuss:

- Dr. Sutariya's perspective on the current healthcare landscape (2:50)

- AI in service of improving value-based care (4:15)

o Growth of hyper-scalers in the healthcare industry and what is lacking with this technology specific to healthcare

• • The need for a comprehensive data platform that aggregates across multiple sources with terminology mapped to data and ontology applied for meaningful data

- Going forward with industry-based data platforms (7:25)

o Applying AI and genAI

o Applications with pre-formatted workflows running on a comprehensive platform

- Facing challenges in value-based care and technology choices (14:16)

o The option of platform as a service (PaaS) helping to meet the needs for value-based care contracts

- The Oracle strategy with cloud and genAI-based advancements (15:54)

o EHR agnostic capabilities

Notable quotes:

"We now have a unique opportunity, particularly leveraging the might of Oracle, to layer advanced AI, including generative AI, on top of our existing healthcare technology – taking us far beyond where we were before." - Bharat Sutariya, MD, Senior Vice President and Chief Health Officer, Oracle Health

"At the end of the day, with value-based care, it's really about the insights you get from the data – how do we make better use of that data in service of improving healthcare outcomes?" - Scott Wiesner, Go-to-Market Strategy and Operations, Oracle Health

CTA:

Want to enhance a connected healthcare ecosystem and accelerate value-based care efforts while improving clinician decision-making and the patient experience? See how Oracle Health can help with our suite of population health management solutions here: https://www.oracle.com/health/population-health/ 

----------------------------------------------------------------

Episode Transcript:

Introduction  0:00 

Music.

 

Introduction 0:13 – 0:28

Welcome to perspectives on health and tech podcast brought to you by Oracle Health. In this series, we have conversations on creating a seamless and connected healthcare world where everyone thrives. Let's get started.

 

Scott 0:29 – 0:58

You're listening to perspectives on health and tech. I'm Scott Wiesner, Senior Director go to market strategy in Oracle Health. With me today is Doctor Bharat Sutariya, Senior Vice President and Chief Health Officer in Oracle Health. Dr. Sutariya has over 20 years-experience in care delivery transformation, value-based care, and healthcare technology. He's also board certified in emergency medicine and has practiced medicine for over 25 years. Welcome Bharat.

 

Bharat 0:59 – 1:00

Scott, it's great to be with you.

 

Scott 1:00 – 1:08

Great to have you. Very fortunate to have you here at Oracle as well. Let's get into it. Why don't you tell us a little bit about what's driving you these days?

 

Bharat 1:08 – 2:30

Scott, in many ways, it's the same thing that has driven me for the last 25 years, and that is to significantly improving the healthcare ecosystem of providers, payers, and the life sciences, and to achieve the best outcome and experience for the patient. I've spent the last couple of decades developing and deploying healthcare technology products and solution and I've been fortunate to partner with leading health systems that think forward and solve complex problems that others mimic in healthcare then. I'm excited that I have this potential to make a significant progress, because I believe that the technology is more aligned to the problem now, and our ability to solve the problem now is better than ever before. So that's what excites me. Last thing I would say is it's great to be back now at Oracle Health, because Oracle is a full stack company having the most modern and efficient database, cloud infrastructure application development and proven, you know, technology over decades, and it's really taking that advantage of that capability and applying to health care, it likely excites me the most.

 

Scott 2:31 – 2:52

Well, it's great when passion and experience come together. Let's sort of take the next step here. This This podcast is about perspectives, and particularly your perspective, and you've got a very extensive and a lot of experience as a practitioner, educator, implementer, and, of course, executive leader quite some time. Let's talk a little bit about, you know, what you're seeing in healthcare at this moment.

 

Bharat 2:53 – 3:36

Interesting question. You know, I feel like we are at a unique juncture in healthcare where multiple forces are coming together. The cost of healthcare is rising. The outcomes are not necessarily keeping up. All of us are paying more out of our pocket, and overall, you know, that's not a sustainable system. But what's exciting is that we now that technology, you know, particularly with novel technology coming that has such an amazing promise to solve complex healthcare that it, you know, it, it gives me so much passion to look forward at solving these problems that we haven't been able to solve in the last 27 years.

 

Scott 3:37 – 4:17

So, you know, technology is both a promise and a solution. And what we're hearing from customers today really true of any industry. How do I reduce that cost? But then take those cost savings and power innovation. That's kind of the two levers there that you that you want to pull to drive efficiency and better outcomes. And one of these things we can't talk about in this day and age, whether, you know, without spelling it out, of course, is artificial intelligence. And really, how do we look at artificial intelligence and generative AI in service of, you know, improving value-based care? Can you elaborate a little bit on those two areas?

 

Bharat 4:18 – 6:50

As you know, my healthcare is very broad, and the movement toward value-based care, of course, many models, ranging from shared savings to full risk arrangement, both in commercial and government space, continues to grow, so I think it's an important topic. Now. I've spent a decade on value-based care strategy, technology development and partnering with health systems to really enable success in value-based care model. And there, you know, I've learned quite a bit, right? You know, I see going forward, the hyper-scalers have already made a significant progress with the penetration into healthcare, but I'm not sure that that hyper-scaler presence in healthcare has particularly been uplifting for value-based care, because in order to achieve value-based care in a programmatically and sustainable way, you have to solve some core challenges. And in the hyper-scalers, they'll provide robust technology platform, they've not necessarily solved these challenges. And the challenges that I'm talking about is, first and foremost, you have to have a very comprehensive data platform that aggregates data across multiple data sources, and that data sources need to have a high degree of terminology mapped to it, and then ontology needs to be applied to make meaning out of it, because what happens in healthcare, in particularly value-based care, is that an average value based care provider is likely providing 50 to 60% of care in their own network, meaning they have the data, but the rest of it is provided outside of their network, into the community for which they don't have clinical data, and they can only get the insight by using the claims data. So, what's happening is that the forward looking, advanced value-based care organizations have a desire to aggregate this data from multiple EHRs, where patients get their care, multiple payers, where they have taken payer contracts. They want to get data across VBM, social determinants of health, and basically anywhere patient is touching healthcare institution. They want to understand that data, because it is that aggregated data that can give them the full insight so that they can then provide a comprehensive care.

 

Scott 6:51 – 7:27

Yeah, it's a great point. You know, whether you're a hyper-scaler or otherwise, you know, everybody can provide a data platform where you're aggregating data. You know, some version of that. What we're describing here actually is, how do we make that better use of that data in service of value-based care, and all the contracts and regulations and things that you pointed out once before is, you know, always changing. And you can't just solve that like, you know, everybody can do that, but it's really the next thing. So maybe you can elaborate on that a little bit more, and where we're going with industry-based data platforms.

 

Bharat 7:28 – 9:27

I see many in the industry are starting such a platform today. While we've had a decade head start, we've had Healthe Intent for more than a decade now that has been recognized as a highly scalable world class data aggregation platform that reconciles large swath of data, you know, maps it and creates a medical grade longitudinal record. And we've been able to use this platform to help our customers achieve initial success in value-based care model. On top of that platform, you apply intelligence, you create gaps in care insight, you also empower the risk adjustment capability as well as care coordination capability and all of that together then operate, you know, provides operational capability for the value-based care organizations. So that's kind of the current state of where we are, right. And while we have a highly organized platform and software approach, you know, I feel like many in the industry are still catching up, you know, to where we are. We now have a unique opportunity, particularly leveraging the mind of Oracle to layer, you know, advanced AI, including genAI, on top of it. So, imagine, you know where we were, which was already fairly advanced, and now we have the ability to layer more advanced capability on top of it, and that is the go forward future. And at least you know that Healthe Intent that people know today is now the Health Data Intelligence that has all this capability that I just talked about.

 

Scott 9:28 – 9:52

So let me just take a step back just for a minute. Here, seems we kind of talked about the table stakes of a data platform. And of course, in order to enable generative AI in particular, as you mentioned, seems to me you kind of got to get your house in order. And if I make a little bit of pun out of out of this, not your just your house, your data warehouse, in order, in order to enable artificial intelligence and generative AI, is that that's sort of the trend that we're seeing here.

 

Bharat 9:53 – 10:55

Yeah, we were able to get a head start into this generative AI and overall intelligence powering the value based-care platform, because we already have a strong foundation. If you don't have the right data foundation, particularly across the broad network of aggregated data, then the models you deploy on top is not going to work. So that's point number one. Two, you also need this platform that's evolving with the continuous technology as well as continuous intelligence. And that's, you know, where we're going as well is to have an agile platform with the agile software capabilities on top of it, and continuous layering of AI, with the end result being able to power every component of value-based care management, from a clinical intelligence, from a care coordination, and from an analytic perspective.

 

Scott 10:56 – 11:36

So, on one hand, you talked about hyper-scalers, kind of on the one end, and marshaling the data for these insights. There's also the other proposition, where, hey, look, you know, there's, there's vendors out there that provide these insights, sort of out of the box, but they're not a they're not a hyper-scaler, they're not a data platform. So can you talk a little bit about that end, because at the end of the day, with value-based care for my what I'm gathering here is, it's really about the insights that you get out of the data. So, we could talk about kind of the dashboard approach. You talked about the data platform. Talk a little bit about kind of the SaaS version of the software as a service, kind of dashboard, end of things.

 

Bharat 11:36 – 14:15

I think, you know, strong platform that aggregates data is obviously, you know, needed in a strong set of applications that run on top, that have pre-formatted workflow, is also needed. But as we go forward here, we have to advance more than that, and that's where really the use of Gen AI capabilities come into place. That we no longer have to build an application or a analytic query or dashboard for every single things that we want to know from an insight to make a decision about value-based care. We're now able to use modern technology, particularly the Oracle analytic cloud, infused with the artificial intelligence, so that we're able to treat analytic almost like a conversational search. We're able to ask the analytic engine, for example, show me all of the patients that have hemoglobin A1C greater than nine, that have not seen physician in the last six months, and that don't have an appointment coming in the next six months, and the system is able to show you to list the patients with all the pertinent data so that a care coordinator or a physician's office can act and get them on the schedule. In the past or even in current systems, some would say, you would have to build a specific dashboard workflow to achieve that insight. But going forward, we're able to use the AI-driven analytics to achieve such insight. By the way, all of it needs to be based on world class security and data privacy. I don't think we can say enough of that. That is such an important concept in this day and age that, we restore health data and deal with health data, the security needs to be a first-class priority. Now, the other interesting part Scott is the VBC contracts are continuously changing. The network continues to change, the regulatory environments continue to change, and you also need a platform that's agile, that's constantly evolving at the platform level, application level, and the AI that's integrated into it needs to also be highly adaptive to serve the ever-changing business needs.

 

Scott 14:16 – 15:03

So of course, if you're speaking to your friends who are heads of population health, chief medical information officers. Sounds like they're kind of facing some of these challenges. Look, I've got some regulatory requirements, you know, I want to develop really precision of care for value-based care. Wanted to also take advantage of some of these new innovations in generative AI, all, it sounds great. What are these folks facing today? There's, there's a lot of choices in the industry as well. You know, as having been in the industry for over 25 years, lots of choices, so I'm kind of seeing this, as you said, the other side and made me think of, you know, the two sides of the same coin. Hey, look, we want to use our money wisely one side, and you've got to be able to have a fast, scalable, secure platform, and you also have the interface to be able to utilize that data most effectively. Describe a little bit of that for me.

 

Bharat 15:03 – 15:53

Scott, I think it's important the choice of technology to our value-based care needs to be highly strategic in nature. In the past, you know, there was difficulty in choosing big strategic platform. How long will it take for me to stand it up and mature it right? But now, with the platform as a service, the choices are a little bit easier, and how fast you can get value out of it is also easier. So, I think in today's day and age, you can achieve both, and that is, how do I get technology that can help me meet my needs for this year's contract, but more importantly, how does the investment evolve with my needs over many years, and that is the balanced choice that people can make today.

 

Scott 15:54 – 16:27

Yeah, and that makes a lot of sense, because, you know, people are moving careers and jobs, and we as a provider, a technology provider, need to show a value today and tomorrow and of course, beyond. Makes a lot of sense, and to be able to think strategically, obviously, also makes sense as well. Lot of technologies over the years to meet some of these requirements. And so look, we're both Oracle folks here, and you know, we'd be remiss if we didn't talk a little bit about to our listeners here about the Oracle strategy, covering both cloud and generative AI based advancements. Can we talk a little bit about that?

 

Bharat 16:27 – 18:43

Yes, Scott, let's, let's make sure we earn our pay. I'm super excited about the path that we're on. And quite frankly, I don't think that path was possible prior to acquisition of Cerner by Oracle. As I mentioned earlier, Cerner had previously developed Healthe Intent platform that's been in place for more than a decade, and having personally been involved, we leveraged the best possible technology components that were available at the time several years ago, and there was even an attempt to make sure that we keep the platform updated, but we now have an amazing new opportunity, and that is to leverage the total might of Oracle. You know, Oracle being a full stack company, it has the most modern database. It has the modern cloud infrastructure. It has the modern cloud analytics capability. It has the generative AI capability. So when we put all that asset together in one full stack, we're able to do things that we could not do in past. And that is what our teams have developed now into health data intelligence on top of this, health data intelligence as a platform, we layer a new set of application called Clinical intelligence, care coordination analytics, and then many purpose-specific assets such as HCC and many different risk models associated with it. We do all of this in a completely EHR agnostic manner, in fact, system agnostic manner, so not every customer has to have our own electronic health record to benefit from it. It doesn't matter to us, which EHR brand you use, what hyper-scaler cloud you may already be aligned to, from a data storage and computing perspective, we're able to coexist because this is a purpose-specific healthcare intelligence platform, and then when it's used for value-based care, we actually have a purpose specific value-based care applications in workflows that go on top of it.

 

Scott 18:43 – 20:09

Yeah, that's interesting. So, and I wanted to kind of go back something that was, was interesting. And I think our, our listeners, customers, can identify with your journey, you know, as a almost a developer as well, you're saying, you know, filling the needs of the requirements of your customers where, you know, look, not all of our customers are, you know, some of the hyper-scalers out there, they've got, you know, they're not IT companies, you know, they're really interested in the outcomes, not developing and supporting a data platform, you know, a non-industry data platform. Even though, as you pointed out, the hyper-scalers have made some inroads into that. And t's about, again, outcomes. How do I make value-based care more efficient? Allow for better insights, kind of time to value of data and that precision healthcare that we talked about, again, about the outcomes at the end of the day. So, if we as Oracle, can provide that platform, that we manage, that then drives and allows you, the customer, to take advantage of all those insights. Really want to be here for you for that so when you're ready for that next step of generative AI, not having to manage the platform itself, but also getting the insights through the applications that you mentioned. It's already there for you, and can basically start with that the very next day. Any final thoughts, Bharat?

 

Bharat 20:10 – 20:34

It's my pleasure, and I'm actually quite excited to leverage all of the assets we now have from previous Cerner and now Oracle, and it's exciting to be part of this journey, and looking forward to working with our customers to get it in their hands and help them achieve their value-based care outcomes.

 

Scott 20:35 – 20:45

Fantastic. Thank you very much, and thank you for listening. Be sure to subscribe to the perspectives on health and tech podcast. Thank you very much.

 

Outro 20:45 – 21:20

That's all for this episode of Perspectives on Health and Tech podcast. Be sure to subscribe to catch all our future episodes. For more information from industry experts, visit oracle.com forward slash health and oracle.com forward slash life hyphen sciences, or follow Oracle Health and Oracle Life Sciences on social media, thank you for listening and join us again for the next insightful episode of Perspectives on Health and Tech.

 

 

While science and technology have driven remarkable breakthroughs, they've also created unintended barriers between clinical research and care. The complexity and cost of research limit trials to only the most well-resourced hospitals. As a result, just 3% of patients and providers participate, and doctors often lack access to or the ability to act on life-changing therapies at the point of care. Oracle is closing this gap—embedding clinical trials, evidence-based insights, and innovative therapies directly into electronic health records. The vision: every hospital research-ready, every patient encounter fueling discovery, and therapeutic innovation reaching patients where and when it matters most.

Featuring:

·       Moderator: Raj Modi, Senior Director, Global Customer Centre of Excellence, Life Sciences, Oracle

·       Panelist: Maria Clark, Market Development Associate Greenphire-Suvoda, Patient Advocate for Cystic Fibrosis Foundation

·       Panelist: Christopher P. Boone, Ph. D., Group Vice President, Research Services, Health & Life Sciences, Oracle

Listen as they discuss:

o   Why therapeutic innovation often stops short of the point of care—and what it takes to close that gap

o   How aggregating genomic, clinical, and real-world data at scale — safely and securely — is key to unlocking this future and driving personalized medicine

o   How embedding trials, insights, and therapies into the EHR will reshape access to cutting-edge treatments, lowering cost, and improving outcomes

o   How the industry is approaching this shift—and what progress is already underway

Notable quotes:

"Because of these CFTR modulators, patients like myself are living longer than ever before. I am only 23 years old and when I was born my life expectancy was early 20's." – Maria Clark

"We have to reimagine our own business processes and really put the needs and preferences of the patients at the center of everything we do." – Christopher P. Boone, Ph. D.

CTA:

Harness real-world evidence and data-driven insights to inform critical decisions. Our expertise spans commercialization, market access, regulatory and safety protocols, oncology, and rare diseases. Bolster your strategies with data-driven solutions tailored to the life sciences and healthcare industries: Learn More

-----------------------------------------------------------------

Episode Transcript:

 Raj Modi: 

Hello and welcome to from bench to bedside bringing therapeutic innovation closer to patients. I'm Raj Modi and I'll be your host today. This conversation speaks directly to Oracle's vision for health and life sciences. Despite all the advances we've seen in medical research over the last few decades, there's still a significant gap between scientific discovery and care delivery. And today we're going to explore how we close that gap by embedding research directly into care utilizing unified data. Connected systems and AI. I'm joined today by two fantastic guests who bring both deep expertise and lived experience. First, we have Dr. Chris Boone, who's the group vice president for Oracle Research Services. Chris is a recognized leader in real world evidence and health data innovation. And also joining me is Maria Clarke:, who is a passionate patient advocate who lives with cystic fibrosis and also works tirelessly in our industry helping organizations better understand and support research participants. Chris and Maria, welcome. Thank you both for being here. 

 

Chris Boone: 

Thank you, Raj. It's great to be here. 

 

Maria Clarke: 

Thank you. So happy to be here. 

 

Raj Modi: 

Let's dive into the discussion. Maria, let me start with you. You've written very powerfully about your experience living with cystic fibrosis. When people talk about patient centered research, what does that really mean to you, and how far off are we as an industry from making that real? 

 

Maria Clarke: 

Well, I believe this collaborative model, you know, ensures that studies are designed, conducted and interpreted with direct input from patients reflecting on their real-world experiences, their needs and priorities. This ensures you know, patients are full collaborators, not just subject ID numbers you know, in a database. Real humans with real stories and you know, research that better reflects real needs, helps promote trust, and leads to more effective personalized care. 

 

Raj Modi: 

That's really powerful, Maria. Thank you for sharing. You've read some raised some really pertinent points here. As a follow up to you, when it comes to access, whether that's clinical trials or the latest treatments, what barriers have you personally faced in your journey and what needs to change? 

 

Maria Clarke: 

So accessing care even you know when I'm fortunate enough to have, you know, insurance and advanced medications, it still comes with its own set of hurdles. For instance, you know ordering medications can be complicated, and you know, once appointments are coordinated, the burden of traveling to the clinic and missing work or school for you know, 5 plus hours can be extremely overwhelming. I mean, for instance, yesterday I was at the clinic for five plus hours participating in a research study. It's a long term study. It's like a five year study. I've been involved in with the Children's Hospital of Philadelphia and I was working remotely the whole day while getting tests done and blood drawn. And after all that, you know, had to drive home very weak, especially on the school for those who are from the Philadelphia area. It's pretty brutal after a long day in the clinic so. 

 

Raj Modi: 

Maria, that's a, that's a, that's a significant burden on, you know, on your participation into research. Chris, let me bring you in here. You've spent your career at the intersection of policy evidence and strategy from the industry side - how should we be thinking about patient centered research? How do we move from theory to something that actually involves patients in the study design, in access decisions, and in outcomes. 

 

Chris Boone: 

That's a phenomenal question and I will say this, Maria, I was in Philadelphia last week and got to experience the traffic that you guys have there first hand. So I, I empathize, in fact, you were driving home after such a pretty intense treatment and and all of that. So it's tough, but I think it's a it's a perfect example that I think embodies all the things that we need to consider as industry as we're becoming you know as as we take it to your point Raj from theory to actual practice, we've been talking about this whole notion of patient centered approaches for a very long time. But I think in my in my mind what it means is that we align the business strategies and the entire, sort of drug development process around the needs and the preferences and outcomes of of patients that are most afflicted with these particular. You know we've we've we've talked that nauseam about, you know, you'll hear a lot about patient driven or patient centric R&D or clinical trials and all these things. But you know just hearing stories like Maria is very Maria is is very powerful because it reminds us that there are real people on the other side of that who have priorities who are, who are prioritizing, you know, sort of the the side effects of these therapies or the inability to drive home after a 5 hour procedure and and just improving the overall quality of life. So I think that we have to start really pivoting our thinking to - how do we design trials in light of all the the advancements we've made in, in digital technologies to the advancements we made even in in sort of scientific outcomes research? You know, I think about, you know there was a big wave of of interest over the last several years of this idea of decentralized trials was sort of was born, out of the was born out of the pandemic and and you know the idea of doing these things virtually was it was definitely embraced, I think about the the notion of utilizing to your point, Raj, real-world evidence and and patient reported outcomes more so in in in trial design and trial data collection more so than we ever did. One of the interesting things about the trial itself that people often forget is that I think randomized special trials are are still the gold standard for for for evidence generation, but they're very limited too, right? And I think that there's a lot that happens outside the walls of these sort of controlled trials that you know it's data that's reflecting the everyday lives of patients that we need to capture that's typically captured through, whether it be their health records or whether it be in this case, wearables or or any other sort of patient generated health data. So I think as the world we start to really pivot to you know, to this, this idea of patient centric, you know sort of drug development or therapy development, I think that we have to sort of reimagine our own business processes and and we and and really put the the needs and the preferences of patients at the center of everything that we do. 

 

Raj Modi: 

Thanks, Chris. And you know to follow up on that, there's a huge buzz right now about AI. What's your perspective on AI? I mean, how does AI help with things like identifying eligible patients, surfacing biomarkers, enabling more personalized treatments? 

 

Chris Boone: 

Oh, hey, you know what, man? I I know there's a significant amount of fear and and skepticism about the sheer ability of AI, you know? But but I I'm I'm a believer. I'm a fan. I thought it was something that the industry needed for a very long time and it and it is and and honestly, I think the expanded use of AI is is a patient centered approach. Because what we're effectively trying to do is personalize and get closer to precision medicine by utilizing all the available data that's out there utilizing many of the you know whether it's generative AI and natural language processing or other AI approaches to really get closer to what it takes to drive to positive outcomes for patients, right. And and I think that what you gave some perfect examples, the the identification of of biomarkers which then feeds into trial design which that trial design can then feed into carefully identifying the appropriate patients and patient you know cohorts or populations that will be most suitable for these types of trials and and honestly which would allow those particular patients that would have some sort of response to that particular therapy which we can learn a lot from. I I can see the the use of AI and so many use cases throughout the entire life cycle of a patient journey and and an entire life cycle of of a of a therapy. Right? And and I think that it it gets us closer to precision medicine. I think it gets us closer to this idea truly of a learning health system which we all strive for. And and I think that for patients like Maria, we would be able to sort of I I think you believe it or not it it sort of it sounds kind of counterintuitive to say that I think AI will get us closer to a place of empathy and compassion for patients, you know, and building trust that I feel like we need to have. And this whole patient centered approach, but I do believe that to be the case. 

 

Raj Modi: 

Maria, let me bring you in there. Empathy and compassion. What's your perspective? You know, how do you feel about the role of AI and generative AI? Large language models which have become incredibly popular recently. What's your perspective on that? 

 

Maria Clarke: 

I mean, personally, you know when I can clearly see how my data is used and when I'm included in that process and when there's real accountability, then I can trust the system. And that trust makes me more willing to share, which ultimately leads to better care and stronger research outcomes. 

 

Raj Modi: 

So Maria, I'm I'm I'm hearing a thumbs up from you on on on AI. Of course, AI is nothing without data, Chris, real-world data is now a major part of how regulators and clinicians make decisions. Can you talk a little bit about that? And also, can you talk about how Oracle is helping customers turn real world data into real-world evidence? 

 

Chris Boone: 

Yeah, yeah, I think. You know, as you think about this idea of real-world data, the real value of it and and, so the challenges that it was trying to address had a lot to do with how do we better capture sort of the patient experience. How do we sort of track the progression of a disease or our patient experience beyond the clinical trial? How do we sort of, how do we create a more, it's more equitable access. Because while Maria lives in Philadelphia, she has access to the Children's Hospital of Philadelphia, there are folks that live in remote parts of Pennsylvania who may not have that same access and and honestly, we we we are not, we haven't effectively designed these sort of accessible trials the way we need to in order to do that. Where I see the world of of of RWE coming in, especially from the patient experience of those that are are are suffering from, if we wanted to use CF as an example, I think it's the AI sort of allows us to sort of aggregate and analyze all the data from all these various sources, which are very important, right? I mean, we have a number of CF patient registries out there. There is the EHR data that we know there's a data from the trial and then of course there is that patient reported data. That data is generated from from RWE and what we're able to do with that is sort of track what the long term impacts and outcomes are of these different therapies, how it affects the quality of life for many of of the patients. And oftentimes, I think when it comes to patients that are dealing with particularly rare diseases is that honestly, once that therapy goes sort of in a what we call the post marketing phase or the post authorization phase, meaning that once it's actually approved by the FDA, you sort of lose sight of those patients, right? Because there's not that longitudinally across from the trial experience to what they're dealing with in the real world. And so I think the the the the power of real world evidence in this case is really sort of to strengthen what we can do sort of in a post approval world and post approval engagement and really tracking the progression of you know and the sort of how the outcomes of those therapies ensuring to Maria's point that there's a level of trust and and sort of open communication from patients as they're tracking their own experiences on a daily basis, and they're reporting it, and it's being captured and actually analyzed along with the other data that's being collected and hopefully it starts to get to this point of really personalizing, you know, I like to call it the the end of one trial of The Walking clinical trial where we're really getting specific to individuals and tailoring our trial protocols for their specific needs. And and and if you're talking about CF, which is has a you know a host of subgroups, those specific mutations of CF you know are important. 

 

Raj Modi: 

Yeah, Maria, let me bring you in here. What's your perspective on real world evidence and what does it mean when we say that we wanna reflect the true lived experience of patients? 

 

Maria Clarke: 

So you know, when I hear real world evidence as a patient advocate, it resonates deeply. It means, you know, capturing the lived experiences of real people in everyday life, not just what's happening, you know, in tightly controlled clinical trials. It's about evidence that reflects real settings, you know, diverse populations and real needs, ensuring health decisions are meaningful, inclusive, and patient focused. 

 

Raj Modi: 

Thanks, Maria. That's that's really insightful. We've covered a lot today. I just want to thank you both for such a thoughtful and inspiring conversation. Before we close Maria and Chris, if listeners want to reach out to you, where could they find you? 

 

Maria Clarke: 

Yes, so I am very open on LinkedIn. I post a lot about my experiences as a patient and working within the industry, especially like different feature stories on blogs or news, articles, any of that sort so you can find me on LinkedIn. It's my name: Maria Clark. And I also have an Instagram for specifically cystic fibrosis and my experience is as a patient. So for anyone out there that is interested in learning more about CF or has CF, that is Marias dot dot miracles so you can find me there or on LinkedIn and I'm happy to connect. 

 

Raj Modi: 

Excellent. Thanks Maria, Chris. How can people reach out to you? 

 

Chris Boone: 

Yeah, I'll go the same. I mean, I think LinkedIn is is a great a great resource or a great tool to to, to, to connect with me. You can find me data hippie on LinkedIn that's truly, truly my handle. And I'm also data hippie on YouTube and data hippie on X. So if you're interested if you use those platforms. I'm I'm available there as well. 

 

Raj Modi: 

Wow, you're both so social media savvy. That's amazing. Both again, for for, for the podcast. I've really enjoyed this conversation. Thank you to our listeners. And remember, innovation only matters in this industry if it reaches patience when and where they need it. To learn more, I'd encourage you to read Seema Verma's recent article on LinkedIn which is called AI and the feature of Precision Medicine and also explore what Oracle is doing to embed research directly into the heart of clinical care. Thanks for tuning in and we'll see you next time. 

Perspectives on Health and Tech 

How CAMH is Advancing Mental Health Through Innovation and Social Justice

Listen in for a timely conversation in recognition of Mental Health Awareness Month and National Nursing Week. In this episode, Dr. Gillian Strudwick from The Centre for Addiction and Mental Health (CAMH) and Danny Gladden from Oracle Health discuss how mental health care is evolving, and how CAMH is advancing care through the dual lenses of technology and social justice. Learn how AI tools like Oracle Health Clinical AI Agent are easing clinician workloads, how CAMH is using data to drive impact, and why framing mental health as a social justice issue is key to helping the CAMH team deliver more equitable and compassionate care.

Featuring:

Dr. Gillian Strudwick, Chief Clinical Informatics Officer, The Centre for Addition and Mental Health

Danny Gladden, LCSW, MBA, Director, Behavioral Health and Social Care, Oracle Health

Listen as they discuss:

o   The Centre for Addiction and Mental Health (CAMH) background – 2:45

o   Mental health care viewed as social justice work at CAMH and examples – 5:00

o   Technology innovations at CAMH with a human-centered approach – 9:30

• • Wearable devices and the impact they have on research
  • Repetitive Transcranial Magnetic Stimulation (RTMS) treatment
  • Evidence-based apps and the integration of these into clinical care processes
  • Optimizing EHR use and exploring the opportunity to share mental health notes in Canada

o   CAMH's perspective on AI technology and its potential impact on clinicians – 18:25

Notable quotes:

"Mental health is social justice work." – Dr. Gillian Strudwick

"To be able to deliver compassionate care in this day and age, we have to be innovative in our use of technology." – Dr. Gillian Strudwick

CTA:

Learn how Oracle behavioral health solutions combine real-time, clinical data from across each patient's unique healthcare journey and how Oracle is working to reduce the documentation burden on physicians and elevate the patient experience with the Oracle Health Clinical AI Agent.

-----------------------------------------------------------------

Episode Transcript:

Intro  0:00  - 0:29

Welcome to perspectives on health and tech podcast brought to you by Oracle Health. In this series, we have conversations on creating a seamless and connected healthcare world where everyone thrives. Let's get started.

 

Danny 0:30 – 01:44

Welcome to perspectives, Oracle Health and Life Sciences podcast. I'm your host today. Danny Gladden, I'm a licensed clinical social worker and general manager of behavioral health and social care here at Oracle Health. As we step into the month of May, we recognize Mental Health Awareness Month, a time to raise awareness reduce stigma and highlight progress in mental health care. I'd also like to give a special shout out to our nurses across Canada and the US as we celebrate National Nursing week. Thank you for your unwavering dedication and compassion. Social workers and nurses make great teams. Today, we're honored to be joined by a leader in mental health care innovation. Please welcome Dr. Gillian Strudwick from CAMH, the Centre for Addiction and Mental Health, Canada's largest mental health and addiction teaching hospital and one of the world's leading research centers in its field. So, Gillian, welcome. Before we dive into big topics here, can you introduce yourself and tell us a little bit about the great work happening at CAMH.

 

Gillian 1:45 – 03:47

Thank you, Danny, and thank you for the opportunity to be a part of this great podcast. I might break this into two sections. First, I'll introduce myself, and then I'll tell you a little bit about the organization that I'm fortunate to work for. I'm Dr Gillian Strudwick. I'm a registered nurse, and I've worked primarily in mental health clinical settings here in Toronto, Canada, and also in other parts of Canada and internationally. Currently, I am the inaugural Chief Clinical Informatics Officer at CAMH, representing our nurses and all of our non-physician health disciplines, like social work. And I have a couple of other hats as well. So one is that I'm the head scientist of the digital mental health lab, and I'm also the scientific director of our Digital Innovation Hub, which is about really accelerating our work in this digital sphere and research practice, education and beyond.

So that's about me, but I'll move on to talking about CAMH. So CAMH is C, A, M, H, the Centre for Addiction and Mental Health, and it's Canada's largest mental health and addictions teaching hospital. We think, and I think there's lots to suggest that we're true in saying this, that we're a world leading Research and Education Center on mental health, and we're located right in the heart of downtown Toronto, but we serve people across our province, Ontario and across the country as well. In terms of a few numbers that I'll share with you, we've had just over 16,000 emergency department visits in the last year, over 40,000 patients that were treated, over 80,000 virtual care appointments. And I'll provide a few more numbers here as well, almost 8000 RTMS visits, 60 million in a new research funds more than 1000 articles published. I think you get the point that there's a lot going on at CAMH, and it's a great place to be.

 

Danny 03:48 – 04:50

You know, I have been on your campus a number of times. I always appreciate that your campus is right in the heart of Toronto, in a bustling area, and I think there's, there's no greater way to reduce stigma than, you know, placing such a well-respected mental health and addiction treatment organization right in the heart of the city. Whereas if you go to many other communities, you'll kind of see the mental health hospitals and treatment providers kind of on the outskirts of town. Really appreciate CAMH's role right there in the heart of Toronto. And I think this goes into something Gillian that you speak about passionately, which is the idea that mental health treatment is social justice. For our audience, tell us what you mean by that. Why is it an important lens - social justice, which you view your work?

 

Gillian 4:51 – 07:43

I think it's quite an important point that you bring up, Danny, and it's something we're really proud of talking about, that mental health work is social justice work. Part of doing social justice work is to be informed in this space. And part of being informed is understanding that mental illness disproportionately affects marginalized communities who are also often facing barriers to things like accessing care, and this could be due to racism, poverty, stigma, geography, and I could continue so on and so forth. At CAMH, we see mental health is deeply rooted in social justice, because access to care, dignity and treatment and prevention are not actively distributed. CAMH advocates for policies and systems change that ensure mental health care is not a privilege but a right. And so that's really our social justice lens, framing and shaping the last few statements that I made.

We have done some work more recently in the last couple of years on dismantling anti-black racism, which has become a more formalized organizational commitment. I'll just read a section from one of our documents around dismantling anti-black racism. And excuse me for it sounds like I'm reading here because I'm reading from a document, but systemic anti-black racism, is a barrier to high quality health care for black patients at CAMH and across the health care system, the data lay bare with those in black communities have signaled for decades. Discrimination and oppression based on race delays care and harms individuals on their way to recovery. Racism also has a negative impact on the quality of work life for black staff, beyond the damaging emotional and psychological consequences, it limits their career trajectory, and it goes on from there. I bring this out as one of the many initiatives that the organization is committed to. And as a result of this commitment, this public commitment, you can read what I just read on our website, camh.ca, that there's a number of activities that the organization is doing everywhere, from doing offering more culturally appropriate therapies to education for staff, staff support groups, creations of processes that support equity, lots of advocacy work with the government. A lot of this work is ongoing, but this gives you sort of a more grounded, more concrete example of some of the ways in which we look at social justice as being so related to mental health.

 

Danny 7:44 – 09:31

My goodness, you know the social worker in me is just grinning from ear to ear, as you describe, you know, the foundation in which CAMH is caring for folks. You know, I'm still a licensed clinician in Missouri and Alaska. You know, particularly, I think about a state like Alaska, with a disproportional number of folks who are Alaska Native. And we see, you know, in those communities, so much generational trauma, and the impact you know, and the impact that oppression you know has on sort of repeating traumatic occurrences across the generations and so, so very important, I think, an important perspective to look at the the experience of mental health and the treatment of mental health through a social justice lens. Gillian, I just appreciate that, that that is a focus of CAMH, and I'm sure the indigenous populations your organization works with, you see a similar, you know, a similar experience than the those in the in Alaska here. Now, as we pivot here, thinking about, you know, you're, I think the work you're describing, from a social justice perspective, is innovative. It seems like CAMH is always at the cutting edge of innovation. We're a technology company, and so, you know, from a technology innovation perspective, what are you seeing? What's CAMH doing?

 

Gillian 9:32 – 15:53

Great question. Danny, and because of my various roles at the organization, I get excited about this kind of a question, and it also describes the work that I'm doing every day, with my colleagues, with our patients, their family members and others across the organization. So yes, we're always interested in how we can use technology and to innovate with technology, but we do that so we can achieve various things and the things that we want to achieve are being able to improve access to care so we can see more patients, because probably unlike, or not unlike various organizations in the rest of Canada and in the US, we have long waiting lists for care. The second is to be able to improve the quality of care. And not to say that care isn't good already, but more that as we learn and develop evidence and get feedback from our clinicians, from our patients, we can then integrate that into care. So that's the second piece. The third is to improve the patient experience, and the fourth is to really personalize care. When we think about how we innovate with technology, we're really looking to see if we can do those four things. And yes, there's other, you know, other reasons you invest in technologies for various efficiencies and cost savings. But I'm going to talk about more work on the earlier four points that I described.

So maybe I'll provide a couple of concrete examples. The first one is thinking about the opportunity that we have by embedding wearables into care processes. These are things like Oura rings or Fitbit that you know, it doesn't matter which company it is. There's lots of wearables out there, but embedding them into care processes so we can look at sleep and activity which are often impacted when people have symptoms of depression or anxiety. We hope at CAMH to use this information to better understand someone's individual patterns, which could really help us tailor their treatments, as you can imagine, but also be able to identify early when a treatment may be starting to take some effect, or an early warning sign, or an indicator of someone potentially falling ill or relapsing. Lots of potential in that space, and we're getting going primarily in the research domain, in the wearable space. So that's sort of one concrete example.

Another concrete example is RTMS. So CAMH has been a leader in this space and doing brain stimulation research for a number of years. RTMS, in case listeners aren't familiar with it. It's a non-invasive treatment. It uses magnetic fields to stimulate very specific regions of the brain, and it's been shown to be particularly effective for people with treatment resistant depression. These are individuals who have not responded well to medication or therapy alone. To date, we've had about 8000 individuals last year who have received RTMS. We're thinking about it from advancing the science, treating individuals, of course, and doing lots of advocacy work.

The third example I'll provide is around the app space. There's lots if you were to type in depression or anxiety into any app library, you're going to see lots and lots of apps, most of which don't have a scientific backing to them, some of which may actually be a waste of time to engage in. It's also really hard to make sense of that app landscape. So, we've been working to develop and integrate into clinical care processes, apps that have that evidence base behind them, and have some sort of a portal or interface with clinicians so that the data can be used for care purposes. We've got one called my change plan for smoking cessation of behavioral modifications. We've got one called App for independence, which is a platform for supporting people with complex behavioral and mental health conditions, and it's currently used for recovery processes with individuals with psychosis and schizophrenia and now opioid use disorders. And then we also have another app called Hope by CAMH, which is a safety planning intervention for people at risk for suicide. So, there's, you know, that doesn't cover all the apps, but gives you a sort of a flavor of the various apps that we've been working on, so that there's the credibility the science and the engagement and feedback loop for those particular areas.

And then the finally, the last one I want to talk about is our electronic health record. We use the Oracle Health platform, and we're really thinking about how we can optimize our use of it for the best experience for clinicians and patients alike, including this concept of open notes through our patient portal, so where patients can see their notes and so well, if you're in the US and thinking, well, this is the norm for us, it's not quite the norm for folks in other countries. It's optional in Canada to share mental health notes, and so we're showing some real leadership by identifying how best we can do that and opening up our notes. So I'll just close on this topic, Danny, by just saying that importantly, we're taking a human centered approach when we're doing this work, whether it be in apps, wearables, with our EHR that we're co-designing with patients and clinicians to ensure that they're usable and they meet the needs that are the most pressing needs, but also that we deliver and implement technology that allows us to provide compassionate care. Because I think when we think about technology, it's often this sort of antithetical approach to compassion. And we are showing that to be able to deliver compassionate care in this day and age, we have to be innovative in our use of technology.

 

Danny 15:54 – 18:07

Wow. What a, what just, what a robust list of innovation. You know, that CAMH, is sponsoring. I'm not, not at all surprised Gillian, knowing your history. You know, Gillian, maybe a part two to this conversation. A separate podcast can be sort of on the intersection of social justice and technology. You know we regularly describe some just phenomenal innovation, consumer facing innovation and yet, we know that there's consumers of care that don't always get to take advantage of the latest and greatest innovation. The wearables or access to a device to allow, you know, portal or telehealth. You know, lack of hardware, lack of bandwidth, lack of sort of knowledge or trust in the available tools. So, you know, maybe we can. We'll bookmark that, I think for another day, but in the area of innovation, CAMH was part of our clinical AI work group for behavioral health. This was a year-long process. You know, Oracle has been an AI space for many, many, many years. You know, I'm sitting in a Marriott right now where, you know, I used Oracle tools to check in and to engage with the Marriott staff. Oracle knows a thing or two about AI, and has taken what they know about AI and applied it to healthcare. And we, Oracle Health, and CAMH and others have taken that and morphed it for behavioral health. So, our clinical AI agent today is available in the US in behavioral health, used across a number of behavioral health providers. I think to date, we've had nearly 20,000 medication management notes that were documented using Oracle Health's Clinical AI Agent. So, what's CAMH thinking about from an AI perspective?

 

Gillian 18:08 – 22:38

Oh, we're thinking about lots from an AI perspective. And I will just note that while you're sitting at a Marriott, I'm sitting at the hospital right now, and on the overhead speaker is a code being called. Apologies if you can hear that. We are really quite excited about the potential for AI and what it could bring for things like research, education, of course, clinical care, and how we operate and potentially achieve some efficiencies. I think there's a whole bunch of areas where we see the potential for AI. We're fairly early in our journey, but we're setting up all the right infrastructure so that we can accelerate more quickly. The first is that we recently launched, just this month, a BMO chair in artificial intelligence and mental health. So that's a research chair role specifically for AI in mental health, and I believe it's the first and only in Canada at this time. So Dr. Tristan Glittard Is the inaugural chair. He's an AI computer scientist, researcher and engineer, highly collaborative with clinicians. I think we have high expectations for what this role will achieve. We're also hiring for an AI scientist. From a research perspective, I think we expect big things, and I'll have more to report back on Danny in the not too distant future around that one.

In terms of education, we currently have a digital mental health and AI Certificate Program, which is free and currently available on our website. So folks here who are listening are welcome to go to camh.ca and who and can navigate to finding the digital mental health and AI certificate program, and that's really thinking about, mostly for clinicians who are working in this space where there's more AI tools available for them to develop their competencies and thinking about how to use them within their clinical practice. We're getting, sort of our baseline of folks ready so that we're able to really accelerate in this space.

And then I'll just mention one thing lastly, and while we don't have anything concrete yet to share the potential of AI scribes and ambient scribes, and using this sort of technology to free up our documentation time for essentially all clinician types is of big interest. Not just the documentation, but also other tools like being able to do note summarization or querying the electronic health record or the patient record. So I think all of these sorts of things are of interest for us, and our clinicians would jump on at scale. These sorts of things can have a big impact. And I'll give you an example. Not too long ago, we did a fairly small change in our EHR, and it result, and that was about nurses reducing their documentation time. We took out some particular areas of a power form. It resulted in a couple of seconds per power form that nurses were not documenting anymore. But when we calculated the total time savings over the course of the year for nurses, it was the equivalent of a full-time nurse by just doing that small change. And so if we think about that's just a really small example that we saved a full 1.0 full time equivalent of nursing time. If we did that at scale by using ambient scribes, by doing things like note summarization and querying, we could really take that to the next level and save large amounts of time, which we hope, could really support clinicians in being even more engaged less burnout. You know, the list goes on. So of course, in doing any of this work in AI, we need to be mindful of risk and bias, ethics. So there's a lot to be mindful of there, ensuring we keep mental health care human and so we're really making sure we're getting this right. We're starting our journey to ensure that we have all these various safeguards in place. But I will say it's a really exciting place to be. There's some very cool tools coming out, and I can't wait to get my hands on them.

 

Danny 22:39 – 23:58

Yeah, Gillian, we are so excited. You know our psychiatrist, psychiatric nurse practitioners, nurses, social workers, case managers, therapists, all benefiting today from use of Oracle Health Clinical AI agent. So, thank you for sharing those insights. Now. Before we close, we want to remind our listeners that if you or someone you know is struggling, help is available. In the US you can call or text, 988, 24/7 365.

988, is the suicide and crisis lifeline in Canada also, 988, 24/7 365, and just interestingly enough, 988, in Canada is provided and managed by CAMH to ensure that no one has to face a crisis alone. Trained responders are there for support. Dr. Gillian Strudwick, thank you for sharing your insights and for the work you and CAMH are doing every day to make mental health care better, smarter and more just. And thank you to our listeners for tuning in. Take care of yourselves and each other.

 

Outro 23:48 – 24:20

That's all for this episode of perspectives on health and tech podcast, be sure to subscribe to catch all our future episodes. For more information from industry experts, visit oracle.com forward slash health and oracle.com forward slash life hyphen sciences, or follow Oracle Health and Oracle Life Sciences on social media. Thank you for listening and join us again for the next insightful episode of perspectives on health and tech.

 

 

 

In this episode, we dive deep into the transformative journey of two beta customers who are among the first to experience the Oracle Health EHR system and Clinical AI Agent's in an ambulatory setting. They share their firsthand experiences while working with the design and testing of this cutting-edge technology. Joining the conversation is an Oracle Health clinical executive, Ashleigh George, who provides insights into the design, vision, and potential impact of this EHR solution on improving patient care. Together, they explore how this innovative system is reshaping the landscape of healthcare delivery and what it means for the future of ambulatory care.

---------------------------------------

Episode Transcript:

Welcome to Perspectives on Health and Tech Podcasts, brought to you by Oracle Health, where we dive deep into the world of innovation and transformation in health care. My name is Matt Patterson, your host and moderator for today's discussion. Today, we're thrilled to welcome three renowned experts who are pioneering change in the health care industry. 

 

00;00;59;03 - 00;01;28;18 

Unknown 

Joining us today, we have Ashley George, a visionary in health care technology and leader with an Oracle health product development. Dr. Ryan McFarland, a family medicine physician based out of Hudson, Wisconsin. And Dr. Randy Thompson, an emergency physician by training who now serves as the chief health analytics officer at Billings Clinic. In today's episode, we're going to explore challenges facing health care systems and how groundbreaking innovation is paving the way for a brighter, healthier future. 

 

00;01;28;20 - 00;01;48;22 

Unknown 

So grab a seat and prepare to be inspired as we embark on this insightful journey. First off, I'd like to allow the opportunity for each of you to introduce yourselves. We'll start with Ashley and then Dr. McFarland and Dr. Thompson. Ashley Yeah, Thanks, Matt. Well, I think you actually might have a new calling in as a podcast broadcaster. 

 

00;01;48;23 - 00;02;24;09 

Unknown 

That was an impressive intro. You've got a radio voice almost, but that's great. Well, anyway, thanks to Matt for having me on today. I'm Ashley George. I'm a clinician, actually, by background started my career 25 years ago in a neuro ICU unit and from there have had the opportunity to work in health care I.T. for the last 20 years and have really been at the forefront of the changes that have occurred over the last several decades and and excited for the work that I hand at Oracle Health, where we're doing today within our products and serving our clinicians around the world. 

 

00;02;24;12 - 00;02;48;16 

Unknown 

Thanks, Ashley. And Dr. McFarlane, why don't you tell us a little bit about your yourresponsibilities in the organization and patients that you serve? Yeah, my name's Ryan McFarland. I'm a family medicine physician in Hudson, Wisconsin, part of a large private practice group. We've got about 60 providers. I'm one of the owners in the practice on our medical board, kind of help direct our practice into the future. 

 

00;02;48;16 - 00;03;14;05 

Unknown 

And one of the big parts of my job has been working with our I.T. tech and things like that. And that's how we got involved with Oracle and fortunate enough to help be in the early beta testing and help build these products and everything. Thanks. And Dr. Thompson? Yeah. Good morning. My name's Randy Thompson. I'm the chief health Analytics officer for Billings Clinic Emergency Physician by training but work full time. 

 

00;03;14;05 - 00;03;46;09 

Unknown 

And it now in our system is the largest independent health care system in Montana, where those clinic at Logan Health merge in 2023, we have over 1200 providers representing 80 medical specialties. My job is to try to make their lives better. And I, I could say I'vebeen in health care for 41 years now and there has never been a more exciting time to be in health care in terms of the positive solutions coming to our providers and nurses. 

 

00;03;46;11 - 00;04;11;16 

Unknown 

Wonderful. Yeah, Thanks, Dr. Thompson. And I think that's a good segway into to get right into the meat of the conversation here. So today's podcast is obviously really about exactly what you just mentioned. Randy, The opportunities that exist within health care really to raise the bar in the industry with some of the Gen AI technologies that we're entering intothis new era of beyond. 

 

00;04;11;16 - 00;04;33;11 

Unknown 

So within the current landscape, I want a level set where we're at today. Ashley Can you tell us a little bit about the biggest challenges that health care systems are seeing today? Really, how is technology currently influencing health care delivery today? Yeah, I mean, I'll say as I think about this, my my response isn't just US based centric. 

 

00;04;33;11 - 00;04;51;12 

Unknown 

It is also thinking about internationally as I meet with customers around the world. And hands down top of mind is how are we supporting our clinicians so that they can better take care of the patients? Right. And I think you could I could be as dramatic to say as like we're at a moment of reckoning in terms of people are tired, they're exhausted. 

 

00;04;51;12 - 00;05;11;17 

Unknown 

We don't have enough clinicians around the world to serve, you know, the patients that we need to take care of. Everyone is on razor thin margins. They're trying to do more with less. And yet it doesn't stop the regulations that continue to come in. It doesn't stop almost theinability for clinicians to be able to access care appropriately. 

 

00;05;11;17 - 00;05;43;01 

Unknown 

And I think that's where for us, it's not an option. We have to transform and rethink how we're delivering health care and how technology can play a pivotal role in that. It's not the only answer, but it is a big answer in terms of how we're going to approach this. And I think, you know, I feel that here at Oracle Health, we we feel that urgency is to be able to help our clinicians, like the ones that are joining today's podcast, like how can we do better for them so that they themselves can do better and help take care of their patients. 

 

00;05;43;01 - 00;06;23;08 

Unknown 

And that's really what we wake up every single day, striving to deliver. Wonderful. And Dr. McFarland, Dr. Thompson, you're from your purview. Well, what trends are you seeing that that opens up opportunity to really reshape health care? You know, I think the biggest trends are, you know, trying to get more, I would say, you know, clinician and patient focused and centered resources and technology for the first time versus it's previously been just purely a data gathering billing tool that didn't serve anyone other than the insurers and certain researchers. 

 

00;06;23;10 - 00;06;40;17 

Unknown 

So that's I think the biggest trend is that we're actually seeing patient forward and physician forward products for the first time, which is part of why I think it's so exciting to see what's coming. So that's what I think is really the trend that we're seeing. That'sgoing to be a huge impact to our careers and patient care. 

 

00;06;40;20 - 00;07;22;08 

Unknown 

And I would just add to that, having the system work for the providers and the nurses and the schedulers and the reps cycle people rather than us working for that solution. And I'll just give an example with the new H.R., the system is working on behalf of the clinician and going out and searching the record, finding out relevant information, bringing that back, collating it and presenting it to the clinicians in a manner that makes sense to them so that so that they can make decisions and, you know, have a better chart and so now it's the opposite way. 

 

00;07;22;09 - 00;07;42;21 

Unknown 

We have to go out and we have to find relevant notes and find relevant studies and try to tweak the details and gather those details so we can consider that what their interaction with the patient and then document that all in the chart afterwards. And it's just almost impossible to do with a clinicians busy schedule the amount of time that takes. 

 

00;07;42;23 - 00;08;03;17 

Unknown 

So that's what I'm excited about. Yeah, I mean that's I mean, it's huge. I mean, that's what I spend the bulk of my time doing is before I see a patient. Even when I'm in with the patients, it's digging through this slog of just repetitive data, good data, bad data, what'srelevant, where is the relevant information? And it falls on me to just sift through this huge backlog of data. 

 

00;08;03;19 - 00;08;32;03 

Unknown 

And this is the first time where it's being brought forward to us. It's going to help us make better decisions, not miss things. You know, just give an example. And, you know, I was looking at one patient's note and the summary, the problem based summary had gone out and looked at 11 different notes and brought that information forward and presented it in a really succinct manner that was understandable and complete. 

 

00;08;32;06 - 00;09;00;17 

Unknown 

So that so that, you know, that was really actionable information that it would be almost impossible for a clinician to do in the limited amount of time they have to review the record and then bring that forward. So I mean, it's just really exciting. Well said. You know, Ashley and I were actually talking yesterday in preparation for this podcast about the acceptance that exists in the industry around training requirements when you go to a new EMR. 

 

00;09;00;19 - 00;09;20;15 

Unknown 

And I think it's just exemplary of where the bar stands today and the opportunity to raise that bar that you don't require 15 hours of training to understand where you need to go to find what you need, because now the technology works on your behalf as opposed to you having to figure out the technology to find what you need to provide care. 

 

00;09;20;15 - 00;09;44;22 

Unknown 

So very well said. And I think a good segue way again to the next piece that we're going to dig into a little bit more about the Oracle health. Are each of you are very involved in, you know, being an early adopter, a part of the overall design as we've been going through this journey of the future state of really what an Oracle health model can bring to the industry. 

 

00;09;44;25 - 00;10;07;21 

Unknown 

So Ashley, you know, focusing a little bit on the Oracle health are in that broader context. We just spoke to. Can you just talk a little bit about the vision of the system that you've been designing over the recent years? Yeah, absolutely. So if we even kind of unpack like Oracle Health electronic health record, right, to us, the vision is it's not it's not a record anymore. 

 

00;10;07;21 - 00;10;34;05 

Unknown 

I mean, certainly has to be a record things, but it's beyond a record. It's a system of intelligence. And how do we really think about it as a partner, as a care team member that's aiding our clinicians, the staff, whoever's interacting with that, to really automate, to anticipate, to connect care. And really, at the end of the day, how does that empower our clinicians and not weigh them down? 

 

00;10;34;07 - 00;11;03;29 

Unknown 

You'll hear us often say, even not to be so cliche, but it's like, how do we bring the joy to when a clinician is interacting with the system and making this meaningful and an invaluable to to him or her and all the interactions? And so I think when it comes down to it is it is how are we pivoting from just being a system of record to truly a system of intelligence that is acting on behalf as a care team member with the with the entire group and the team. 

 

00;11;04;01 - 00;11;51;12 

Unknown 

And thanks, Ashley and Dr. McFarland. Dr. Thompson, can you just speak a little bit about your experience thus far and the impact to your practice that you believe you'll see? Yeah, it's I mean, it's been pretty exciting. Seven were part of a beta testing for the last two years I think almost now between the the COAG, the, you know, the ambient listening and creating notes to building orders the new are, I mean even from where we're at now, we went from struggling to find scribes to help support our practices to now I have a smart agent that writes my notes, is proposing orders for me, allowing me to keep productivity volume going. 

 

00;11;51;14 - 00;12;09;05 

Unknown 

And then when we have seen the the new and getting to beta test that it's been I mean, it's it's incredible. You know, I keep having this desire to well, I need to go find the notes. I need to go look and dig in and all sort of like, she's just telling me right here what what'sbeen done, what the history is. 

 

00;12;09;05 - 00;12;32;27 

Unknown 

And it's it's a it's really kind of creating an entire different paradigm of how we're going to interact with the electronic health record. Like, like Ashley was saying, it's not going to be so much more of a record. I do truly think they're building a product that will be more of kind of like a part of the care team, something that the physician can utilize to care for a patient and a patient can even utilize to understand their care better. 

 

00;12;33;03 - 00;13;06;22 

Unknown 

That's where I kind of see this. The impact that it making. And I would just add, so we became a beta test partner kind of for selfish reasons. And, you know, our providers like to offer their opinions on why that solution is so terrible, right? But they don't have the opportunity to really help craft that solution. And so for us, having our providers have the opportunity to really help in the development of a solution that really makes sense to them and meets their needs. 

 

00;13;06;22 - 00;13;41;03 

Unknown 

And so that was why we really volunteered to be a beta test partner. And it's been extremely rewarding both to the providers who, you know, previously would not participate in these test validations because they would do something, they'd read their feedback and nothing would happen, and so they would lose interest pretty quickly. But really exciting that when they rolled out like CAA, the the initial product was pretty basic, but it quickly improved based on the early and often feedback sessions that were scheduled. 

 

00;13;41;05 - 00;14;04;13 

Unknown 

And the first time they saw their suggestion incorporated into the product. I mean, that was really exciting. And so we had like zero problem recruiting volunteers for this. So so that was really exciting. And, you know, Oracle I think is on the right track in terms of theyhave a vision for a solution like caa or the new h.r. 

 

00;14;04;15 - 00;14;29;27 

Unknown 

And then they build something and then bring in clinicians both on the build side because, you know, on the new h.r. There have been work groups for providers and nurses for the acute ambulatory side of this for a while now. Since last year that they've been running the solution by them and soliciting feedback. Now they've got a product that they're in front of the beta testers and they're doing the same thing, soliciting that feedback and making changes on the fly. 

 

00;14;29;29 - 00;14;50;05 

Unknown 

And so, I mean, to me, that's just the right way to do this. And everybody's pretty excited about that. Yeah, it's I mean, it's been incredible to be part of the process and to see, you know, feedback and frustrations get fixed quickly within, you know, a week or two direct feedback communication with the engineering team. I mean, it's been cool. 

 

00;14;50;05 - 00;15;13;02 

Unknown 

We've had the engineers out at our clinic to watch our workflow because they weren'tunderstanding some of our, you know, issues or complaints. And then they see us using they go, that's what you need, which is I mean, instead of them giving us something, the engineers are actually in, Oracle's actually building something for the clinicians with direct clinician input, which has been pretty exciting to be part of. 

 

00;15;13;04 - 00;15;38;03 

Unknown 

Yeah, I'll just add to that. They, they brought a team of over 20 engineers and, and solution people out here and they weren't just focused on one product they wanted to understand workflows so that they could then incorporate that into their design and build. And to me that was a big investment for them and I think well worth it for our end users. 

 

00;15;38;05 - 00;16;02;23 

Unknown 

Great. And Dr. Thompson, Dr. McFarland, obviously Ashley just gave some insight on the overall Oracle health design strategies. But from your perspective, day in, day out, living in that world, can you talk a little bit more about really just what Oracle brings from, you know, a technology innovation strategy perspective? Matt Where are you directing that to me? Sorry, Yeah. 

 

00;16;02;24 - 00;16;29;27 

Unknown 

Ashley Sorry. Yeah, yeah, yeah. I mean, got me to restate that. Yeah, maybe. Sorry. Let me, let me restate that pause. So, Ashley, having heard from Dr. Thompson and Dr. McFarland talk about some of the engagements and early adoption into strategies, can you just talk a little bit more about that detail from somebody working in the day in, day out? 

 

00;16;29;29 - 00;16;55;19 

Unknown 

Yeah, I mean, you you heard Dr. Thompson say like in the legacy system, feedback was given and then it felt as if it went to a black hole and died like there was nothing that was coming out of out of the customer, even engaging in the feedback. And I think the theapproach and the engagement that the Oracle health team has taken is our design and development is a reflection of the customer voice first and foremost. 

 

00;16;55;19 - 00;17;30;17 

Unknown 

And so it is how do we engage often and frequently and have that feedback loop that is constant so that we are constantly improving. I think we can also point to the fact of, you know, your hours and our history with our, you know, our current legacy systems, right?There's 30, 40 plus years of knowledge. And so there's also being able to take what worked really, really well in terms of some of the design, the usage and the patterns and what are we what should sustain or, you know, be persistent, but also what completely needs to be reimagined. 

 

00;17;30;17 - 00;17;50;00 

Unknown 

And I think that is the piece as we are engaging with customers, is also we often say like check the brain of everything that you know historically about ours. And why did we always do it this way? Was it because it was a technology hindrance or we were had a limitation? Is it because it was a process issue that we now could maybe solve in a different way? 

 

00;17;50;00 - 00;18;10;09 

Unknown 

And then how can I and automation completely turn it on its head to say, well, why does this need to take so many clicks tabs? Or do I even have to do that work? And it just automatically presented. And so it's really challenging our own kind of approach to how we'rethinking about these workflows to ensure that it's meeting the end users really needs. 

 

00;18;10;09 - 00;18;46;29 

Unknown 

And it isn't just an answer with technology, but how does it all come together from a clinician perspective, their workflows and the lives and hopefully you guys are seeing that, you know, day in and day out in terms of the engagements that we're we're doing it at our customer sites and in these design sessions. Yeah, I would say I mean, we're it's we're seeing and it's been fun, you know, having been involved early to see what the kind of these dreams were and that here's our vision for the future and to see it slowly come out and start to as we're now culminating in the new EHR and seeing how these technology pieces interact to 

 

00;18;46;29 - 00;19;22;11 

Unknown 

build this. I mean, it's unlike any other, you know, electronic system out there, which is pretty exciting to kind of see that come to fruition. Do you have any good stories, Dr. McFarland, Dr. Thompson, that you'd like to share on the impact thus far? Yeah. So couple, you know, personal impacts from a patient care standpoint. I mean, largely around the CAA order entry and some of the I would say some of the safety and accuracy that comes along with it. 

 

00;19;22;13 - 00;19;44;10 

Unknown 

One patient's love of the product, the fact that I'm not on the computer, I'm sitting listening to them, and then the other one being, as you know, we're talking about orders and labs as we go along the visit. And it's tracking that for me and proposing these. So I'm not responsible for keeping up with them later. A good example was a long visit. 

 

00;19;44;10 - 00;20;03;29 

Unknown 

I'd forgotten that we'd talked about a colonoscopy that they'd had elsewhere that wasn't in the h.R. And they were telling me how they needed a colonoscopy. And I said, yep, will help coordinate that. And then 30 minutes later, when the visit was done, I'd completely forgotten about it. But because or the oracle, the cia was listening, it proposed the colonoscopy order for me. 

 

00;20;04;02 - 00;20;21;21 

Unknown 

You know, something that didn't get missed. While it may seem small, likely, yeah. The patient may have called back later. It saves a phone call. It's better. Patient care care is delivered accurately and on time. And I you know, I think we both probably have a lot of stories, but I mean, we just get feedback all the time. 

 

00;20;21;21 - 00;20;44;09 

Unknown 

Like this week I got feedback from her provider that she said she was almost addicted to CAA and our chief of neurosurgery had a conversation with our CEO and said, if you ever take this away from me, I'm going to quit, which is pretty powerful. I was out in RTI shopping a couple of weeks ago and a family medicine physician made icon tacked it, headed my way. 

 

00;20;44;09 - 00;21;04;18 

Unknown 

And usually you kind of dread those interactions because it's usually not positive. It'slike, how did it hurt me this week? But it wasn't that conversation. It was really she was ready to cut down on her FTE. She was always had to quit charts. She'd go home and chart late at night and on the weekend and never caught up. 

 

00;21;04;21 - 00;21;26;23 

Unknown 

And then the first day she used it, she was done at 530 Notre Dame. She went home and enjoyed her family and that had never happened before. So that was really, really positive. Another person commented, That saved my career, very similar. And so we hear these stories all the time and and they're I mean, they're real and meaningful. 

 

00;21;26;25 - 00;21;45;16 

Unknown 

You Yeah, we were sitting in our one of our owner meetings not too long ago, and someone brought up, you know, making sure that like, is the CAA worth it is what we're doing is this you know necessary. And I think four or five of the physicians stopped and goes, let me be clear, if we don't have this, I'm retiring today. 

 

00;21;45;18 - 00;22;03;18 

Unknown 

So, I mean, it's it's, you know, a huge joy factor for physicians. It's career extending, it's work life balance. You know, it's patient safety. It's all of it. I mean, the notes are better as we review, you know, previous physician notes who we continually had to be like, hey, these notes aren't up to par. We need more in there. 

 

00;22;03;18 - 00;22;42;17 

Unknown 

It's from a billing, safety, legal standpoint, whatever it was, those aren't conversations we need to have anymore because it's just ambient me doing it. And that's just what I would say is the more quote unquote simple of the products that's coming, you know, coming out. And it's already had just such a huge impact. I love that. And one of the key goals at Oracle, as we've taken on this health care journey is really for technology to become an aid to clinicians, to patients, and as opposed to a hindrance as its historically existed. 

 

00;22;42;19 - 00;23;02;13 

Unknown 

Dr. Macfarlane, you spoke to this a little bit earlier. I'd be curious to your lines on this not only now, but moving forward as we as a closing question, does a guide does the journey that we're on with Oracle Health, does I feel like a member of the team to actually become that assistant or or just another observer? 

 

00;23;02;16 - 00;23;22;21 

Unknown 

You know, I think it does. I was talking with someone the other day and I kind of made the analogy to the airline industry and I kind of see, you know, the physician career and what I envision it is we're going to become truly more like a pilot. And the air is the airplane that we're flying, that it does a whole lot of things for us, right? 

 

00;23;22;21 - 00;23;45;22 

Unknown 

I'm there for takeoff. I'm collecting the patient information, I'm interviewing the patient, doing the exam, getting the correct, the stuff I'm trained for. I'm collecting the healthdata, using my expertise and training to elicit the important information I collect that I help make clinical decisions. And then the AI is doing all the automated stuff. Once we'retaken off, it's helping me with their maintenance. 

 

00;23;45;22 - 00;24;10;02 

Unknown 

What do they do when all the automated stuff that I really shouldn't be using my brain power for? I don't need to be memorizing all the rules around immunization intervals, colonoscopy intervals. The AI is doing that for me, understanding that also patients are unique and unexpected. Unexpected things happen just like, you know, turbulence, mid-air. Something happens. I can intervene just like a pilot can intervene, and then I'm there for the landing. 

 

00;24;10;02 - 00;24;31;13 

Unknown 

We get all the data and information back. The air is helping me give me feedback and telling me what things are happening and what things to maybe zoom in on, and then I can help make the clinical decision and help, you know, make the unique treatment plan for the patient. Understanding that the air just has the data that's put in, the patient has data that they'rebringing into the room. 

 

00;24;31;13 - 00;24;49;09 

Unknown 

And I can help synthesize all of that and help, quote unquote, land the plane and help deliver that patient care. So that's kind of how I see the future, where it's doing a lot of very important things, but things that doesn't necessarily need the expertise of a physician to do. Yeah, that's that's a really good summary of that. 

 

00;24;49;09 - 00;25;19;04 

Unknown 

And, you know, the more involved we get with the AI, the more we see the potential possibilities of AI, because I think we're already signed up for like 15 beta test solutions. And every time we have a conversation, we think of additional use cases coming down the road that I could help with. And so now we're getting to the point where we need to really be thoughtful about A.I. governance. 

 

00;25;19;07 - 00;25;47;06 

Unknown 

And as far as I can tell, everybody's struggling with that whole concept of A.I. governance and how do we make sure that that we're delivering, you know, safe products and safe care from an AI perspective? And that's that's I think a hot button for most organizations is how do they do that better? But I think we're getting to that point where the system can help us and many things, and we're just starting with K but the new RB part of that. 

 

00;25;47;06 - 00;26;10;06 

Unknown 

But ultimately, you know, having the system take every new piece of input, information that it comes at it, consider it in the context of the patient. And if it identifies an insight, we should know about that. Even if we haven't seen the patient, haven't seen the result, haven't seen that piece of information, if it impacts potentially the patient, we should know about it so we can then act on that. 

 

00;26;10;06 - 00;26;35;06 

Unknown 

And so I think we're getting there. It's really exciting. We're all about safe travel here at Oracle. That's so. So Ashley, we'll have you close us out. As as health care organizations consider, you know, Oracle health for the future. What guidance would you give them you know in the the broader consideration of someone like Larry Ellison, what he really is out to go achieve? 

 

00;26;35;08 - 00;26;57;24 

Unknown 

You know, I think obviously making sure that you have a clear vision for where you want your organization to go and why you're making the change and I think anchoring that decision as well in terms of what do you need today as well as where you're going in the future, if you think about, I'll say the competition or the rest of the the legacy laws that are out there. 

 

00;26;57;26 - 00;27;23;00 

Unknown 

They're all what Dr. McFarland, Dr. Thompson has described, they're heavy on burden on the clinician because they're relying on them to do all the cognitive load decision making without really presenting meaningful information. And I really think that it's important for organizations as they're assessing their strategies for an are is how are how are those hours and other systems applying AI is it a bolt on that? 

 

00;27;23;00 - 00;27;47;27 

Unknown 

I typically see the rest of the industry doing and trying to figure out how do they retrofit a AI that can only go an inch deep in supporting their needs, or are they really thinking about it, how Oracle's thinking about it, where it's woven at every single layer of the application to the data in the services. So that's allowing organizations to really transform how they manage care. 

 

00;27;48;00 - 00;28;12;26 

Unknown 

An example I give is, you know, how do you best search for information in structured, unstructured data? Right? That's the power of the Oracle database is allowing us to do that. And so also thinking about the breadth and depth of the problems that organizations are looking to solve for, it might be clinical workflows today, it might be financials, tomorrow, it might be how are you stitching your supply chain together? 

 

00;28;12;29 - 00;28;39;19 

Unknown 

So making sure that you're also thinking about in our system that can connect all of these threads together holistically and have the data to compute all the while in a safe, secure cloud that OCI can bring. So I think as we kind of round out to where Larry's vision is, right, Larry's has stated multiple times that it's a moral obligation for us to fix health care. 

 

00;28;39;22 - 00;29;04;09 

Unknown 

And he knows that this is a long play, a long game that we're going to be in. And it's the commitment that you also want to make sure as an organization that you're hedging your wagon to an organization that also has that same commitment behind it that is willing to go on this journey with you. And I think that speaks volumes, too, to Larry and what he's doing and how he's helping to transform health care across the globe. 

 

00;29;04;12 - 00;29;29;22 

Unknown 

Thanks, Ashley, and thanks for your leadership in that journey. It's a bold vision that I know we're out to go to go conquer. So thank you for leading charge. And I want to pay Special thanks to Dr. McFarland and Dr. Thompson for your partnership, for your time here today and for your leadership in that journey as well. You've been very influential to our teams continuing to move the meter forward on the innovation journey where we're out to go achieve. 

 

00;29;29;24 - 00;29;57;24 

Unknown 

That's all for this episode of Perspectives on Health and Tech podcast. Be sure to subscribe to catch all of our future episodes. For more information from industry experts, visit Oracle dot com Forward slash health and Oracle dot com forward slash life hyphen Sciences. Thank you again for listening and join us again for the next insightful episode of Perspectives on Health and Tech. 

 

 

In recognition of World Suicide Prevention Day (September 10), Oracle Health brings together leading voices in clinical care, behavioral health, and technology to explore how data-driven innovation can help prevent suicide and improve mental health outcomes. Join Oracle Health's Danny Gladden, LCSW, MBA, Director, Behavioral Health and Social Care and Dr. Keita Franklin, Chief Behavioral Health Officer at Leidos, a nationally recognized expert in suicide prevention, as they discuss how ethical, person-centered use of data can detect risk earlier, connect people to care faster, and support clinicians on the frontlines. From integrated screening tools like the PHQ-9 and C-SSRS to risk alerts, we'll examine how technology, with quality care—when paired with compassion—can close critical gaps in behavioral health. This conversation is a call to action for health systems, providers, and technology partners to change the narrative on suicide, together. If you or someone you know is in crisis, please reach out to your local helpline or call/text 988 in the U.S. and Canada.

-----------------------------------------------------------
Episode Transcript:   Intro  00:00 - 00:29

Welcome to Perspectives on Health and Tech podcast. Brought to you by Oracle Health. In this series, we have conversations on creating a seamless and connected health care world where everyone thrives. Let's get started. 

Danny Gladden 00:30 - 02:26

Welcome to Perspectives on Health and Tech. Thank you for joining us. I'm Danny Gladden, general manager of behavioral health and social care at Oracle Health. I'm also a licensed clinical social worker, and I've spent my career working in suicide prevention from crisis lines to community mental health to supporting national efforts with the Department of Defense and the VA. For me, the work is personal and lifelong. At Oracle Health, we believe technology has a role to play in ending suicide with one of the largest global electronic health record footprints and long standing partnerships with the VA and the DoD. We see the impact that suicide has across every community we serve. This isn't an issue that only affects certain families or certain health system. It impacts all of us. That's why we're speaking out as a technology company. Because suicide prevention is not only about crisis intervention, it's about building systems that connect people to help earlier equip clinicians with the right tools and make sure that no one falls to the cracks. Our responsibility is to use data design and technology in ways that honor the human side of care, while supporting providers who are on the frontlines every day. And today, I'm honored to be joined by Doctor Keita Franklin, chief of behavioral health at Leidos, one of the nation's foremost experts in suicide prevention, who's led this work at the highest levels of government and continues to advance the field through research, policy and practice. And so, Keita, it's so good to be with you today. I'm so glad you've joined us. You and I have had a chance to do some pretty incredible work together. You have, spent much of your career leading national suicide prevention efforts with the VA, the DoD, the Columbia Lighthouse project. How has that experience shaped your perspective on the urgency of this issue?

Keita Franklin 02:26 - 03:44
Thank you so much for having me, Danny. And I always love our work together and our connection as social workers in the field over the years, so I truly appreciate the chance to talk to you this morning. You know, one of the first things that comes to mind for me is just a basic, sort of lesson is just the complexities around suicide. Now, I don't think people know, you know, when somebody dies by suicide, there is a lot of variables and factors at play. And it's never it's never one reason. But like you'll hear about people that struggle with a host of reasons, some of which are medically oriented and pain management oriented and complexities around TBI, and some of them are mental health related, and some of them are things that you and I always talk about related to social determinants of health. So just the complexities, that's probably one of my biggest sort of things to think about. And sure, in terms of shaping my perspective. And then I appreciate the upstream. I'm definitely an upstream sort of thinker in terms of like, how do we get, you know, the military used to call this left of boom, but like, how do we get, away from just intervening at the time at the single point in time of crisis? I don't know if you saw the CDC and the National Action Alliance just pushed out this new upstream toolkit or guide this week. I have that on my list of things to look at. 

Danny Gladden 03:45- 04:15
Yeah, it's really great, isn't it, to have, more folks in across health care and beyond talking about suicide, suicide prevention now. So Oracle, we're a technology company. We believe we have a part to play in the bigger ecosystem of suicide prevention. If you think about a company like Oracle and Oracle Health, you know, why is it important for a company like ours to be part of this conversation? 

Keita Franklin 04:15 - 05:34
Well, for a couple different reasons. And I'm in the same boat. You know, Leidos is also a technology company, and we're so thrilled for our partnership with you all around some of these issues. But really, a couple of things that we know about suicide is at the center of a public health approach is just the importance of data. Like data drives the entire public health approach. And whether you're like a brand new suicide prevention coordinator on the ground in a local county, or whether you're tackling suicide at the National level, you have to have your hands on a good set of data. And I know that you are all about data, as is Oracle at large. But then also what do we do with the data and how do we bring more technology tools to the fight when it comes to preventing suicide. By using good data, not only in mental health care systems as flags and as you know, part of predictive analytics. But also, I think we're seeing on the horizon more AI tools and advanced ways to bring self-help tools with clinician oversight. Maybe we'll talk about that more in the podcast. But definitely there is a role for technology. And I've always over the years I've put it in the pilot bucket. When you're doing good public health programing, you always have four or 5 or 6 pilots going where you're testing new interventions, trying to advance the needle with new and innovative treatments and the like. And I think technology fits in there. 

Danny Gladden 05:35 - 07:22
Well, I feel a burden, a healthy burden. If we think about, say, behavioral health technology companies, of course, they're the users of their tech,  kind of have a responsibility to ensure they account for suicide prevention and screening and whatnot. As an enterprise health care EHR, that service primary care, chronic conditions and an emergency department in med surge and oncology, we have to be really diligent about where we can also infuse best practices for screening across health care delivery system. And I feel sort of, a burden there to make sure we get that right, have the right questions and the right workflows in the right place so that we can, help a doctor who's treating someone with heart disease also be able to talk about the stresses of heart disease and, risk suicide risk that comes from living with a chronic illness. And so that takes me kind of, you know, this year's World Suicide Prevention theme is changing the narrative on suicide. I'm just curious, what does that mean to you? Changing the narrative. It really struck me. I want to hear your perspective and also talk about. I think you've got some really interesting things happening in your career. So, like changing the narrative on suicide. What about small acts of kindness and community engagement and connection? How can that make a difference? 

Keita Franklin 07:23 - 10:22
No. I so appreciate your question. And also the work that you're doing to embed suicide prevention into like a whole of health care system. So first and foremost, like the, early on in my career, I learned the importance of, like, if we just screen or if we just wait for mental health care alone. You know, we will have missed about many. You know, I learned this at the VA front and center where they, the veterans would go in for headaches and backaches and all of these other types of physical care issues. And when they're doing that, if we don't screen them and we don't engage around suicide prevention, it's a missed opportunity. And it's awful when we see it in the fatality reports after the fact that perhaps they've been to one of our primary care clinics in the days leading up to their death. It's just incredibly tragic for our system to, like, miss any single opportunity to say, disable that. So I'm so pleased that you're doing that. And it is hard work. Right. Because the docs will tell you, I'm busy with this, I'm busy with this, and I have a lot of things to balance. And, you know, they're here for their podiatry appointment. What do you mean? I have to screen, but you just don't know what's going on for people. So that's one thing. And then, I, I think you and I both love the theme, like changing the narrative on suicide. Right? I mean, part of the narrative is that it's upstream. The other small piece that resonates with me about changing the narrative. I'm curious what you think about this as well. Is the focus on lived experience like, I absolutely love for us as a field to never forget the voice of those that have this lived experience, whether you know it's a mom or dad that have lost a loved one, a child to suicide, and you know, of course, in the most tragic of ways, but for us to hear from them and to think about how their experiences can inform our policies and to just keep their voices in our mind at all that we do. And I felt fortunate to do that. In the day when I was leading suicide prevention for the Pentagon, I had the most contact, but also at the VA and even further back with the Marine Corps, just having the ability to stay in touch with troops that have lost one of their own and just hear from them. So I hope that becomes more of the narrative as we quote unquote, change the narrative. And then the last thing I'll tell you guys, I've been in the weeds with the research you can appreciate on a new book called The Humanity Cure. And in the book I've been again researching the most basic of things. Who knew that there's a mountain of research on the importance of small acts of kindness, and on the reciprocal nature of kindness, the reciprocal nature of helping, and how, you know, sometimes when you're when you're in your worst state, reaching out your hand in helping someone actually helps you and just how reciprocal that can be. And it could be life changing. So I'm reading these personal narratives of people that will tell me that they interacted with a stranger a single point in time for less than five minutes, and they, and it changed the full trajectory of their life, like, how is this humanly possible? But it's their story and it's true, and it's in the data and it bears out over time. So I've been digging in on those kind of concepts. 

Danny Gladden 10:23 - 10:49
Well, I'm excited to, I'm excited to get my get my hands on your new book. And I will tell you, I think we hear from those with lived experience on how they were yearning for human connection, who they just if we've heard stories. So if only someone would reach out. If only someone would have asked. How are you doing? Are you okay? 

Keita Franklin 10:50 -11:13
I guess I I've been writing about belongingness and compassion and being included. Like, just the power of being included. A people feeling like maybe they don't fit in in their family, but they fit in in this community or that community. Like, they know that if they're not there, someone will call them and say, where were you on Tuesday? You're always there, right? You're so. Yeah, that's so true. 

Danny Gladden 00:11:14 - 12:24
Yeah. I well, I think your, perspective, what you've written about will add very importantly to the narrative, particularly at a time where we have, in my view, a compassion crisis in this and, around the world. And, we need more human connection. I I'm so lucky I had a mentor who said these words to me, and I've never forgotten them. And I repeat them as often as possible, which is, you can't fuss at someone until they know you care about them. And, you know, and I think about from the health care lens and all the do's and don'ts that I, the health care providers tell folks, do this, don't do this, do this, don't do this. And I just think, in suicide prevention and, all my time on the crisis line, all folks really looking for is connection and to know that I care. And maybe I've got some advice or some guidance or some suggestions for them to consider, but they're really there for the I'm glad you called this is and I'm here for you.

Keita Franklin 00:12:25 - 00:12:40
Yes, I've been even pulling the thread on this idea of being present and not always knowing. Like to say. So you might just be physically with them or on a call and you might not have the right words. And that's okay. You did enough by being present. 

Danny Gladden 00:12:41 - 14:00
Well, I just have. I've been trying to be a good steward of moments and another I just also have great mentors. Another mentor would call that the ministry of Presence. And she, she comes from, she's  a therapist and also, a faith leader. And I just think so much about that. The Ministry of Presence, you know, particularly, following a crisis, you'll see, in the media, counselors have been brought in, right? You've been in that, post-crisis debrief, I've done the same and off that there aren't a lot of words, but the ministry of presence, the importance of warmth and connection and folks just knowing that you're there. So, now we're going to where we do a hard pivot. So that's kind of some of the human side and talk about technology. Okay. So as we think about using kind of embedded screening tools, like, I mean there's the Q9 or any of the cuz the Columbia Suicide by Columbia suicide Severity Rating scale, you know, how has embedding these tools and then the, the alerts that might come from them. How is that sort of made an impact? 

Keita Franklin 00:14:00 - 00:15:11
Well, what's been on my mind recently is just the power of these evidence based screening tools in, to provide burnout prevention for clinicians, particularly when you're embedded into workflows in such a way that clinicians are able to focus on the client front and center and maintain that eye contact and develop that therapeutic rapport and just get on with the business of delivering therapy.  And they're not having to fumble through, this paper and this screener and this thing. And, you know, and or they're not on the screen like trying to find 5 or 10 different things based on what their client just told them, like when it's embedded into a workflow and it's just business as usual. Of course, we have to be careful that they're not, you know, treating it as too much of a business as usual, that they're sort of, you know, blindly clicking their way through important assessment tools, which I don't necessarily think would be a problem. But we should always, you know, be mindful for that. But this idea of, just making it part of life into the fabric of the organization, makes it easier for clinicians. And then I think they're able to really think about, okay, I'm on session two, I'm delivering CBT. This is what that looks like, you know, instead of all the other sort of things.

Danny Gladden 00:15:11 - 00:16:07
And as we think about the whole of health care, again, we have an opportunity to embed across health care, you know, some really simple suicide screening questions upstream I worry about downstream is the infrastructure there to be able to get someone connected seamlessly into  community services? Do we run the risk curve over hospitalizing or creating stigma because we don't know how to respond, to someone's side risk? And so yes, to more screening and also yes to more within the health ecosystem. Getting from custodial services to an, oncology nurse and everyone in between getting the right preparation for what to do when we learn that someone might be at risk of suicide. 

Keita Franklin 00:16:07 -  00:16:52
Yes. I always talk about suicide screening in the context of, like, be ready for the answers, right? Yes. Yeah. You ready? Yeah. Because, yeah. You don't realize. I mean, of course, the Columbia, Rating scale, suicide severity rating scale can be used by non-medical entities as well. And so that comes with it inherent responsibility to be ready. If you ask the question, you know, do you want to go to sleep and not wake up and they tell you, yes, like you've got to handle that well. And with the careful and grace and respect that it that it deserves, make sure we get them to the right care. And I know we worried in the field, both of us on and the excitement of 988 and making sure the care delivery is in place for, for that new infrastructure. And I think we've come a long way, but there's likely more to do at the community level.

Danny Gladden 00:16:52 - 00:17:15
You know, speaking of the now I actually have 988 tattooed on my forearm. I've had enough for a couple of years, but I don't think I considered the now what? Like there are moments that I might not have an interest of going deep with someone, but I think I should wear long sleeves on those days.

Keita Franklin 00:17:15 - 00:17:20
Know you will take me to gear. I know you too. Well. 

Danny Gladden 00:17:20 - 00:17:55
Yeah. So let's talk about AI. Okay. No doubt the promise of AI for good exists. Yes. Right. Yes. You know, it's ambient listening, and what comes from that? The data that can service from things that are missed in a conversation or in the broader, say, record. How can, structured and unstructured data, inform kind of AI decision support, to help risk, is surfaced potential risk. 

Keita Franklin 00:17:56 - 00:19:13
Well I think that it is amazing to me how much data agencies are sitting on the federal government is sitting on that is untapped, first of all. And then when we can bring good data sources together, like in an ideal world, if we were really, you know, in charge for a day of all things data, like what would it look like for private and public sector to come together around good data and to really use that data to drive like not only like business based efficiencies, but clinical care and outreach that might even go to family members. Like if we're able to learn certain things in the data that tell us, like, okay, this person could benefit from  these support systems, which might not go directly to them but would go to their family, which, by the way, is who they go to when they're struggling with risk. First. I just think there's so many opportunities and then we're so scared, right? Like we want to do ethical use of data. We want to be a good stewards in governance, government practices, I'm sorry, governance practices with our data, of course, and we want to secure it in a proper way and just do all the right things. But I never want, to miss a chance to be sitting on data. It's also shameful for sitting on it. We're not using it to advance how we can design a new technology workflow or a new piece of gear that will help our clients do better in a quicker way. 

Danny Gladden 0019:14 - 00:19:34
Yeah, I think maybe key to that's one of our calls to action. You and I, very excitedly talk about what could we do if in the right seats. The de-identified data to, make a material impact. I think we're in those right seats. 

Keita Franklin 00:19:34 - 00:19:36
I think You're right. 

Danny Gladden 00:19:37 - 00:21:00
Yeah. So, we talk so much about the progress of technology and the problems solved by technology. In 2010, I was going to some of the more remote parts of Alaska, and we were working to stand up tele-behavioral health services to communities that didn't have otherwise access. Now think about that. That was, standing up health, tele-behavioral health pre-pandemic, like ten years before the pandemic. You know, and then but yeah, I also just think about folks who don't have access to technology, hardware, bandwidth, 988 is great; not everyone has a phone. Right. And so and then also the it an electronic health record is still not mandated by the federal government for behavioral health organizations. And a and a big and  when health systems or disparate community mental health providers have EHRs, the behavioral health data is walled off and the cardiologist doesn't know about the depression diagnosis or that the prior substance use treatment. And so, despite the progress where this technology is still far short in supporting, suicide prevention. 

Keita Franklin 00:21:00 - 00:22:45
I mean, I think one of the big things that I've seen recently that may or may not hit on some of the things you're discussing is, people's fear around the use of technology in the field of mental health. Right? Like back when you were doing your Alaska work, which I've loved to follow over the years. Just because is there a better petri dish for learning about rural areas and how to deliver care? I mean, that's just got to be it. But, people worried in the day that even delivering mental health care, tele therapy, if someone was at risk for suicide, they would say, I can't do it right because they're in their own home. What if they're near a firearm or they're in their own home? Well, if they're not getting care, they're in their own home too. So I was pleased to see Covid at least get us through that hump in the field of like, deliver care when and where people need it. Like in the absence of them coming in in person, like they still need it. And so that's one thing. But otherwise, I know people are hesitant to fully adopt certain types of technology right now and into the mental health because they're afraid it will go rogue like that. The technology will take over, it will get in the way of the human relationship that our, our careers were built on. And I sort of think like it should always be an adjunct to care, like we should never be back in the day where you're just waiting for your one hour session with your psychotherapist that you have to drive, you know, perhaps an hour to get to in traffic in DC or wherever. And then you're home all throughout the week with nothing that you could, like, have as a self-help tool or no technology that could send you push reminders or like, there's just so many ways it could be used that people are  hesitant in our field. And I'm hoping that, you know, that that's coming around little by little through use cases and, you know, letting them get in there and see that it does no harm and actually can help.

Danny Gladden 00:22:46 - 00:23:13
Our time goes by fast here, Keita, as we close, I'll share that in Oracle Health. We're deeply committed to behavioral health innovation supporting suicide prevention. Through our work and data and care coordination, user centered technology, consumer facing technology. Just what encouragement would you offer to colleagues, partners, health systems, around prioritizing suicide prevention in their work?

Keita Franklin 00:23:14 - 00:24:11
I would I appreciate the question and I would definitely say like we push it out during suicide Prevention Month, like it should be an all month, all hands, all the time, effort and sustained over time. And so like we should continue to do everything we can to advance the data science to push for innovation. If the numbers of death by suicide in our nation weren't what they were, I could maybe agree with people that are kind of at a place where saying, oh, we don't need new technology or new innovations, but that's not our current state. The data continues to rise, particularly with vulnerable populations like veterans and service members and those in rural America, as we've talked about. So we need to continue to think strategically about technology innovation and then do our tried and true things that you and I talked about being kind of making sure people feel connected and increase their social supports.
All of those protective factors are important to weave into the fabric of people's lives. Like sustained all the time. 

Danny Gladden 00:24:12 - 00:25:59
I couldn't agree more. I'll mention, around the world, communities have access to a variation of a suicide or crisis line. In the U.S. and Canada, that three digit number is 988. It is available 24-7-365. There are prompts for Spanish speaking. There are prompts for our veterans. There's, ability to text into a crisis text line. I always ask if folks will say, well, how bad should I be when I call or whatnot? And  my response is, if you consider calling, do call. You can always be anonymous, although it is helpful if you feel comfortable to share who you are, you can also help someone else call who might. It might be a challenge for them. You can call with them. And, I think finally, it's there are no hopefully in health care. There are no wrong doors. But health care is just one avenue. Whether it's communities of faith, community support organizations, and schools and universities, there are helpers everywhere we look. We just have to reach out. And as a helper, we need to be warm care, kind and compassionate. And so Dr. Keita Franklin, Leidos, thank you for the partnership. Thank you for the work that's happening. And that's all for this episode of Perspectives on Health and Tech. Thank you for listening. And join us again for the next insightful episode of Perspectives on Health and Tech.

Outro 00:25:59 - 00:26:29
That's all for this episode of Perspectives on Health and Tech Podcast. Be sure to subscribe to catch all our future episodes! For more information from industry experts, visit oracle.com/Health and oracle.com/life-Sciences, or follow Oracle Health and Oracle Life Sciences on social media. Thank you for listening and join us again for the next insightful episode of Perspectives on Health and Tech.

Leading organizations share how data-driven innovation transforms care delivery and patient outcomes. In this Oracle Health and Life Sciences Summit 2025 keynote, Alaa "AJ" Adel, Senior Vice President of Oracle Health International, joins distinguished leaders from West Suffolk NHS Foundation Trust in the United Kingdom, Bajaj Group in India, King Faisal Specialist Hospital & Research Centre in Saudi Arabia, and Western Health in Australia. Together, they reveal how hospitals and health systems are designing the future of care through artificial intelligence, advanced data strategies, and radically human-centered solutions built on Oracle technology. Hear real-world stories from West Suffolk NHS Foundation Trust, Bajaj Group, King Faisal Specialist Hospital & Research Centre, and Western Health as they share how Oracle Health is helping each organization reimagine hospital infrastructure, improve patient engagement, and drive operational excellence. Understand how this global perspective unlocks new, scalable healthcare models for a connected, healthier world.

----------------------------------------------

Episode Transcript:

00:00:00:00 - 00:00:37:14

Welcome to Perspectives on Health and Tech Podcasts, brought to you by Oracle Health, where we dive deep into the world of innovation and transformation in healthcare. 

 

00:00:37:16 - 00:01:18:11

Shanna Adamic

I'm your host Shanna Adamic, Director of Oracle Health Executive Content and Video. In this episode of Perspectives on Health and Tech we feature a panel discussion recorded at The Oracle Health and Life Sciences Summit held in Orlando on September 10th, 2025. In this discussion distinguished leaders from West Suffolk NHS Foundation Trust in the United Kingdom, Bajaj Group in India, King Faisal Specialist Hospital & Research Centre in Saudi Arabia, and Western Health in Australia reveal how hospitals and health systems are designing the future of care through artificial intelligence, advanced data strategies, and radically human-centered solutions built on Oracle technology. 

 

00:01:18:17 - 00:01:47:18

The discussion is led by AJ Adel, Senior Vice President of Oracle Health International. 

 

AJ Adel

Good afternoon. Today I get the pleasure of presenting four leaders from four different continents with six time zones. Don't ask me about the math. That's what we came out with. The topic of discussion is AI on a global scale. As we are traveling around the globe and we're visiting our clients, we get to see the cool things they all do, and they all work on.

 

00:01:47:20 - 00:02:09:17

So today, I have the pleasure of presenting those leaders who are thinking about things differently, whether they're building a hospital or delivering care or just engaging with their patients. They have a different view on things. So, I'm super excited to introduce them all on stage. I already told them we're going to change the questions. But what I didn't tell them is, we're all friends before anything else.

 

00:02:09:19 - 00:02:33:16

And we all decided this is going to be the most fun session ever. Let me start with you, Kathy. You. You come from King Faisal Hospital, a huge organization in Saudi Arabia, doing amazing things, serving 20% of the population of Saudi.

 

00:02:33:18 - 00:02:53:17

And you're keeping the patients and the people at the center of everything you do. When you put the patient at the center of your design, it's not always easy. Can you share? And what are some of the challenges you're facing when you're actually just focusing on the patient? 

 

00:02:53:18 - 00:03:28:15

Kathy Sienko

Delighted to be here from King Faisal Specialist Hospital. The one thing we know is that, even though we are largely an Islamic society, not all of our patients are homogenous. And as we think about how we design around patients, the first thing is really understanding what do the patients actually want and how do we use the data that we have around our patient's experience to tell us what's working and not what's not working for them, and how do we factor that into the design of services.

 

00:03:28:16 - 00:03:57:17

Kathy Sienko

The other bigger problem, I think, is really moving from the rhetoric to the practicality. We all say that we want a better patient experience. We want to build our services around patients, but the provider workflows need to change in order to make that happen, to facilitate that. And that's not always so easy to change when people have been doing something the same way for many, many years.

 

00:03:57:18 - 00:04:19:14

Kathy Sienko

So, we are 50 years old this year, believe it or not, and some of our people might even have been there for nearly all of that time. And so, getting those changes into practice, moving from the rhetoric of what we'd like to do to actually making the physical changes to the way that we work from a provider centric model to a patient centric model, is one of the challenges we have.

 

00:04:19:14 - 00:04:47:07

Kathy Sienko

And then there is the question about the technology that supports that patient journey and the integration between solutions, that actually makes that patient's experience very, very different. But we also think about it in terms of design. How do we design facilities to be healing and healthy environments as well. So, we think about fine details like color and artwork and all of those sorts of things.

 

00:04:47:07 - 00:05:11:15

Kathy Sienko

But perhaps important to know about King Feisal is that we are a specialist tertiary organization, quaternary even. And so, we see people who are really at, the most serious stage of their disease. And that actually drives for us as we think about our patient innovation, because we really want to do a great job for those patients. For many of them, we are their last port of call.

 

00:05:11:17 - 00:05:32:14

Kathy Sienko

And so, it really drives a lot of innovation. It features in things like clinical trials. And we actually are running about 48% of all of the clinical trials in Saudi Arabia at King Faisal Hospital. So, it drives a culture of innovation and wanting to do more and better but of course, there is the cultural change that needs to happen.

 

00:05:32:16 - 00:05:57:17

Kathy Sienko

And then there is also the technological workflows that actually support the kind of work that we want to do. So, as you say, it's not easy work. It's culture change and technology change. It's change that really focuses on why we are here. And we really are there for the patients. And so, we follow through on that as a philosophy into practice.

 

00:05:57:19 - 00:06:16:03

AJ Adel

I've been visiting King Feisal for the last 15 out of the 50 you mentioned, and I've always looked at how all the leaders have one thing in common. Every vision has the patient at the center of it. So that's amazing. Russell, every time I open my LinkedIn, I see you building a hospital.

 

00:06:16:05 - 00:06:34:05

Russell Harrison

Not me personally. 

 

AJ Adel

No. Not you. Well, I do see you with the hoodie and the vest and everything, but you're also, down in Australia. You're changing healthcare, and you're going to places where healthcare hasn't been before. But you're also doing it while keeping the patient at the center of this. Can you share your vision?

 

00:06:34:05 - 00:06:50:22

Russell Harrison

Yeah. I just say we're quite fortunate, you know, why build one new hospital? One. You can do two at the same time and two little ones. So, four in total. But that's just for that. Population is growing so quickly. And for me, I don't disagree with what Kathy said, but I'm going to come out from a different angle.

 

00:06:50:22 - 00:07:11:16

Russell Harrison

And as part of that build, we've seen the opportunity to put our patients and our staff at the center of how you design a new facility. And that's been quite challenging because a lot of the guidance is written for ten years ago, and our staff and our patients are imagining a new world, about what they want and how they want the workflows to work.

 

00:07:11:18 - 00:07:38:10

Russell Harrison

And that's been quite challenging, going against the sort of the building regulations, they're not true regulations, but they're sort of guidance notes to actually put our staff in fabulous facilities with light and our patients in rooms with light, not the old hospitals we've got. So, it's been great to be able to do that. And through the process, the technology has changed because, you know, no offense to many clinicians, myself included, you cannot read a plan and imagine what a room will be.

 

00:07:38:12 - 00:07:53:21

Russell Harrison

But with AI and modelling, you can kind of get a sense of how that will look. We are in a room this sort of size and it was all on the floor, and you can move walls around. So, using technology in the design really allows us to put our staff and our patients at the center and actually then feel what that facility will look like.

 

00:07:53:21 - 00:08:19:07

Russell Harrison

So, our aim is that we get a much better facility that our staff want to work in, can work in, and our patients can be cared for in a very different environment that's healing and light, and hopefully they go home. They don't want to stay forever, but, it will be a much better experience. And I think, you know, that's the important bit about how we can design new facilities and use technology to help do that, rather than just kind of go off a plan and go, "Well, that's what you get." 

 

00:08:19:07 - 00:08:52:22

Russell Harrison

Let's challenge that and let's get the clinicians and patients pushing for the same thing. 

 

AJ Adel

Yeah. You also had a couple of go lives recently. And I remember you; you're calling up and saying, "We need this, this and this because the patient needs it. That's what I want. And I want that for them, not for me." Moving to the Nirav. The Bajaj Group is into a lot of things, but recently into healthcare. You've done - when we did the math- 35 visits around the globe to multiple healthcare facilities, government entities and beyond looking at the best view of what the future looks like.

 

00:08:53:00 - 00:09:09:06

AJ Adel

So, in many ways, you do have a crystal ball. You can look into the future. What have you seen looking into the future? How does the hospital of the future look like as you've seen it, as you design it in your mind? And I still remember the video you showed us on how things would look like.

 

00:09:09:12 - 00:09:31:05

AJ Adel

You're literally doing it from scratch based on the previous experience of others. Would love to hear from you on the hospital for the future for you. 

 

Nirav Bajaj

Thank you for staying on script. So, the way we look at it, we've been to four continents now. We've been looking at all the different so-called best facilities in the world.

 

00:09:31:06 - 00:09:54:07

Nirav Bajaj

The way we've structured our organization is we want to focus on prevention and be proactive rather than reactive. And I think that's something that, honestly, is what the future is. Because you want people to stay healthy. You want positive health rather than dealing with people who are unwell and get them to that stage. The other thing is it's actually an ecosystem.

 

00:09:54:11 - 00:10:13:16

Nirav Bajaj

So, I don't look at it as a hospital. I look at it as an ecosystem to even get prevention and be proactive. You need to have them in the entire continuum. You have to build the entire continuum of care. So right from home to home and everything in between. And many people say that, okay, you're building clinics, you're building ambulatory, and that's a feeder to the hospital.

 

00:10:13:18 - 00:10:30:13

Nirav Bajaj

The way we're looking at it is the hospital is a feeder to the clinics, because the clinics are going to be in your localities close to your home. You recover better when you're at home rather than when you're in the hospital. So, we think of it as an ecosystem rather than thinking of it just as a hospital or as a clinic.

 

00:10:30:15 - 00:10:51:04

Nirav Bajaj

And lastly, as I think that it's going down to the trend of, personalized care and personalized medicine, and we look at it even from the logistic point of view. So why can't we, for example, we know when you've entered our campus, we've already allocated a parking spot for you. We already put you in the queue for your OPD appointment.

 

00:10:51:05 - 00:11:24:20

Nirav Bajaj

And the same with IPD is why can't we have you already checked in to the room? Because we know you're on our campus. You'll be there in a few minutes. That's on the logistics side. On the medical side, which is human, which body is different and reacts different to the same medicine. So why can't we understand what your genetic sequence is and see how you react to this medicine, whether through a digital twin, which, of course, now AI is playing a big role in, or just understanding you better emotionally and mentally.

 

00:11:24:22 - 00:11:48:07

Nirav Bajaj

So that's how we're looking at the future of healthcare. 

 

AJ Adel

I think we're going to start calling hospital for the next 19 minutes the ecosystem. And I love what you said. It's going to feed the clinics, not the other way around. Russell, with the construction you all are doing. Are you looking at things differently?

 

00:11:48:07 - 00:12:07:10

Russell Harrison

Well, we're trying to. Hospitals usually are not places for community to come unless they're unwell. And we're trying to spin that to make our new facilities actually a community resource. I might pinch that one but much more about the community can come in and not use the facilities but get the benefits of the fact that a health precinct is there. And that's about -- sort of some message about primary prevention. 

 

00:12:07:10 - 00:12:28:12

Russell Harrison

There will be GPs there. There will be sort of primary healthcare providers. We're also -- and it's strange for an acute hospital to do this. But we're building kind of a new twist on a day hospital. So chronic condition patients can come in. They can get some peer support. So, we've employed lots of lived-experience workers, both mental health and physical health. 

 

00:12:28:14 - 00:12:52:13

Russell Harrison

We've got carer-support workers that are carers themselves that have been through the process. You can see your clinician. You can talk to a peer. You can talk to AI, hopefully, if you can deliver it for me, AJ, No challenge. Can we have it, yesterday?

 

AJ Adel

He had to put that in there. 

 

Russell Harrison

Got to do it. But it's about how do we actually get people coming in to try and get into that primary prevention space, rather than have to come to an ED and get stuck in a system?

 

00:12:52:15 - 00:13:13:01

Russell Harrison

So how can we get patients to engage, you know, to self-drive their own care to peer-peer support and become those future leaders and community, take messages out to the wider community? So, we're careful about what outlets we let there in terms of food and, you know, dietary nutrition intakes. So, I think we're trying to come at it slightly differently.

 

00:13:13:01 - 00:13:30:09

Russell Harrison

It's a bit of a sort of experiment but our community kind of saying they want that. And they want to sort of be in the hospital, but not an inpatient facility but just use that as a community resource to actually bring that health and wellbeing back into our communities. 

 

AJ Adel

Yeah. Giving the patient the control and giving them the options.

 

00:13:30:09 - 00:13:51:15

Nirav Bajaj

I think, historically -- sorry to pitch in -- it's always been a place that you want to avoid versus making it welcoming. And then it makes me think back to, when your car needs service, you always go on time.  But when your body needs service, you try to procrastinate and delay it until it's too late. So, I think making it a welcoming space makes it a big difference.

 

00:13:51:15 - 00:14:13:01

AJ Adel

Agreed. Great. Speaking of making it work, Nicola at the NHS, there's a lot of history. There's a lot of, process. Let's just say that. But every time I talk to you, you're thinking of new ways to deliver care. Can you share a little bit of examples of what new ways that are you looking to deliver care today as we step into the future?

 

00:14:13:03 - 00:14:44:12

AJ Adel

And is that making an impact to the patient, to the hospital operations? What's your view so far? 

 

Nicola Cottington

Yeah, sure. So, I'm as a Chief Operating Officer, I'm really interested in how we make not only the hospital, but how healthcare system work more smoothly. But that is only for the benefit of the patient. So, I often when I describe my role, I say, you know, the value that patients get is when they meet with their clinician and the operational team and the logistics team are there to make that happen as smoothly as possible.

 

00:14:44:14 - 00:15:07:13

Nicola Cottington

So, we're also building a new hospital. It seems like everyone's going to a new hospital.

 

AJ Adel

We're going to call it an ecosystem. 

 

Nicola Cottington

But exactly because, well, I'll come on to that, actually. And our hospital is also currently just over 50 years old and in West Suffolk we need to build a new hospital because there's lots of problems with the construction of it, and we've had to do a lot of remedial work.

 

00:15:07:15 - 00:15:30:22

Nicola Cottington

But when we're thinking about our new hospital program, we've actually called it our Future System program, coming back to that system of care, because in order to make a hospital run smoothly, we need the community services to be running smoothly. And we need to support patients to be able to get the same experience that they would experience in a hospital, but in their own home.

 

00:15:30:22 - 00:15:52:01

Nicola Cottington

So, we've put in place a virtual ward, for example. We have used some remote monitoring technology. But some of it is also just about how we encourage people to feel as safe and secure as they do in a hospital. So yes, people put off coming to a hospital, but actually people also see it as a bit of a safe space.

 

00:15:52:03 - 00:16:14:17

Nicola Cottington

They feel safe. They can see the nurses and the doctors, and we want to create that same feeling. But out there in the community. So, we already run community health services as well. So, we have some experience of that. And we have a team called our Early Intervention Team who take patients and go and visit patients who are diverted from ambulance calls.

 

00:16:14:21 - 00:16:39:18

Nicola Cottington

So, somebody might call 999, as it is in the UK. That's triaged by an unscheduled care hub. And our early intervention team will go out and see that patient rather than a paramedic team, if that's appropriate. What I'm interested in is, as we move forward, how do we use AI to perhaps inform some of that decision making and to automate some of that with the relevant safety checks in place as well?

 

00:16:39:18 - 00:17:07:14

Nicola Cottington

Of course. But so that we are making the best use of our resources so that we are protecting our high acuity resources for those patients that really, really need it and really need our emergency department care. 

 

AJ Adel

Well, we're definitely going off script now in a good way. Kathy, I know for a fact King Faisal had done no harm initiative a couple of years back, which back to what was Nicholas saying, you want to make it a safe place.

 

00:17:07:14 - 00:17:26:07

AJ Adel

Eventually you have to go to the hospital, right? And eventually you have to be treated. But you want to make it a safe place. You want to make it a place where people feel comfortable being vulnerable. Right. What's King Faisal doing to ensure new ways of delivering care? You're innovating. You're always sharing a new vision.

 

00:17:26:08 - 00:17:54:11

AJ Adel

Where are you right now? 

 

Kathy Sienko

So, this is one of the best things about being at King Faisal is that there's a huge ambition and a commitment to innovating for patients. And one of the things that we really focus on is how do we enable our clinicians to practice at the very tops of their licenses, and that involves removing from them parts of the workflow that could be done through AI or through technology.

 

00:17:54:13 - 00:18:19:00

Kathy Sienko

It also means for us, keeping people at home because we know that quite a lot of hospital, a lot of infections are acquired in hospitals. As part of our zero-home initiative, our home healthcare is a big part of that. We know that for some patients, it is safer for them to be in their home environment than to actually be in a hospital environment, particularly because of the patient population that we serve.

 

00:18:19:00 - 00:18:40:22

Kathy Sienko

A lot of oncology patients. We have one of the biggest liver transplant programs or transplant programs in the world. We do quite a lot of, high, complexity neuro cases, etc. So, we think about where the safest place for those patients is to be, and also how can we assure their safety when they come into hospital.

 

00:18:40:23 - 00:19:06:01

Kathy Sienko

Part of that is by releasing time to care, so using technology as an adjunct to enable clinicians to spend the maximum amount of time with patients. We have a very highly complex home healthcare service. There are things that we didn't used to do at home that we now do at home. We do quite a lot of telemedicine, not just in the Riyadh area or the Jeddah area, but across the whole of Saudi Arabia.

 

00:19:06:01 - 00:19:28:01

Kathy Sienko

We provide support to many other organizations as well. Even at the interface, the front, the entry point to the hospital, the way that we use AI agents as part of our customer service model, that has been part of how we've created a more seamless AV environment for patients. But our goal is always also down to some of the very simple things that I believe many people here will be doing.

 

00:19:28:07 - 00:19:48:03

Kathy Sienko

How do we keep an eye on safety every single day? Our huddles are a great way of doing that. And as the chief nurse, of course, nursing is a huge part of our organization. We are about 40% of nearly of the whole organization. Nurses are always thinking about what we could do differently to keep people out of hospitals. 

 

00:19:48:04 - 00:20:13:15

Kathy Sienko

So wound care is one of the areas that we're looking at matching clinician judgment with AI technology to see whether we can keep people at home, monitor their wounds at home without them needing to come into the hospital environment. The biggest thing that has happened for us recently is that there are many conditions that we use to send patients abroad for, people who needed CAR T-cell therapies.

 

00:20:13:15 - 00:20:38:10

Kathy Sienko

We've just manufactured our own CAR-T cells, have been able to treat, our first patient locally for what used to cost us millions of Riyals every year. And what that means is that we are then able to provide that for many more patients locally. So, I think this is just the start and that AI technology and the solutions we have will enable us to go much further in the future.

 

00:20:38:12 - 00:20:57:11

AJ Adel

Yeah. I can't wait to see some of the research that you're going to do on those patients. Nirav, moving to the Bajaj Group, which is in many industries and, and I'm sure you sit on multiple boards, and you get to see all the innovation going on in finance going on in transportation.

 

00:20:57:11 - 00:21:30:18

AJ Adel

Your sister organization, if I may say so. As you're building your new ecosystem, what are you seeing in other industries, like smart ideas, things that we can adopt in healthcare? And how do you see them playing a role in your future as a healthcare organization? 

 

Nirav Bajaj

So, thanks, AJ, for that. The way we're looking at certain things is when it comes to culture in India, a lot of the physicians are consulting physicians, which makes it - it's either you or me.

 

00:21:30:20 - 00:21:55:16

Nirav Bajaj

It's not you and me. And when I look back at sport, which I played very briefly in my life, it's a team sport. And how can you actually get physicians, nurses to work together for the common good, for the common goal of the patient who comes out the winner versus it's either your statistics or mine.

 

00:21:55:18 - 00:22:19:00

Nirav Bajaj

So that's when it comes to sports. I see our group's values for almost a century now has been transparency and trust. And that can only come with information and openness. So, I mean, if you see it, which happens in the U.S, I'm amazed whenever I fly in the US and I get notifications about delays on my mobile.

 

00:22:19:02 - 00:22:38:16

Nirav Bajaj

And I'm like, I wish that there was something as transparent when it comes to healthcare. And why can't we have possibly transparent, bill estimates and live bill tracking? In India, it's still very fee for service and out of pocket. So, we don't find out, how much we have to pay at the end of the day until the final bill shows up.

 

00:22:38:18 - 00:23:07:13

Nirav Bajaj

So instead, what can't I see along the way is what's my out-of-pocket expense? So, there's a lot of trust that doesn't exist in the healthcare ecosystem, which actually should be the most trusted industry. 

 

AJ Adel

Yeah. No, I think everybody agrees we would love to get to that point. And actually, you also engage with multiple other departments in the UK government, education, transportation and others.

 

00:23:07:15 - 00:23:29:12

AJ Adel

Are you seeing some of those innovations and are you trying to say the biggest flattery is copying. Are you trying to see what you can copy into healthcare ecosystem. 

 

Nicola Cottington

Yeah. Well in fact in the UK, we were lucky enough, a team of us from West Suffolk, to go to the Oracle Industry Lab in Readding.

 

00:23:29:14 - 00:23:45:00

Nicola Cottington

And I know the Oracle team were a little bit nervous about what they were going to show us there and thought, would we be able to translate this into healthcare? But one of the most exciting presentations when we were there was from the Red Bull Formula One racing team. And you might think, you know, what's the connection there?

 

00:23:45:05 - 00:24:16:10

Nicola Cottington

But really it was their use of data in real time. And it really made me think about how we could apply this in hospital and community services. So, what they're doing is they're using real time data the whole time while the car is going around the track, while it's in the pit stop, and looking at what can they tweak to improve performance but also running simulations constantly and using this single data layer to enable improvements all the time. 

 

00:24:16:15 - 00:24:42:22

Nicola Cottington

In the NHS and in our trust, we have so much data. And actually, we don't face, some of the barriers that other international, health services do in terms of sharing that data. But even within our organization, we have so many millions and millions of data points, and we're not using it in that way. So that's what really inspired me as to how can we use that both on a patient level and to spot what's going on for this patient right now?

 

00:24:43:00 - 00:25:07:18

Nicola Cottington

What's changing because we collect it all. But do we use it to inform their care now and their care in the future? But also, when you extrapolate that out to a whole emergency department. And so, what's coming in? How many patients need beds? How are we using all this to know what we're going to need to do in, you know, 12 hours' time? But also, when we're thinking about planning our new hospital, how could we run some simulations, you know?

 

00:25:07:18 - 00:25:29:08

Nicola Cottington

What if we change this? What impact would that have? If we added a ward here, added an operating theater here, what would the impact be? So that was what really inspired me. So, from thinking what's the connection with racing cars? There really are lots. There's lots of things that you can learn from other industries. 

 

AJ Adel

Well, everybody from Oracle here loves you for saying that.

 

00:25:29:13 - 00:25:48:10

AJ Adel

Russell, maybe we stay with you in one more question, and then we'll open it up for the panel here. A simple one with a complicated answer. 

 

Russell Harrison

There's no such thing as a simple question. You know that.

 

AJ Adel

 

No, no. Agreed, agreed. How do you see technology changing the game in healthcare? Let's just start there. What excites you about using AI in the ecosystem we're creating for the future?

 

00:25:48:10 - 00:26:14:15

Russell Harrison

I think it's the possibilities it's going to bring. It's the speed at which it will help, bring insights. I'm going to call it, rather than information to the fore for clinicians to treat our patients in different, better, faster ways. The stats about how quickly the evidence base is shifting is so quick.

 

00:26:14:15 - 00:26:31:14

Russell Harrison

You can probably leave university now, and it's out of date or leave med school and it'll be out of date. So, it's how we can enable our clinicians to give our patients the best care they can in that interaction, or over a series of interactions. And I think, you know, part of that is about how we do that better than we are at the moment.

 

00:26:31:16 - 00:26:47:22

Russell Harrison

I'm going to stay very grounded because we still use faxes in Australia to send information around. So, we digitize stuff, print it off, fax it, re digitize it. You know, we can't share things by email yet because it's illegal. So, I was kind of envious of what Nicola was saying about, you know, sharing stuff. So, it's nuts.

 

00:26:47:22 - 00:27:06:02

Russell Harrison

But that keeps us pretty grounded around where we can get the technology to get us to. So, it's going to be very pervasive, and it's going to be really kind of challenging.

 

00:27:06:04 - 00:27:25:11

Russell Harrison

But the challenge for me is our clinicians need to keep that critical thinking. They can't just rely on the tech. And I think we run the risk of making it too easy that they just become taskmasters, and they don't apply the judgment that will need them to continue to keep applying. And I think that's some of the challenge I see with the tech.

 

00:27:25:11 - 00:27:45:19

Russell Harrison

It's almost getting too good that if we're not careful, generations coming through, clinicians will get to the point where they're not thinking, they're not applying that critical judgment. They just believe the tech. Now, probably 99% of the time, it's right. But we really want our clinicians, as Kathy said, at the top of scope, doing what they've been trained to do, supported by tech.

 

00:27:45:21 - 00:28:05:16

Russell Harrison

And that's, I think, where we need just to be careful. But yeah, what we've seen this week is pretty impressive. I'm sure it will continue to accelerate. The pace of change now is huge. You know it's just continued to accelerate. So that's the exciting bit. And I think it's how do we keep pace with an industry that is often conservative and slow to adopt? We've got to change that very quickly.

 

00:28:05:18 - 00:28:24:03

AJ Adel

Yeah. A question for everybody and we'll start with you, Nicola. When we all retire and hopefully, we retire in the top of our game - we're going to look back and say we changed healthcare for generations to come.

 

00:28:24:03 - 00:28:44:10

AJ Adel

I think you hit on that a little bit, Russell. What's our role as a society here, as a healthcare society from your perspective? And we'll go down, down the list. What's the role that everybody in this room plays in creating the next generation of healthcare for our children and our children's children. 

 

00:28:44:10 - 00:29:11:22

Unknown

Nicola Cottington

I believe you can't be a leader in healthcare now without being a digital leader. But part of what we need to do are those leadership lessons that we all know, which is about genuinely listening to our clinical staff, our non-clinical staff and our patients about what are the problems that they have that we have a responsibility to, to try and solve for them.

 

00:29:12:00 - 00:29:38:02

Nicola Cottington

So, understanding how work really happens, not how we think it happens, that just because we've rolled out some tech, that everyone's using it and they're using it optimally. So really understand what's happening on the ground and then from that, creating a vision, a compelling vision and communicating that about how things could be. And from what I've heard the last couple of days, that is a really exciting vision.

 

00:29:38:07 - 00:30:03:21

Nicola Cottington

And the patient is at the center and it's patient powered and that's what people want, and that's what gets people fired up. 

 

AJ Adel

Beautiful. Kathy?

 

Kathy Sienko

So, I'm going to use a very sophisticated leadership term. I'm totally stoked about AGI. And I am so excited about AI agents, particularly for clinicians. I think it helps keep us on our why?

 

00:30:03:21 - 00:30:30:01

Kathy Sienko

Why are we all in healthcare? We are there to add value. We're there to solve and to deal with the issues that really matter to people. And I know that health is absolutely wealth. It's the tide that floats all boats. And if our goal is to have healthy communities, healthy societies, healthy individuals, then we really ought to do everything that keeps us focused on that space.

 

00:30:30:03 - 00:31:06:22

Kathy Sienko

And that means leaning into curiosity about what is possible. I think technology offers us the opportunity to democratize leadership to where the best decisions are not always made by the people at the top. In fact, that they're probably rarely made by the people at the top, But they're made in a more diffused way across organizations where we can innovate really quickly and where we can involve patients in a really meaningful way and not involve them by inviting them in, but partner with them to deliver healthcare in a way that is very different, and to receive and define healthcare in a way that's really different.

 

00:31:07:00 - 00:31:30:18

Kathy Sienko

So, I have no plans of retiring right now. I'm 57. I'm planning to live to 115. That's my plan. 

 

AJ Adel

Well, I think you touched on something that Nirav said, together, not separate. Absolutely, Nirav, Russel, final thoughts? 

 

Nirav Bajaj

So, I'm going to take a slightly tangential view on this one. 

 

AJ Adel

I knew it. 

 

00:31:30:20 - 00:31:59:15

Nirav Bajaj

Maybe I am not invited next year. But I think that culture is what really drives outcomes. The way the organization behaves and performs is the way that, patients will actually feel and recover. So, something that Tom said yesterday was quite interesting is how patients believe that AI was more compassionate and empathetic to the patients versus the physician. Well, I think that that's where the problem is, is we're people business.

 

00:31:59:15 - 00:32:24:23

Nirav Bajaj

We're not a patient business. So, we need to take care of our people who take care of the patients. And I think that that's where technology comes in and that's where AI comes in, is it builds in efficiency. And this is also probably a not-so-popular thing to say is about efficiency in healthcare. But efficiency and empathy are always in tension because empathy makes you inefficient, and efficiency makes you not empathetic.

 

00:32:25:01 - 00:32:49:01

Nirav Bajaj

But the reality is, if you can build in efficiency with technology at the back end to make your physicians, your nurses, and all of the staff who are at the hospital, at the clinics, actually spend more time and more care with the patients. I think that's what's going to drive, real outcomes. 

 

AJ Adel

Beautiful. Russell?

 

Russell Harrison

Dangerous going last because I got to say something profound, which is a worry. I should have let Nirav go last. 

 

00:32:49:01 - 00:33:12:22

Russell Harrison

But, I think, for me, the leadership thing that we need to do for the next generation is to promote better change management, to embrace the technology. And I think as a leader, I've got to encourage and keep promoting risk taking within whatever frameworks you have to comply. But actually, don't be afraid to push the envelope, to push the boundary, to take a risk calculated.

 

00:33:13:00 - 00:33:36:00

Russell Harrison

Probably better than just a wild one. But I think it's about keeping that ambition, as Nirav said, people are coming to care for people. They want to do that job. They've got a passion for that. That's what we're in healthcare for. It's about serving that patient. But if we lose the ability to take a risk, to do a challenge, to push the boundary we'll not improve care in the way that I think everybody wants to.

 

00:33:36:02 - 00:33:52:07

Russell Harrison

Tech will help that. But let's take some risks in and around the tech. 

 

AJ Adel

I think what I got out of this is nobody's retiring in this seat, and we're all going to live to 150. I'll do 140. I'm good with that. I want to thank everybody here. I want to I want to wish you all safe travels back home.

 

00:33:52:07 - 00:34:23:22

AJ Adel

And for our audience, thank you for being with us. And thank you for trusting us and continuing to partner with us in creating the future of healthcare. Thank you everybody. Appreciate it. 

 

Unknown

That's all for this episode of Perspectives on Health and Tech Podcast. Be sure to subscribe to catch all our future episodes. For more information from industry experts, visit oracle.com/health and oracle.com/life Hyphen Sciences, or follow Oracle Health and Oracle Life Sciences on social media.

 

00:34:24:00 - 00:34:35:19

Unknown

Thank you for listening and join us again for the next insightful episode of Perspectives on Health and Tech.