Perspectives on Health and Tech

Join this special International Nurses Day episode as we honor the extraordinary dedication and global impact of nurses—those at the heart of healthcare. In this inspiring edition, nursing professionals share their personal stories, valuable insights, and pioneering innovations that are helping redefine patient care and shape the future of the industry. Discover how nurses are leading transformative change, leveraging technology, and driving meaningful enhancements in care delivery. Celebrate the compassion, resilience, and ingenuity of nurses around the world with Oracle Health. --------------------------------------------- Episode Transcript: 00;00;00;04 - 00;00;23;08 Michael Draheim Well, thank you for tuning in. My name is Michael Draheim, and I'm the Chief Clinical Information Officer for the JAPAC region, based in Australia. I work for Oracle Health, and I'll be your host and moderator for today's session. In honor of International Nurses Day, we're dedicating this special episode to nurses around the globe—celebrating their unwavering dedication and measurable impact on patient care. 00;00;23;10 - 00;00;45;16 Michael Draheim We invite you to join us as we share stories, insights, and groundbreaking advances from nursing professionals who are shaping the future of healthcare. Whether you're a nurse, a healthcare leader, or simply inspired by the spirit of caregiving, this episode is for you. I'm delighted to welcome our panel. Angela. 00;00;45;19 - 00;00;51;11 Angela Ryan I'm Angela Ryan and the lead healthcare executive of JAPAC, based in Sydney. 00;00;51;13 - 00;00;52;25 Michael Draheim Patience. 00;00;52;27 - 00;01;00;26 Patience Chinwadzimba Hi everyone. Patience Chinwadzimba. I'm a healthcare executive based in the UK. 00;01;00;28 - 00;01;07;27 Tiago Dias Hi everyone. My name is Tiago. I am senior clinical consultant. I'm based in the Middle East in Dubai. 00;01;08;27 - 00;01;45;19 Michael Draheim Welcome panel, and let's get into the questions. So, if we look at workforce—workforce is a big issue. Nurses face intense pressures today, including long shifts, high patient acuity, rising clinical demand, and workforce shortages. These pressures don't just affect their quality of care, but also nurse retention, safety, and long-term health. So how do you see technology advances being optimized to help alleviate documentation load and cognitive burden, rather than add to it?. 00;01;41;01 - 00;01;46;16 Michael Draheim For these nurses that are under a lot of pressure? And Patience, I'll start off with you. 00;01;46;19 - 00;02;15;11 Patience Chinwadzimba There is pressure, and nurses are burnt out. I think what we need to think about, and one of the pitfalls people fall into, is when they are designing new documentation on new technology. I think we need to be smarter and not just replicate what we have. We need to reimagine how we want to document and how we want to work. 00;02;15;11 - 00;02;42;26 Patience Chinwadzimba Because currently, you hear complaints of, "Oh, I have to go to the computer," and the computer seems to be in the way of nurses wanting to do their work. So if we're smarter in reimagining how we do documentation—not transferring paper to computer, but thinking about streamlining it and forgetting about "we've always done it that way." 00;02;42;27 - 00;03;08;28 Patience Chinwadzimba We want this for one thing because we have always documented it. I think we need to start thinking about what this information is useful for, who it is useful for, and ensure we are not simply collecting information that is of no use to anyone. Because that is the cognitive burden—you're now trying to find what you really need from the bulk of the information you've put in there. 00;03;09;01 - 00;03;23;25 Patience Chinwadzimba So I think it's about being smarter in how we move from paper to technology to make it easier for nurses to do their job and to know, "I just need to go and document what I've done for my patient—how my patient is." 00;03;23;28 - 00;03;49;02 Angela Ryan Yeah. And you bring up a couple of really good points there and age, you know, get you to comment around, you know, the documentation burden versus the compliance burden and, and how that's impacting, you know, nurses in Australia, you know, and we see comprehensive care coming, which is really important. But it's added this, you know, significant burden in regard to documentation for compliance reason. 00;03;49;05 - 00;04;11;13 Angela Ryan Yeah, look, thanks Michael, and it's great to be here with you all. I think the issue around compliance is a big one. Patience has already made that comment around the sort of mimic of paper to digital. We've all been living with that, I think, for some decades. Systems were not designed intentionally to sit inside workflows, but rather to mimic what we did on paper. 00;04;11;13 - 00;04;41;01 Angela Ryan We're still left with that legacy, and that's where a lot of cognitive burden has been introduced by systems designed that way. Certainly, in Australia, we have a very important organization called the Australian Commission on Safety and Quality in Health Care. There are similar organizations in each country, but this one sets the standards for how health services deliver care. 00;04;41;04 - 00;05;12;12 Angela Ryan Some of those, components that sit within those standards, I guess, have been challenging for workforces not just to work alongside, but also to implement. So, what's happened is that one of the very large standards which Michael has referred, which is comprehensive care, that talks about basically how we care for our patients, how we ensure that they are safe in our environments, how we ensure that they don't fall over, that they don't get pressure areas and all of that kind of fundamental stuff. 00;05;12;12 - 00;05;37;01 Angela Ryan But I guess in trying to ensure that that environment is safer, we've put in place all of these additional checkboxes and ticks and other things that need to be completed. And so it sort of gets in the way of actually determining whether or not those things are, in fact, having an outcome. Are you actually starting to see patients safer in that environment, or are we just saying, yes, we actually did complete that checklist? 00;05;37;07 - 00;05;46;25 Angela Ryan So I think that's been a really big topic of conversation for us. So it's not to say that the standards are not important, but it's the way in which we're trying to implement them. 00;05;46;26 - 00;06;04;02 Michael Draheim And I think you bring up some really good points there around that balance. Can I go to you, Tiago? In the region you work in, one of your biggest challenges from a nursing perspective is that you have a very diverse workforce. And I do want to talk a little bit about that. 00;06;04;02 - 00;06;28;00 Michael Draheim So, you know, how do you manage those things from a workforce perspective, linking back into where technology helps? Because you've got a lot of people coming in from different countries. So I think there's a more unique challenge around language and culture, etc. But we still deal with those things in the UK and Australia—it's probably just a little less impactful on our day-to-day basis. 00;06;28;05 - 00;06;33;11 Michael Draheim It's probably a little bit of a less, impact on some day to day basis. 00;06;33;13 - 00;07;04;18 Tiago Dias Yeah, Michael, I do agree with you. My starting point is really acknowledging the specific challenges of the region. We have a lot of diversity in terms of manpower. Technology has changed significantly over the years, especially in the region. 00;07;04;20 - 00;07;31;07 Tiago Dias When it comes to nursing care, we have seen that systems were more focused on billing and compliance rather than clinical workflows. And sometimes nurses from different backgrounds struggle to understand how care is being delivered because technology was not well developed for nursing workflows. The time spent with patients was affected. 00;07;31;07 - 00;08;06;28 Tiago Dias That's why now we are starting to see a shift in how new EMRs are being designed, especially around capturing information at the bedside. In the near future, with advancements like voice recognition, I think it will help standardize verbal handovers, assessments, and documentation. 00;08;07;01 - 00;08;35;27 Tiago Dias This is especially important in regions with diverse cultures and workforces. We aim to standardize how documentation is done and how care is provided in a consistent way. The system landscape in the region is growing, and as we improve, we can reach better outcomes. 00;08;35;29 - 00;08;57;03 Michael Draheim Yeah, and Tiago, you've touched on something important—the reason nurses are there is for the patient. We're here to care and support people. 00;08;57;03 - 00;09;33;03 Michael Draheim But we can't ignore the fact that we're here for the patients. We're here to care. We're here to support those people. So, you know, based on that, you know, I what I've got you. I'll keep you going. What we what we're talking about is saying the how does how do then, you know, we further explore that thing around how do we make sure the documentation and technology and, you know, we seeing eye and other things coming in, how does that actually then flow over and actually support the staff, but also can help us to support better patient outcomes and better, you know, better integration in the, you know, in a 00;09;33;03 - 00;09;40;17 Michael Draheim very complex system, but also the, the involvement of other family members and things in people's care. 00;09;40;20 - 00;10;20;22 Tiago Dias This is a key point. AI is progressing very fast, and we need to leverage it to achieve better outcomes. In nursing, there are critical areas where it can help, especially in documentation and clinical recommendations. 00;10;20;22 - 00;10;43;14 Tiago Dias One of the biggest issues today is the number of clicks and the amount of manual documentation required, which takes time away from patient care. Technology can reduce this and allow nurses to spend more time with patients. 00;10;43;17 - 00;11;04;00 Tiago Dias We are also seeing progress in early detection—analyzing vital signs, lab trends, and scoring tools. This helps prevent critical events like cardiac arrest and reduces admissions, especially in critical care. 00;11;04;03 - 00;11;31;08 Tiago Dias And in this case even decrease the number of admissions, especially in the critical care area on the other side, as you touch bases, really, terms of the workforce planning, right, as we progress in the technology, will support part, as I think, in terms of analytics and themes of prediction. Yeah, I think it will help us how we restructure the workforce and especially impact certain points in terms of the burnout, what some of us can be facing. 00;11;31;08 - 00;11;40;11 Tiago Dias Right. So, technology is a strong ally—we just need to use it effectively to achieve better outcomes. 00;11;40;11 - 00;12;03;14 Michael Draheim And that makes sense. I think that makes perfect sense. I'll come to you, Patience is you've seen a lot of uptakes about sort of, the NHS and changes around AI etc. You know, what's been, the feedback around that technology from patients? 00;12;03;14 - 00;12;30;02 Patience Chinwadzimba That. Thank you, thank you. Thank you, Michael. So, you know, we talk about how we use technology. So, from a nursing standpoint, we're seeing a lot more need for mobile technology that, document the ability to document using my mobile phone. We're seeing advancements, certainly in our own field, in our own company, where we are developing AI. 00;12;30;02 - 00;12;51;24 Patience Chinwadzimba That allows me to talk about the cam given to the patient, to the wound that I'm seeing, and my responses popped, pre-populated in the fields on a form that I would normally go in and click a dropdown to select a response. So, I can say, you know, the patient's output. Is this their blood pressure? Is this. And that is now helping me. 00;12;51;24 - 00;13;14;14 Patience Chinwadzimba I don't have to go to the computer to go type it in. As I'm speaking, AI is picking out those discrete data and dropping it into the form. For me, from a patient perspective, we are discharging patients with, tracking devices. They are tracking the blood pressure at home. They are checking their, you know, their vitals at home, they become their PMS. 00;13;14;16 - 00;13;36;13 Patience Chinwadzimba And so, with that, we have other companies that are bringing in technology that allows the patient to enter that data, that interface with the main patient record and, and populates that. So, we have hospital at home. Yeah. We have virtual wards with the patient is at home. But they're feeding that information in. And that is something that we're seeing now that was never there before. 00;13;36;20 - 00;13;58;22 Patience Chinwadzimba You had to go walk around with this fig. If anyone remembers what a twig was, and if they can still take a blood pressure with this big and a proper thermometer. But that's all gone, and things are moving forward. We're, you know, looking at the patient's acuity, we're able now to kind of know we have ten acute patients on this ward. 00;13;58;24 - 00;14;18;15 Patience Chinwadzimba We need to look at who's coming on shift. How qualified are they? Who do we have on our books. Yes. And all of that is all interlinked with all the new systems that are coming in that can look at patient acuity, what staff we have, who can we bring in to make sure we are delivering that, that care that the patients need. 00;14;18;18 - 00;14;24;11 Patience Chinwadzimba So it's also helping with, workforce planning. And don't forget the patient portals right now. 00;14;24;24 - 00;14;43;20 Angela Ryan Angela. One of the things so you know so and patients is you know, summed up I think very nicely some of the stuff that, you know, you're seeing in the UK and you know, in other parts of the world, I know sometimes Australia is a little bit slower. It's not deliberately, it's just, you know, the nature of what's happened. 00;14;43;20 - 00;14;48;15 Michael Draheim I think sometimes you are little bit, you know, cautious around certain things. What are you saying today. 00;14;48;18 - 00;15;12;04 Angela Ryan So, I think that clinicians are always looking ways, looking for ways to make processes more efficient. And, and the reason why ambient scribes have just exploded is because they solve a particular problem. So, we introduced the problem with our systems, not intentionally, but this is the reason why, you know, we've seen a lot of technology come and go, particularly around, you know, various hype cycles, but that's why this works. 00;15;12;04 - 00;15;36;17 Angela Ryan And so, I think we're having the same, experiences here in Australia. And obviously there are several different scribes in use. Obviously, we have, our Oracle version and we're working closely with, some of our, local customers on how we will implement that. I think where it's exciting is that there is a genuine desire, for people to get, involved. 00;15;36;17 - 00;15;59;28 Angela Ryan I think that the positions are adopting AI faster than we can sort of put our governance around it. And I think that consumers also expect that we would be using AI where it's appropriate because, you know, heaven knows we know that they are using it also. So, I think we are starting to see that with our, clinical notes, clinical note. 00;16;00;03 - 00;16;30;17 Angela Ryan We're getting a lot of interest and excitement and enthusiasm to participate in the design of. So, you know, the new, in the design and, involvement and engagement with the nursing AI, tool where there is an enormous amount of interest for that because I think, as patient says, you know, we really want to shift that. We want those tools to support us so that we can continue to care and that that information or that documentation is just happening around us. 00;16;30;18 - 00;16;47;25 Angela Ryan Obviously, decisions aren't being made for us, but where our workflows can be supported, is where we want those tools, to meet us. So I think we're, you know, we're equally excited here in Australia. We, I hope that we won't be too far down the down the road map there right now. 00;16;47;25 - 00;17;05;23 Michael Draheim One word to sum up the international nurses decision. No pressure. 00;17;05;25 - 00;17;08;19 Angela Ryan Empowerment. 00;17;08;22 - 00;17;13;29 Tiago Resilience and patience. 00;17;14;02 - 00;17;16;10 Patience Chinwadzimba Celebration. 00;17;16;13 - 00;17;41;14 Michael Draheim Thank you, panel members. So, as we close out this special International Nurses Day episode, I want to extend our deepest gratitude to the nurses who make profound difference every single day in hospitals, clinics, communities and across the globe. Your dedication, resilience and compassion are the backbone of our health care system, and your willingness to embrace change and lead innovation is truly inspiring. 00;17;41;16 - 00;18;03;19 Michael Draheim Thank you to our speakers. It was lots of fun for sharing your insights and stories. And thank you to all the nurses who exceptional service and commitment to care with your listening. As a fellow nurse, a health care professional, or someone whose life has been touched by nursing care. We hope you feel inspired by today's short conversation. Happy international Nurses Day from all of us and Oracle Health.

We stand at a transformative moment in healthcare. Artificial intelligence is moving from theory to practice, shaping the way we diagnose, treat, and engage with patients. While much of the AI conversation focuses on technology, today our focus is on the humans at the centre of care: the clinicians and their patients. This episode explores how AI can transform the NHS by driving efficiencies and productivity—core priorities in the NHS 10 Year Health Plan—while continuing to deliver personal, meaningful care. Key questions include: How can AI help enhance the clinical experience and enable clinicians to focus on what matters most? What new opportunities arise for clinicians to help strengthen their connection with patients as technology becomes central to healthcare delivery? How can AI continue to evolve so patients feel connected and empowered throughout their health journey and in partnership with clinicians? Speakers Moderator: Tim James, Director and Clinician Executive, Oracle Health UK Panellists: Dominic Cavlan, Clinical Lead for Acute Medicine, Barts Health NHS Trust Deirdre Lyons, Consultant Gynaecologist, Imperial College Healthcare NHS Trus ------------------------------------------------------------ Episode Transcript: 00:30 – 2:31 Tim James: Thank you for joining us. My name is Tim James, Director and Clinician Executive at Oracle Health in the U.K., and I'm your host and moderator for today's discussion. Today, we take an in-depth look at the transformative experiences of two U.K. customers who are among the first to use Oracle Health Clinical Agent note generation in an outpatient care setting. These early adopters share valuable insights from their direct involvement in the design and testing of this innovative technology. They discuss how AI has supported frontline patient care at their hospitals, highlighting the use of Oracle Health Clinical AI Note Generation to streamline documentation, elevate note accuracy and quality, and ease cognitive and administrative burden. This supports real-time clinician decision-making and helps strengthen the accuracy of diagnosis and care plans. Together, we'll explore how this innovative solution is redefining healthcare delivery and what it could mean for the future of care and patient interactions. Joining us today from the U.K., I am delighted to welcome our renowned experts: Dominic Cavlan, Clinical Lead for Acute Medicine at Barts Health NHS Trust, and Deirdre Lyons, Consultant Gynecologist at Imperial College Healthcare NHS Trust. Welcome to you both. Let's start with the first question about your experience rolling out the Clinical AI Agent Note tool. As practitioners, can you share some specific features of the Oracle Health Agent tool that have helped enhance your daily workflow, where you've seen the strongest adoption so far, and what you believe has enabled its success? Let's start with Dom. 2:32 – 4:42 Dominic Cavlan: I can probably share some experiences. I run an AI patient and technology clinic, and for our new patients, we allow 45 minutes per appointment. That's a long time spent speaking with patients, which also leads to a long period of time documenting what we've discussed. With this kind of appointment, I know I can press the button to record our conversation, and then I find myself, when I finish with a patient, realizing we've been speaking for 35 to 40 minutes. Then, instead of facing another half hour of documentation, I can efficiently turn that into something to share with GPs, colleagues, or the patients themselves. I finished my Monday afternoon outpatient clinic on time regularly for the first time in a decade. And it's not only during clinic time—previous workflows for producing correspondence involved thirdparty apps and dictation software with multiple steps and people involved. In terms of adoption, we've run our pilot, and a number of specialties have really taken this on board, including Orthopaedics, Gastroenterology, and Dermatology—some of which were already quite mature in their use of Millennium. We introduced this with our Red Shirts training program, training people live in the room with the patient present. That hands-on approach was one of the big things that got this rolling quickly. 4:42- 4:48 Tim James: That's great, thank you. And Deirdre, tell us a little about your experience at Imperial. 4:48 – 7:15 Deirdre Lyons: I think the most important aspect, from our point of view, was that it's actually integrated with the Oracle Health record. From a safety perspective, people aren't copying and pasting from one area to another, which was a big improvement. For example, if I discuss surgical risks with a patient, the system will detail all those risks for me. So rather than typing notes after the fact—just like Dominic described—it now automatically captures it, and I can use all or part of it for the GP letter. Like many people, we spent a lot of time post-clinic charting, but within about a day of starting this, my colleague stopped doing it. There were no more little scraps of paper to dispose of, and he found it much less painful and time-consuming. He could finish his clinic on time. We're using it across Chelsea, Westminster, London North West, and Hillingdon Hospital, so a wide variety of clinicians are now involved. The product has mainly been used for outpatients, but some clinicians have used it in other settings as well. For general gynecology, our main area, it has worked very, very well. Even some nurse specialists have adopted it. I think it's been very helpful because, for many people, the cognitive burden of constant typing is a real struggle. It takes a while to get used to, but some people adopted it right away—my dyslexic colleague did so from day one. And I think this is a big step forward. We're finding more and more people saying they like the way it works—it truly feels like the way of the future. 7:15 – 7:44 Tim James: Thanks, Deirdre. Productivity is a major focus in healthcare, both worldwide and within our national health services. You've spoken about cognitive burden, which is a real issue we're looking to address, but there's also the challenge of productivity. What are your perspectives on how this solution supports productivity? 7:45 – 9:53 Dominic Cavlan: The first thing we did was gather feedback as we introduced this into clinics—we had Oracle people in the clinics getting feedback live and running surveys. The survey found that clinicians were saving at least five minutes per patient. This is significant, especially in Orthopaedics, where appointments are only 10 minutes. When we use tools to measure time spent in the records, we saw a reduction of 10–15% per encounter. We asked doctors if this system would allow them to see an extra patient per clinic, and a third of respondents said yes. The productivity gains are clear: clinicians can see patients more quickly and spend less time on admin in clinic sessions. People want to do more, see more patients, and do less admin. Clinicians have become resistant to adding more outpatient clinics—not because they don't want to see patients, but because each clinic creates a mountain of administrative work. Recently, we've heard consistent feedback that this tool makes the overall experience easier, and it's boosting morale. With a happier workforce, people are more prepared to go the extra mile. 9:53 - 10:02 Tim James: So, happier clinicians and hopefully some happier patients as well! Thank you for sharing that. Deirdre, how about in your context? 10:02 – 11:10 Deirdre Lyons: I think clinicians are happier with less cognitive burden, which leads to increased productivity. I agree that saving five minutes per patient adds up. When you're trying to train, type, and teach at the same time, you can't multitask that well. This lets you focus more on training, teaching, research, or improvement projects. One clinician said, "Well, I could see another patient in clinic." It gives more time to think and to talk to patients. It's difficult to quantify, but if you save five minutes per patient and see up to ten patients per clinic, that's another 50 minutes—enough to see another patient. The softer aspects of productivity are important, too. Clinicians who are happier are more likely to be more productive. 11:10 – 11:36 Dominic Cavlan: And Tim, if I can add, regarding clinician morale, not only have clinicians been happier, but our entire informatics and technical teams have enjoyed supporting clinicians with this tool. 11:37 – 12:32 Tim James: Thanks for that perspective. We've noticed that as well, from the Oracle Health side, supporting you during roll-out. There really is a sense of delight for end users getting the benefits from this functionality. On that note, I want to talk about preparing teams. There's a big global conversation around artificial intelligence, and the agent is of course using AI technology. How is your organization preparing clinicians and teams to work with AI technologies? How do you see the role and clinical oversight evolving as AI becomes more embedded in practice? 12:32 – 15:28 Deirdre Lyons: Previously, people were using unregulated products, perhaps developed for private practice, but no one knew what those tools were doing. It was important to bring in a regulated product that met all requirements. Many people were interested even before we brought the product in. Nominations came from our divisions and digital showcase events, where we talked about digital solutions, and we emailed all clinicians to gauge interest. Identifying interested people was key for starting the pilot and evaluating the product, as well as assisting Oracle in improving it. Organizationally, it's a process. We set up a steering group over a year ago to review new products from a trust perspective, bringing together a clinical group to assess products and protocols. Clinical oversight remains vital—we always emphasize, as we use more of these tools, that you must check and verify the outputs. Even if it works correctly 90% of the time, you need to review it every time. It's important for clinicians to know they can accept or edit parts of the note—they don't have to take it as is. Clinical groups will continue to evolve and provide guidance on regulation and safety. Overall, working with Oracle has supported us as we bring in other digital products, too. 15:29 – 15:32 Tim James: Thanks, Dom, anything to add from your perspective? 15:32 – 17:08 Dominic Cavlan: As we roll this out, we keep reminding people that this is an assistant—it doesn't take away their decision-making abilities. The intention is to give people more time to be present in consultations and think critically, rather than using the appointment as a memory test. Clinicians are empowered to review and edit the notes, so the correspondence supports better thinking and better care. As Deirdre mentioned, it also gives us more time for training. We're excited about the potential impact as this expands into the inpatient space, which involves even more collaborative consultations. I'm starting to engage with the medical school to prepare new doctors for this new way of working. 17:08 – 17:35 Tim James: I want to move us toward my final question, which is about patient experience. How have patients responded when clinicians use note generation during visits? How have your interactions with patients changed, if at all, and what feedback have you received? 17:35 – 19:33 Dominic Cavlan: From our surveys and my own experience, I've found that—when I'm not writing notes by hand or turning away to type at the computer—I can look patients in the eye and have a true, traditional clinical encounter. Patients appreciate that. Of course, we always ask for consent to use software for note-taking, and I explain it helps ensure I don't forget anything. Patients have definitely appreciated this, and we've received lots of positive feedback. Working with Oracle, we've also seen that updates and changes we've suggested have been quickly implemented, which has improved the experience for everyone. 19:33 – 19:38 Tim James: How about you, Deirdre? What feedback have you received from patients? 19:38 – 20:54 Deirdre Lyons: After 30-plus years as a clinician, for the first time in a long time, I feel I can actually look at patients and talk to them directly, which is a big change. Before, I had to type, switch between talking and typing, and worry about spelling. Now, I can just sit and listen. I think I listen better, too. Patients have noticed; some have remarked how nice it is to have eye contact with their clinician and really feel heard. Clinicians are less stressed, no longer worried about note-taking for five minutes after the visit. Sometimes, improved encounter quality means we don't need as many follow-up visits. Better quality notes can mean fewer unnecessary returns. 20:55 – 22:10 Tim James: Thank you. As you said, Deirdre, these are "softer" benefits, but perhaps the most important ones. I absolutely agree. Ultimately, we want to care for patients—and patients want to be cared for. Good conversations, eye contact, and listening provide reassurance and support, which helps patients on their journey. Thank you both so much for sharing your experience and your partnership with us at Oracle Health. Today's conversation has shown that while AI is fundamentally transforming care delivery, the essential role of the clinician as healer, advocate, and trusted partner for patients remains unchanged. Thank you, Dom and Deirdre, for your collaboration, your time, and your leadership in this journey.

Leading organizations share how data-driven innovation transforms care delivery and patient outcomes. In this Oracle Health and Life Sciences Summit 2025 keynote, Alaa "AJ" Adel, Senior Vice President of Oracle Health International, joins distinguished leaders from West Suffolk NHS Foundation Trust in the United Kingdom, Bajaj Group in India, King Faisal Specialist Hospital & Research Centre in Saudi Arabia, and Western Health in Australia. Together, they reveal how hospitals and health systems are designing the future of care through artificial intelligence, advanced data strategies, and radically human-centered solutions built on Oracle technology. Hear real-world stories from West Suffolk NHS Foundation Trust, Bajaj Group, King Faisal Specialist Hospital & Research Centre, and Western Health as they share how Oracle Health is helping each organization reimagine hospital infrastructure, improve patient engagement, and drive operational excellence. Understand how this global perspective unlocks new, scalable healthcare models for a connected, healthier world. ---------------------------------------------- Episode Transcript: 00:00:00:00 - 00:00:37:14 Welcome to Perspectives on Health and Tech Podcasts, brought to you by Oracle Health, where we dive deep into the world of innovation and transformation in healthcare. 00:00:37:16 - 00:01:18:11 Shanna Adamic I'm your host Shanna Adamic, Director of Oracle Health Executive Content and Video. In this episode of Perspectives on Health and Tech we feature a panel discussion recorded at The Oracle Health and Life Sciences Summit held in Orlando on September 10th, 2025. In this discussion distinguished leaders from West Suffolk NHS Foundation Trust in the United Kingdom, Bajaj Group in India, King Faisal Specialist Hospital & Research Centre in Saudi Arabia, and Western Health in Australia reveal how hospitals and health systems are designing the future of care through artificial intelligence, advanced data strategies, and radically human-centered solutions built on Oracle technology. 00:01:18:17 - 00:01:47:18 The discussion is led by AJ Adel, Senior Vice President of Oracle Health International. AJ Adel Good afternoon. Today I get the pleasure of presenting four leaders from four different continents with six time zones. Don't ask me about the math. That's what we came out with. The topic of discussion is AI on a global scale. As we are traveling around the globe and we're visiting our clients, we get to see the cool things they all do, and they all work on. 00:01:47:20 - 00:02:09:17 So today, I have the pleasure of presenting those leaders who are thinking about things differently, whether they're building a hospital or delivering care or just engaging with their patients. They have a different view on things. So, I'm super excited to introduce them all on stage. I already told them we're going to change the questions. But what I didn't tell them is, we're all friends before anything else. 00:02:09:19 - 00:02:33:16 And we all decided this is going to be the most fun session ever. Let me start with you, Kathy. You. You come from King Faisal Hospital, a huge organization in Saudi Arabia, doing amazing things, serving 20% of the population of Saudi. 00:02:33:18 - 00:02:53:17 And you're keeping the patients and the people at the center of everything you do. When you put the patient at the center of your design, it's not always easy. Can you share? And what are some of the challenges you're facing when you're actually just focusing on the patient? 00:02:53:18 - 00:03:28:15 Kathy Sienko Delighted to be here from King Faisal Specialist Hospital. The one thing we know is that, even though we are largely an Islamic society, not all of our patients are homogenous. And as we think about how we design around patients, the first thing is really understanding what do the patients actually want and how do we use the data that we have around our patient's experience to tell us what's working and not what's not working for them, and how do we factor that into the design of services. 00:03:28:16 - 00:03:57:17 Kathy Sienko The other bigger problem, I think, is really moving from the rhetoric to the practicality. We all say that we want a better patient experience. We want to build our services around patients, but the provider workflows need to change in order to make that happen, to facilitate that. And that's not always so easy to change when people have been doing something the same way for many, many years. 00:03:57:18 - 00:04:19:14 Kathy Sienko So, we are 50 years old this year, believe it or not, and some of our people might even have been there for nearly all of that time. And so, getting those changes into practice, moving from the rhetoric of what we'd like to do to actually making the physical changes to the way that we work from a provider centric model to a patient centric model, is one of the challenges we have. 00:04:19:14 - 00:04:47:07 Kathy Sienko And then there is the question about the technology that supports that patient journey and the integration between solutions, that actually makes that patient's experience very, very different. But we also think about it in terms of design. How do we design facilities to be healing and healthy environments as well. So, we think about fine details like color and artwork and all of those sorts of things. 00:04:47:07 - 00:05:11:15 Kathy Sienko But perhaps important to know about King Feisal is that we are a specialist tertiary organization, quaternary even. And so, we see people who are really at, the most serious stage of their disease. And that actually drives for us as we think about our patient innovation, because we really want to do a great job for those patients. For many of them, we are their last port of call. 00:05:11:17 - 00:05:32:14 Kathy Sienko And so, it really drives a lot of innovation. It features in things like clinical trials. And we actually are running about 48% of all of the clinical trials in Saudi Arabia at King Faisal Hospital. So, it drives a culture of innovation and wanting to do more and better but of course, there is the cultural change that needs to happen. 00:05:32:16 - 00:05:57:17 Kathy Sienko And then there is also the technological workflows that actually support the kind of work that we want to do. So, as you say, it's not easy work. It's culture change and technology change. It's change that really focuses on why we are here. And we really are there for the patients. And so, we follow through on that as a philosophy into practice. 00:05:57:19 - 00:06:16:03 AJ Adel I've been visiting King Feisal for the last 15 out of the 50 you mentioned, and I've always looked at how all the leaders have one thing in common. Every vision has the patient at the center of it. So that's amazing. Russell, every time I open my LinkedIn, I see you building a hospital. 00:06:16:05 - 00:06:34:05 Russell Harrison Not me personally. AJ Adel No. Not you. Well, I do see you with the hoodie and the vest and everything, but you're also, down in Australia. You're changing healthcare, and you're going to places where healthcare hasn't been before. But you're also doing it while keeping the patient at the center of this. Can you share your vision? 00:06:34:05 - 00:06:50:22 Russell Harrison Yeah. I just say we're quite fortunate, you know, why build one new hospital? One. You can do two at the same time and two little ones. So, four in total. But that's just for that. Population is growing so quickly. And for me, I don't disagree with what Kathy said, but I'm going to come out from a different angle. 00:06:50:22 - 00:07:11:16 Russell Harrison And as part of that build, we've seen the opportunity to put our patients and our staff at the center of how you design a new facility. And that's been quite challenging because a lot of the guidance is written for ten years ago, and our staff and our patients are imagining a new world, about what they want and how they want the workflows to work. 00:07:11:18 - 00:07:38:10 Russell Harrison And that's been quite challenging, going against the sort of the building regulations, they're not true regulations, but they're sort of guidance notes to actually put our staff in fabulous facilities with light and our patients in rooms with light, not the old hospitals we've got. So, it's been great to be able to do that. And through the process, the technology has changed because, you know, no offense to many clinicians, myself included, you cannot read a plan and imagine what a room will be. 00:07:38:12 - 00:07:53:21 Russell Harrison But with AI and modelling, you can kind of get a sense of how that will look. We are in a room this sort of size and it was all on the floor, and you can move walls around. So, using technology in the design really allows us to put our staff and our patients at the center and actually then feel what that facility will look like. 00:07:53:21 - 00:08:19:07 Russell Harrison So, our aim is that we get a much better facility that our staff want to work in, can work in, and our patients can be cared for in a very different environment that's healing and light, and hopefully they go home. They don't want to stay forever, but, it will be a much better experience. And I think, you know, that's the important bit about how we can design new facilities and use technology to help do that, rather than just kind of go off a plan and go, "Well, that's what you get." 00:08:19:07 - 00:08:52:22 Russell Harrison Let's challenge that and let's get the clinicians and patients pushing for the same thing. AJ Adel Yeah. You also had a couple of go lives recently. And I remember you; you're calling up and saying, "We need this, this and this because the patient needs it. That's what I want. And I want that for them, not for me." Moving to the Nirav. The Bajaj Group is into a lot of things, but recently into healthcare. You've done - when we did the math- 35 visits around the globe to multiple healthcare facilities, government entities and beyond looking at the best view of what the future looks like. 00:08:53:00 - 00:09:09:06 AJ Adel So, in many ways, you do have a crystal ball. You can look into the future. What have you seen looking into the future? How does the hospital of the future look like as you've seen it, as you design it in your mind? And I still remember the video you showed us on how things would look like. 00:09:09:12 - 00:09:31:05 AJ Adel You're literally doing it from scratch based on the previous experience of others. Would love to hear from you on the hospital for the future for you. Nirav Bajaj Thank you for staying on script. So, the way we look at it, we've been to four continents now. We've been looking at all the different so-called best facilities in the world. 00:09:31:06 - 00:09:54:07 Nirav Bajaj The way we've structured our organization is we want to focus on prevention and be proactive rather than reactive. And I think that's something that, honestly, is what the future is. Because you want people to stay healthy. You want positive health rather than dealing with people who are unwell and get them to that stage. The other thing is it's actually an ecosystem. 00:09:54:11 - 00:10:13:16 Nirav Bajaj So, I don't look at it as a hospital. I look at it as an ecosystem to even get prevention and be proactive. You need to have them in the entire continuum. You have to build the entire continuum of care. So right from home to home and everything in between. And many people say that, okay, you're building clinics, you're building ambulatory, and that's a feeder to the hospital. 00:10:13:18 - 00:10:30:13 Nirav Bajaj The way we're looking at it is the hospital is a feeder to the clinics, because the clinics are going to be in your localities close to your home. You recover better when you're at home rather than when you're in the hospital. So, we think of it as an ecosystem rather than thinking of it just as a hospital or as a clinic. 00:10:30:15 - 00:10:51:04 Nirav Bajaj And lastly, as I think that it's going down to the trend of, personalized care and personalized medicine, and we look at it even from the logistic point of view. So why can't we, for example, we know when you've entered our campus, we've already allocated a parking spot for you. We already put you in the queue for your OPD appointment. 00:10:51:05 - 00:11:24:20 Nirav Bajaj And the same with IPD is why can't we have you already checked in to the room? Because we know you're on our campus. You'll be there in a few minutes. That's on the logistics side. On the medical side, which is human, which body is different and reacts different to the same medicine. So why can't we understand what your genetic sequence is and see how you react to this medicine, whether through a digital twin, which, of course, now AI is playing a big role in, or just understanding you better emotionally and mentally. 00:11:24:22 - 00:11:48:07 Nirav Bajaj So that's how we're looking at the future of healthcare. AJ Adel I think we're going to start calling hospital for the next 19 minutes the ecosystem. And I love what you said. It's going to feed the clinics, not the other way around. Russell, with the construction you all are doing. Are you looking at things differently? 00:11:48:07 - 00:12:07:10 Russell Harrison Well, we're trying to. Hospitals usually are not places for community to come unless they're unwell. And we're trying to spin that to make our new facilities actually a community resource. I might pinch that one but much more about the community can come in and not use the facilities but get the benefits of the fact that a health precinct is there. And that's about -- sort of some message about primary prevention. 00:12:07:10 - 00:12:28:12 Russell Harrison There will be GPs there. There will be sort of primary healthcare providers. We're also -- and it's strange for an acute hospital to do this. But we're building kind of a new twist on a day hospital. So chronic condition patients can come in. They can get some peer support. So, we've employed lots of lived-experience workers, both mental health and physical health. 00:12:28:14 - 00:12:52:13 Russell Harrison We've got carer-support workers that are carers themselves that have been through the process. You can see your clinician. You can talk to a peer. You can talk to AI, hopefully, if you can deliver it for me, AJ, No challenge. Can we have it, yesterday? AJ Adel He had to put that in there. Russell Harrison Got to do it. But it's about how do we actually get people coming in to try and get into that primary prevention space, rather than have to come to an ED and get stuck in a system? 00:12:52:15 - 00:13:13:01 Russell Harrison So how can we get patients to engage, you know, to self-drive their own care to peer-peer support and become those future leaders and community, take messages out to the wider community? So, we're careful about what outlets we let there in terms of food and, you know, dietary nutrition intakes. So, I think we're trying to come at it slightly differently. 00:13:13:01 - 00:13:30:09 Russell Harrison It's a bit of a sort of experiment but our community kind of saying they want that. And they want to sort of be in the hospital, but not an inpatient facility but just use that as a community resource to actually bring that health and wellbeing back into our communities. AJ Adel Yeah. Giving the patient the control and giving them the options. 00:13:30:09 - 00:13:51:15 Nirav Bajaj I think, historically -- sorry to pitch in -- it's always been a place that you want to avoid versus making it welcoming. And then it makes me think back to, when your car needs service, you always go on time. But when your body needs service, you try to procrastinate and delay it until it's too late. So, I think making it a welcoming space makes it a big difference. 00:13:51:15 - 00:14:13:01 AJ Adel Agreed. Great. Speaking of making it work, Nicola at the NHS, there's a lot of history. There's a lot of, process. Let's just say that. But every time I talk to you, you're thinking of new ways to deliver care. Can you share a little bit of examples of what new ways that are you looking to deliver care today as we step into the future? 00:14:13:03 - 00:14:44:12 AJ Adel And is that making an impact to the patient, to the hospital operations? What's your view so far? Nicola Cottington Yeah, sure. So, I'm as a Chief Operating Officer, I'm really interested in how we make not only the hospital, but how healthcare system work more smoothly. But that is only for the benefit of the patient. So, I often when I describe my role, I say, you know, the value that patients get is when they meet with their clinician and the operational team and the logistics team are there to make that happen as smoothly as possible. 00:14:44:14 - 00:15:07:13 Nicola Cottington So, we're also building a new hospital. It seems like everyone's going to a new hospital. AJ Adel We're going to call it an ecosystem. Nicola Cottington But exactly because, well, I'll come on to that, actually. And our hospital is also currently just over 50 years old and in West Suffolk we need to build a new hospital because there's lots of problems with the construction of it, and we've had to do a lot of remedial work. 00:15:07:15 - 00:15:30:22 Nicola Cottington But when we're thinking about our new hospital program, we've actually called it our Future System program, coming back to that system of care, because in order to make a hospital run smoothly, we need the community services to be running smoothly. And we need to support patients to be able to get the same experience that they would experience in a hospital, but in their own home. 00:15:30:22 - 00:15:52:01 Nicola Cottington So, we've put in place a virtual ward, for example. We have used some remote monitoring technology. But some of it is also just about how we encourage people to feel as safe and secure as they do in a hospital. So yes, people put off coming to a hospital, but actually people also see it as a bit of a safe space. 00:15:52:03 - 00:16:14:17 Nicola Cottington They feel safe. They can see the nurses and the doctors, and we want to create that same feeling. But out there in the community. So, we already run community health services as well. So, we have some experience of that. And we have a team called our Early Intervention Team who take patients and go and visit patients who are diverted from ambulance calls. 00:16:14:21 - 00:16:39:18 Nicola Cottington So, somebody might call 999, as it is in the UK. That's triaged by an unscheduled care hub. And our early intervention team will go out and see that patient rather than a paramedic team, if that's appropriate. What I'm interested in is, as we move forward, how do we use AI to perhaps inform some of that decision making and to automate some of that with the relevant safety checks in place as well? 00:16:39:18 - 00:17:07:14 Nicola Cottington Of course. But so that we are making the best use of our resources so that we are protecting our high acuity resources for those patients that really, really need it and really need our emergency department care. AJ Adel Well, we're definitely going off script now in a good way. Kathy, I know for a fact King Faisal had done no harm initiative a couple of years back, which back to what was Nicholas saying, you want to make it a safe place. 00:17:07:14 - 00:17:26:07 AJ Adel Eventually you have to go to the hospital, right? And eventually you have to be treated. But you want to make it a safe place. You want to make it a place where people feel comfortable being vulnerable. Right. What's King Faisal doing to ensure new ways of delivering care? You're innovating. You're always sharing a new vision. 00:17:26:08 - 00:17:54:11 AJ Adel Where are you right now? Kathy Sienko So, this is one of the best things about being at King Faisal is that there's a huge ambition and a commitment to innovating for patients. And one of the things that we really focus on is how do we enable our clinicians to practice at the very tops of their licenses, and that involves removing from them parts of the workflow that could be done through AI or through technology. 00:17:54:13 - 00:18:19:00 Kathy Sienko It also means for us, keeping people at home because we know that quite a lot of hospital, a lot of infections are acquired in hospitals. As part of our zero-home initiative, our home healthcare is a big part of that. We know that for some patients, it is safer for them to be in their home environment than to actually be in a hospital environment, particularly because of the patient population that we serve. 00:18:19:00 - 00:18:40:22 Kathy Sienko A lot of oncology patients. We have one of the biggest liver transplant programs or transplant programs in the world. We do quite a lot of, high, complexity neuro cases, etc. So, we think about where the safest place for those patients is to be, and also how can we assure their safety when they come into hospital. 00:18:40:23 - 00:19:06:01 Kathy Sienko Part of that is by releasing time to care, so using technology as an adjunct to enable clinicians to spend the maximum amount of time with patients. We have a very highly complex home healthcare service. There are things that we didn't used to do at home that we now do at home. We do quite a lot of telemedicine, not just in the Riyadh area or the Jeddah area, but across the whole of Saudi Arabia. 00:19:06:01 - 00:19:28:01 Kathy Sienko We provide support to many other organizations as well. Even at the interface, the front, the entry point to the hospital, the way that we use AI agents as part of our customer service model, that has been part of how we've created a more seamless AV environment for patients. But our goal is always also down to some of the very simple things that I believe many people here will be doing. 00:19:28:07 - 00:19:48:03 Kathy Sienko How do we keep an eye on safety every single day? Our huddles are a great way of doing that. And as the chief nurse, of course, nursing is a huge part of our organization. We are about 40% of nearly of the whole organization. Nurses are always thinking about what we could do differently to keep people out of hospitals. 00:19:48:04 - 00:20:13:15 Kathy Sienko So wound care is one of the areas that we're looking at matching clinician judgment with AI technology to see whether we can keep people at home, monitor their wounds at home without them needing to come into the hospital environment. The biggest thing that has happened for us recently is that there are many conditions that we use to send patients abroad for, people who needed CAR T-cell therapies. 00:20:13:15 - 00:20:38:10 Kathy Sienko We've just manufactured our own CAR-T cells, have been able to treat, our first patient locally for what used to cost us millions of Riyals every year. And what that means is that we are then able to provide that for many more patients locally. So, I think this is just the start and that AI technology and the solutions we have will enable us to go much further in the future. 00:20:38:12 - 00:20:57:11 AJ Adel Yeah. I can't wait to see some of the research that you're going to do on those patients. Nirav, moving to the Bajaj Group, which is in many industries and, and I'm sure you sit on multiple boards, and you get to see all the innovation going on in finance going on in transportation. 00:20:57:11 - 00:21:30:18 AJ Adel Your sister organization, if I may say so. As you're building your new ecosystem, what are you seeing in other industries, like smart ideas, things that we can adopt in healthcare? And how do you see them playing a role in your future as a healthcare organization? Nirav Bajaj So, thanks, AJ, for that. The way we're looking at certain things is when it comes to culture in India, a lot of the physicians are consulting physicians, which makes it - it's either you or me. 00:21:30:20 - 00:21:55:16 Nirav Bajaj It's not you and me. And when I look back at sport, which I played very briefly in my life, it's a team sport. And how can you actually get physicians, nurses to work together for the common good, for the common goal of the patient who comes out the winner versus it's either your statistics or mine. 00:21:55:18 - 00:22:19:00 Nirav Bajaj So that's when it comes to sports. I see our group's values for almost a century now has been transparency and trust. And that can only come with information and openness. So, I mean, if you see it, which happens in the U.S, I'm amazed whenever I fly in the US and I get notifications about delays on my mobile. 00:22:19:02 - 00:22:38:16 Nirav Bajaj And I'm like, I wish that there was something as transparent when it comes to healthcare. And why can't we have possibly transparent, bill estimates and live bill tracking? In India, it's still very fee for service and out of pocket. So, we don't find out, how much we have to pay at the end of the day until the final bill shows up. 00:22:38:18 - 00:23:07:13 Nirav Bajaj So instead, what can't I see along the way is what's my out-of-pocket expense? So, there's a lot of trust that doesn't exist in the healthcare ecosystem, which actually should be the most trusted industry. AJ Adel Yeah. No, I think everybody agrees we would love to get to that point. And actually, you also engage with multiple other departments in the UK government, education, transportation and others. 00:23:07:15 - 00:23:29:12 AJ Adel Are you seeing some of those innovations and are you trying to say the biggest flattery is copying. Are you trying to see what you can copy into healthcare ecosystem. Nicola Cottington Yeah. Well in fact in the UK, we were lucky enough, a team of us from West Suffolk, to go to the Oracle Industry Lab in Readding. 00:23:29:14 - 00:23:45:00 Nicola Cottington And I know the Oracle team were a little bit nervous about what they were going to show us there and thought, would we be able to translate this into healthcare? But one of the most exciting presentations when we were there was from the Red Bull Formula One racing team. And you might think, you know, what's the connection there? 00:23:45:05 - 00:24:16:10 Nicola Cottington But really it was their use of data in real time. And it really made me think about how we could apply this in hospital and community services. So, what they're doing is they're using real time data the whole time while the car is going around the track, while it's in the pit stop, and looking at what can they tweak to improve performance but also running simulations constantly and using this single data layer to enable improvements all the time. 00:24:16:15 - 00:24:42:22 Nicola Cottington In the NHS and in our trust, we have so much data. And actually, we don't face, some of the barriers that other international, health services do in terms of sharing that data. But even within our organization, we have so many millions and millions of data points, and we're not using it in that way. So that's what really inspired me as to how can we use that both on a patient level and to spot what's going on for this patient right now? 00:24:43:00 - 00:25:07:18 Nicola Cottington What's changing because we collect it all. But do we use it to inform their care now and their care in the future? But also, when you extrapolate that out to a whole emergency department. And so, what's coming in? How many patients need beds? How are we using all this to know what we're going to need to do in, you know, 12 hours' time? But also, when we're thinking about planning our new hospital, how could we run some simulations, you know? 00:25:07:18 - 00:25:29:08 Nicola Cottington What if we change this? What impact would that have? If we added a ward here, added an operating theater here, what would the impact be? So that was what really inspired me. So, from thinking what's the connection with racing cars? There really are lots. There's lots of things that you can learn from other industries. AJ Adel Well, everybody from Oracle here loves you for saying that. 00:25:29:13 - 00:25:48:10 AJ Adel Russell, maybe we stay with you in one more question, and then we'll open it up for the panel here. A simple one with a complicated answer. Russell Harrison There's no such thing as a simple question. You know that. AJ Adel No, no. Agreed, agreed. How do you see technology changing the game in healthcare? Let's just start there. What excites you about using AI in the ecosystem we're creating for the future? 00:25:48:10 - 00:26:14:15 Russell Harrison I think it's the possibilities it's going to bring. It's the speed at which it will help, bring insights. I'm going to call it, rather than information to the fore for clinicians to treat our patients in different, better, faster ways. The stats about how quickly the evidence base is shifting is so quick. 00:26:14:15 - 00:26:31:14 Russell Harrison You can probably leave university now, and it's out of date or leave med school and it'll be out of date. So, it's how we can enable our clinicians to give our patients the best care they can in that interaction, or over a series of interactions. And I think, you know, part of that is about how we do that better than we are at the moment. 00:26:31:16 - 00:26:47:22 Russell Harrison I'm going to stay very grounded because we still use faxes in Australia to send information around. So, we digitize stuff, print it off, fax it, re digitize it. You know, we can't share things by email yet because it's illegal. So, I was kind of envious of what Nicola was saying about, you know, sharing stuff. So, it's nuts. 00:26:47:22 - 00:27:06:02 Russell Harrison But that keeps us pretty grounded around where we can get the technology to get us to. So, it's going to be very pervasive, and it's going to be really kind of challenging. 00:27:06:04 - 00:27:25:11 Russell Harrison But the challenge for me is our clinicians need to keep that critical thinking. They can't just rely on the tech. And I think we run the risk of making it too easy that they just become taskmasters, and they don't apply the judgment that will need them to continue to keep applying. And I think that's some of the challenge I see with the tech. 00:27:25:11 - 00:27:45:19 Russell Harrison It's almost getting too good that if we're not careful, generations coming through, clinicians will get to the point where they're not thinking, they're not applying that critical judgment. They just believe the tech. Now, probably 99% of the time, it's right. But we really want our clinicians, as Kathy said, at the top of scope, doing what they've been trained to do, supported by tech. 00:27:45:21 - 00:28:05:16 Russell Harrison And that's, I think, where we need just to be careful. But yeah, what we've seen this week is pretty impressive. I'm sure it will continue to accelerate. The pace of change now is huge. You know it's just continued to accelerate. So that's the exciting bit. And I think it's how do we keep pace with an industry that is often conservative and slow to adopt? We've got to change that very quickly. 00:28:05:18 - 00:28:24:03 AJ Adel Yeah. A question for everybody and we'll start with you, Nicola. When we all retire and hopefully, we retire in the top of our game - we're going to look back and say we changed healthcare for generations to come. 00:28:24:03 - 00:28:44:10 AJ Adel I think you hit on that a little bit, Russell. What's our role as a society here, as a healthcare society from your perspective? And we'll go down, down the list. What's the role that everybody in this room plays in creating the next generation of healthcare for our children and our children's children. 00:28:44:10 - 00:29:11:22 Unknown Nicola Cottington I believe you can't be a leader in healthcare now without being a digital leader. But part of what we need to do are those leadership lessons that we all know, which is about genuinely listening to our clinical staff, our non-clinical staff and our patients about what are the problems that they have that we have a responsibility to, to try and solve for them. 00:29:12:00 - 00:29:38:02 Nicola Cottington So, understanding how work really happens, not how we think it happens, that just because we've rolled out some tech, that everyone's using it and they're using it optimally. So really understand what's happening on the ground and then from that, creating a vision, a compelling vision and communicating that about how things could be. And from what I've heard the last couple of days, that is a really exciting vision. 00:29:38:07 - 00:30:03:21 Nicola Cottington And the patient is at the center and it's patient powered and that's what people want, and that's what gets people fired up. AJ Adel Beautiful. Kathy? Kathy Sienko So, I'm going to use a very sophisticated leadership term. I'm totally stoked about AGI. And I am so excited about AI agents, particularly for clinicians. I think it helps keep us on our why? 00:30:03:21 - 00:30:30:01 Kathy Sienko Why are we all in healthcare? We are there to add value. We're there to solve and to deal with the issues that really matter to people. And I know that health is absolutely wealth. It's the tide that floats all boats. And if our goal is to have healthy communities, healthy societies, healthy individuals, then we really ought to do everything that keeps us focused on that space. 00:30:30:03 - 00:31:06:22 Kathy Sienko And that means leaning into curiosity about what is possible. I think technology offers us the opportunity to democratize leadership to where the best decisions are not always made by the people at the top. In fact, that they're probably rarely made by the people at the top, But they're made in a more diffused way across organizations where we can innovate really quickly and where we can involve patients in a really meaningful way and not involve them by inviting them in, but partner with them to deliver healthcare in a way that is very different, and to receive and define healthcare in a way that's really different. 00:31:07:00 - 00:31:30:18 Kathy Sienko So, I have no plans of retiring right now. I'm 57. I'm planning to live to 115. That's my plan. AJ Adel Well, I think you touched on something that Nirav said, together, not separate. Absolutely, Nirav, Russel, final thoughts? Nirav Bajaj So, I'm going to take a slightly tangential view on this one. AJ Adel I knew it. 00:31:30:20 - 00:31:59:15 Nirav Bajaj Maybe I am not invited next year. But I think that culture is what really drives outcomes. The way the organization behaves and performs is the way that, patients will actually feel and recover. So, something that Tom said yesterday was quite interesting is how patients believe that AI was more compassionate and empathetic to the patients versus the physician. Well, I think that that's where the problem is, is we're people business. 00:31:59:15 - 00:32:24:23 Nirav Bajaj We're not a patient business. So, we need to take care of our people who take care of the patients. And I think that that's where technology comes in and that's where AI comes in, is it builds in efficiency. And this is also probably a not-so-popular thing to say is about efficiency in healthcare. But efficiency and empathy are always in tension because empathy makes you inefficient, and efficiency makes you not empathetic. 00:32:25:01 - 00:32:49:01 Nirav Bajaj But the reality is, if you can build in efficiency with technology at the back end to make your physicians, your nurses, and all of the staff who are at the hospital, at the clinics, actually spend more time and more care with the patients. I think that's what's going to drive, real outcomes. AJ Adel Beautiful. Russell? Russell Harrison Dangerous going last because I got to say something profound, which is a worry. I should have let Nirav go last. 00:32:49:01 - 00:33:12:22 Russell Harrison But, I think, for me, the leadership thing that we need to do for the next generation is to promote better change management, to embrace the technology. And I think as a leader, I've got to encourage and keep promoting risk taking within whatever frameworks you have to comply. But actually, don't be afraid to push the envelope, to push the boundary, to take a risk calculated. 00:33:13:00 - 00:33:36:00 Russell Harrison Probably better than just a wild one. But I think it's about keeping that ambition, as Nirav said, people are coming to care for people. They want to do that job. They've got a passion for that. That's what we're in healthcare for. It's about serving that patient. But if we lose the ability to take a risk, to do a challenge, to push the boundary we'll not improve care in the way that I think everybody wants to. 00:33:36:02 - 00:33:52:07 Russell Harrison Tech will help that. But let's take some risks in and around the tech. AJ Adel I think what I got out of this is nobody's retiring in this seat, and we're all going to live to 150. I'll do 140. I'm good with that. I want to thank everybody here. I want to I want to wish you all safe travels back home. 00:33:52:07 - 00:34:23:22 AJ Adel And for our audience, thank you for being with us. And thank you for trusting us and continuing to partner with us in creating the future of healthcare. Thank you everybody. Appreciate it. Unknown That's all for this episode of Perspectives on Health and Tech Podcast. Be sure to subscribe to catch all our future episodes. For more information from industry experts, visit oracle.com/health and oracle.com/life Hyphen Sciences, or follow Oracle Health and Oracle Life Sciences on social media. 00:34:24:00 - 00:34:35:19 Unknown Thank you for listening and join us again for the next insightful episode of Perspectives on Health and Tech.

In recognition of World Suicide Prevention Day (September 10), Oracle Health brings together leading voices in clinical care, behavioral health, and technology to explore how data-driven innovation can help prevent suicide and improve mental health outcomes. Join Oracle Health's Danny Gladden, LCSW, MBA, Director, Behavioral Health and Social Care and Dr. Keita Franklin, Chief Behavioral Health Officer at Leidos, a nationally recognized expert in suicide prevention, as they discuss how ethical, person-centered use of data can detect risk earlier, connect people to care faster, and support clinicians on the frontlines. From integrated screening tools like the PHQ-9 and C-SSRS to risk alerts, we'll examine how technology, with quality care—when paired with compassion—can close critical gaps in behavioral health. This conversation is a call to action for health systems, providers, and technology partners to change the narrative on suicide, together. If you or someone you know is in crisis, please reach out to your local helpline or call/text 988 in the U.S. and Canada. ----------------------------------------------------------- Episode Transcript: Intro 00:00 - 00:29 Welcome to Perspectives on Health and Tech podcast. Brought to you by Oracle Health. In this series, we have conversations on creating a seamless and connected health care world where everyone thrives. Let's get started. Danny Gladden 00:30 - 02:26 Welcome to Perspectives on Health and Tech. Thank you for joining us. I'm Danny Gladden, general manager of behavioral health and social care at Oracle Health. I'm also a licensed clinical social worker, and I've spent my career working in suicide prevention from crisis lines to community mental health to supporting national efforts with the Department of Defense and the VA. For me, the work is personal and lifelong. At Oracle Health, we believe technology has a role to play in ending suicide with one of the largest global electronic health record footprints and long standing partnerships with the VA and the DoD. We see the impact that suicide has across every community we serve. This isn't an issue that only affects certain families or certain health system. It impacts all of us. That's why we're speaking out as a technology company. Because suicide prevention is not only about crisis intervention, it's about building systems that connect people to help earlier equip clinicians with the right tools and make sure that no one falls to the cracks. Our responsibility is to use data design and technology in ways that honor the human side of care, while supporting providers who are on the frontlines every day. And today, I'm honored to be joined by Doctor Keita Franklin, chief of behavioral health at Leidos, one of the nation's foremost experts in suicide prevention, who's led this work at the highest levels of government and continues to advance the field through research, policy and practice. And so, Keita, it's so good to be with you today. I'm so glad you've joined us. You and I have had a chance to do some pretty incredible work together. You have, spent much of your career leading national suicide prevention efforts with the VA, the DoD, the Columbia Lighthouse project. How has that experience shaped your perspective on the urgency of this issue? Keita Franklin 02:26 - 03:44 Thank you so much for having me, Danny. And I always love our work together and our connection as social workers in the field over the years, so I truly appreciate the chance to talk to you this morning. You know, one of the first things that comes to mind for me is just a basic, sort of lesson is just the complexities around suicide. Now, I don't think people know, you know, when somebody dies by suicide, there is a lot of variables and factors at play. And it's never it's never one reason. But like you'll hear about people that struggle with a host of reasons, some of which are medically oriented and pain management oriented and complexities around TBI, and some of them are mental health related, and some of them are things that you and I always talk about related to social determinants of health. So just the complexities, that's probably one of my biggest sort of things to think about. And sure, in terms of shaping my perspective. And then I appreciate the upstream. I'm definitely an upstream sort of thinker in terms of like, how do we get, you know, the military used to call this left of boom, but like, how do we get, away from just intervening at the time at the single point in time of crisis? I don't know if you saw the CDC and the National Action Alliance just pushed out this new upstream toolkit or guide this week. I have that on my list of things to look at. Danny Gladden 03:45- 04:15 Yeah, it's really great, isn't it, to have, more folks in across health care and beyond talking about suicide, suicide prevention now. So Oracle, we're a technology company. We believe we have a part to play in the bigger ecosystem of suicide prevention. If you think about a company like Oracle and Oracle Health, you know, why is it important for a company like ours to be part of this conversation? Keita Franklin 04:15 - 05:34 Well, for a couple different reasons. And I'm in the same boat. You know, Leidos is also a technology company, and we're so thrilled for our partnership with you all around some of these issues. But really, a couple of things that we know about suicide is at the center of a public health approach is just the importance of data. Like data drives the entire public health approach. And whether you're like a brand new suicide prevention coordinator on the ground in a local county, or whether you're tackling suicide at the National level, you have to have your hands on a good set of data. And I know that you are all about data, as is Oracle at large. But then also what do we do with the data and how do we bring more technology tools to the fight when it comes to preventing suicide. By using good data, not only in mental health care systems as flags and as you know, part of predictive analytics. But also, I think we're seeing on the horizon more AI tools and advanced ways to bring self-help tools with clinician oversight. Maybe we'll talk about that more in the podcast. But definitely there is a role for technology. And I've always over the years I've put it in the pilot bucket. When you're doing good public health programing, you always have four or 5 or 6 pilots going where you're testing new interventions, trying to advance the needle with new and innovative treatments and the like. And I think technology fits in there. Danny Gladden 05:35 - 07:22 Well, I feel a burden, a healthy burden. If we think about, say, behavioral health technology companies, of course, they're the users of their tech, kind of have a responsibility to ensure they account for suicide prevention and screening and whatnot. As an enterprise health care EHR, that service primary care, chronic conditions and an emergency department in med surge and oncology, we have to be really diligent about where we can also infuse best practices for screening across health care delivery system. And I feel sort of, a burden there to make sure we get that right, have the right questions and the right workflows in the right place so that we can, help a doctor who's treating someone with heart disease also be able to talk about the stresses of heart disease and, risk suicide risk that comes from living with a chronic illness. And so that takes me kind of, you know, this year's World Suicide Prevention theme is changing the narrative on suicide. I'm just curious, what does that mean to you? Changing the narrative. It really struck me. I want to hear your perspective and also talk about. I think you've got some really interesting things happening in your career. So, like changing the narrative on suicide. What about small acts of kindness and community engagement and connection? How can that make a difference? Keita Franklin 07:23 - 10:22 No. I so appreciate your question. And also the work that you're doing to embed suicide prevention into like a whole of health care system. So first and foremost, like the, early on in my career, I learned the importance of, like, if we just screen or if we just wait for mental health care alone. You know, we will have missed about many. You know, I learned this at the VA front and center where they, the veterans would go in for headaches and backaches and all of these other types of physical care issues. And when they're doing that, if we don't screen them and we don't engage around suicide prevention, it's a missed opportunity. And it's awful when we see it in the fatality reports after the fact that perhaps they've been to one of our primary care clinics in the days leading up to their death. It's just incredibly tragic for our system to, like, miss any single opportunity to say, disable that. So I'm so pleased that you're doing that. And it is hard work. Right. Because the docs will tell you, I'm busy with this, I'm busy with this, and I have a lot of things to balance. And, you know, they're here for their podiatry appointment. What do you mean? I have to screen, but you just don't know what's going on for people. So that's one thing. And then, I, I think you and I both love the theme, like changing the narrative on suicide. Right? I mean, part of the narrative is that it's upstream. The other small piece that resonates with me about changing the narrative. I'm curious what you think about this as well. Is the focus on lived experience like, I absolutely love for us as a field to never forget the voice of those that have this lived experience, whether you know it's a mom or dad that have lost a loved one, a child to suicide, and you know, of course, in the most tragic of ways, but for us to hear from them and to think about how their experiences can inform our policies and to just keep their voices in our mind at all that we do. And I felt fortunate to do that. In the day when I was leading suicide prevention for the Pentagon, I had the most contact, but also at the VA and even further back with the Marine Corps, just having the ability to stay in touch with troops that have lost one of their own and just hear from them. So I hope that becomes more of the narrative as we quote unquote, change the narrative. And then the last thing I'll tell you guys, I've been in the weeds with the research you can appreciate on a new book called The Humanity Cure. And in the book I've been again researching the most basic of things. Who knew that there's a mountain of research on the importance of small acts of kindness, and on the reciprocal nature of kindness, the reciprocal nature of helping, and how, you know, sometimes when you're when you're in your worst state, reaching out your hand in helping someone actually helps you and just how reciprocal that can be. And it could be life changing. So I'm reading these personal narratives of people that will tell me that they interacted with a stranger a single point in time for less than five minutes, and they, and it changed the full trajectory of their life, like, how is this humanly possible? But it's their story and it's true, and it's in the data and it bears out over time. So I've been digging in on those kind of concepts. Danny Gladden 10:23 - 10:49 Well, I'm excited to, I'm excited to get my get my hands on your new book. And I will tell you, I think we hear from those with lived experience on how they were yearning for human connection, who they just if we've heard stories. So if only someone would reach out. If only someone would have asked. How are you doing? Are you okay? Keita Franklin 10:50 -11:13 I guess I I've been writing about belongingness and compassion and being included. Like, just the power of being included. A people feeling like maybe they don't fit in in their family, but they fit in in this community or that community. Like, they know that if they're not there, someone will call them and say, where were you on Tuesday? You're always there, right? You're so. Yeah, that's so true. Danny Gladden 00:11:14 - 12:24 Yeah. I well, I think your, perspective, what you've written about will add very importantly to the narrative, particularly at a time where we have, in my view, a compassion crisis in this and, around the world. And, we need more human connection. I I'm so lucky I had a mentor who said these words to me, and I've never forgotten them. And I repeat them as often as possible, which is, you can't fuss at someone until they know you care about them. And, you know, and I think about from the health care lens and all the do's and don'ts that I, the health care providers tell folks, do this, don't do this, do this, don't do this. And I just think, in suicide prevention and, all my time on the crisis line, all folks really looking for is connection and to know that I care. And maybe I've got some advice or some guidance or some suggestions for them to consider, but they're really there for the I'm glad you called this is and I'm here for you. Keita Franklin 00:12:25 - 00:12:40 Yes, I've been even pulling the thread on this idea of being present and not always knowing. Like to say. So you might just be physically with them or on a call and you might not have the right words. And that's okay. You did enough by being present. Danny Gladden 00:12:41 - 14:00 Well, I just have. I've been trying to be a good steward of moments and another I just also have great mentors. Another mentor would call that the ministry of Presence. And she, she comes from, she's a therapist and also, a faith leader. And I just think so much about that. The Ministry of Presence, you know, particularly, following a crisis, you'll see, in the media, counselors have been brought in, right? You've been in that, post-crisis debrief, I've done the same and off that there aren't a lot of words, but the ministry of presence, the importance of warmth and connection and folks just knowing that you're there. So, now we're going to where we do a hard pivot. So that's kind of some of the human side and talk about technology. Okay. So as we think about using kind of embedded screening tools, like, I mean there's the Q9 or any of the cuz the Columbia Suicide by Columbia suicide Severity Rating scale, you know, how has embedding these tools and then the, the alerts that might come from them. How is that sort of made an impact? Keita Franklin 00:14:00 - 00:15:11 Well, what's been on my mind recently is just the power of these evidence based screening tools in, to provide burnout prevention for clinicians, particularly when you're embedded into workflows in such a way that clinicians are able to focus on the client front and center and maintain that eye contact and develop that therapeutic rapport and just get on with the business of delivering therapy. And they're not having to fumble through, this paper and this screener and this thing. And, you know, and or they're not on the screen like trying to find 5 or 10 different things based on what their client just told them, like when it's embedded into a workflow and it's just business as usual. Of course, we have to be careful that they're not, you know, treating it as too much of a business as usual, that they're sort of, you know, blindly clicking their way through important assessment tools, which I don't necessarily think would be a problem. But we should always, you know, be mindful for that. But this idea of, just making it part of life into the fabric of the organization, makes it easier for clinicians. And then I think they're able to really think about, okay, I'm on session two, I'm delivering CBT. This is what that looks like, you know, instead of all the other sort of things. Danny Gladden 00:15:11 - 00:16:07 And as we think about the whole of health care, again, we have an opportunity to embed across health care, you know, some really simple suicide screening questions upstream I worry about downstream is the infrastructure there to be able to get someone connected seamlessly into community services? Do we run the risk curve over hospitalizing or creating stigma because we don't know how to respond, to someone's side risk? And so yes, to more screening and also yes to more within the health ecosystem. Getting from custodial services to an, oncology nurse and everyone in between getting the right preparation for what to do when we learn that someone might be at risk of suicide. Keita Franklin 00:16:07 - 00:16:52 Yes. I always talk about suicide screening in the context of, like, be ready for the answers, right? Yes. Yeah. You ready? Yeah. Because, yeah. You don't realize. I mean, of course, the Columbia, Rating scale, suicide severity rating scale can be used by non-medical entities as well. And so that comes with it inherent responsibility to be ready. If you ask the question, you know, do you want to go to sleep and not wake up and they tell you, yes, like you've got to handle that well. And with the careful and grace and respect that it that it deserves, make sure we get them to the right care. And I know we worried in the field, both of us on and the excitement of 988 and making sure the care delivery is in place for, for that new infrastructure. And I think we've come a long way, but there's likely more to do at the community level. Danny Gladden 00:16:52 - 00:17:15 You know, speaking of the now I actually have 988 tattooed on my forearm. I've had enough for a couple of years, but I don't think I considered the now what? Like there are moments that I might not have an interest of going deep with someone, but I think I should wear long sleeves on those days. Keita Franklin 00:17:15 - 00:17:20 Know you will take me to gear. I know you too. Well. Danny Gladden 00:17:20 - 00:17:55 Yeah. So let's talk about AI. Okay. No doubt the promise of AI for good exists. Yes. Right. Yes. You know, it's ambient listening, and what comes from that? The data that can service from things that are missed in a conversation or in the broader, say, record. How can, structured and unstructured data, inform kind of AI decision support, to help risk, is surfaced potential risk. Keita Franklin 00:17:56 - 00:19:13 Well I think that it is amazing to me how much data agencies are sitting on the federal government is sitting on that is untapped, first of all. And then when we can bring good data sources together, like in an ideal world, if we were really, you know, in charge for a day of all things data, like what would it look like for private and public sector to come together around good data and to really use that data to drive like not only like business based efficiencies, but clinical care and outreach that might even go to family members. Like if we're able to learn certain things in the data that tell us, like, okay, this person could benefit from these support systems, which might not go directly to them but would go to their family, which, by the way, is who they go to when they're struggling with risk. First. I just think there's so many opportunities and then we're so scared, right? Like we want to do ethical use of data. We want to be a good stewards in governance, government practices, I'm sorry, governance practices with our data, of course, and we want to secure it in a proper way and just do all the right things. But I never want, to miss a chance to be sitting on data. It's also shameful for sitting on it. We're not using it to advance how we can design a new technology workflow or a new piece of gear that will help our clients do better in a quicker way. Danny Gladden 0019:14 - 00:19:34 Yeah, I think maybe key to that's one of our calls to action. You and I, very excitedly talk about what could we do if in the right seats. The de-identified data to, make a material impact. I think we're in those right seats. Keita Franklin 00:19:34 - 00:19:36 I think You're right. Danny Gladden 00:19:37 - 00:21:00 Yeah. So, we talk so much about the progress of technology and the problems solved by technology. In 2010, I was going to some of the more remote parts of Alaska, and we were working to stand up tele-behavioral health services to communities that didn't have otherwise access. Now think about that. That was, standing up health, tele-behavioral health pre-pandemic, like ten years before the pandemic. You know, and then but yeah, I also just think about folks who don't have access to technology, hardware, bandwidth, 988 is great; not everyone has a phone. Right. And so and then also the it an electronic health record is still not mandated by the federal government for behavioral health organizations. And a and a big and when health systems or disparate community mental health providers have EHRs, the behavioral health data is walled off and the cardiologist doesn't know about the depression diagnosis or that the prior substance use treatment. And so, despite the progress where this technology is still far short in supporting, suicide prevention. Keita Franklin 00:21:00 - 00:22:45 I mean, I think one of the big things that I've seen recently that may or may not hit on some of the things you're discussing is, people's fear around the use of technology in the field of mental health. Right? Like back when you were doing your Alaska work, which I've loved to follow over the years. Just because is there a better petri dish for learning about rural areas and how to deliver care? I mean, that's just got to be it. But, people worried in the day that even delivering mental health care, tele therapy, if someone was at risk for suicide, they would say, I can't do it right because they're in their own home. What if they're near a firearm or they're in their own home? Well, if they're not getting care, they're in their own home too. So I was pleased to see Covid at least get us through that hump in the field of like, deliver care when and where people need it. Like in the absence of them coming in in person, like they still need it. And so that's one thing. But otherwise, I know people are hesitant to fully adopt certain types of technology right now and into the mental health because they're afraid it will go rogue like that. The technology will take over, it will get in the way of the human relationship that our, our careers were built on. And I sort of think like it should always be an adjunct to care, like we should never be back in the day where you're just waiting for your one hour session with your psychotherapist that you have to drive, you know, perhaps an hour to get to in traffic in DC or wherever. And then you're home all throughout the week with nothing that you could, like, have as a self-help tool or no technology that could send you push reminders or like, there's just so many ways it could be used that people are hesitant in our field. And I'm hoping that, you know, that that's coming around little by little through use cases and, you know, letting them get in there and see that it does no harm and actually can help. Danny Gladden 00:22:46 - 00:23:13 Our time goes by fast here, Keita, as we close, I'll share that in Oracle Health. We're deeply committed to behavioral health innovation supporting suicide prevention. Through our work and data and care coordination, user centered technology, consumer facing technology. Just what encouragement would you offer to colleagues, partners, health systems, around prioritizing suicide prevention in their work? Keita Franklin 00:23:14 - 00:24:11 I would I appreciate the question and I would definitely say like we push it out during suicide Prevention Month, like it should be an all month, all hands, all the time, effort and sustained over time. And so like we should continue to do everything we can to advance the data science to push for innovation. If the numbers of death by suicide in our nation weren't what they were, I could maybe agree with people that are kind of at a place where saying, oh, we don't need new technology or new innovations, but that's not our current state. The data continues to rise, particularly with vulnerable populations like veterans and service members and those in rural America, as we've talked about. So we need to continue to think strategically about technology innovation and then do our tried and true things that you and I talked about being kind of making sure people feel connected and increase their social supports. All of those protective factors are important to weave into the fabric of people's lives. Like sustained all the time. Danny Gladden 00:24:12 - 00:25:59 I couldn't agree more. I'll mention, around the world, communities have access to a variation of a suicide or crisis line. In the U.S. and Canada, that three digit number is 988. It is available 24-7-365. There are prompts for Spanish speaking. There are prompts for our veterans. There's, ability to text into a crisis text line. I always ask if folks will say, well, how bad should I be when I call or whatnot? And my response is, if you consider calling, do call. You can always be anonymous, although it is helpful if you feel comfortable to share who you are, you can also help someone else call who might. It might be a challenge for them. You can call with them. And, I think finally, it's there are no hopefully in health care. There are no wrong doors. But health care is just one avenue. Whether it's communities of faith, community support organizations, and schools and universities, there are helpers everywhere we look. We just have to reach out. And as a helper, we need to be warm care, kind and compassionate. And so Dr. Keita Franklin, Leidos, thank you for the partnership. Thank you for the work that's happening. And that's all for this episode of Perspectives on Health and Tech. Thank you for listening. And join us again for the next insightful episode of Perspectives on Health and Tech. Outro 00:25:59 - 00:26:29 That's all for this episode of Perspectives on Health and Tech Podcast. Be sure to subscribe to catch all our future episodes! For more information from industry experts, visit oracle.com/Health and oracle.com/life-Sciences, or follow Oracle Health and Oracle Life Sciences on social media. Thank you for listening and join us again for the next insightful episode of Perspectives on Health and Tech.

Perspectives on Health and Tech How CAMH is Advancing Mental Health Through Innovation and Social Justice Listen in for a timely conversation in recognition of Mental Health Awareness Month and National Nursing Week. In this episode, Dr. Gillian Strudwick from The Centre for Addiction and Mental Health (CAMH) and Danny Gladden from Oracle Health discuss how mental health care is evolving, and how CAMH is advancing care through the dual lenses of technology and social justice. Learn how AI tools like Oracle Health Clinical AI Agent are easing clinician workloads, how CAMH is using data to drive impact, and why framing mental health as a social justice issue is key to helping the CAMH team deliver more equitable and compassionate care. Featuring: Dr. Gillian Strudwick, Chief Clinical Informatics Officer, The Centre for Addition and Mental Health Danny Gladden, LCSW, MBA, Director, Behavioral Health and Social Care, Oracle Health Listen as they discuss: o The Centre for Addiction and Mental Health (CAMH) background – 2:45 o Mental health care viewed as social justice work at CAMH and examples – 5:00 o Technology innovations at CAMH with a human-centered approach – 9:30 Wearable devices and the impact they have on research Repetitive Transcranial Magnetic Stimulation (RTMS) treatment Evidence-based apps and the integration of these into clinical care processes Optimizing EHR use and exploring the opportunity to share mental health notes in Canada o CAMH's perspective on AI technology and its potential impact on clinicians – 18:25 Notable quotes: "Mental health is social justice work." – Dr. Gillian Strudwick "To be able to deliver compassionate care in this day and age, we have to be innovative in our use of technology." – Dr. Gillian Strudwick CTA: Learn how Oracle behavioral health solutions combine real-time, clinical data from across each patient's unique healthcare journey and how Oracle is working to reduce the documentation burden on physicians and elevate the patient experience with the Oracle Health Clinical AI Agent. ----------------------------------------------------------------- Episode Transcript: Intro 0:00 - 0:29 Welcome to perspectives on health and tech podcast brought to you by Oracle Health. In this series, we have conversations on creating a seamless and connected healthcare world where everyone thrives. Let's get started. Danny 0:30 – 01:44 Welcome to perspectives, Oracle Health and Life Sciences podcast. I'm your host today. Danny Gladden, I'm a licensed clinical social worker and general manager of behavioral health and social care here at Oracle Health. As we step into the month of May, we recognize Mental Health Awareness Month, a time to raise awareness reduce stigma and highlight progress in mental health care. I'd also like to give a special shout out to our nurses across Canada and the US as we celebrate National Nursing week. Thank you for your unwavering dedication and compassion. Social workers and nurses make great teams. Today, we're honored to be joined by a leader in mental health care innovation. Please welcome Dr. Gillian Strudwick from CAMH, the Centre for Addiction and Mental Health, Canada's largest mental health and addiction teaching hospital and one of the world's leading research centers in its field. So, Gillian, welcome. Before we dive into big topics here, can you introduce yourself and tell us a little bit about the great work happening at CAMH. Gillian 1:45 – 03:47 Thank you, Danny, and thank you for the opportunity to be a part of this great podcast. I might break this into two sections. First, I'll introduce myself, and then I'll tell you a little bit about the organization that I'm fortunate to work for. I'm Dr Gillian Strudwick. I'm a registered nurse, and I've worked primarily in mental health clinical settings here in Toronto, Canada, and also in other parts of Canada and internationally. Currently, I am the inaugural Chief Clinical Informatics Officer at CAMH, representing our nurses and all of our non-physician health disciplines, like social work. And I have a couple of other hats as well. So one is that I'm the head scientist of the digital mental health lab, and I'm also the scientific director of our Digital Innovation Hub, which is about really accelerating our work in this digital sphere and research practice, education and beyond. So that's about me, but I'll move on to talking about CAMH. So CAMH is C, A, M, H, the Centre for Addiction and Mental Health, and it's Canada's largest mental health and addictions teaching hospital. We think, and I think there's lots to suggest that we're true in saying this, that we're a world leading Research and Education Center on mental health, and we're located right in the heart of downtown Toronto, but we serve people across our province, Ontario and across the country as well. In terms of a few numbers that I'll share with you, we've had just over 16,000 emergency department visits in the last year, over 40,000 patients that were treated, over 80,000 virtual care appointments. And I'll provide a few more numbers here as well, almost 8000 RTMS visits, 60 million in a new research funds more than 1000 articles published. I think you get the point that there's a lot going on at CAMH, and it's a great place to be. Danny 03:48 – 04:50 You know, I have been on your campus a number of times. I always appreciate that your campus is right in the heart of Toronto, in a bustling area, and I think there's, there's no greater way to reduce stigma than, you know, placing such a well-respected mental health and addiction treatment organization right in the heart of the city. Whereas if you go to many other communities, you'll kind of see the mental health hospitals and treatment providers kind of on the outskirts of town. Really appreciate CAMH's role right there in the heart of Toronto. And I think this goes into something Gillian that you speak about passionately, which is the idea that mental health treatment is social justice. For our audience, tell us what you mean by that. Why is it an important lens - social justice, which you view your work? Gillian 4:51 – 07:43 I think it's quite an important point that you bring up, Danny, and it's something we're really proud of talking about, that mental health work is social justice work. Part of doing social justice work is to be informed in this space. And part of being informed is understanding that mental illness disproportionately affects marginalized communities who are also often facing barriers to things like accessing care, and this could be due to racism, poverty, stigma, geography, and I could continue so on and so forth. At CAMH, we see mental health is deeply rooted in social justice, because access to care, dignity and treatment and prevention are not actively distributed. CAMH advocates for policies and systems change that ensure mental health care is not a privilege but a right. And so that's really our social justice lens, framing and shaping the last few statements that I made. We have done some work more recently in the last couple of years on dismantling anti-black racism, which has become a more formalized organizational commitment. I'll just read a section from one of our documents around dismantling anti-black racism. And excuse me for it sounds like I'm reading here because I'm reading from a document, but systemic anti-black racism, is a barrier to high quality health care for black patients at CAMH and across the health care system, the data lay bare with those in black communities have signaled for decades. Discrimination and oppression based on race delays care and harms individuals on their way to recovery. Racism also has a negative impact on the quality of work life for black staff, beyond the damaging emotional and psychological consequences, it limits their career trajectory, and it goes on from there. I bring this out as one of the many initiatives that the organization is committed to. And as a result of this commitment, this public commitment, you can read what I just read on our website, camh.ca, that there's a number of activities that the organization is doing everywhere, from doing offering more culturally appropriate therapies to education for staff, staff support groups, creations of processes that support equity, lots of advocacy work with the government. A lot of this work is ongoing, but this gives you sort of a more grounded, more concrete example of some of the ways in which we look at social justice as being so related to mental health. Danny 7:44 – 09:31 My goodness, you know the social worker in me is just grinning from ear to ear, as you describe, you know, the foundation in which CAMH is caring for folks. You know, I'm still a licensed clinician in Missouri and Alaska. You know, particularly, I think about a state like Alaska, with a disproportional number of folks who are Alaska Native. And we see, you know, in those communities, so much generational trauma, and the impact you know, and the impact that oppression you know has on sort of repeating traumatic occurrences across the generations and so, so very important, I think, an important perspective to look at the the experience of mental health and the treatment of mental health through a social justice lens. Gillian, I just appreciate that, that that is a focus of CAMH, and I'm sure the indigenous populations your organization works with, you see a similar, you know, a similar experience than the those in the in Alaska here. Now, as we pivot here, thinking about, you know, you're, I think the work you're describing, from a social justice perspective, is innovative. It seems like CAMH is always at the cutting edge of innovation. We're a technology company, and so, you know, from a technology innovation perspective, what are you seeing? What's CAMH doing? Gillian 9:32 – 15:53 Great question. Danny, and because of my various roles at the organization, I get excited about this kind of a question, and it also describes the work that I'm doing every day, with my colleagues, with our patients, their family members and others across the organization. So yes, we're always interested in how we can use technology and to innovate with technology, but we do that so we can achieve various things and the things that we want to achieve are being able to improve access to care so we can see more patients, because probably unlike, or not unlike various organizations in the rest of Canada and in the US, we have long waiting lists for care. The second is to be able to improve the quality of care. And not to say that care isn't good already, but more that as we learn and develop evidence and get feedback from our clinicians, from our patients, we can then integrate that into care. So that's the second piece. The third is to improve the patient experience, and the fourth is to really personalize care. When we think about how we innovate with technology, we're really looking to see if we can do those four things. And yes, there's other, you know, other reasons you invest in technologies for various efficiencies and cost savings. But I'm going to talk about more work on the earlier four points that I described. So maybe I'll provide a couple of concrete examples. The first one is thinking about the opportunity that we have by embedding wearables into care processes. These are things like Oura rings or Fitbit that you know, it doesn't matter which company it is. There's lots of wearables out there, but embedding them into care processes so we can look at sleep and activity which are often impacted when people have symptoms of depression or anxiety. We hope at CAMH to use this information to better understand someone's individual patterns, which could really help us tailor their treatments, as you can imagine, but also be able to identify early when a treatment may be starting to take some effect, or an early warning sign, or an indicator of someone potentially falling ill or relapsing. Lots of potential in that space, and we're getting going primarily in the research domain, in the wearable space. So that's sort of one concrete example. Another concrete example is RTMS. So CAMH has been a leader in this space and doing brain stimulation research for a number of years. RTMS, in case listeners aren't familiar with it. It's a non-invasive treatment. It uses magnetic fields to stimulate very specific regions of the brain, and it's been shown to be particularly effective for people with treatment resistant depression. These are individuals who have not responded well to medication or therapy alone. To date, we've had about 8000 individuals last year who have received RTMS. We're thinking about it from advancing the science, treating individuals, of course, and doing lots of advocacy work. The third example I'll provide is around the app space. There's lots if you were to type in depression or anxiety into any app library, you're going to see lots and lots of apps, most of which don't have a scientific backing to them, some of which may actually be a waste of time to engage in. It's also really hard to make sense of that app landscape. So, we've been working to develop and integrate into clinical care processes, apps that have that evidence base behind them, and have some sort of a portal or interface with clinicians so that the data can be used for care purposes. We've got one called my change plan for smoking cessation of behavioral modifications. We've got one called App for independence, which is a platform for supporting people with complex behavioral and mental health conditions, and it's currently used for recovery processes with individuals with psychosis and schizophrenia and now opioid use disorders. And then we also have another app called Hope by CAMH, which is a safety planning intervention for people at risk for suicide. So, there's, you know, that doesn't cover all the apps, but gives you a sort of a flavor of the various apps that we've been working on, so that there's the credibility the science and the engagement and feedback loop for those particular areas. And then the finally, the last one I want to talk about is our electronic health record. We use the Oracle Health platform, and we're really thinking about how we can optimize our use of it for the best experience for clinicians and patients alike, including this concept of open notes through our patient portal, so where patients can see their notes and so well, if you're in the US and thinking, well, this is the norm for us, it's not quite the norm for folks in other countries. It's optional in Canada to share mental health notes, and so we're showing some real leadership by identifying how best we can do that and opening up our notes. So I'll just close on this topic, Danny, by just saying that importantly, we're taking a human centered approach when we're doing this work, whether it be in apps, wearables, with our EHR that we're co-designing with patients and clinicians to ensure that they're usable and they meet the needs that are the most pressing needs, but also that we deliver and implement technology that allows us to provide compassionate care. Because I think when we think about technology, it's often this sort of antithetical approach to compassion. And we are showing that to be able to deliver compassionate care in this day and age, we have to be innovative in our use of technology. Danny 15:54 – 18:07 Wow. What a, what just, what a robust list of innovation. You know, that CAMH, is sponsoring. I'm not, not at all surprised Gillian, knowing your history. You know, Gillian, maybe a part two to this conversation. A separate podcast can be sort of on the intersection of social justice and technology. You know we regularly describe some just phenomenal innovation, consumer facing innovation and yet, we know that there's consumers of care that don't always get to take advantage of the latest and greatest innovation. The wearables or access to a device to allow, you know, portal or telehealth. You know, lack of hardware, lack of bandwidth, lack of sort of knowledge or trust in the available tools. So, you know, maybe we can. We'll bookmark that, I think for another day, but in the area of innovation, CAMH was part of our clinical AI work group for behavioral health. This was a year-long process. You know, Oracle has been an AI space for many, many, many years. You know, I'm sitting in a Marriott right now where, you know, I used Oracle tools to check in and to engage with the Marriott staff. Oracle knows a thing or two about AI, and has taken what they know about AI and applied it to healthcare. And we, Oracle Health, and CAMH and others have taken that and morphed it for behavioral health. So, our clinical AI agent today is available in the US in behavioral health, used across a number of behavioral health providers. I think to date, we've had nearly 20,000 medication management notes that were documented using Oracle Health's Clinical AI Agent. So, what's CAMH thinking about from an AI perspective? Gillian 18:08 – 22:38 Oh, we're thinking about lots from an AI perspective. And I will just note that while you're sitting at a Marriott, I'm sitting at the hospital right now, and on the overhead speaker is a code being called. Apologies if you can hear that. We are really quite excited about the potential for AI and what it could bring for things like research, education, of course, clinical care, and how we operate and potentially achieve some efficiencies. I think there's a whole bunch of areas where we see the potential for AI. We're fairly early in our journey, but we're setting up all the right infrastructure so that we can accelerate more quickly. The first is that we recently launched, just this month, a BMO chair in artificial intelligence and mental health. So that's a research chair role specifically for AI in mental health, and I believe it's the first and only in Canada at this time. So Dr. Tristan Glittard Is the inaugural chair. He's an AI computer scientist, researcher and engineer, highly collaborative with clinicians. I think we have high expectations for what this role will achieve. We're also hiring for an AI scientist. From a research perspective, I think we expect big things, and I'll have more to report back on Danny in the not too distant future around that one. In terms of education, we currently have a digital mental health and AI Certificate Program, which is free and currently available on our website. So folks here who are listening are welcome to go to camh.ca and who and can navigate to finding the digital mental health and AI certificate program, and that's really thinking about, mostly for clinicians who are working in this space where there's more AI tools available for them to develop their competencies and thinking about how to use them within their clinical practice. We're getting, sort of our baseline of folks ready so that we're able to really accelerate in this space. And then I'll just mention one thing lastly, and while we don't have anything concrete yet to share the potential of AI scribes and ambient scribes, and using this sort of technology to free up our documentation time for essentially all clinician types is of big interest. Not just the documentation, but also other tools like being able to do note summarization or querying the electronic health record or the patient record. So I think all of these sorts of things are of interest for us, and our clinicians would jump on at scale. These sorts of things can have a big impact. And I'll give you an example. Not too long ago, we did a fairly small change in our EHR, and it result, and that was about nurses reducing their documentation time. We took out some particular areas of a power form. It resulted in a couple of seconds per power form that nurses were not documenting anymore. But when we calculated the total time savings over the course of the year for nurses, it was the equivalent of a full-time nurse by just doing that small change. And so if we think about that's just a really small example that we saved a full 1.0 full time equivalent of nursing time. If we did that at scale by using ambient scribes, by doing things like note summarization and querying, we could really take that to the next level and save large amounts of time, which we hope, could really support clinicians in being even more engaged less burnout. You know, the list goes on. So of course, in doing any of this work in AI, we need to be mindful of risk and bias, ethics. So there's a lot to be mindful of there, ensuring we keep mental health care human and so we're really making sure we're getting this right. We're starting our journey to ensure that we have all these various safeguards in place. But I will say it's a really exciting place to be. There's some very cool tools coming out, and I can't wait to get my hands on them. Danny 22:39 – 23:58 Yeah, Gillian, we are so excited. You know our psychiatrist, psychiatric nurse practitioners, nurses, social workers, case managers, therapists, all benefiting today from use of Oracle Health Clinical AI agent. So, thank you for sharing those insights. Now. Before we close, we want to remind our listeners that if you or someone you know is struggling, help is available. In the US you can call or text, 988, 24/7 365. 988, is the suicide and crisis lifeline in Canada also, 988, 24/7 365, and just interestingly enough, 988, in Canada is provided and managed by CAMH to ensure that no one has to face a crisis alone. Trained responders are there for support. Dr. Gillian Strudwick, thank you for sharing your insights and for the work you and CAMH are doing every day to make mental health care better, smarter and more just. And thank you to our listeners for tuning in. Take care of yourselves and each other. Outro 23:48 – 24:20 That's all for this episode of perspectives on health and tech podcast, be sure to subscribe to catch all our future episodes. For more information from industry experts, visit oracle.com forward slash health and oracle.com forward slash life hyphen sciences, or follow Oracle Health and Oracle Life Sciences on social media. Thank you for listening and join us again for the next insightful episode of perspectives on health and tech.

Discover the Value of AI in Healthcare Are you interested in using AI tools to drive operational efficiencies within your organization, but not sure where to start? Listen in as two industry experts from HIMSS and Oracle discuss how AI is helping to transform healthcare operations and how to consider implementing AI technology in a healthcare organization. Hear about how AI is being used in healthcare today, risk factors to consider before implementing AI tools, and how AI can be used to boost clinician satisfaction while helping to reduce operational waste. Featuring: Mary Ann Borer, Senior Copywriter, Strategic Marketing Services, HIMSS Matt Patterson, Executive Director of Oracle Health AI, Oracle Listen as they discuss: - How AI is being used in healthcare IT today and the impact it is having on the industry (1:00) - Key factors that are important to consider before implementing AI technology in healthcare systems (6:45) - Clinical and healthcare business workflows that may be best suited today for AI applications (8:20) o Automation vs augmentation - Key risk factors to consider when adopting AI in clinical practices (12:20) - Which aspects of AI may add the most value to help improve the efficiency of current processes (15:22) - What's to come for healthcare AI in the future (21:35) Notable quotes: "My number one area of opportunity in healthcare, that's best suited right now, today, for artificial intelligence is addressing physician and clinician burnout." – Matt Patterson (9:47) CTA: Learn how Oracle is working to reduce the documentation burden on physicians and elevate the patient experience with the Oracle Health Clinical AI Agent. --------------------------------------------------------- Episode Transcript: 00:00:00:00 - 00:00:38:08 You're listening to Perspectives on Health and Tech. A podcast by Oracle with conversations about connecting people, data, and technology to help improve health for everyone. In this episode, you'll hear a conversation recorded by HIMSSCast where the host and guest speaker delve into unlocking the value of AI within healthcare. Your host for this session is Mary Ann Borer and the guest speaker is Matt Patterson. 00:00:38:10 - 00:01:05:11 Mary Ann Hi, I'm Mary Ann Borer with HIMSS. Today I'm joined by Matt Patterson, executive Director of Oracle Health AI at Oracle, and we'll be talking about unlocking the value of AI within health care. Matt, thanks for joining us today. Matt Thanks for having me, Mariana. I'm excited to be here. Mary Ann Wonderful, Matt. Can you start off by telling us a little bit about how artificial intelligence is being used in healthcare IT today, and what impact does it have on the industry? 00:01:05:13 - 00:01:31:21 Matt Yeah, absolutely. And I'll start just kind of a brief introduction of my, my experience here leading into, what's been one of the most exciting chapters in my career. But I've spent about 15 years in health care, serving in a variety of different health care entities across the globe to extract value from technology investments. So have had the opportunity to really work with some large scale players across the globe. 00:01:31:23 - 00:01:56:14 Matt And that's enabled me to learn some from some of the most innovative, forward thinking leaders across the industry on a variety of use cases. So I really started, in the heat of the adoption of core EMR technology during the meaningful use era. And throughout that journey, you know, 15 years ago till today, standing up care management programs to support value based care, you know, revenue cycle optimization initiatives. 00:01:56:14 - 00:02:22:03 Matt Most recently, I led a venture around, a lab is strategy to advance diagnostic capabilities, which is another topic, but one that I believe, you know, diagnostics has so much room for, for growth in the future. But that's often back of mind for health care organizations today. But again, as I noted, this AI initiative is really the most fun that I've had in my career. 00:02:22:05 - 00:02:54:01 Matt Of really just the value that it's bringing to healthcare professionals. To start off, just, you know, backing up a little bit around AI and healthcare, it's obviously the buzz of the last, you know, 12 plus months. But AI has been in health care for nearly half a century, and I refer to it as classic AI. It's used to carry out a specific task that a human typically performs, recognizing patterns and data to predict and drive what might happen next, or summarize what's already happened. 00:02:54:03 - 00:03:28:13 Matt Or making suggestions. What's really happened in the last 12 plus months is within healthcare is leveraging generative AI. That's the newest development in healthcare that leverages massive amounts of data and computing power to look at things in a much broader context and generate something completely new. So GenAI generate documents that can summarize existing information. It can translate a document and extract information and classify text based on a specific request. 00:03:28:15 - 00:04:07:01 Matt ChatGPT is obviously if anybody has actually tested that, it's a really good example of ask a question and it will give you a very succinct, summarized answer that's structured better than a lot of what humans can do. And so that's really where we're seeing this substantial shift in the healthcare industry is this shift from classic AI, which is if this happens, then I can drive this result to generative AI that truly can create something completely new around automation of administrative tasks, looking at precision medicine, etc.. 00:04:07:03 - 00:04:29:06 Matt And as you think about just the impact on what generative AI can really bring to healthcare AI, I go back to what Bill gates, an article he wrote in 2023 after he really he had a meeting with OpenAI and it started to click for him around what AI is really going to mean foundationally for a variety of industries. 00:04:29:06 - 00:04:55:15 Matt But, you know, in his article, he was kind of focusing on health care. And, and he said this "AI will become as fundamental as the creation of the personal computer. It's going to change the way people operate to face some of healthcare's most significant challenges and rising costs, lack of equitable access and aging populations, doctor, nurse burnouts and global pandemics." 00:04:55:17 - 00:05:37:22 Matt We're already seeing a lot of those impacts at different levels, leveraging GenAI so, you know, rising he mentioned rising costs. Today we're, we're driving operational efficiencies across health care around more efficient scheduling, claims processing, supply chain management and eliminating waste of supplies through real time forecasting, timely interventions of care that can eliminate readmissions and higher acuity costs. 00:05:37:22 - 00:06:06:16 Matt So we're impacting the cost curve already through AI, lack of equitable access to care. Social determinants of health is a big thing that we're embedding into a EMR today to provide an Uber access so somebody doesn't miss their appointment. And doctor nurse burnout. So I'm going to get into more of that today because that's where I'm spending a lot of my time within Oracle is addressing administrative tasks through leveraging AI. 00:06:06:18 - 00:06:32:07 Matt In short, the integration of AI and healthcare. It truly is transforming the industry by improving accuracy and diagnostics and treatment, reducing costs, and ultimately leading to better patient outcomes. But we'll get into some of this today. It also raises important considerations regarding data privacy, like the ethical use of AI, how to put controls around it, and the need for regulatory oversight. 00:06:32:07 - 00:06:48:00 Matt So overall, it's playing a crucial role around the evolution of health care. It's making it smarter, more patient, more efficient and more patient centered. But important to put controls in policy as organizations look to bring AI into your organizations, 00:06:48:03- 00:06:55:12 Mary Ann What are some key factors that you consider important before implementing AI technology in health care systems? 00:06:55:14 - 00:07:28:12 Matt It's one that I receive often. Where do we start? So the possibilities when you really dig into the technology of cloud hyper-scalers, the capabilities are endless, which is exciting. Yet it's also overwhelming when you really kind of dig in to what the possibilities are. So where to start is hard. And so a lot of clients and folks that I'm working with week in, week out, I give them this simple advice : start small and start now. 00:07:28:14 - 00:07:59:09 Matt You can go address low risk use cases. Now to learn the technology, understand how to wrap your arms around it, and put controls and protocol around it before you get to those larger scale, higher risk use cases such as do I drive a diagnosis directly to a physician into their physician workflow, you're going to want to put a higher level of protocol controls and risk management around that type of larger AI. 00:07:59:11 - 00:08:15:00 Matt We'll call it recommendation. In comparison to something like, how do I go create a draft note for a physician to have to review? So in short, my recommendation is always start small, but get going now. 00:08:15:02 – 00:08:25:09 Mary Ann Now that's an excellent point. And let me add to that a little bit and ask you which clinical and health care business operations do you feel are best suited for AI today? 00:08:25:11 - 00:08:52:24 Matt So as I mentioned on the front end, I've been fortunate, to have a variety of experiences across, the healthcare entities I've worked with throughout my career. And, I'll tell you, from my experience, it's all of the functions of the healthcare system that need automation and really need to have the opportunity to eliminate manual process and waste, supply chain. 00:08:53:00 - 00:09:21:00 Matt You know, I mentioned AI, more effective predictive analytics to eliminate waste, huge opportunity across our healthcare system, of, you know, things that aren't necessarily needed and are wasted on a daily basis, that if we had more effective ways to forecast what's needed and when we could eliminate cost, eliminate that waste within our supply chain management system. Revenue cycle, there is more manual process in rev cycle. 00:09:21:02 - 00:09:47:11 Matt And there are more tools coming out to augment that. Those manual processes, leveraging AI. So the automation of coding and prior authorizations claims processing, denials, management, a variety of aspects of how we can automate manual process today, predictive analytics to reduce readmissions, health equity programs that I mentioned on the front end. There truly are countless opportunities across the functions of healthcare. 00:09:47:13 - 00:10:20:00 Matt But my number one area of opportunity in healthcare that's best suited right now, today for artificial intelligence, is addressing physician and clinician burnout. So before I get too far into the why there, I just summarize the where to start through the evaluation of two different concepts. One is automation. The second is augmentation. So think of automation as the automation of a process. 00:10:20:02 - 00:10:56:18 Matt Creating a note automatically driving a code within for an ICD ten coding. It's addressing an administrative task versus augmentation. Is the AI actually providing a recommendation directly to the end user? I personally believe that as you think about those two concepts, the nature of what health care serves myself, my mom, my dad, my kids, it's so personal that we really do need to be careful with AI. 00:10:56:20 - 00:11:30:24 Matt And so starting with automation of process and the administrative burden, there is so much opportunity there. My recommendation is start with automate automation. As you as we continue to see the AI improve, which it will exponentially in the coming years, I think that's when we start to look at the augmentation of care. And there are a variety of organizations out there that are continuing to look at this augmentation concept, meaning I want to drive a recommendation of a diagnosis or a treatment plan directly into the clinician workflow. 00:11:31:01 - 00:12:02:20 Matt But again, my $0.02 starting small. Start with automation of administrative process. And as AI improves, think about da Vinci three to chat GPT four. There has been so much improvement around AI hallucinations, and those hallucinations are real in artificial intelligence. The iterations of AI will just continue to improve. And so as the AI improves, I think that's where there will be our opportunity to get to the next level of that true augmentation of healthcare. 00:12:02:22 - 00:12:05:01 Matt That will really take AI to the next level. 00:12:05:03 – 00:12:23:01 Mary Ann That's such a great point, especially when you think about how some of those kind of cumbersome administrative processes that are really a big factor for clinician burnout, what are some key risk factors, not that you would consider when it comes to adoption of AI in clinical practices? 00:12:23:03 – 00:12:35:06 Matt Regardless of the use case, small or big, there's an associated risk, and it's important that it's articulated to the end users. 00:12:35:06 - 00:13:12:10 Matt And as organizations think about policy, AI is meant to support human functions or decisions. It is not meant to replace it. So I've spent a lot of time and, you know, in recent months, traveling with providers across the nation to adopt ambient listening technology to automate their documentation within any of our. And when you sit down with the providers, I'm always very clear that the AI generated note is a draft. 00:13:12:12 - 00:13:42:13 Matt The actions that the AI will recommend are proposed. It's critical that on the front end of the adoption, you really talk to, in this case, the physicians, about what the AI is and what it is not. It is not a replacement of your responsibility as a licensed professional to sign that note or to sign off on that medication or that prescription. 00:13:42:15 - 00:14:17:14 Matt Right. So from my perspective, as we continue to get to the next level, the education of what artificial intelligence really is meant to be - an assistant, but not a replacement - is critical as we move forward. It's impressive what it is doing. Yet it's also important that clinicians, and end users of the I understand their responsibility. It still lies on them to sign off on as the human and the owner on really the impact of patient care at the end of the day, right? 00:14:17:14 - 00:14:52:10 Matt So it's about putting the right controls in place so that you can control the AI and wrap your arms around it. You know, AI will, as I've mentioned, fabricate. There was actually an example from my book that I read around, asking that in this case it was for Da Vinci Three about how they knew, how did they learn so much about Metformin and the at that time, Da Vinci three replied with, I received a master's in public health and personal experience with diabetes in my family. 00:14:52:10 - 00:15:14:16 Matt Well, they I did not actually receive a master's in public health. And so we kind of laugh about it when, you know, you're playing around at home with the power of what, you know, ChatGPT is or in this example, Da Vinci three at the time, but at that is an a hallucination of, you know, what the artificial intelligence is. 00:15:14:16 - 00:15:21:02 Matt And so it's just very careful that you treat, like you do anything else in life with caution. 00:15:21:04 – 00:15:30:06 Mary Ann Fantastic. So, Matt, what aspects of AI do you see adding value to help current processes to help transform health care? 00:15:30:09 – 00:15:43:04 Matt I'm going to go back to my earlier number one opportunity that I believe right now. Current state AI has the opportunity to go advance. 00:15:43:06 - 00:16:16:18 Matt And it's really providing an intelligent assistant to doctors and nurses to decrease administrative burden and to give some background that everybody knows about. But I've been on the front lines experiencing it in the practices, not at the corporate level or in the C-suite office, but in the provider practices that are doing, you know, every single day serving 25 plus patients in primary care, various specialties, etc. physician burnout is real. 00:16:16:20 - 00:16:36:14 Matt And, you know, the administrative workload that has been put on to physicians and nurses, it has increased dramatically over the last 20 years. And candidly, it's diminished the noble desire of having young students enter into various health care roles to just help people because there's too much day to day documentation and paperwork. I've got to create these notes and insurance claims and requesting prior offers for lab tests. 00:16:37:16 - 00:17:04:04 Matt It takes up 49% of a working day for doctors and nurses. So the net of this is that we need strategies to reduce administrative work on doctors and nurses to get back to what they do, provide patient care. And so, again, back to some of the things I've hinted at today automation versus augmentation, precision medicine, and some of these neat things that I am very excited about what it will be. 00:17:05:15 - 00:17:30:11 Matt But my focus today, right now at Oracle Health is how can we automate administrative tasks to enable physicians, nurses and clinicians alike to get back to patient care? That is where we're going to see outcomes improve there. If you ask any provider - and I had the opportunity down in Knoxville, I won't mention her name, but a physician looked me in the eyes. 00:17:30:13 - 00:17:56:09 Matt She's adopted our technology. She actually, has a four year old and a six year old, and she was telling me how on Sundays, she will spend anywhere from 4 to 5 hours doing documentation so that on Monday, she's not behind before she goes into the office. And she's got a full patient load. You know, tremendous, patient bedside manner. 00:17:56:11 - 00:18:22:07 Matt And so, you know, she's a busy physician, bottom line. But still, I'm allowing her to spend time on Sundays that that 4 to 5 hours has gone down to 30 minutes to 1 hour. So the technology that we're providing to her is enabling her to spend four more hours per weekend with her four year old and her six year old. 00:18:23:09 - 00:18:50:15 Matt And as a mom, that matters. And so what she told me, and she looks me in the eye as I was walking out of her practice, is. Thank you for contributing to the quality of care for my patients. And we have talked about, you know, her four year old and her six year old earlier in our meeting. But the bottom line is that there's direct correlation around physician satisfaction, linking back to patient satisfaction, engagement, and improved outcomes. 00:18:51:17 - 00:19:25:09 Matt So if the physician is looking me in the eye, as opposed to typing on their computer, I feel engages the patient, I'm going to be more likely to remember what was said during the visit. I'm going to be more likely to follow through with the instructions that the provider has given to me. So I see the most important aspect of who are leveraging AI today, right now, in the near future, is getting clinicians back to what they were, what they went to school to go do, provide patient care. 00:19:25:11 - 00:20:00:08 Matt It extracts across the entirety of a practice the health care system, the unit, you know, of a given floor. It's about addressing administrative burden. And that will bring attractiveness for young students to enter into health care again. Again, back to that noble desire strictly to help people. So in the near term, that's my focus to really bring back the joy of practicing medicine, I've had the pleasure to hear from countless providers on what this AI technology can really bring from Oracle and, getting them back to their practice and their patients. 00:20:00:10 - 00:20:09:05 Matt And so that's, that's really it. I think in the short term, where the core focus should be and the excitement that is, AI's bring it into health care. 00:20:10:08 – 00:20:16:20 Mary Ann Wonderful. Now, Matt, on that note, what excites you the most for what AI can bring to health care in the future? 00:20:16:21 - 00:21:01:23 Matt So this is the art of the possible, right? And it does. You know, again, as I mentioned, I've had the opportunity to learn quite a bit about the capabilities that exist within Oracle's cloud. And other hyper-scalers have similar capabilities. It really, truly is endless around and to my earlier comment, overwhelming on what it is that we could go do, but to just name, you know, a few examples of really where I think and I'll, I'll go back to that automation versus augmentation to really getting to that augmentation aspect of what we can do to assist health care holistically, leveraging AI. 00:21:02:00 - 00:21:26:10 Matt What I'm most excited about, and some of this is already starting to come out, with various entities. I think the impact is still, TBD around adoption, etc., but things like personalized medicine, how you can leverage AI to tailor treatments to individual patients by analyzing genetic information. Again, you know, there's a lot of interest there. 00:21:27:12 - 00:22:01:06 Matt I don't necessarily know that it's being adopted across healthcare systems throughout the globe yet, but it's a very exciting on what I can bring there. And we're just scratching the surface. Medical imaging. So AI can be utilized to analyze medical images, to detect anomalies and aid radiologists in a, in a diagnosis that is very exciting so that a radiologist doesn't miss something if they're doing a night shift. Hypothetically. 00:22:02:06 - 00:22:33:04 Matt Clinical decision support. So actually getting to the point that the AI can assist a health care provider for evidence based recommendations of patient care, how do you how does the AI potentially, you know, remind a provider or a nurse or a clinician of something they might have missed, right. Drug discovery. I think there's tremendous opportunity around what I can do to accelerate the drug discovery process. 00:22:34:06 - 00:22:57:00 Matt Going back to, you know, the Bill Gates quote that I opened up with, how do you get ahead of significant things like we just went through in the pandemic? Well, AI can assist us in that as we think about what it can bring to the future. And, the other one, you know, to wrap in a bow is patient engagement. 00:22:58:02 - 00:23:23:09 Matt I think that we all have our own ways of how it is that we want to engage with, you know, our own bodies, our own health care and AI powered chat bots. It can really know who you are, understand who you are, and how it is best to engage with you to get the best result of the engagement. 00:23:24:09 - 00:23:47:03 Matt For - Are you doing your walking for diabetes right? Are you filling your prescriptions or not? Have you gone in for your annual wellness check? Are you going and seeing getting your dental exam on an annual basis? Small things that ultimately lead to more healthy populations and preventative care. I think AI has tremendous opportunity just through, you know, the scale of how it can actually analyze data. 00:23:48:05 - 00:24:09:21 Matt It will take some of the pop health strategies and patient engagement strategies that exist today to the next level. So that's more getting to the augmentation aspect that I mentioned earlier, as opposed to just I think, you know, the core focus of automation, a process that we're that is the more of the here and now today. So, exciting times, a lot more to come. 00:24:10:23 - 00:24:20:03 Matt And, I truly do believe that we're just scratching the surface of what artificial intelligence will be able to bring to health care. As we look back ten years from today. 00:24:21:05 – 00:24:26:11 Mary Ann I'm sure looking forward to seeing what comes next. Matt, thank you so much for joining us today, and thanks for sharing your insights with us. 00:24:27:14 - 00:24:40:21 That's all for this episode. Be sure to subscribe to Perspectives on Health and Tech Podcast. For more insights from industry experts. Visit oracle.com/health or follow Oracle Health on social media.

As society's focus on mental health intensifies, technology stands at the forefront of this evolving narrative. Listen in as this group of experts examines technology's paradoxical role in mental wellbeing: constant connectivity that reveals insights yet also increases burnout due to poor design, and social media, where overuse is linked to decreased mental health but provides a beacon of hope through innovation. Hear about the challenges and opportunities of using technology to enhance mental health, exploring how digital advancements can be harnessed for a healthier, more balanced future. Featuring the following panel at SXSW Conference: Moderator: David Feinberg, M.D., Chairman, Oracle Health Danny Gladden, MBA, MSW, LCSW, Director, Behavioral Health and Social Care, Oracle Health Tracy Neal-Walden, Ph.D., Chief Clinical Officer, Cohen Veteran Network Michelle Patriquin, Ph.D., Director of Research, Associate Professor, Menninger Listen as they discuss: The moment realized, that access to care needs to be fixed (0:40 What is happening from a technological standpoint that is helping individuals, patients, families, and communities (4:33) The use of iPads Research assistance The collection of outcomes data An example of something done based on data to change the way that care is delivered (6:20) The role of sleep Post-treatment and post-discharge risks Q15 (15-minute patient safety) checks Example of the effectiveness of telehealth (9:15) Prior and post-pandemic Impacts on standard measures Additional data insights Impact on no-show appointments Using technology to tell a fuller story (12:45) Wearable devices Digital therapeutics and inputs Research to practice gap and the potential of technology (15:38) Concerns with technology not helping or distracting from human connection (17:05) Social media and the link to depression (17:50) People who are left behind; technology access and literacy (19:00) Psychologic safety of technologies (20:00) Concerns from the clinician perspective (20:45) Helping clinicians with documentation and proper training of tools leveraging AI (21:44) Clinician burnout (22:34) Notable quotes: "This is why I love wearables, and I've always loved wearables, psychophysiology, because it fills a tremendous gap in our ability to measure the dynamic fluctuations and the way our emotions and behaviors change." Michelle Patriquin, Ph.D., Director of Research, Associate Professor, Menninger (15:10) Learn more about how Oracle behavioral health solutions combine real-time clinical data from across each patient's unique healthcare journey. Watch on-demand and live webcasts by registering for Oracle Health Inside Access. -------------------------------------------------------- Episode Transcript: 00:00:00 You're listening to Perspectives on Health and Tech, a podcast by Oracle with conversations about connecting people, data and technology to help improve health for everyone. 00:00:11 David My name's David. I'm the chairman of Oracle Health. And before I introduce this esteemed panel, there's a few patients that I've cared for, and I'm a child psychiatrist that have just stuck with me. And for a lot of reasons. Well, I actually feel like for whatever long I've been in this 30 plus years, I'm just trying to make it better for these patients and their families. 00:00:34 David So let me describe them. And I think it really sets the stage for the role of technology in mental health. Okay. This little girl in third grade at the local school where my kids actually went to school writes in her haiku poem that she wants to commit suicide. And this is pre cell phone guys pre technology. The teacher reads the haiku poem and tells the prince at home that night tells the principal. 00:01:01 David The next morning, the principal then calls the mother at home. And then this is L.A. And because they knew people, they were able to get in to see me in three weeks. And I was like, my God, if my kid was suicidal, it doesn't matter who, you know, you got to be seen today, right? I didn't know this word, but I know. 00:01:22 David And now I'm going to fix access. I mean, that's what we use is this term access to me is my kid is suicidal and I'm calling an 800 number and my insurance doesn't cover it or I got to pull strings and God forbid I'm from the other side of the tracks where I don't know anyone. I will never get it like. 00:01:40 David So how can technology help there? Right now, I think what we're supposed to talk about, too, is the negative part of technology, right? I'm stuck on my phone. I'm not I'm not socializing. I'm, you know, we all go to dinner and we're like this instead of actually being together. So why don't we go down the line and introduce yourselves? 00:02:03 Michelle Okay, everybody, I'm Michel Patrick Quinn, and I'm a psychologist and a child psychologist, and I'm director of research at the Menninger Clinic and an associate professor at Baylor College of Medicine. I'm excited for this conversation. The Menninger Clinic is really known for humane treatment of mental illness. We are historic, known as an inpatient psychiatric hospital and really revolutionary and something called the therapeutic milieu. 00:02:30 Michelle And so kind of actively intervene and doing psychotherapy while someone is inpatient. So it's not a passive intervention. And it's really just remarkable. We still hold on to that kind of psychotherapy within an inpatient context. 00:02:47 Tracy I am Tracy Neal Walden. I'm a clinical health psychologist. I work for I'm the chief clinical officer for Coimbatore and Network. We're a network of mental health clinics across the US. We have clinics in 16 states covering, supporting 25 states. So and that's because of telehealth. So we utilize we don't do solely telehealth, but we've been able to utilize telehealth in order to expand our reach across the US. 00:03:18 Tracy I'm also a veteran of the United States Air Force. I served for 24 years and served as a psychologist during that time in the Air Force as well. We serve not only the veteran but the veteran's family members. As a veteran, myself, my family doesn't have access to care in the VA, and that's no fault of the VA. 00:03:37 Tracy It's the way the system is set up. And so we're able to reach and provide those resources to families and in a much shorter time period, especially due to the advances that we're going to be talking about now with technology, 00:03:53 Danny Thank you and so I'm Danny Gladden. I'm the director of behavioral health and social care for Oracle. 00:03:59 Danny Happy to be the social worker on the stage. And I really proud to work with just a whole group of social workers in the delivery of mental health services and all the great work social workers do. 00:04:11 David Today, what in your organizations is happening from a technological standpoint that you think is improving access, improving quality, democratizing care, making care more affordable, more culturally sensitive, helping with, you know, inequities that we know that are in care? What are you doing to harness technology that's actually helping individuals, patients, families, communities? Sorry, go for it. 00:04:34 Michelle Yeah. So it's not really revolutionary in any way, but we use iPads and research assistants and collect outcomes data across our whole hospital and with inpatients in outpatients, outpatients, it's pretty standard. People are able to complete, you know, outcomes, measure, self-report, inpatient. It gets more complicated. And we have to we have to guide people, help people. Some good times, people resist, don't want to do it, and that's fine. 00:05:00 Michelle They don't do it. But that to me is the foundation, right? So if you collect outcomes data that gives people a voice in their treatment, particularly on inpatient. So our inpatient units are locked units, you have reduced someone's on autonomy when you measure how they're doing, from their perspective, it gives them some control back. And I think that is one of the most powerful things that we can do is give people control back through data and measuring these things and measuring the change over time. 00:05:32 Michelle Whether it's positive or negative. And technology allows us to do that. So many of our patients want to use the iPad, and then we visualized the data in graphs that are provided to the treatment team through our electronic health record. And so that gives data driven feedback that the treatment teams can actually provide to the patients at the patient level. 00:05:50 Michelle We also use it for research to understand like aggregate results, what's working for who and what's not. But I think, you know, I'm biased, I'm director of research, so I love data. I'm the PI over our outcomes. But I think that's tremendous. And we can advocate for better inpatient environments, better inpatient care, better inpatient outcome. 00:06:12 David Can you? I think it's a great example. First of all, the simplicity of it is sometimes to make things simple. It's really hard and so this is great. Can you give an example of something you've done based on the data to change how care is delivered? 00:06:23 Michelle Yes. So well, something we're working on right now, all of our results are lining up really around the role of sleep. One thing we are constantly thinking about is suicide risk with inpatient, and particularly suicide risk post-discharge for those of you who may not know post-discharge from inpatient is the highest risk period for suicide. Over and above any other time in someone's life and also relapse. 00:06:52 Michelle So post in our highest level of care. And to us that is incredibly concerning. So we have been really thinking about the role of sleep as well as other measures and look at longitudinally outcomes while someone's inpatient what is predicting suicide risk and we have a paper that we published, we showed it is sleep over and above everything else that you can put in the model. 00:07:16 David And you measure using our rings and things like that or how are you. 00:07:18 Michelle Not yet. We are now because it is so important and we've now designed our own like API and with wearables to replace things that we do in inpatient that actually disrupt sleep. So like you, 15 checks and these checks. So there's checks done on inpatient to ensure someone's safety and sound checks. And these are often pretty disruptive. We have data now from active Griffey that we've lined up with the checks in about 75% of those checks. 00:07:48 Michelle So someone going in their room, usually a stranger that they do not know, opens the door, sometimes shines a flashlight in their face to make sure that they're breathing and that they're asleep. Or if they're not asleep, they'll ask them to raise their hand. And so and for us at our hospital, it's every 15 minutes that happens. That equals about 36 times a night. 00:08:06 Michelle Someone comes in their room. So we've designed our own kind of in-house homegrown system to replace that. And that is one and it's just one thing that, like we always say, you know, when technology is, you know, going to take over and ruin people's privacy, things like that. But in that situation, it improves people's privacy. People can sleep and be and have intact sleep. 00:08:29 Michelle Great. So it's that and that has just that's one of our favorite examples. Right. Just kind of generic outcomes data into a new intervention that leverages technology that improves some of these outcomes. Hopefully in the end we're still working on it, but so cool. 00:08:46 Tracy Yeah. I think it's really interesting what Michelle just discussed in terms of outcomes because we do measurement based care for all of our clients. So we measure their, their symptoms at every session and we do that via iPad. If they come into the clinic or we push it out electronically for those who are being seen for via telehealth. 00:09:10 Tracy And one thing that we found is that we actually we want to take a look at how effective is telehealth, because many people say it's not effective. You know, prior to the pandemic, people were very skeptical. And we actually use this data and we have a research institute that's part of our and veterans network. And within the institute, they reviewed the data recently and we found clinically significant change in Q nine scores is for depressed individuals and for those with PTSD, a clinically significant change in their PCL. 00:09:50 Tracy So these are the measures that are the standard measures given for those populations. And not only did we find clinically significant change, but we also found that those individuals were in remission. That's one of the things that I love about technology. It allows us to get those additional data insights. We rolled out telehealth in 2018, so before the pandemic, and we did it to improve access and not just access due to long wait, but to decrease no shows in to improve that accessibility for clients who were already in care. 00:10:29 Tracy I remember a few years ago I had a client and we would advertise in our clinic. We had rolling slides that would tell about the different things that we offered, and we had a slide that talked about telehealth and it said, Ask your clinician if you'd like to know more about it. And my client came in that day and said, Hey, would I be a candidate for telehealth because I fall asleep on the drive home from here and I was like, Yes, you being silly. 00:10:59 Tracy And that's also the beauty of telehealth, because it also it allows you to oftentimes squeeze additional appointments in if someone knows shows and it helps to prevent no shows, too, because oftentimes some people like to come in, they will they like to come in and see their clinician face to face, which is great. But sometimes life gets in the way. 00:11:23 Tracy And so if someone calls to say, hey, I'm going to be late, then we say, Would you like to convert that to a telehealth appointment so that they don't have to miss that appointment? 00:11:34 David Okay, Danny, take us home on that wonders of technology. Yeah. Then we're going to flip it. 00:11:39 Danny We're going to flip it. Okay, Well, so. So for Oracle, we build tools. We build tools to ensure that the work that providers are doing with consumers of care have what they need to sort of ensure that that, you know, the clinical experience checks the box so that, you know, the 15 minute check that Michelle was mentioning is something that happens in our tools and the screening and the screening that happens in our tools. 00:12:05 Danny We've embedded in the workflow for nurses, for oncologists, for the ED attending. We've embedded in the workflow a suicide screening tools and, and then and then alerts so that if someone is at risk, it's not just one person who's aware, but the entire treatment team can have this ability face up to this type of information. And so we sort of want to help folks use digital tools to be able to track patient information, to be able to get folks get folks in quicker. 00:12:37 Danny But I think beyond that, the beauty of technology in general is there's an opportunity to tell a fuller story, you know, through wearables, through some of the cognitive behavioral interventions, the digital therapeutics. It just really provides a variety of different types of modalities for consumers of care to be able to sort of deliver inputs about their experience. 00:13:02 Danny You know, if I have to get in the car, drive to a clinic to see Michelle in person, I'm putting on a mask. And all you really know about this individual is probably what happened an hour or two before they got to you. Like it's the stress of the moment using wearables, using sort of digital inputs throughout the week in between sessions, I'm able to I'm able to sort of have a more holistic picture of what your week looked like. 00:13:31 Danny And because you're doing the session in your own home, you don't have to put on a mask. It is more intimate. And I'm able to, as the provider, just have a more holistic picture of what I'm working with. Okay. 00:13:45 Tracy Can I add one more thing? 00:13:46 David You could add ten more things. 00:13:47 Tracy It gives you more accurate information. You know, as I was thinking about what you were saying, Danny, about the technology and you, Michelle, when you were talking about sleep, sleep is one of the number one concerns within mental health. People may come in with issues such as depression, anxiety, PTSD, but there's usually an underlying sleep problem. And as a health psychologist, I love to treat sleep, but clients history directly underrepresented the amount of sleep that they actually get. 00:14:19 Tracy And by using something like a wearable, a watch or a ring, you get that accurate data that then you can immediately share with them or they can see it immediately themselves. 00:14:32 Michelle I completely, completely agree with Tracy and Danny, and I think the beauty of the data when we talk about outcomes data, self-reported data, those data are collected, you know, every week. So you have huge gaps in the information that you are getting about somebody's experience. You know, our emotions can change within seconds. You know, there's a you know, can be a traumatic event happen or just a, you know, an argument with someone. 00:15:01 Michelle So our lives and our emotions behaviors are very dynamic and our outcome measures and the data that we have now is why I love wearables. And I've always loved wearables, psycho physiology, because it fills a tremendous gap in our ability to measure the dynamic fluctuations and the way our emotions and behaviors change. That is so important, I think, for understanding the ultimate outcome and just that that the kind of higher temporal resolution of the data is something we don't have now in practice. 00:15:36 Michelle There's such a research to practice gap there that I think technology will certainly fill in and also has the potential. And one reason I love the wearables, because it really demonstrates that it's not all in your head. Yes, too, when you do a self report, that is your perception, right, of how you feel in and with the wearables, too, it gives an objective marker for the first time in vivo in the situation to show, Hey, I'm really experiencing this, this is real, this is how I'm inside. 00:16:11 Danny Yeah. And I think about this just real quick. Like in our. 00:16:14 David Now we're cooking. 00:16:14 Danny Yeah, I mean, well, in our discipline historically, you know, we don't we don't get access to labs, We don't get access to some, you know, some good radiology scan. We find out something about someone by asking a bunch of really nosy and intrusive questions by observation or someone has sort of engaged, you know, has had a crisis in their, you know, the courts or corrections or a probation and it is point in time, like, how many times do you start a session where, you know, how have you been since I saw you,fine, right. 00:16:49 Danny I mean, and that's sort of the starting point. So the ability to have real time inputs, the seven or the 14 days in between the times of seeing each other it just enriches the clinical experience so much. 00:17:03 David We're flipping gears. What are your concerns around tech not helping us, tech distracting us from human connection? 00:17:14 Danny I'll start us here. And so, you know, I, I still see I still see a few clients from time to time. I particularly enjoy working with adolescents and sort of the narrative from adolescence in the stories they sort of come up with in their mind about the world around them is really quite distorted, you know, based on the stories they get from social media. 00:17:40 Danny And I'm not talking about sort of what fake news, which is its own lane, but sort of the attitude that, you know, folks around me are just having a much better experience than I am. And what we all know is that there's likely all of it is inflated a little bit or a lot of it. 00:17:59 Danny Right. And so we know this. We know that the data on sort of overuse of social media and the link to depression and anxiety in young people is real. What we are seeing, though, is that transition, you know, it's not. So if I'm down, I'm feeling bad about myself. I'm now starting to engage in, you know, in ways to numb that pain. 00:18:25 Danny And that's, you know, through self-harm, through self-injury. It's, you know, through alcohol use or other substances or it's sort of engaging in relationships that are unhealthy. So I'm really I'm from the adolescents that I get to work with. I'm really concerned about that. On the other side, the part that concerns me about tech is, is I mean, we've just sat here and talked about all of the benefits that technology can bring, the access, the data, physio, bio physiology data. 00:18:55 Danny But the problem is there are people left behind, there are people left behind in the in the most remote parts of Alaska. There are there are folks that are left behind within a, you know, a mile radius around here. And so, you know, we have to ensure that that the tools that are created impact and benefit all of the people. 00:19:19 Danny And you know, so I think tech access, tech literacy, all are concerning to me as so much of our particular discipline moves into the tech space. 00:19:30 Michelle I'll kind of jump off from there. You know, I think when, you know, I'm not in the tech space, but I love technology. But I think technology does such a good job with some of these data privacy issues, and they do a lot in terms of the technicalities of how things are going to work with the interface. Looks like is are there protections in place, right, that safety is built in? 00:19:54 Michelle I think one thing that is forgotten, though, and, you know, I don't know if we even knew that was going to be a consequence is no one was testing the psychological safety of these technologies, especially when it comes to social media. Right. As we, you know, are kind of zooming forward with technology. There's all these, you know, kind of ethical safety guidelines, American Psychological Association. 00:20:18 Michelle These are really good job at starting to think about the psychological safety. What are the psychological kind of safety parameters that we need to test as we develop new technologies? But also then how do we put the guardrails up on the things that are here now? 00:20:35 David Tell me other things that concern you about technology and mental health. 00:20:39 Tracy I actually have another thing, and I'm going to shift it a little bit. I get concerned from the clinician perspective because we've technology has really helped us. We instead of, you know, giving a and I remember when we gave out the paper and pencil measures to our clients when they came in to the door, you had to wait for them to finish it. 00:21:01 Tracy But the good thing about that is when they did, then I immediately had it. I reviewed the scores. Now measures are sent to us, you know, automatically, and then they go into our system. And so you really have to train the clinicians to utilize that data and not just have the client submit their data without it being utilized. 00:21:29 Tracy Someone could submit data that could indicate that their risk status has changed. And if it's not being looked at, that's a huge concern. We're also looking at ways to help clinicians with documentation. However, a concern that I have with that too, is that, you know, if you're using AI to do your documentation, there could potentially be errors. And so we have to train our clinicians to properly utilize these wonderful technologies so that they can use them effectively. 00:22:03 David Yeah, we're working really hard on that. I think we've got good stuff coming out. 00:22:08 Danny Well, yeah, and, and actually so big because we don't have labs and radiology scan to sort of show a paper. Here's the evidence for the diagnosis. Our word, our discipline is very narrative rich. And you know, just to be able to sort of either get a prior authorization for service or to be able to continue service. And so we have a clinician burnout issue because of the administrative burden, the documentation burden. 00:22:36 Danny And, you know, so that's and the tech just facilitates that. But I do think is exciting, you know, ambient genitive AI and ambient for documentation. Our little our slice of the pie has been carved out and I'm so excited. And, you know, so Microsoft has gone there's some other startups out there that got Oracle's working on its tool that will really shift the burden away from documentation. 00:23:04 Danny I think it's going to be a game changer. 00:23:06 David Great gratitude to all of you folks, and thank you for participating. Thank you. 00:23:11 Be sure to subscribe to Perspectives on Health and Tech podcast for more insights from industry experts, visit Oracle dot com slash Health or follow Oracle Health on social media.

In the last decade, a growing amount of research has increasingly exposed how a lack of funding for medical and pharmaceutical research around women's bodies has put both patients and clinicians at a disadvantage for treating even common illnesses. With a lack of knowledge and awareness on women's health, clinicians don't have the data with which they need to practice, and patients don't feel heard, some even experiencing bias at the bedside. How can AI and other technologies help address some of these challenges? Listen in on this first episode of a two-part series. Featuring: Moderator: Nasim Afsar M.D., MBA, chief health officer, Oracle Health Christy Dueck, Ph.D., global head of the Learning Health Network and Health System Activation, Oracle Health Esther Gathogo, M.Pharm., Ph.D., senior performance improvement leader, Oracle Health Sarah Matt, M.D., MBA, vice president, physician and healthcare technology executive, Oracle Health Listen as they discuss: The moment they realized, personally or professionally, there was a gap in women's health care (2:47) In practice for oncology patient Collegiate athlete performance Menstrual health care in school settings In practice, while pregnant What is being done to address the lack of research on women and diversity amongst women (10:56) Representation in clinical trials Product development Expanding inclusivity in EHR data What can be done to help address the lack of women and women of color in clinical studies (15:11) The role of AI in care delivery (17:15) Tips for training AI algorithms Burnout, patient engagement, automation Notable quotes: "When we think about women's health in general, using more automation, using more AI/ML, could it help women in their ability to get care for themselves? It absolutely could … Because right now I think what we're finding is that the system's stressed, all the people are stressed, the patients are stressed. Everyone needs a break and we can't do more with less. We're going to have to do things differently." – Dr. Sarah Matt "At the end of the day, we want to make, just like you said, those 15 minutes with the community members that you serve more impactful and with the option to bring more innovative things to your community than ever before." – Christy Dueck, Ph.D. "And we know that if there's such a low representation of women in clinical trials, it means that products are being approved without the representation of these women. And it means that the real-world evidence then becomes really important. If we are then using these products, we have to understand the female body and the diversity—in terms of the genetic background as well—and that diversity means that they might respond differently to the approved medicines. It's also thinking about how to recruit and making it a lot simpler for women to understand the products." – Esther Gathogo, M.Pharm, Ph.D. --------------------------------------------------------- Episode Transcript: 00:00:00 Nasim Afsar You're listening to Perspectives on Health and Tech, a podcast by Oracle with conversations about connecting people, data and technology to help improve health for everyone. Today on the podcast, we're discussing women and health equity. From personal and professional experience, how we've become familiar with the lack of resources and research on women's health and how AI and other technologies can help address some of these challenges. 00:00:35 Hi, I'm Dr. Nasim Afsar, chief health officer at Oracle Health. And joining me today on the podcast are three of my colleagues from around the world. I'll ask them to introduce themselves and give a brief overview of what they do. Sarah Matt Thanks, Nasim. I'm Dr. Sarah Matt. I'm a surgeon by training my fellowships and burns, but I've been in product development all over the world for my entire career. That's building our electronic medical records, new mobile applications, patient engagement solutions, you name it. First, I came in to drive our OCI, the cloud side of our business for health care and life sciences. And now, after our acquisition of Cerner, I focus on new product development. Nasim Afsar Thank you. Esther? Esther Gathogo Hi, I'm Dr. Esther Gathogo, and I'm a pharmacist with 18 years' experience working across different sectors: community, hospital, academia and clinical research. And I currently work as a senior performance improvement leader in international based in UK. And I also focus on health equity and AI. 00:1:37 Nasim Thank you, Esther. Christy? Christy Dueck Hi, everyone, I'm Dr. Christy Dueck. I'm the vice president and global head of our Learning Health Network and really have responsibilities around creating health system partnerships with life sciences industries to bring clinical research as an integrated component of clinical care. Nasim Thank you, Christy. And my background is in internal medicine. I practiced as a hospitalist for over a decade in tertiary quaternary academic medical centers. I've been in health care administration on the health care delivery side for over sixteen years in roles, in quality roles, in health management, contracting and health care operations. My team is focused on how do we ensure that across the globe we have healthy people, healthy workforce and healthy businesses. Driving the best of products and services to ensure that we're improving the health of the world. So thrilled to be here and thank you all for joining me today as we talk about women and health equity. 00:02:47 To start us off, I want to talk about the moment that you all realize that there is a wide gap in women's care and that could be either personally and professionally. Nasim So, to kick us off all kind of share a story from my background. This really kind of hit me a number of years ago when I had the privilege of taking care of a 48-year-old woman with end-stage metastatic colon cancer during her final hospitalization. I learned during this hospitalization that leading up to her terminal diagnosis, for about a year, she had seen a number of providers with her symptoms. Initially started off with fatigue. She then had some abdominal pains, some nausea, and this was continually attributed to stress, irritable bowel syndrome. And during those 12 months, she was really never provided the appropriate diagnostic interventions, like a colonoscopy, until it was too late. I also learned during that time that she was a phenomenally dedicated teacher. She was a caring mother. She was a spouse, a child, a sister, an incredible friend to many. It was absolutely heartbreaking to see that her voice was not heard as she didn't receive standard of care that really could have been lifesaving. And I wish I could say that this was a rare case. But cases like this happen every single day in the U.S. and across the globe. 00:04:22 Christy, I'm wondering if you can share with us when this really became real for you. Christy Sure. A little bit different story for me, and mine's actually personal. So, when I was studying pre-med, I was an intercollegiate athlete in rowing with aspirations of competing at the national and elite level. And like so many female athletes' experience, I really got caught up in the cycle of being asked to lose a significant amount of weight by my coaches, because rowing, like other sports, has weight classifications. So over the course of a summer, I dutifully lost 35 pounds and returned back in the fall at under 130 pounds, which is a light weight. And in about three months I had a full osteoporotic hip fracture at the age of 20. And it was really a peak milestone for me. I was in my junior year. I was pre-med at the time. 00:05:22 I was never given, obviously, any guidance around the impact that that weight loss would have on my health, my endocrine system. And so that was really a milestone of it ended my rowing career, unfortunately. But it was really a driver for my career. I went on and got my Ph.D. in reproductive endocrinology and did a whole lot of research around the female-athlete triad since I was sort of the poster child for it at that time. 00:05:50 Nasim What a challenging personal experience to go through. Christy, thank you so much for sharing that, Sarah. 00:05:58 Sarah So I think, you know, as I went through my medical training, you kind of see things, you hear things, if things don't seem quite right a lot of times. I think where it really hit me is when I started having my own children. So, I have four kids, and my first, I was still doing surgery at the time. And when I think back to that time, there were so many assumptions made about what I, as a professional, might already know about women's health or might know about my own body, and that I didn't. And when I would ask caregivers, they would either be like, "Oh, well, you know, it's this or it's that." And I think that having come from the medical field and having a baseline of information already, I still didn't have the answers I needed. And I was relying on my grandma or my mother or my sister or friends to ask advice when I couldn't get what I needed out of the medical system. And as a medical professional, I needed information like, "Hey, if I'm going to go into a vascular procedure, do I need to wear lead?" 00:06:57 "Hey, is this chemical okay for me? What if I get exposed to that?" And yes, sometimes there was a paper that I could Google and sometimes I could ask my doctor, but sometimes there just wasn't. And there wasn't the right people for me to ask within the medical community or otherwise. So I can really see how people just struggle, because I had, theoretically, all the resources I could possibly want available to me, and I still couldn't get the answers that I wanted. 00:07:27 Nasim Thank you for sharing that, Sarah. It really brings out the part of the heart of the matter, which is even when you have resources and knowledge, it can be so incredibly challenging. And so many women across the globe don't have the resources and the knowledge. Esther? 00:07:46 Esther I'm just going to take us back to the early years of when you're probably a teenager and you had the reproductive health conversation. And I was in boarding school and we came back after having been given sanitary towels and shown tampons and everything else. And I think at that point the main focus was on the menstrual cycle and what's normal. But no one really talked about how bad it can be, I think for most. And so I think what became very clear is when girls, you know, because that's the stage when the menstrual cycle is being regular, more regular, and you started to see serious, serious problems. 00:08:33 You know, we had one girl who had to be taken by ambulance and started on a drip for menstrual pain, you know, and it's something that hadn't obviously seen before. And then as we got older, the conversations where I've had friends who've had a hysterectomy before 40 for benign conditions. And when you listen as a group, particularly around the problems that people face with the menstrual cycle, you realize that there's not a lot of treatment options. And this is after many years of many women coming in to the medical center and recognizing that 10, 15, 20 years down the line, we're still using hormonal treatments as the main treatment for most of the conditions. And I think when you listen to how, you know, it's impacting the mental health, you know, the life and social life and just their well-being, then you end up realizing that over time, more needs to be done with this. You know, because I think the medical community has somehow become just complacent because they have benign conditions and they can see that it's, you know, in terms of self-management or whatever it is that women do. 00:10:06 But I think thinking about now, especially as we are working women and, you know, how stress affects your system, it's something that I think and just thinking about needing more options. And like even getting down to understanding the basic understanding of why the disease happens, you know, some of those questions are still, you know, they're not there. So that's why. 00:10:35 Nasim Thank you for that, Esther. I think you highlight the challenges of managing something that is as basic as it gets and it's biologic, and how much work and understanding still needs to happen for some of the most basic and biologic processes in women. So I really appreciate you sharing that. 00:10:56 So, we know that a lot goes into these gaps of care from lack of understanding or honestly acknowledgment of biases in vulnerable populations to lack of medical and pharmaceutical research considering women's health, I think you all touched on different sides of this. So let's focus on representation of women and women of color in research. What has been done to address this gap in research and data? Esther, I'm going to ask you to kick us off. 00:11:30 Esther Yeah, and I was reading a bit around this and just throwing out some figures that, you know, women are representative of 22% of clinical trial research. And for women of color, it's been reported even as low as 2%. It makes you think about the information in terms of the clinical research, whether it's truly representative of the diversity of women, you know, across even the globe, if I want to say it that way. And we know that if there's such a low representation of the of women in clinical trials, it means that products are being approved without, you know, the representation of these women. And it means that the real-world evidence then becomes really important. Which is where I think if we are then using these products, we have to understand that the female body and the diversity of all of us in terms of the genetic background as well—and that diversity means that they might respond differently to the approved medicines—is also thinking about like how to recruit and making it a lot simpler for women in terms of understanding the products. 00:12:51 Because one of the biggest things would be how does this product affect my body? Most of the time people are concerned about fertility, you know, and a lot has been done over the years to try and just put women's minds at ease. But it is difficult. And this is where I find that the electronic health record and thinking about not just about that the information is within the record, but are you collecting information in the clinical care of women and representing it in that way and within if you're doing clinical observation studies, because if you've got a product and you're not, for example, collecting information on the impact on the menstrual cycle, but you're getting lots of reports from women saying they've had a few missed menstrual cycles and they don't understand why it could have been the product that they're taking. But if this information is not being captured, then it's not within the system, which means that you start you still can't glean the insights that you need from the electronic health care records. 00:14:03 So I feel that not only around and when you look at internationals looking at the numbers in terms of the proportion of women who are conducting clinical research as well, and that's quite low. So it can also then make you think about in the end, when are designing the clinical trials, is someone speaking up for the diversity of women to include them in the clinical trials or in the trial design? Because then you are collecting the information that will be useful as well for women when it comes to evaluating whether or not they should take a product or they should be recruited into a trial. 00:14:51 Nasim So there's a real multi multifaceted problem, right? It needs to really be tackled from multiple, multiple angles as you highlighted. So, Christy, Esther highlighted how low representation of women and minorities as has carried out in clinical research. What are we going to do to fix that? 00:15:11 Christy Oh, that's a big question, but I think, you know, we got to we got to start with working with what we have in the most effective way. And so, you know, from my angle of the world, I'm not a practicing clinician, but I've been engaged in clinical research my whole career. And coming from Cerner, we had this realization of, oh my gosh, we're literally sitting on 40 years of digitized health care data. How do we turn that as a giant lever to help address some of these broad stroke issues, like women and access to clinical research? And so in my world, one of the things that we did was create a partnership with health systems and an opportunity for them to share their data with other health systems so that we could create a searchable dataset, a real world data set that we could then work in partnership with health systems to bring clinical studies that address issues in women's health to the point of everyday health care, and use that data as the accelerant to get very prescriptive in finding women that are a match for the specific study criteria or enabling care teams to engage directly with their patient populations that may be a fit for a new, innovative trial in a rural community that would never have had that opportunity before. So right now we're sitting at this critical point in health care where we know we've got a whole bunch of data. 00:16:51 That's our quality problem. We've got more data than we know how to use. And to Esther's point, it's now making that data a lever we can pull to accelerate clinical research, to focus on the specialty groups where we've seen disparities in care given up until this point in time. 00:17:11 Nasim Agreed. Agreed. So, you know, we've talked a couple of times around the role of technology in helping address disparities. I want to focus in on the role of AI in health care delivery. What's the potential and what are the downsides? 00:17:30 Sarah So, you know, when we think about AI/ML it's been the buzzword for how many years now? And I think during COVID, everyone recognized that we have to do things differently now than we did in the past. And so everyone's heard about ChatGPT. It's been a huge buzz. Everyone wants to talk about AI/ML, but a lot of health care organizations, a lot of ministries of health, have been slow rolling in how they deal with AI/ML over the last couple of years. A lot of that has to do with trust and why would we be concerned about that for the same reasons that health care in general has had problems for decades and decades and decades. 00:18:04 So that means whether it's structured data coming from an electronic medical record, straight from a clinical trial database, wherever that data is coming from it, we have to make sure we're comparing apples to apples. And every single algorithm, every AI model that we build out, has to be trained. So, when we think about women's health and how we can improve women's health, ultimately, there's going to be models that are trained on data that doesn't include women. Well, how is that going to impact us? If you think about all the different ways we treat people today, whether it's in nephrology and kidney health and the way African-Americans have been treated in the past, in terms of those algorithms, whether it's X, Y or Z, we have so many clinical rules that we use today that have their own inherent biases based on medical data from the past. 00:18:54 So if we're going to build out new algorithms, we have to make sure that we're training it properly. So things to think about for people developing these algos is: who is your set of patients that you're going to bring into this model? Are women included? Are people of color included? What other kinds of people should be included in this algorithm's data set to make it a great model? When we think about women's health in general, using more automation, using more AI/ML, could it help women in their ability to get care for themselves? It absolutely could. When we think about the nursing shortages all over the world, when we think about how hard it is to make a doctor's appointment on a Monday, when you have a bunch of kids, when you have a job, when you think about how much time a provider is actually going to take with you … how can we automate things for the patient? 00:19:48 How can we automate things for the provider? How can we provide that small town doctor feeling in 15 minutes? How can we provide that care and engagement with less? Because right now I think what we're finding is that the system's stressed, all the people are stressed, the patients are stressed. Everyone needs a break and we can't do more with less. We're going to have to do things differently. 00:20:18 Christy I love that. I'm just going to jump in right now and do a high-five to you on that one, because I think, right, fundamentally—and, Nasim, you and I've talked about this before as well is—at the end of the day, we have to change our behavior around health and care, regardless of what side of it you're on, whether you're a provider of it or a receiver of it. And that behavior change is what's going to drive our ability to be able to actually leverage and receive the benefits of all the cool stuff, Sarah, you just talked about. But if we don't change the behavior around health care as the starting point, it doesn't matter what great tools we develop if people don't use them. And so in my world, you know, we're trying to engage critical-access hospitals who have never, ever participated in a clinical research study before. 00:21:14 And the first thought and the first line of defense is, "I don't know how to do that. We've never done that. No." And really, it's creating that opening of, "We're here to partner with you. We've got all of the tools and technology in place to enable you to do it." And at the end of the day, we want to make, just like you said, those 15 minutes with the community members that you serve more impactful and with the option to bring more innovative things to your community than ever before. And on the patient side, or being a community member, you know, I love all the powerful stories that I get to hear of people who are busy, women who are really busy, and now they look at participating in a clinical trial as even a control patient, as a way to give back, as a way to serve. And most of those stories end with an, "Oh my gosh, I thought I was a control patient, and I actually got diagnosed as a result of my participation in that study because I haven't done anything in my health care over the last three years with COVID" because of all the reasons we all just talked about. 00:22:22 Nasim I think you all highlighted how technology can really be used to facilitate receiving care, getting care, getting better care, facilitating your care at the time that we need. And there are barriers that we have to overcome. And I think that's kind of Christy, your point about that changing relationship. Esther, you were touching on this. I think those are the elements that we have that we have to work through as a society to be able to move things forward. 00:22:56 Well, thank you all for joining us for this thought-provoking conversation about women and health equity. I want to thank our panelists Christy Dueck, Sarah Matt and Esther Gathogo. Great conversation around the role of technology and how can we address some of these shortcomings and limitations that we have for women to receive better care. But lots of areas identified where we really need to work together in partnership to address this as we move forward. Looking forward to ongoing dialog around this, and more importantly, action around how we can impact better health for women across the globe. Thank you. Be sure to subscribe to Perspectives on Health and Tech podcast for more insights from industry experts, visit oracle.com/health or follow Oracle Health on social media.

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.

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.

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 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