Oracle sets lofty goals after completing acquisition of Cerner
A national patient database, improved clinician interfaces and support for patient engagement are among goals set for the combined companies by Larry Ellison.
With Oracle’s $28.3 billion acquisition of Cerner now complete, the networking and technology giant is describing some of the advances it hopes to achieve in healthcare through the purchase of the electronic health records system company. That includes an effort to create a national patient records database that could prove difficult and controversial.
In a 90-minute web-based presentation June 9 titled “The Future of Healthcare,” Oracle executives – including co-founder and chief technology officer, Larry Ellison – outlined ambitious plans to use Oracle’s technology platforms and prowess to ease caregivers’ workloads, decrease administrative burden and defragment patients’ often-dispersed health records.
The presentation also featured Cerner CEO David Feinberg, MD, who briefly spoke in a recorded segment and was identified as president and CEO of newly named Oracle-Cerner.
Components of the strategies mentioned during the presentation are either already underway throughout the industry or otherwise have been found to be extremely complicated and vexing to solve, industry experts note.
National database proposed
During the presentation, Ellison noted that Oracle had been working in healthcare “for decades.” The company moved to increase its role in the industry, closing the $28.3 billion deal on June 8.
Ellison called for creating a unified, yet secure, national database patient records built on a platform of Cerner’s systems and Oracle’s cloud technology.
He noted that patient records often are fragmented across the healthcare ecosystem. “Health records are in thousands of databases, and you can’t get at that data,” he said. The problems associated with this lack of accessibility were obvious during the COVID-19 pandemic, he said.
Ellison envisions a national database that would be fed by all provider organizations’ records systems, irrespective of the vendor system used to capture that information. Access to that information would be enabled across the ecosystem, but only with patients’ permission to share their data. A large national database would facilitate access to a wide range of patient data that could be used during national health emergencies as well as to enable research on diseases and treatments, Ellison said.
“All the data is anonymized, and we make sure we’re not compromising data privacy and we give a new window for public health officials,” Ellison said. “We solve these two problems at the same time.”
But the proposed creation of a national database raises major technical issues as well as serious privacy and security concerns, some industry experts say.
“I’m not sure where this discussion came from,” said John Moore, CEO and founder of Chilmark Research.
The technical and system issues involved are more complex than challenges Oracle has faced in other industries, he said. Being successful in this arena will require “deep domain knowledge for Oracle as it looks to make an impact on healthcare,” Moore added.
Some privacy advocates already had expressed concern that Cerner’s database of de-identified patient data, which it makes available for research purposes, could somehow be combined with Oracle’s trove of consumer data to create more complete consumer profiles that then could be used to, for example, help companies develop more targeted advertising. The creation of an even broader patient database could raise new concerns.
Patient engagement
Ellison also said components will be added to Cerner’s EHR system to meet the needs of value-based care.
For example, a new patient engagement system will “open a new two-way channel between patients and their healthcare providers through an app on their phones,” Ellison said.
The EHR system also will be enhanced to collect information from wearables and home diagnostic devices, he said, citing potential benefits for patients who need ongoing monitoring after procedures or who are undergoing therapies, such as chemotherapy, which are primarily provided on an outpatient basis.
The enhanced records system also will enable increased patient participation in clinical trials through an expansion of Cerner’s records system. “This allows anyone to participate in clinical trials – they can share information with doctors who are running clinical trials, enabling a more diverse of population of patients” being used for research, Ellison said.
Chillmark’s Moore said this renewed emphasis on research harkens back to Oracle’s past. “Oracle at one time had a very strong presence in clinical trials,” he said. “This has faded due to lack of investment. But with Cerner and its Enviza division, could also be a very interesting play for the market.”
Cerner’s Enviza unit provides data, analytics and research to the life sciences industry.
Assisting clinicians and organizations
Oracle also expects to expand Cerner’s capabilities in other ways. For example, Ellison said Cerner’s systems will expand use of hands-free voice interfaces to the EHR, which he contended will make it easier for providers to find patient data without having to touch a keyboard and reduce the amount of time needed to input patient notes.
“We want to make sure clinicians have the right information for their patients,” Feinberg said in his recorded comments. “We have an opportunity to change healthcare like it’s never been changed before. We want to make workflows easier – we can bring world-class technology with an understanding of how healthcare works.”
Ellison said other components of the patient record will be automated, such as integrating information from telemedicine encounters and telemetry from patients who are being treated in their homes.
Other vendors have been integrating voice recognition into healthcare for years, particularly Nuance, Moore noted. “It’s possible that Nuance is light years ahead of Oracle in this,” he added.
Oracle expects to bring other efficiencies to healthcare organizations through development of the administrative components of Cerner systems. Those mentioned during the presentation include:
- Improving enterprise resource planning functionality for providers;
- Implementing better capabilities for human resource functions, such as scheduling, recruiting and paying doctors, enabled by capabilities in Oracle’s Fusion application running in the cloud;
- Expanding capabilities for using e-commerce and managing distributed inventories using RFID tags and supply replenishment systems. This could include the use of blockchain technology to help eliminate concerns about counterfeit medications.
Ellison also mentioned improving data exchange between providers and payers to expedite prior authorization communications, citing estimates of $265 billion wasted in the industry on bill administration. “We want to automate that,” he said, noting Oracle’s current capacity in supporting systems for both providers and payers.
Automating prior authorization is a point of focus within the industry, particularly in expediting care for patients by eliminating bureaucratic hurdles in determining whether payers will approve payment for treatments. However, several initiatives in this arena, including HL7’s Da Vinci Project, are already underway.