While innovative technologies in healthcare today aim to drive efficiency, reduce administrative burden and empower patients to take charge in their care, this hasn't always been the case.
Take for example the first generation of EHR systems, which were designed for regulatory compliance rather than optimized to streamline clinician workflows. Now, some technology companies are working hand-in-hand with clinicians as they create new tools to ensure the latest developments help rather than hinder providers.
To learn more about what this innovation looks like in a practical setting, Becker's Healthcare recently spoke with Thomas Selva, MD, chief medical information officer at University of Missouri Health Care (Columbia, Mo.) and medical director of the Tiger Institute for Health Innovation.
Eliminating 'busy work' to focus on patient care
Over the last 10 years, technology has democratized how healthcare is delivered. Patient access to personal health information and medicine has never been more available. Today's EHR has become a platform where clinicians come together to share in the care of patients, populations and communities.
"One of my mentors taught me that every patient has a great tapestry of their life," Dr. Selva said. "When physicians see patients, they tug on one fine thread of this tapestry. We're now at a point where physicians can see more of the tapestry than ever before, so we have a better understanding of patients as a whole."
Regardless of the EHR platform, most physicians and clinicians have unfortunately had to use software that isn't very user friendly. However, with advancements like generative AI and automation, technology has now reached a point where systems can be designed with physicians, collaboration and complexity of healthcare populations in mind.
Dr. Selva's philosophy is guided by his approach to eliminate administrative "busy work" so physicians can focus on what matters most: patient care. This shift in focus, he said, will enable healthcare providers to focus more on patient relationships and the nuances of good care, rather than simply accessing information in the EHR and making rapid decisions.
"I think when we look at the healthcare industry, it's ready for disruption," Dr. Selva said. "We're ready for a disruptor to come in and say, 'Let's take everything we've learned — the good and the bad — and create a much better platform not only for physicians, nurses and allied healthcare professionals, but also for patients."
Strong partnerships are key to designing innovative EHR solutions
University of Missouri Health Care is leveraging this mindset on an enterprise scale. The health system plays a central role in the design of Oracle Health's EHR system through the Tiger Institute for Health Innovation, which is a public-private partnership with Oracle Health.
Oracle Health is looking to be the disruptor and is committed to putting patients and providers first by reducing the burden of tedious, overwhelming administrative tasks that divert clinicians' time away from patient care. To achieve these goals, the company is involving providers like Dr. Selva's team in the design and development of its next-generation EHR.
"We pair medical professionals with software engineers," Dr. Selva said. "Part of our job is to provide physician and provider insight into how healthcare is delivered. When Oracle Health decided to develop a new EHR from scratch, we were in a perfect position to help their engineers and designers."
In practice, Oracle designers stand behind physicians, observe patient encounters when appropriate and truly experience exactly what clinicians do on a daily basis. By developing a system from the ground up with the user and patient in mind, it's possible to focus on best practices, while leaving flawed functionality and designs behind. For existing customers, the new EHR builds upon the current Millennium technology by using Oracle databases and security models, eliminating the need for complex migrations.
"It's not just about user-centered design," Dr. Selva explained. "It's about delivering a product that will work in an environment that's controlled chaos on a good day. As an Oracle Health lead beta validation partner, we can bring the system to our users, really kick the tires, figure out where it's working and where it isn't, then watch the team iterate quickly. That's exciting."
AI integration: an important step to stay future ready
Oracle Health is not simply building its new EHR for today's needs; it's preparing it for the future. The system has been designed with a simple, intuitive interface to significantly ease user adoption. For example, instead of hunting for records, clinicians can simply request that the system pull up a patient's latest lab records.
Oracle Health's new EHR is built on Oracle Cloud Infrastructure, which benefits from the industry-leading scalability, security and performance that modern healthcare organizations demand. It also leverages Oracle Database, just like the legacy Oracle Millennium EHR system. Thanks to this common data foundation, disruptions associated with data migrations can be eliminated.
This combination helps ensure that Oracle Health's next-generation EHR is not only adaptable to clinician needs but is also equipped to evolve with the ever-changing healthcare technology landscape.
The new EHR experience breaks down data silos by unifying multiple data sources, such as EHR information, claims data, pharmacy records and more. The result is a comprehensive, longitudinal patient record. This holistic view empowers clinicians to make informed decisions that support improved patient experiences.
Many EHRs have incorporated AI into their systems as a bolt-on. Oracle Health is instead taking an AI-first approach. The next-generation EHR has been built from the ground up with AI as a core component. This enables seamless integration of AI into every workflow, allowing clinicians to work smarter, not harder. The AI-driven platform delivers real-time insights at the point of care, providing the right information and intelligent recommendations based on clinical guidelines, recent studies and patient-specific information.
"As we encounter patients who present a diagnostic conundrum, there can be confirmation bias," Dr. Selva said. "Generative AI solutions can identify the things that you aren't thinking about and determine whether they apply to your patient. If they do, that can break the confirmation bias and help you reach a diagnosis more quickly."
For example, Oracle Health's new EHR system can nudge clinicians with alerts about relevant clinical trials, best practices for treatment or potential medication interactions. It can also identify care or quality gaps, such as overdue screenings, and provide insights on quality or financial metrics, like potential impacts to reimbursement or adherence to value-based care measures. This allows healthcare providers to access meaningful and actionable insights to support better decision-making.
Over time, this next-generation EHR will learn from clinician behaviors and adapt accordingly. It will remember the most-used order sets and how users like to view patient summaries. By tailoring itself to user preferences, the system will make routine tasks more efficient and reduce the need for repetitive data entry.
Unifying clinical, patient and enterprise applications and data driven healthcare efficiency
University of Missouri Health Care recently integrated its existing Oracle Health EHR system with that of its sister hospital in Jefferson City, Mo. This has transformed the way the system delivers care and is helping to drive better patient experiences.
"By sharing the same instance of the EHR, we have the ability to communicate seamlessly between primary care physicians, specialty physicians, inpatient care teams and outpatient rehab. Not only can we provide higher-quality care to patients, but we can also manage capacity better," Dr. Selva said.
Although the goal is to keep patient care as local as possible, University of Missouri Health Care has found it helpful, when necessary, to transfer lower-acuity patients to the hospital in Jefferson City and treat higher-acuity patients in Columbia. The fully integrated Oracle Health EHR system enables this.
Thanks to increased collaboration between healthcare providers and technology companies, clinical staff are feeling more optimistic about how next-generation EHRs and other solutions will improve the way patient care is delivered. By providing hospitals and health systems with more intelligence and automating entire processes, Oracle Health is enabling organizations to be more efficient, secure and effective.
"We have the potential to ease the burden on physicians and empower patients to provide good care for themselves and be part of the care team," Dr. Selva said.