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

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.

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)