Oracle Announces Generative AI Tool, Dana-Farber To Launch New Hospital

September 20, 2023 - In this inaugural episode of Healthcare Strategies | Headlines, we dive into new technologies, partnerships, and data. Oracle has announced a new generative AI model that integrates voice commands into EHRs. The tool will be available within the next year. Meanwhile, Blue Shield of California is partnering with Salesforce to improve both care management and enrollment processes. Strained by workforce shortages, healthcare organizations are turning to virtual nursing. Meanwhile, Dana-Farber Cancer Institute announced it will end its affiliation with Brigham and Women's Hospital--much to Brigham and Women's surprise--and partner with Beth Israel Deaconess Medical Center (BIDMC) to establish a new cancer hospital. Finally, data shows that often-lauded strategies around care coordination and social determinants of health interventions may only be effective among patients who are engaged with their heatlh.

Hello and welcome to Healthcare Strategies, the Headlines edition. This is Kyle Murphy, vice president of editorial at Xtelligent Healthcare Media. And as always, I am joined by the wonderful Kelsey Waddill, senior editor of HealthPayerIntelligence and multimedia manager for Xtelligent--all things media?

Kelsey Waddill

Yep. I'll own that.

Kyle Murphy

You'll own that. So this is a new segment that we are rolling out on a weekly basis where we bring to you what we consider to be the most important headlines over the past week to hopefully keep you informed and keep you abreast of all the issues with a little bit of, lemme say, banter?

Kelsey Waddill

Yeah. Insight?

Kyle Murphy

Friendly interaction. Insight is better.

Kelsey Waddill

I like to think of it as our wise insight.

Kyle Murphy

Yeah, I've been doing this for too long now. I think I have some opinions on the matter. Alright, let's get into it. First item here. Are you ready, Kelsey?

Kelsey Waddill

I'm ready.

Kyle Murphy:

Oracle foresees gains in healthcare. So Oracle is set to release its generative AI for EHRs in the next 12 months.

Kelsey Waddill

Wow.

Kyle Murphy

You've heard about generative AI?

Kelsey Waddill

I have. I haven't been able to escape it.

Kyle Murphy

Yeah, it's inescapable. It's everywhere on the internet. The company recently announced that its digital assistant will enable healthcare providers to use voice commands--revolutionary--to automate clinical documentation. It can also automatically take notes and suggest context-aware actions like ordering medications. The product also allows providers to retrieve patient EHR data during appointments, which might be useful with the goal of informing clinical decision making while enhancing patient-provider interactions, reducing burnout, and empowering patients through self-service. If these sound like buzzwords to you, you would be correct. Buzz buzz buzz buzz buzz.

Additionally, Oracle has added healthcare-specific features to its financial and supply chain management products to streamline financial consolidation and reporting, procurement, and replenishment planning and recall management. It also introduced workforce management capabilities to address staffing challenges using AI and cloud technology for efficient staff scheduling and financial planning. The announcements follow a rough patch for Oracle due to its Cerner EHR business and the losses of key clients. So it's obviously a lot right there.

Kelsey Waddill

Yeah, you had both the patient stuff and the company level.

Kyle Murphy

Even if they accomplish just a fraction of this, if they could reduce burnout, that'd be huge. If they can empower patients, that'd be huger.

Kelsey Waddill

Yeah.

Kyle Murphy

Who knew? Sounds like a silver bullet. All right. Item number two. Breaking up is the hardest thing to do. We're used to mergers and acquisitions, but there are also breakups in healthcare. Dana-Farber Cancer Institute is ending its affiliation with Brigham and Women's Hospital and partnering with Beth Israel Deaconess, otherwise known as BID, to create a freestanding cancer center or hospital in Boston. The decision marks a significant change in Dana Farber's affiliations and came out as a surprise to Brigham and Women's as they were in negotiations to continue their partnership and invest in new cancer facilities.

Kelsey Waddill

So it's really only a breakup for Brigham and Women's.

Kyle Murphy

Yeah, Dana-Farber is moving on. It's going better places onward and upward. Dr. Lori Glimcher, the CEO of Dana-Farber cited the changing landscape of cancer care due to an aging population and increased diagnoses among younger adults as the driving factor for the move. The new hospital aims to increase patient capacity and leverage tech advancements in innovations from both Dana-Farber and BID. Anyone taking notes? So Beth Israel Deaconess had previously merged with Lahey Health in 2019, forming a 13-hospital system. So the transition is expected to take several years during which time Dana Farber's current affiliation with Brigham Williams Hospital for inpatient and surgical care will continue.

Kelsey Waddill

Sounds awkward to me.

Kyle Murphy

Strange bit fellows. Yes. Yeah, it's really hard. A clean break is very hard to come by these days. They're just going to be friends for a bit. Try it out. Might be awkward, see what happens. But at the end of the day, it's probably for the best considering that an organization or a hospital focused exclusively on cancer care should probably be for the benefit of patients, considering that's all they'll be doing. And as we've seen historically, you can be decent at multiple things, but you can be really good at one. That describes my life.

Kelsey Waddill

True for humans, true for companies,

Kyle Murphy

Jack of all trades, master of none or what one? Yes. Alright. What's next?

Kelsey Waddill

So Blue Shield of California has an exciting new partnership with Salesforce. They're enhancing their care management services and streamlining their enrollment processes. With this introduction of CareConnect, it's a care management system built on Salesforce Health Cloud. CareConnect consolidates data from 13 different sources, providing

Kyle Murphy

Lucky number.

Kelsey Waddill

Yep. We already have that once in the show, so...

Providing care managers with a comprehensive view of member health needs. So it's going to pull from clinical, lab, pharmacy, behavioral health, care gap, and a lot of other health data facilitating real-time care plans and hopefully connecting members to in-network benefits as well. The goal is to improve the overall member experience and also create a unified member experience and improving the enrollment experience for employers and brokers as well.

Kyle Murphy

That's a positive.

Kelsey Waddill

Yeah, so the current enrollment process for commercial markets tends to be pretty manual and very lengthy for payers and employers. I have to write about it quite a lot. Blue Shield and Salesforce, however, are developing basically a single self-service digital process and they say that it reduces the processing time for benefits administration from 24 hours to five minutes.

Kyle Murphy

That seems big.

Kelsey Waddill

That seems huge. That would be a huge time-saver.

Kyle Murphy

There are a lot of minutes in 24 hours. I can't do the math top of my head, but that's huge.

Kelsey Waddill

It's a pretty big percentage drop. This is not the end of the partnership either. [Blue Shield of California is] planning to collaborate with other external partners, expand that platform, and expand member access to it. So more to come on that, but...

Kyle Murphy

It's almost like they're treating members like consumers.

Kelsey Waddill

Yeah, I think that's the way we're going. Consumerist healthcare.

Kyle Murphy

It's interesting. More of these health plans want to be in the care management decision-making process. So it stands to reason that they actually start working with a--what do you call them--a CRM company, that's Salesforce. We're editors, so we don't deal with this sales side of things, but it seems to be important.

Kelsey Waddill

Yeah, I've heard people talk about it quite a lot on the sales side.

Kyle Murphy

And the other thing is, it's interesting that if this works in California per se, the Blues are a big association. So it'd be interesting if this is something that gets rolled out to all the different regions and that could be a huge win for at least Blue subscribers, members, employers, and there are many.

Kelsey Waddill

Yeah, yeah, for sure. I think it's also interesting how they're doing a lot of things in one. I think we are seeing that in a couple spaces right now with the Oracle announcement and with this announcement tackling not just member experience related things, but also tackling internal problems, trying to provide solutions for both members and for internal issues as well is a lot to tackle at once. But

Kyle Murphy

It's a lot. But a company like Salesforce is pretty substantial. It crosses many industries and they're very mature in the way they operate. So rather than reinventing the wheel, this would seem to be a big payoff.

Kelsey Waddill

And it's cloud. So, limitless.

Kyle Murphy

Cloud, cloud, cloud.

Kelsey Waddill

Speaking of digital tools, we are going virtual in order to overcome the nursing shortage.

There's a survey conducted recently by Joslyn Insight that surveyed 789 different healthcare professionals in mostly acute care settings and found that about three-quarters of them or 75 percent of healthcare professionals see virtual nursing as an opportunity to recruit nurses who cannot or will not work at the bedside. Sixty-six percent of the respondents believed that virtual nursing will become integral to acute care delivery models and over a third of respondents had already implemented virtual nursing or were in the process of doing so. It's not just a hypothetical, it's already in the works, which is pretty fascinating. They highlighted a couple key use cases for virtual nursing, which included patient discharge admissions, patient education, and expert clinical oversight. They also went into some of the key metrics for measuring success, which is important with any new sort of method or process. And what they highlighted was improving nurse satisfaction and retention, the workload burden for current staff, and patient experience were the things to look for when implementing something like this. That said 14% cited a lack of confidence in the return on investment. ROI.

Both

Roy.

Kelsey Waddill

Yep. Good old Roy. As a reason for not implementing virtual nursing, a lack of confidence on ROI for not implementing it. And 13 percent cited budget constraints as well. So it sounds great, but it sounds like there's some things to overcome before it's reality.

Kyle Murphy

There is the question of how much you're actually paying for a virtual nurse. Competitive pay is obviously one of the reasons why getting nurses on staff and retain them is a huge issue. But the major upstream question is more just where have all the nurses gone? We still haven't answered that. This may be one of your temporary solutions, but there clearly is a lack of a workforce and maybe the job is not all it's cracked up to be. The fact that it says "will not work at the bedside." I know I've been around a hospital bed, it's not a fun place to be.

Kelsey Waddill

And with the attacks on the workforce, the healthcare workforce that have been going up, I wonder if people even who want to work at the bedside might see this as an alternative that might be safer for them. So that's a positive, but at the same time, what will that do to our bedside workforce? We still might have a shortage of people who are in-person and present and that's important.

Kyle Murphy

You still have the question where somebody still needs to be physically present, so that's obviously not a nurse if you can't afford a nurse and you have a virtual one there. So really the question is then: who is actually there? Obviously a lower license. Maybe a nurse's aide is there? There still needs to be that human touch component. There's only so much interacting you can do over a screen that can actually meet human need. But obviously, there are more pressing concerns right now where physically these organizations are understaffed. So any stop-gap measure is better than nothing. Right?

Kelsey Waddill

For sure.

Kyle Murphy

We roll on. Last item of the day: a formula for success. So a study by Camden Coalition in Kaiser Permanente found that when hospitals coordinate post-discharge access to social services and managed care for socially complex patients, and when patients actively engage in these interventions, better outcomes are achieved such as reduced hospital readmission rates, which is an important quality metric and an incentive payment-tied metric.

The study focused on patient engagement levels is a follow-up to a 2020 report that didn't find significant improvements in readmission rates through care coordination and SDOH interventions alone. Patients categorized as more engaged had significantly better outcomes with a 48 percent lower relative 30-day hospital readmission risk and a 52 percent lower relative 90-day readmission risk compared to less engaged patients. Patients experiencing housing instability over the history of criminal justice involvement were found to be less likely to engage with care coordination suggesting a need to tailor interventions to address these specific needs. Now this brings us back to the quadruple aim or quintuple aim I should say, where health equity is now a big component and social determinants of health are a major factor. I think we're getting into the behavioral economics of healthcare where you can only deliver so much care that if the patient's not engaged, you're not getting anywhere. And it's kind of remarkable that a study is so eyeopening for something so basic, but...

Kelsey Waddill

But sometimes you need the stats behind it to be like, yes, this is real.

Kyle Murphy

It's true, it is healthcare. There's no evidence, no buy-in. You have to prove ROI and all those other things that we love to talk about. It is good to see though, that following their previous report, which didn't necessarily yield the results they wanted, that they stuck with it and they actually saw that there's two sides to the equation where there's the provider and then there's the actual patient. The patient, who is kind of left out of all these conversations and decision-making, but the onus on the individual to actually adhere to their care plan, adhere to their medications. All those are opportunities to disrupt health and wellbeing. So, obviously it speaks to the need for greater patient education as to why it should matter, which is a whole other matter, but at least it's a start. And with that, those are the healthcare headlines. Thanks for joining us. Make sure to follow us on Spotify and Apple.

Kelsey Waddill

And all the other listening platforms.

Kyle Murphy

Wherever you find us. We'll be there.

Kelsey Waddill

Yeah.

Kyle Murphy

And we'll catch you next week.

Kelsey Waddill

See you later!