Perspectives on Health and Tech

An interview with Romel Khalife, Country Manager – UAE and Kuwait, Oracle Health & Life Sciences, conducted by Peter Birch during WHX Dubai 2026, about the evolution and future of Electronic Health Records (EHRs). The podcast highlights how EHRs had transformed from being mere compliance tools into strategic assets for improving healthcare, enabling population health, and supporting research. Romel discussed the primary challenges in healthcare, such as clinician burnout and data silos, and outlined the necessary components for a modern EHR, including clean data, clinician-centric workflows, and interoperability. In addition, the conversation covered the critical role of a robust cloud infrastructure in enabling scalable and native AI solutions, the importance of governance in deploying new technologies, and the need for collaboration within the healthcare ecosystem. Romel concluded by advising healthcare leaders to adopt an agile, user-centric, and iterative approach to innovation.

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Episode transcript:

Peter Birch (00:07):

Welcome to WHX Insights. My name is Peter Birch. Today, I'm joined by Romel Khalife, country manager for UAE in Kuwait. Romel, so great to have you here on the show today.

Romel Khalife (00:17):

Good afternoon, Pete. The pleasure is mine. Thank you for hosting me.

Peter Birch (00:21):

It's great to have you here and talk about electronic health records, EHRs. It's a well-known tool, an acronym within healthcare. But over the years, I think there's been a fair bit of evolution and the landscape has changed. Perhaps you could set the scene for us. Tell us a bit about EHRs, what they are maybe, but where they've come from and where we are today.

Romel Khalife (00:42):

Yeah, thank you. Thank you. So over the past five to 10 years, there have been really that significant shift in the EHR market. EHR was often seeing more of a compliance tool or maybe a checkbox for digitalization. But nowadays, especially healthcare leaders in the Middle East, they really see that as a strategic asset. Strategic asset for what? For mainly transforming the healthcare landscape, also enabling population health, assisting in research, and mainly alignment with government initiatives when it comes to digital transformation and public health. So that shift today really happened from not anymore how to implement EHR, but really how to extract real and positive outcomes out of it.

Peter Birch (01:29):

Yeah. It's interesting, isn't it? I guess back in the day, one might see an EHR as this is where we put the information, where it's a repository of data and that's just good for record keeping. But what needs to happen? What does it need to do exactly in order for it to achieve those outcomes that you just outlined?

Romel Khalife (01:54):

Yeah. So allow me to cover here some of the healthcare challenges today. So 65% of clinician in the US, they feel burnout. If we talk about actionable data, 70% of that, it's due to not actionable data and not fully integrated. And if I would say the time that physicians spend at EHR, it's about 52%, which is really considerable. So back to your question, Pete, when it comes to evolving from a passive record, from a passive system of record to more a proactive decision support engine, three things need to be there. First of all, data. Data should be clean and standardized with a high quality for the system to trust it and to analyze it. The second one is really about workflows. Workflows need to be designed around clinicians, and that's essential for having the right decision at the right time at the point of care.

(03:04):

And finally, we talk about interoperable data. If you've seen previous discussion, they were mainly about data and big data. Now that shifted into more of how can I get the full picture, more interpretable data within my organization when it comes to healthcare, but also the surrounding data from the ecosystem where it comes to the back office and outside of that organization. And this is very essential to aggregate those data to complete the picture for clinicians and patients.

Peter Birch (03:38):

That last one, the interoperability, such an important point. We talk about it a lot, but I feel like interoperability is sometimes almost like renovating your house. It's almost like it's not like an end state. There's always something to do. And then it's a weird analogy, but I'm going to run with it because I think many health systems might struggle a little bit with being interoperable. How do you think about what, I guess, needs to happen or what interoperability when it's done looks like and what it might enable to really break down some of those data silos?

Romel Khalife (04:18):

Yeah. If you talk about interoperability, you talk about semantic interoperability. So that's structuring and mapping data consistently across systems. So this includes shared data platform and using open standards and putting incentives in place for those to enable those data and have it interoperable. So here you come the question about the AI data platform or the Oracle AIDP. It play a critical role where it connects, for example, generative AI model with data, workflow, and applications. And all of this in one single purpose, which is enabling more informed, timely patient care. So when you have such unified data foundation with that foundation basis, it supports the long-term patient population health outcome.

Peter Birch (05:20):

Yeah. It's like getting the plumbing right, ensuring that the data can move seamlessly in order for you to achieve something. The interoperability isn't the end state. It's kind of like it enables you to do something. And I feel like the something is, these days, we talk a lot about artificial intelligence, and you touched on that, the enabling the data in order to do, say, generative AI. How do you ... But like any innovation in healthcare, it can't just be a single solution. It's got to be scalable, it's got to be reliable and all of these things. What needs to be true? Or how do you enable, say, an AI solution in healthcare, but the one that is truly scalable and meets the clinician needs and workflows and things like that?

Romel Khalife (06:06):

Yeah. Great question, Pete. So before talking about scalability of the aisle, we need to speak about the underlying infrastructure that is really essential in this. So I think no one can deny today the power and the security and the performance that the Oracle Cloud Infrastructure bring into the picture, and that's essential today. So it really harness that power of innovation and artificial intelligence. So this is essential. It comply with local data regulations and also allow all of the healthcare providers today to be scalable. We know we live in a very agile environment where expansions are within the region, outside of the region, and this Oracle infrastructure bring this to the picture. So I spoke about the AI data platform. I spoke about the underlying technology with the Oracle Cloud Infrastructure. So both together in conjunction, they really break down those silos and build rich longevity patient record.

(07:06):

We speak here and the leaders in the UAE speak about longevity, how to live longer but healthier. And this is all what's about the quality of life and not just treating symptoms as they arise. Now to answer your question, how we can scale this up, we really need to work from day one with the clinician and the operational leader, defining what's really my problem today. What's the problem I'm trying to solve? And is it like reducing documentation time? So all of this need to come with a context of a workflow. It need to come with delivering insights within the context. So this is key for those AI solution. They should not be as bolt-on. We see a lot today in the market, bolt-on solutions on top of EHRs, on top of ... They should be native so they can bring that value in a context of a patient and they can be deployed at scale once they are successful as a tested and validated real outcome.

Peter Birch (08:10):

Yeah. Yeah, that makes sense. Hey, earlier you rightfully pointed out this issue of clinician burnout in the US and across the world. And I feel like the modern EHR has a role to play to reduce that clinician burnout in order for it to be successful. We're continually needing to do more with less, but at higher quality. Sometimes a technology tool could be implemented and it may alleviate a particular stress or concern or a need in one part of the value chain, but it kind of just pushes the problem further down the road. How do you think about the role of the modern EHR in truly addressing some of those issues that create the clinician burnout and what needs to happen in order to enable that?

Romel Khalife (09:03):

Yeah, you said it right here. So basically we were solving a problem, but we were pushing that problem somewhere else. And now really with that next generation EHR, it's all about easiness of use, spending more time with the patient and removing that burden from those clinicians that they need to do what they do best, which is three things. So the next generation EHR has this AI-powered voice recognition, really. And this is what automate documentation. It has a much easier EHR and fully redesigned in a context of much efficient and more time saving with the patient. So if you take, for example, a clinical AI agent that usually this technology is embedded within the next generation HR, it saved tremendous time when it comes to the documentation..

(10:19):

. So I'll give some great examples about the next generation EHR that are really today roll out in the US. I would ask my EHR, "Can you pull me my appointments for the day? Can you, for example, get me what's the urgent item that need my attention now?" Sweet.

(10:55):

I can engage the assistant at any time to get informed data and search for that information. I can engage that assistant too, to get information for within the EHR when it comes to my visit or when it comes to my diagnosis where I want to see the full picture, a summarized picture. So there is a lot. I will not cover all of the functionalities. There is a lot to do, but all of this is very promising. It's in line with the challenges I highlighted at the beginning for our conversation, and it's all about how we can make it easier, smarter, and improve the healthcare of the population. Yeah.

Peter Birch (11:40):

And thinking about those, I guess, innovative tools or new ways to do things, those sound really promising, but we're in healthcare where any new emerging innovation quickly brings with it risk and compliance and governance and things that almost in the innovation world feel like it's trying to hold the innovation back. Where do you see the role of these important elements of governance and risk and compliance and the role they play? Because sometimes I feel like there's been innovators or clinicians or healthcare players that almost see those elements as impeding innovation or stopping the innovation, but how do we lean into some of those to ensure that those important elements don't slow down the innovation?

Romel Khalife (12:37):

Yeah. If I may think about it, we are always in that rush to deploy new tools, and we really need to establish that clear data stewardship, access control, and auditability. So this is why it's very important, and that's especially to have that governance framework to assess the security and the privacy obligation for all of those emerging AI technologies that's coming into the picture.

Peter Birch (13:08):

I think about Oracle Health, and Oracle Health is pretty big. So one might think you've got the capability to do a lot of things in healthcare, and I know that EHR is a critical component of that, but there's a lot of different facets of healthcare. And I think it's pretty clear that there's no one particular provider that's going to have all the different solutions that every clinical modality is going to need. How do you think about this need for collaboration and partnership and integration that I feel like is a necessity in this world of healthcare, while at the same time enabling that true seamless interoperability, seamless care. So from a patient's point of view, it doesn't matter who the provider of technology is. In the end, the care is delivered effectively.

Romel Khalife (13:57):

Yeah. So that successful collaboration, it really depend on that transparency, shared goal, and clear roles. So we see the best result when there's really that early alignment across stakeholders and standards and data governance and when regulators act as enablers. So joint innovation program, I think we spoke about interoperability and open APIs and public-private partnership that focus on real clinical problem have especially been effective in that area.

Peter Birch (14:27):

Yeah. Love that. Hey, lastly, Romel, you're speaking to a lot of healthcare leaders and decision makers, particularly in the UAE and across the region. What are the critical challenges they're trying to solve, or the types of conversations that you are having, and what would you hope that in their strategic forward-facing decisions, they're factoring in this ever evolving landscape of healthcare?

Romel Khalife (14:55):

Yeah, it's a key mindset change. Indeed. So if you think about it, they need to prioritize today agility and user centricity rather than aiming for one massive and flawless deployment where like we used to. So leaders, really they should in iterative and user-driven innovation, constantly engage clinician and patients, they need to ensure that transformation truly deliver on its promises to improve health outers. I feel we discuss about we have a problem to solve, and this is where it should be focused in an iterative way, we try it, we make it work, and then we scale it up. Thank you, Pete.

Peter Birch (15:41):

Oh, look, I really appreciate you making the time, Ramel. It's great to be able to hone in on, like you say, those problems to solve and how to effectively do innovation and hear about what that modern electronic health record looks like. So I really appreciate you making the time today.

Romel Khalife (15:56):

Yeah, I really appreciate too. I mean, this is a topic that is re-imagining healthcare is keen to our hearts, so it was a pleasure discussion. Thank you, Pete.

Peter Birch (16:05):

And thank you for joining us on WHX Insights. Make sure you subscribe on Apple Podcasts, Spotify, or YouTube, so you can catch all the discussions here on the show. My name is Peter Birch. Thanks so much for joining.

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.

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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.

In this episode of Perspectives on Health and Tech, Oracle Health sits down with Dr. Petal S. Abdool, Geriatric Psychiatrist and Medical Director of the Centre for Addiction and Mental Health (CAMH) Simulation Centre, to explore how virtual reality is transforming the way clinicians are trained to assess suicide risk and respond to opioid-related emergencies. Together, we discuss why immersive simulation is emerging as a powerful tool in mental health education, how VR creates a safe space for clinicians to practice complex and emotionally charged conversations, and what early insights reveal about its impact on learner confidence and preparedness. The conversation also looks ahead to how technologies like VR, AI, and connected clinical systems may shape the future of training the next generation of mental health professionals. ------------------------------------------------------------- Episode Transcript: 00;00;13;09 - 00;00;30;03 Intro 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. 00;00;30;06 - 00;01;00;16 Steve Herron Hello everyone. I'm Steve Herron and I lead the continuum product group at Oracle Health. That includes behavioral and mental health rehabilitation, post-acute care, and social determinants of health. And today, I'm especially excited to talk about innovation at the intersection of mental health education, clinical readiness, and emerging technology. Suicide risk assessment is one of the most critical and most difficult skills clinicians must develop. 00;01;00;19 - 00;01;30;05 Steve Herron These are high stakes conversations that demand empathy, clinical judgment, and confidence, often formed under intense pressure. Yet historically, clinicians have had limited opportunities to practice these skills in a realistic but safe environment. That's where innovation becomes essential. At Oracle Health, we're fortunate to work with organizations that don't just adopt technology, but thoughtfully reimagine how it can support clinicians and patients. 00;01;30;08 - 00;02;00;13 Steve Herron One of those organizations is the center for Addiction and Mental Health, or CAMH in Toronto, Ontario, Canada. During a recent visit, CAMH. I had the opportunity to tour their campus and spend time in their Virtual Reality Learning center. What stood out immediately was how VR is being used not as a novelty, but as a rigorous, evidence-based training tool to prepare clinicians for some of the most complex moments in mental health care. 00;02;00;15 - 00;02;29;19 Steve Herron So today, we'll explore how CAMH is using virtual reality to train clinicians in suicide risk assessment and opioid overdose recognition. What they've learned so far, and what this means for the future of clinical education. I'm delighted to be joined by today's guest, Doctor Petal Abdool geriatric psychiatrist, educator, faculty member at the University of Toronto and medical director of the CAMH Simulation Center. 00;02;29;22 - 00;02;33;18 Steve Herron Doctor Abdool, thank you so much for joining me. 00;02;33;20 - 00;02;44;21 Dr. Petal Abdool Thank you so much, Steve, for this wonderful invitation. It's a true pleasure to be here and to have the chance to highlight this important work. 00;02;44;23 - 00;02;59;24 Steve Herron To start us off. For listeners who may not be familiar with CAMH or your role there, could you share a little bit about a CAMH's mission and your work at the simulation center? Particularly as it relates to education and training in mental health? 00;02;59;26 - 00;03;45;01 Dr. Petal Abdool Absolutely. As you said, CAMH, which is Canada's largest mental health teaching hospital, fully affiliated with the University of Toronto. And our mission is to transform the way we understand and treat mental illness to care; excellent care, research, education, and system advocacy. Our strategic mission is to get upstream advance care and to lift societal health. And at the simulation center, we see our role is to turn that mission into a concrete learning experience that can prepare clinicians for the realities of mental health and addiction care not just for today, but for tomorrow. 00;03;45;03 - 00;04;10;21 Dr. Petal Abdool In my role as a geriatric psychiatrist, an educator, and the inaugural medical director of the CAMH Simulation Center, I should also add that I'm the faculty lead for simulation at the University of Toronto. So, this gives me a wonderful position to oversee programs that use these modalities. And in the past, we've worked with standardized patients, team-based simulations. 00;04;10;23 - 00;04;40;11 Dr. Petal Abdool And now we've opened the door to technology enabled simulation like virtual reality. And this is in order to help our learners to practice high stakes communication, clinical reasoning and to afford collaborative care. A key focus that we have is to give our clinicians a safe space to rehearse difficult conversations, like the ones you mentioned around suicidal ideation, substance use, trauma, stigma. 00;04;40;13 - 00;05;03;24 Dr. Petal Abdool And we want to do this a bit before and alongside real clinical encounters with patients and families in terms of the gaps, we see a disconnect between what clinicians know on paper and how confident they feel when they're in the room with patients, and especially as it pertains to mental health and addictions. With the advent of the pandemic. 00;05;03;29 - 00;05;27;06 Dr. Petal Abdool There were there was a decrease in the number of clinical encounters that many of our trainees had. And that was a gap that allowed us, to acquire funding to build a virtual reality suicide risk assessment training that you were referring to, as well as an opioid overdose management training. So, here we see the opportunity that afforded us. 00;05;27;09 - 00;05;57;10 Dr. Petal Abdool Learners are able to address that worry they have about seeing the wrong thing, or missing subtle cues or escalating distress in the patient. And because of the pandemic, back then, they only had a handful of supervised opportunities to manage these situations in their training. And so simulation actually became so crucial and powerful back then. It allowed us to design these opportunities for repeated structured practice that allowed for what we call mastery learning. 00;05;57;12 - 00;06;12;09 Dr. Petal Abdool And they get the feedback so that by the time they get to the bedside, they're not having their very first high stakes conversation in a real with a real person in crisis. 00;06;12;11 - 00;06;38;05 Steve Herron Thank you. You know, one of the most compelling things that I saw during my visit was the intentional choice to use virtual reality. Not just simulation. More broadly, but immersive VR specifically. What led CAMH to explore VA VR as a training modality and what challenges or limitations in traditional training were you hoping it could help address, especially when it comes to suicide risk assessment? 00;06;38;07 - 00;07;03;01 Dr. Petal Abdool So the move to virtual reality really grew out of two observations. I mentioned that the pandemic had limited the ability for trainees to be in the clinical setting. Many of them had had to pivot to a virtual, platform in order to learn. And so that really allowed us to think, hey, how can we innovate here? How can we increase the authenticity of the virtual platform? 00;07;03;04 - 00;07;30;00 Dr. Petal Abdool And then the other thing is that suicide risk assessment is such a core competency for many clinicians. Yet the opportunities to practice are limited and variable and dependent on, you know, chance to a great extent. We see that the traditional methods that we're using, like lectures, checklists, even roll, please don't always capture that emotional weight and that complexity that you get when you have a real conversation. 00;07;30;03 - 00;07;45;12 Dr. Petal Abdool And so that's where we felt that the opportunity to explore and study the effectiveness of virtual reality with something, CAMH as a leading institution in mental health needed to embrace and explore. 00;07;45;15 - 00;08;07;27 Steve Herron That's exciting. And I'll tell you that being there and experiencing it firsthand, it actually did. You know, I was surprised at how much it impacted me emotionally, being in that virtual reality. And even though I was an observer in the room, I wasn't actually the one with the goggles on. But it still made my heart rate come up. 00;08;07;29 - 00;08;27;07 Steve Herron You know, as I observed what was happening in the room and the the situation as it was occurring. I am curious what other happens with other clinicians. So for clinicians who may feel skeptical about VR going into it, what tends to change once they experience that kind of immersive learning firsthand? 00;08;27;09 - 00;08;45;10 Dr. Petal Abdool Well, I'm really I'm happy to hear how moved you were by the experience. I will say that, we always do a brief with our learners, and we say, if you want to get the most out of this experience, you've got to suspend your disbelief and allow yourself to become immersed. And that's where the true learning can happen. 00;08;45;12 - 00;09;07;03 Dr. Petal Abdool I have some funny stories where we we had trainees in and we built two experiences, two avatars, and you had to interview the avatars. And of course, as someone who is in the user testing phase of that virtual reality, my goal was to try to break it. So I'm in there doing all the wrong things to see how it would evolve. 00;09;07;05 - 00;09;30;25 Dr. Petal Abdool And I jumped in and I didn't try to build rapport with the avatar, with the patient. And I just asked, you know, questions. And he moved his body in a very irritated manner. And I jumped because even though it was an avatar, like you said, it does still trigger that emotional response. And on one occasion we were training some pharmacy students and the time was up. 00;09;30;25 - 00;09;54;13 Dr. Petal Abdool We gave them a set amount of time to experiment and to play, and one of the students came up to me and she said, is she going to be okay in there? And I said, yeah, don't worry about it. We've got it. We've got it under control. And so for me, it was so gratifying to have that question asked because I realized that she had truly invested and engaged with the with the experience. 00;09;54;13 - 00;10;03;26 Dr. Petal Abdool And so I do believe that is laying the groundwork for a really authentic and, evolutionary experience. 00;10;03;28 - 00;10;28;22 Steve Herron Yeah, I know it definitely had that impact on me. Question for you, two of the programs that really stood out to me, were the ones that focused on suicide risk assessment, and then opioid overdose recognition. Both are very emotionally complex, time sensitive situations. Can you walk us through what the VR experience actually looks like for a learner? 00;10;28;24 - 00;10;38;18 Steve Herron And how do avatar based patient interactions, guided feedback, and decision making moments come together to build a clinical skill? 00;10;38;20 - 00;11;02;26 Dr. Petal Abdool That's a great question. So we built two different trainings. One is a suicide risk assessment that it was geared towards clinicians. So frontline clinicians who want to acquire that comfort and expertise with asking difficult and sensitive questions. And so the two training scenarios that we built were two very different patients. One was a male, one was a female. 00;11;02;28 - 00;11;27;03 Dr. Petal Abdool They had different levels of risk, and one had, a comorbid substance use. And what we wanted to do was try to mirror the complexity of our everyday interactions with patients and sort of that holistic approach to asking not just about what their thoughts were like, but about their lifestyle, their stressors, and their supports in the community. 00;11;27;05 - 00;11;52;05 Dr. Petal Abdool So in the training, it's a typical the learner enters a virtual clinical space and they interact with a preceptor, a nurse educator who introduces herself and explains that she was running a group and she was worried about one of the patients. And then she gives them a clipboard with, you know, demographic information and then invites the learner to go in and have a conversation with the avatar, with the patient. 00;11;52;08 - 00;12;22;22 Dr. Petal Abdool And then, once they've explored the learner is guided throughout the experience by selecting drop down a questions from a drop down box. And these these questions and the responses that they receive are aligned with evidence based assessment domains. Things like exploring suicidal thoughts, intention plan, access to means, past history, whether there's substance use, what are the protective factors that that patient may have, might have. 00;12;22;24 - 00;12;46;27 Dr. Petal Abdool And another objective of the training is to help the learner learn to convey empathy and validation and to build rapport, which is so crucial for people to open up and reveal their innermost thoughts. So, the patient will respond not just with words, but in terms of their tone, their body language, and the emotional cues change depending on how the learner engages with them. 00;12;47;00 - 00;13;10;14 Dr. Petal Abdool Once they're done that training, they come back out. They meet with the preceptor avatar, who then acts as though they're a virtual supervisor, prompting the learner to make sure they didn't miss any key risks or domains, and then gently challenging them to move on. And so that's really, a beautiful opportunity for the learner to pause, reflect, and then continue. 00;13;10;17 - 00;13;37;23 Dr. Petal Abdool And at the end they get a summary with regard to the risk of the patient. The other thing is that we built the virtual reality with the understanding that maybe not every learner wants to put on a headset and engage in such an immersive environment. And so we also have a complimentary desktop training that anyone can access and go through the same content, and hopefully get the same learning experience. 00;13;37;26 - 00;13;54;11 Steve Herron Can you talk about that a little bit? How does the VR headset based simulation compare with those other, asynchronous or more flexible delivery models in terms of, you know, access to it, but also then learning impact? 00;13;54;14 - 00;14;22;03 Dr. Petal Abdool So we did study, the virtual reality experience, and compared it to just the desktop experience. What we found were, you know, pretty interesting in that the learning outcomes were very comparable between both trainings. But learners found the VR to be more engaging, more immersive, more appealing, especially for the younger folks who grew up, you know, in that, digital world. 00;14;22;06 - 00;14;50;12 Dr. Petal Abdool However, there were also and this aligns with the what we see in the published literature, there were about 10 to 30% of participants who might have had mild to moderate what we call cyber sickness symptoms, you know, feeling a little bit nauseous or just not wanting to be in that environment. And so that's why we were very grateful that we had the opportunity to offer people, the option to not don the headset and to to sit with a desktop instead. 00;14;50;14 - 00;15;19;15 Dr. Petal Abdool I would say the learning outcomes were comparable in terms of confidence, and the learning objectives that we, we designed the training to achieve were completed equally effectively in both. I think the advantage of the virtual we out of the desktop is that we can disseminated more widely right here in Canada, we have a lot of different people in the North who may not have access to conferences or training opportunities. 00;15;19;19 - 00;15;39;00 Dr. Petal Abdool So we can share links to the desktop, and they can do this training. The virtual reality you would have to order headset we'd have to share that content with you, or you'd need to come to the sim center physically to engage with it. And so I think that, there are advantages and disadvantages to both. 00;15;39;02 - 00;16;07;09 Steve Herron Yeah, that's amazing that it's got that ability to be able to be pushed out to literally anybody who's got access to a desktop, to be able to receive the same training. So that's great. As demand for mental health services grows. Access to high quality training becomes just as important as the access to care. What lessons has CAMH learned about scaling simulation based education? 00;16;07;12 - 00;16;16;20 Steve Herron And how do you see technologies like VR and potentially AI and connected clinical systems shaping the future of clinician training? 00;16;16;22 - 00;16;49;24 Dr. Petal Abdool Well, you're absolutely right that access to training is a critical equity issue, especially as it pertains to mental health care. At camp, one of our priorities has really been to design simulation programs that can reach learners beyond our own walls. We've recently launched what we call the CAMH Global Learning Academy, which means that we've created a learning platform system that can allow us to really, offer programing and training across not just Ontario, across disciplines and across other stages of training. 00;16;50;01 - 00;17;32;07 Dr. Petal Abdool And hopefully that that could mean that we would have a global impact and global reach. Some of the key lessons I think that we learned is that a technology has to follow pedagogy. Like we want to start with clear competencies. We want to make sure that, what we actually want clinicians to do in practice, translates to what we are using the virtual reality or the technology enabled simulation for meaning it's not just a desire to be cool or innovative, but it's also to fill a gap and to do so in a way that, supersedes or equates to what we were doing before. 00;17;32;09 - 00;18;01;28 Dr. Petal Abdool Secondly, I think usability matters enormously. If if hardware is hard to access, or if the support is limited, even the best design simulation will just sit on the shelf. I think we had to think carefully about, workflow, onboarding, making sure we had the technical support, especially for busy clinicians, to make sure that anything that we designed and developed would actually become useful and sustainable. 00;18;02;00 - 00;18;29;02 Dr. Petal Abdool I think the other lessons that we learned is that collaborating is essential. We collaborated with other academic institutions, health systems. We had a huge team of content experts, lived experience advisers, and that allowed us to really build something that could be scaled and that could be applicable across many domains. And it also opened us up to opportunity to study the impact and to continuously improve it. 00;18;29;04 - 00;18;49;19 Steve Herron That's great. In summary here, before we wrap up, I do want to ask you for two quick takeaways. One insight you'd want clinicians to remember about suicide risk assessment training. And also one takeaway for healthcare leaders that are thinking about innovation in education. 00;18;49;21 - 00;19;16;23 Dr. Petal Abdool The one insight that relates to suicide risk assessment training is, I think that a skillful suicide risk assessment is not just a checklist, it's a conversation, one that creates a sense of safety validation and a pathway to support. And the more that we allow our clinicians to practice these conversations in a safe environment, the more present and effective we can be, especially when we are with someone who is struggling. 00;19;16;26 - 00;19;46;04 Dr. Petal Abdool I think that with regard to your second question, I think innovation and education isn't optional. I think technology enabled simulation, is key. If we want to prepare our workforce for the complexity of mental health and for the future ahead of us. I think that things like VR, artificial intelligence, chat bots, all these things that are on the horizon and that are getting better and better with each passing month. 00;19;46;07 - 00;20;01;15 Dr. Petal Abdool I think these are powerful enablers of more equitable, scalable and high quality training, especially when it comes to high stakes things like suicide, risk assessment and opioid overdose management. 00;20;01;17 - 00;20;13;03 Steve Herron Perfect. Assuming someone wants to learn more about this, Doctor Abdool, where can listeners go to learn more about CAMH's virtual reality training programs? 00;20;13;05 - 00;20;34;22 Dr. Petal Abdool So I'm happy to say that you can just go online and Google camh.ca. You can access our Global Learning Academy if you want to try out any of our trainings. And our opioid overdose. I didn't speak about it too much, but it's not just designed for clinicians. We also have a training for patients, families and caregivers. 00;20;35;00 - 00;20;44;17 Dr. Petal Abdool So there is opportunity to upskill yourself. If you think this is an important, area for you to learn about. 00;20;44;19 - 00;21;21;02 Steve Herron Well, Doctor Abdool, thank you again for sharing your insights and for the important work you and your colleagues are doing at CAMH. Seeing this program in action reinforced for me how powerful technology can be when it's grounded in clinical excellence, evidence and compassion at Oracle Health. Our role is to support organizations like CAMH with modern, connected digital systems that enable high quality mental health care, education and research partnerships like this, where innovation extends beyond the EHR and into how clinicians are trained, are what truly move the field forward. 00;21;21;05 - 00;21;47;12 Steve Herron For our listeners who may want to learn more about CAMH makers virtual reality programs, including suicide risk assessment training. We encourage you to explore other resources at camh.ca. And as always, if you or someone you love is in a mental health crisis, the 988 Suicide and Crisis Lifeline is available 24 over seven in the U.S. and in Canada. 00;21;47;14 - 00;22;16;26 Outro 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/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.

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

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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.

In this episode of Perspectives on Health and Tech, Oracle Health welcomes Shelagh Maloney, CEO of Digital Health Canada, for a forward-looking conversation about how Canada can build a more connected, equitable, and digitally empowered healthcare system. From advancing interoperability and clinician mobility to exploring the role of artificial intelligence in care delivery, Shelagh shares insights from Digital Health Canada's AI in Action initiative — including the "winning conditions" needed to deploy AI responsibly and inclusively. Together, we explore how technology, policy, and collaboration can unite care across provinces, empower citizens with access to their data, and help clinicians deliver smarter, more human-centered care from coast to coast to coast. ------------------------------------------------- Episode Transcript:

00:00:00:00 - 00:00:44:03

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. Welcome to the Perspectives on Health and Tech Podcast, brought to you by Oracle Health. I'm Larry Sylvestre and today we're exploring one of the most defining challenges and opportunities in Canadian health care: interoperability.

00:00:44:04 - 00:01:13:04

From enabling clinicians to practice across provincial lines to giving Canadians direct access to their health records, interoperability is key to building a truly connected health system. Joining us today is Shelagh Maloney, the CEO of Digital Health Canada, an organization at the heart of advancing digital health, professional development, and policy collaboration across the country. Shelagh, thank you for being here.

00:01:13:05 - 00:01:38:05

Before we dive in, could you tell us a bit about your vision since taking on the CEO role earlier this year? Well thanks, Larry. First, let me start by saying how thrilled I am to be on your podcast. I'm looking forward to the conversation. And yes, I did join Digital Health Canada. It's been almost a year. I joined at the end of January 2025 and it's been a whirlwind.

00:01:38:05 - 00:02:04:08

And Digital Health Canada, like other, you know, national associations that we really want to provide value to our members. We have networking events and we have influence health policy. We look at advocating for the profession. And, you know, one of the things that I'm excited about is that we've just launched a strategic plan to 2030.

00:02:04:11 - 00:02:22:06

And so a big component of that is going out and asking our members what Digital Health Canada means to them and what they're looking for. We're doing some work in the governance space. I think education is trauma, endless possibilities now, and particularly as AI is getting so big. And I know we're going to talk about that later.

00:02:22:08 - 00:02:47:10

And of course, advocacy for both professionals and the profession at large. That's a perfect set up for our discussion, Shelagh. How can Canada move forward from our fragmented systems to a pan-Canadian model of care that's equitable, citizen centric, and digitally connected? One of the biggest conversations right now in health care is around nation building, breaking down barriers between provinces and territories.

00:02:47:12 - 00:03:14:01

What are you seeing from your standpoint at the leadership role at Digital Health Canada? You know, this is such a timely question and I'll tell you why. Yesterday we had a conversation with, Doctor Anderson Chuck, the CEO of CIHI and Doctor Fahad Razak, who is the among other things, does a role at Unity Health, in Toronto, but also is the Canada research chair and data informed health care improvement.

00:03:14:03 - 00:03:34:00

And it was really interesting. And one of the things we talked about was, and, you know, you and I know this, it's not a technology issue that we're dealing with in terms of interoperability and connected care, but it's a cultural issue. And it's really interesting that, that's a different sort of change in our thinking a little bit.

00:03:34:02 - 00:03:58:22

But certainly, one of the big challenges in a federated system, having a national perspective and doing things at that large national scale is more of a challenge than we would hope that it would be. Yeah. Certainly the landscape is full of different perspectives on how to proceed. And sometimes some of these conversations do get politicized.

00:03:59:00 - 00:04:27:16

But certainly it's great to see, I think some of the federal government perspectives and agencies coming together to try and be facilitators in this discussion. And I think, Canadians in general are ready for us to meet that challenge head on. So it's really inspiring to hear how we're aligning policy and technology and how those things could potentially unlock the possibilities for clinicians and ultimately, better continuity of care for patients.

00:04:27:18 - 00:04:51:01

Let's turn a little bit to the citizen side of the discussion. How does a citizen first approach align with work happening in Canada now? Well, you know, it's kind of interesting in like 2012. So a while ago and this was all the rage when, when patient engagement and patient partners were just sort of, I think coming into mainstream.

00:04:51:07 - 00:05:09:00

Some may argue they're not quite mainstream yet, but that was where the hype really started. And it was Leonard Kish who was an IT strategist in the US. And I remember and you might remember this, Larry, there was a famous quote that he said if patient engagement was a drug, it would be the blockbuster drug of the century.

00:05:09:02 - 00:05:43:05

And so that has been frequently, you know, bantered around. But the rest of the sentence that I really love is and it would be medical malpractice not to use it. And I know and you know, my former roles at Canada Health Info way and CIHI, we did a lot of research in this area. And we know that patients, when they are engaged, when they are part of their, has access to their health records and can see their information and know where they are in the queues, they are more informed about their health care, they are more confident in the care that they receive, and they have better relationships with their care

00:05:43:05 - 00:06:09:13

providers. And all those things together mean that their outcomes are better. So we know it is. There's evidence to demonstrate that engaging patients in the process and including them, as we're developing systems, etc., will make a difference to health care. Agreed. Certainly, when we look across the country and reflecting back on, you know, just the previous question to answer that we corresponded on.

00:06:09:15 - 00:06:32:04

As you look across every province and they have their own health legislation and different policies, procedures, approaches to health care delivery, etc. It really is a bit of a thicket and even the best facilitators in that have failed historically to move the needle and hopefully we're in a much better position now to understand what the challenge is, how we can move it forward.

00:06:32:05 - 00:06:54:23

What was fascinating to me is, as you and I were both at the Infoway Partnership Conference recently was a stakeholder from Portugal who was on stage talking about how they put the patient at the center of interoperability around consent and that they adjudicate which clinicians in the care team are going to have access to their records, and that they have the opportunity to even rescind that.

00:06:55:01 - 00:07:23:09

Do you see that having any potential in Canada? Maybe not in whole, but perhaps in part? My desired answer would be to say, absolutely yes. I think we are getting there, and I think we would love to have that. And I think, frankly, patients and their family, we're getting a little bit impatient, and asking the questions if they don't think that it's already there, it's like, what do you mean

00:07:23:09 - 00:07:55:15

my specialist and my GP are not exchanging information? What do you mean the emergency department and the clinic don't have the same information? And so, I think we're recognizing that we need to get there. And frankly, one of the things that we're seeing is patients increasingly are using ChatGPT and other models, and they're collecting their own information and creating their own health records, because nobody else is doing it and the system is failing them in that regard.

00:07:55:17 - 00:08:18:21

So, you know, if we don't do it for patients with patients, I'm afraid, and rightfully so, they'll find a web mechanism to do it on their own. And that, from a health system perspective, won't be helpful because, you know, the care providers, etc. may not have the information that they need to provide the best care that's available to a patient.

00:08:18:23 - 00:08:57:23

It's excellent point. And that draws me in to sort of another sort of another train of thought about the data is the data. And, you know, there are a lot of constituents across the care continuum who feel like they're living on little islands of data and perhaps not connected with others. And as we talk about building a pan-Canadian infrastructure to enable the mobilization of that data, you start to think about artificial intelligence in that conversation, not only for the sake of the institutions and clinicians who need to deliver care, but for the individuals themselves.

00:08:58:01 - 00:09:32:13

And that becomes particularly material in Canada, where we have one of the lowest population densities on the planet, and we have a very challenging time providing equitable care to this broad and diverse population and massive geography. And so moving the data to the clinicians becomes, you know, paramount to being able to deliver effective care and enabling the patient themselves to have access to their own data so they can leverage AI for their own purposes, might also be a complementary sort of perspective around the movement of data.

00:09:32:15 - 00:09:54:01

Do you have any thoughts on that and how we're progressing as a country relative to those points? Really, we're in such interesting times, aren't we, with the AI? And one of the things that is challenging is the pace of change. And we hardly see that in healthcare. But the pace of change, we're accelerating on a timescale of not years but months.

00:09:54:03 - 00:10:16:13

And so we just have such a tremendous opportunity. And, you know, you make the case like Canada has one of the most diverse populations in the world. And when you think about AI, it runs on data. And so having a diverse population where you can scale and implement things in one region to another, you know, with some differences.

00:10:16:13 - 00:10:39:19

But that's a tremendous opportunity for us. And we've got, you know, a large country, 45 million. It's not huge. And then the data that we do have, it's a diverse data set. It's not just insured or uninsured. We don't separate data that way. And so there's so much opportunity in Canada. And, you know, the other thing that we have is, scientific talent here.

00:10:39:19 - 00:11:00:12

You know, we have a Turing Prize, a Nobel Prize winning for AI. They are Canadians. And so we've got so much potential in Canada. But one of the things that, you know, one of the big five consulting firms did a study a few years ago, and they looked at about 47 countries, and they looked at AI literacy and training for their populations.

00:11:00:17 - 00:11:26:00

And they looked at trust in AI. And Canada scored, you know, 42, 43 out of 47. So we're way down at the bottom. So I think that's what, you know, trust comes up in these conversations all the time and culture comes up. So we need, I think, as a nation to really empower everybody and build trust in AI and use it effectively.

00:11:26:06 - 00:11:51:14

And so, you know, we just the federal government has introduced the minister of Artificial intelligence. That's a really significant move. Let's see what happens with that. So I think there's tremendous opportunity in Canada. But there are other countries who are leapfrogging above us. And we need to really think strategically, about how we do this. And I think that collaboration and partnerships and a singular focus is going to help us and get there.

00:11:51:16 - 00:12:15:23

It will help significantly. Absolutely agreed. And well said, Shelagh. I've heard you mentioned in the past a winning conditions report for AI adoption. And I also know that Digital Health Canada has done an AI in action environmental scan. Can you talk to us a little bit about those two topics and how they relate to what we're conversing about today?

00:12:16:01 - 00:12:38:02

Yeah. Thanks, Larry, for giving me the opportunity to say that. So it was published in May of this year. We went out to about how eight leading health care organizations across Canada hospitals, health authorities, whole provinces. And these are the folks who are sort of a little at the leading edge in terms of using AI in in clinical settings and in health care.

00:12:38:04 - 00:12:56:22

And, and we interviewed them and sort of asked them not about what they're doing, but we asked them what were the winning conditions and what did you need to have in place. So we talked about things like risk management. We talked about governance. We talked about, you know, safety and security. And so there was a not everybody approached it the same way.

00:12:57:00 - 00:13:17:23

But a couple of key things came through. And, you know, the strategy was, you know, you have to address a real world problem. It has to be a big problem. Don't use AI for the sake of using AI. Use it to address something that you're significantly involved in. And then your risk management, your risk tolerance is different.

00:13:17:23 - 00:13:35:06

Some of the big, larger hospitals have more risk tolerance and have more, frankly, expertise in doing this. So it was it was really it's an interesting read. It's available on the Digital Health Canada website free of charge, maybe 12 pages. So it's a it's an easy read as well. So I'd really encourage listeners to take take a look at that document.

00:13:35:08 - 00:13:57:23

And then just in, gosh, just a few months ago, we released this AI Environmental scan. So we went across the country and asked people to and did an of review of, AI in clinical settings only. And what projects were there and that we were available and that we could see publicly. And there were about 152 projects.

00:13:57:23 - 00:14:14:15

And since then, I should say a number of people have seen this report and said, you know, I'll add this one at this one. So we're up to about 170 or so. So we did that across Canada AI in clinical settings. And it was really interesting that one of the sort of I won't bore you with all of the details.

00:14:14:15 - 00:14:44:05

And again, this information is available on the website. But one of the thing that was most interesting to me that, about 59 or 69% of the projects were in pilot state. And so that's, you know, and that's not going to surprise anybody in health care in Canada with our pilot ideas. But, you know, that's so is it a reflection of we're just beginning in this field or is a reflection of our failure potentially to, to scale as a nation?

00:14:44:07 - 00:15:05:23

Yeah, it's a conundrum, isn't it? It's, cautiously optimistic and slightly risk averse is kind of how I would measure the temperature of Canadians right now is with respect to AI. You hear about the incredible potential, but you also hear some of the scary stories that go along with it as well. But I think you use the word very astutely, and it's the word trust.

00:15:06:04 - 00:15:43:23

As we move forward, we all have to really think about how to garner trust and ensure that the systems that are, being advocated for, really deliver on that promise, because I has incredible potential to make health care more equitable and efficient and human centered. But realizing that potential will all come down and depend on collaboration to move the data, transparency about how the black boxes work and shared trust again, it's exciting to see how Digital Health Canada and partners across the ecosystem, including Oracle Health, are laying the groundwork for responsible, data driven innovation that benefits every Canadian.

00:15:44:01 - 00:16:06:17

Shelagh, thank you so much for sharing your valuable insights and for your leadership at Digital Health Canada. Absolutely delighted to be a participant of that organization for many years. And so, thankful that you were in a leadership position there after your many years of great service from across the health care system. Before we close, would you like to leave our listeners with one takeaway?

00:16:06:17 - 00:16:29:16

What should we, as an industry and as Canadians, focus on to make this vision of connected, equitable and AI enabled health care real? Well, so first of all, thank you, Larry, for inviting me to participate. And then I really enjoyed the conversation, and I really appreciate the leadership that Oracle is showing. Not only, you know, in putting this podcast forward, but really, in the industry.

00:16:29:16 - 00:16:54:13

And so certainly, a firm that we are very happy to have included in our membership at Digital Health Canada. And, you know, I think, it's organizations like Oracle and associations like Digital Health Canada, we have I think, a responsibility as leaders in this space to really promote that one Canada approach and really lead the way in changing.

00:16:54:18 - 00:17:24:14

I think it's a culture shift. You know, health can be an economic driver. And this is a data that we have was a real natural resource. And so changing the mindset, I think would be really important for us to do. And I maybe I'll leave that challenge with our listeners and of their. Yeah, absolutely. And I think the messaging out of our federal agencies aligns very much with what you had just stated.

00:17:24:16 - 00:17:53:15

But there's an opportunity for Canada. It's one that can be both enabling for all of our health care journeys and potentially one that can help us fuel innovation and, perhaps potentially even fuel some domestic agency and industry to go alongside it. So in closing, I just want to say that at Oracle Health, we believe interoperability isn't just about connecting systems, it's about connecting people, provinces, and possibilities.

00:17:53:17 - 00:18:22:03

As AI and digital innovation continue to reshape health care, collaboration across technology, policy, and care delivery will be key to ensuring every Canadian benefits from a connected, data driven, and equitable health system. Thank you again, Shelagh, for all of your contributions today and over the course of your fantastic career. That's all for this episode of Perspectives on Health and Tech Podcast.

00:18:22:05 - 00:18:52:03

Thank you for listening, and join us again for the next insightful episode of Perspectives on Health and Tech. 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.

00:18:52:05 - 00:19:04:00

Thank you for listening and join us again for the next insightful episode of Perspectives on Health and Tech.

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.

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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 this episode, we dive deep into the transformative journey of two beta customers who are among the first to experience the Oracle Health EHR system and Clinical AI Agent's in an ambulatory setting. They share their firsthand experiences while working with the design and testing of this cutting-edge technology. Joining the conversation is an Oracle Health clinical executive, Ashleigh George, who provides insights into the design, vision, and potential impact of this EHR solution on improving patient care. Together, they explore how this innovative system is reshaping the landscape of healthcare delivery and what it means for the future of ambulatory care.

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Episode Transcript:

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 health care. My name is Matt Patterson, your host and moderator for today's discussion. Today, we're thrilled to welcome three renowned experts who are pioneering change in the health care industry.

00;00;59;03 - 00;01;28;18

Unknown

Joining us today, we have Ashley George, a visionary in health care technology and leader with an Oracle health product development. Dr. Ryan McFarland, a family medicine physician based out of Hudson, Wisconsin. And Dr. Randy Thompson, an emergency physician by training who now serves as the chief health analytics officer at Billings Clinic. In today's episode, we're going to explore challenges facing health care systems and how groundbreaking innovation is paving the way for a brighter, healthier future.

00;01;28;20 - 00;01;48;22

Unknown

So grab a seat and prepare to be inspired as we embark on this insightful journey. First off, I'd like to allow the opportunity for each of you to introduce yourselves. We'll start with Ashley and then Dr. McFarland and Dr. Thompson. Ashley Yeah, Thanks, Matt. Well, I think you actually might have a new calling in as a podcast broadcaster.

00;01;48;23 - 00;02;24;09

Unknown

That was an impressive intro. You've got a radio voice almost, but that's great. Well, anyway, thanks to Matt for having me on today. I'm Ashley George. I'm a clinician, actually, by background started my career 25 years ago in a neuro ICU unit and from there have had the opportunity to work in health care I.T. for the last 20 years and have really been at the forefront of the changes that have occurred over the last several decades and and excited for the work that I hand at Oracle Health, where we're doing today within our products and serving our clinicians around the world.

00;02;24;12 - 00;02;48;16

Unknown

Thanks, Ashley. And Dr. McFarlane, why don't you tell us a little bit about your yourresponsibilities in the organization and patients that you serve? Yeah, my name's Ryan McFarland. I'm a family medicine physician in Hudson, Wisconsin, part of a large private practice group. We've got about 60 providers. I'm one of the owners in the practice on our medical board, kind of help direct our practice into the future.

00;02;48;16 - 00;03;14;05

Unknown

And one of the big parts of my job has been working with our I.T. tech and things like that. And that's how we got involved with Oracle and fortunate enough to help be in the early beta testing and help build these products and everything. Thanks. And Dr. Thompson? Yeah. Good morning. My name's Randy Thompson. I'm the chief health Analytics officer for Billings Clinic Emergency Physician by training but work full time.

00;03;14;05 - 00;03;46;09

Unknown

And it now in our system is the largest independent health care system in Montana, where those clinic at Logan Health merge in 2023, we have over 1200 providers representing 80 medical specialties. My job is to try to make their lives better. And I, I could say I'vebeen in health care for 41 years now and there has never been a more exciting time to be in health care in terms of the positive solutions coming to our providers and nurses.

00;03;46;11 - 00;04;11;16

Unknown

Wonderful. Yeah, Thanks, Dr. Thompson. And I think that's a good segway into to get right into the meat of the conversation here. So today's podcast is obviously really about exactly what you just mentioned. Randy, The opportunities that exist within health care really to raise the bar in the industry with some of the Gen AI technologies that we're entering intothis new era of beyond.

00;04;11;16 - 00;04;33;11

Unknown

So within the current landscape, I want a level set where we're at today. Ashley Can you tell us a little bit about the biggest challenges that health care systems are seeing today? Really, how is technology currently influencing health care delivery today? Yeah, I mean, I'll say as I think about this, my my response isn't just US based centric.

00;04;33;11 - 00;04;51;12

Unknown

It is also thinking about internationally as I meet with customers around the world. And hands down top of mind is how are we supporting our clinicians so that they can better take care of the patients? Right. And I think you could I could be as dramatic to say as like we're at a moment of reckoning in terms of people are tired, they're exhausted.

00;04;51;12 - 00;05;11;17

Unknown

We don't have enough clinicians around the world to serve, you know, the patients that we need to take care of. Everyone is on razor thin margins. They're trying to do more with less. And yet it doesn't stop the regulations that continue to come in. It doesn't stop almost theinability for clinicians to be able to access care appropriately.

00;05;11;17 - 00;05;43;01

Unknown

And I think that's where for us, it's not an option. We have to transform and rethink how we're delivering health care and how technology can play a pivotal role in that. It's not the only answer, but it is a big answer in terms of how we're going to approach this. And I think, you know, I feel that here at Oracle Health, we we feel that urgency is to be able to help our clinicians, like the ones that are joining today's podcast, like how can we do better for them so that they themselves can do better and help take care of their patients.

00;05;43;01 - 00;06;23;08

Unknown

And that's really what we wake up every single day, striving to deliver. Wonderful. And Dr. McFarland, Dr. Thompson, you're from your purview. Well, what trends are you seeing that that opens up opportunity to really reshape health care? You know, I think the biggest trends are, you know, trying to get more, I would say, you know, clinician and patient focused and centered resources and technology for the first time versus it's previously been just purely a data gathering billing tool that didn't serve anyone other than the insurers and certain researchers.

00;06;23;10 - 00;06;40;17

Unknown

So that's I think the biggest trend is that we're actually seeing patient forward and physician forward products for the first time, which is part of why I think it's so exciting to see what's coming. So that's what I think is really the trend that we're seeing. That'sgoing to be a huge impact to our careers and patient care.

00;06;40;20 - 00;07;22;08

Unknown

And I would just add to that, having the system work for the providers and the nurses and the schedulers and the reps cycle people rather than us working for that solution. And I'll just give an example with the new H.R., the system is working on behalf of the clinician and going out and searching the record, finding out relevant information, bringing that back, collating it and presenting it to the clinicians in a manner that makes sense to them so that so that they can make decisions and, you know, have a better chart and so now it's the opposite way.

00;07;22;09 - 00;07;42;21

Unknown

We have to go out and we have to find relevant notes and find relevant studies and try to tweak the details and gather those details so we can consider that what their interaction with the patient and then document that all in the chart afterwards. And it's just almost impossible to do with a clinicians busy schedule the amount of time that takes.

00;07;42;23 - 00;08;03;17

Unknown

So that's what I'm excited about. Yeah, I mean that's I mean, it's huge. I mean, that's what I spend the bulk of my time doing is before I see a patient. Even when I'm in with the patients, it's digging through this slog of just repetitive data, good data, bad data, what'srelevant, where is the relevant information? And it falls on me to just sift through this huge backlog of data.

00;08;03;19 - 00;08;32;03

Unknown

And this is the first time where it's being brought forward to us. It's going to help us make better decisions, not miss things. You know, just give an example. And, you know, I was looking at one patient's note and the summary, the problem based summary had gone out and looked at 11 different notes and brought that information forward and presented it in a really succinct manner that was understandable and complete.

00;08;32;06 - 00;09;00;17

Unknown

So that so that, you know, that was really actionable information that it would be almost impossible for a clinician to do in the limited amount of time they have to review the record and then bring that forward. So I mean, it's just really exciting. Well said. You know, Ashley and I were actually talking yesterday in preparation for this podcast about the acceptance that exists in the industry around training requirements when you go to a new EMR.

00;09;00;19 - 00;09;20;15

Unknown

And I think it's just exemplary of where the bar stands today and the opportunity to raise that bar that you don't require 15 hours of training to understand where you need to go to find what you need, because now the technology works on your behalf as opposed to you having to figure out the technology to find what you need to provide care.

00;09;20;15 - 00;09;44;22

Unknown

So very well said. And I think a good segue way again to the next piece that we're going to dig into a little bit more about the Oracle health. Are each of you are very involved in, you know, being an early adopter, a part of the overall design as we've been going through this journey of the future state of really what an Oracle health model can bring to the industry.

00;09;44;25 - 00;10;07;21

Unknown

So Ashley, you know, focusing a little bit on the Oracle health are in that broader context. We just spoke to. Can you just talk a little bit about the vision of the system that you've been designing over the recent years? Yeah, absolutely. So if we even kind of unpack like Oracle Health electronic health record, right, to us, the vision is it's not it's not a record anymore.

00;10;07;21 - 00;10;34;05

Unknown

I mean, certainly has to be a record things, but it's beyond a record. It's a system of intelligence. And how do we really think about it as a partner, as a care team member that's aiding our clinicians, the staff, whoever's interacting with that, to really automate, to anticipate, to connect care. And really, at the end of the day, how does that empower our clinicians and not weigh them down?

00;10;34;07 - 00;11;03;29

Unknown

You'll hear us often say, even not to be so cliche, but it's like, how do we bring the joy to when a clinician is interacting with the system and making this meaningful and an invaluable to to him or her and all the interactions? And so I think when it comes down to it is it is how are we pivoting from just being a system of record to truly a system of intelligence that is acting on behalf as a care team member with the with the entire group and the team.

00;11;04;01 - 00;11;51;12

Unknown

And thanks, Ashley and Dr. McFarland. Dr. Thompson, can you just speak a little bit about your experience thus far and the impact to your practice that you believe you'll see? Yeah, it's I mean, it's been pretty exciting. Seven were part of a beta testing for the last two years I think almost now between the the COAG, the, you know, the ambient listening and creating notes to building orders the new are, I mean even from where we're at now, we went from struggling to find scribes to help support our practices to now I have a smart agent that writes my notes, is proposing orders for me, allowing me to keep productivity volume going.

00;11;51;14 - 00;12;09;05

Unknown

And then when we have seen the the new and getting to beta test that it's been I mean, it's it's incredible. You know, I keep having this desire to well, I need to go find the notes. I need to go look and dig in and all sort of like, she's just telling me right here what what'sbeen done, what the history is.

00;12;09;05 - 00;12;32;27

Unknown

And it's it's a it's really kind of creating an entire different paradigm of how we're going to interact with the electronic health record. Like, like Ashley was saying, it's not going to be so much more of a record. I do truly think they're building a product that will be more of kind of like a part of the care team, something that the physician can utilize to care for a patient and a patient can even utilize to understand their care better.

00;12;33;03 - 00;13;06;22

Unknown

That's where I kind of see this. The impact that it making. And I would just add, so we became a beta test partner kind of for selfish reasons. And, you know, our providers like to offer their opinions on why that solution is so terrible, right? But they don't have the opportunity to really help craft that solution. And so for us, having our providers have the opportunity to really help in the development of a solution that really makes sense to them and meets their needs.

00;13;06;22 - 00;13;41;03

Unknown

And so that was why we really volunteered to be a beta test partner. And it's been extremely rewarding both to the providers who, you know, previously would not participate in these test validations because they would do something, they'd read their feedback and nothing would happen, and so they would lose interest pretty quickly. But really exciting that when they rolled out like CAA, the the initial product was pretty basic, but it quickly improved based on the early and often feedback sessions that were scheduled.

00;13;41;05 - 00;14;04;13

Unknown

And the first time they saw their suggestion incorporated into the product. I mean, that was really exciting. And so we had like zero problem recruiting volunteers for this. So so that was really exciting. And, you know, Oracle I think is on the right track in terms of theyhave a vision for a solution like caa or the new h.r.

00;14;04;15 - 00;14;29;27

Unknown

And then they build something and then bring in clinicians both on the build side because, you know, on the new h.r. There have been work groups for providers and nurses for the acute ambulatory side of this for a while now. Since last year that they've been running the solution by them and soliciting feedback. Now they've got a product that they're in front of the beta testers and they're doing the same thing, soliciting that feedback and making changes on the fly.

00;14;29;29 - 00;14;50;05

Unknown

And so, I mean, to me, that's just the right way to do this. And everybody's pretty excited about that. Yeah, it's I mean, it's been incredible to be part of the process and to see, you know, feedback and frustrations get fixed quickly within, you know, a week or two direct feedback communication with the engineering team. I mean, it's been cool.

00;14;50;05 - 00;15;13;02

Unknown

We've had the engineers out at our clinic to watch our workflow because they weren'tunderstanding some of our, you know, issues or complaints. And then they see us using they go, that's what you need, which is I mean, instead of them giving us something, the engineers are actually in, Oracle's actually building something for the clinicians with direct clinician input, which has been pretty exciting to be part of.

00;15;13;04 - 00;15;38;03

Unknown

Yeah, I'll just add to that. They, they brought a team of over 20 engineers and, and solution people out here and they weren't just focused on one product they wanted to understand workflows so that they could then incorporate that into their design and build. And to me that was a big investment for them and I think well worth it for our end users.

00;15;38;05 - 00;16;02;23

Unknown

Great. And Dr. Thompson, Dr. McFarland, obviously Ashley just gave some insight on the overall Oracle health design strategies. But from your perspective, day in, day out, living in that world, can you talk a little bit more about really just what Oracle brings from, you know, a technology innovation strategy perspective? Matt Where are you directing that to me? Sorry, Yeah.

00;16;02;24 - 00;16;29;27

Unknown

Ashley Sorry. Yeah, yeah, yeah. I mean, got me to restate that. Yeah, maybe. Sorry. Let me, let me restate that pause. So, Ashley, having heard from Dr. Thompson and Dr. McFarland talk about some of the engagements and early adoption into strategies, can you just talk a little bit more about that detail from somebody working in the day in, day out?

00;16;29;29 - 00;16;55;19

Unknown

Yeah, I mean, you you heard Dr. Thompson say like in the legacy system, feedback was given and then it felt as if it went to a black hole and died like there was nothing that was coming out of out of the customer, even engaging in the feedback. And I think the theapproach and the engagement that the Oracle health team has taken is our design and development is a reflection of the customer voice first and foremost.

00;16;55;19 - 00;17;30;17

Unknown

And so it is how do we engage often and frequently and have that feedback loop that is constant so that we are constantly improving. I think we can also point to the fact of, you know, your hours and our history with our, you know, our current legacy systems, right?There's 30, 40 plus years of knowledge. And so there's also being able to take what worked really, really well in terms of some of the design, the usage and the patterns and what are we what should sustain or, you know, be persistent, but also what completely needs to be reimagined.

00;17;30;17 - 00;17;50;00

Unknown

And I think that is the piece as we are engaging with customers, is also we often say like check the brain of everything that you know historically about ours. And why did we always do it this way? Was it because it was a technology hindrance or we were had a limitation? Is it because it was a process issue that we now could maybe solve in a different way?

00;17;50;00 - 00;18;10;09

Unknown

And then how can I and automation completely turn it on its head to say, well, why does this need to take so many clicks tabs? Or do I even have to do that work? And it just automatically presented. And so it's really challenging our own kind of approach to how we'rethinking about these workflows to ensure that it's meeting the end users really needs.

00;18;10;09 - 00;18;46;29

Unknown

And it isn't just an answer with technology, but how does it all come together from a clinician perspective, their workflows and the lives and hopefully you guys are seeing that, you know, day in and day out in terms of the engagements that we're we're doing it at our customer sites and in these design sessions. Yeah, I would say I mean, we're it's we're seeing and it's been fun, you know, having been involved early to see what the kind of these dreams were and that here's our vision for the future and to see it slowly come out and start to as we're now culminating in the new EHR and seeing how these technology pieces interact to

00;18;46;29 - 00;19;22;11

Unknown

build this. I mean, it's unlike any other, you know, electronic system out there, which is pretty exciting to kind of see that come to fruition. Do you have any good stories, Dr. McFarland, Dr. Thompson, that you'd like to share on the impact thus far? Yeah. So couple, you know, personal impacts from a patient care standpoint. I mean, largely around the CAA order entry and some of the I would say some of the safety and accuracy that comes along with it.

00;19;22;13 - 00;19;44;10

Unknown

One patient's love of the product, the fact that I'm not on the computer, I'm sitting listening to them, and then the other one being, as you know, we're talking about orders and labs as we go along the visit. And it's tracking that for me and proposing these. So I'm not responsible for keeping up with them later. A good example was a long visit.

00;19;44;10 - 00;20;03;29

Unknown

I'd forgotten that we'd talked about a colonoscopy that they'd had elsewhere that wasn't in the h.R. And they were telling me how they needed a colonoscopy. And I said, yep, will help coordinate that. And then 30 minutes later, when the visit was done, I'd completely forgotten about it. But because or the oracle, the cia was listening, it proposed the colonoscopy order for me.

00;20;04;02 - 00;20;21;21

Unknown

You know, something that didn't get missed. While it may seem small, likely, yeah. The patient may have called back later. It saves a phone call. It's better. Patient care care is delivered accurately and on time. And I you know, I think we both probably have a lot of stories, but I mean, we just get feedback all the time.

00;20;21;21 - 00;20;44;09

Unknown

Like this week I got feedback from her provider that she said she was almost addicted to CAA and our chief of neurosurgery had a conversation with our CEO and said, if you ever take this away from me, I'm going to quit, which is pretty powerful. I was out in RTI shopping a couple of weeks ago and a family medicine physician made icon tacked it, headed my way.

00;20;44;09 - 00;21;04;18

Unknown

And usually you kind of dread those interactions because it's usually not positive. It'slike, how did it hurt me this week? But it wasn't that conversation. It was really she was ready to cut down on her FTE. She was always had to quit charts. She'd go home and chart late at night and on the weekend and never caught up.

00;21;04;21 - 00;21;26;23

Unknown

And then the first day she used it, she was done at 530 Notre Dame. She went home and enjoyed her family and that had never happened before. So that was really, really positive. Another person commented, That saved my career, very similar. And so we hear these stories all the time and and they're I mean, they're real and meaningful.

00;21;26;25 - 00;21;45;16

Unknown

You Yeah, we were sitting in our one of our owner meetings not too long ago, and someone brought up, you know, making sure that like, is the CAA worth it is what we're doing is this you know necessary. And I think four or five of the physicians stopped and goes, let me be clear, if we don't have this, I'm retiring today.

00;21;45;18 - 00;22;03;18

Unknown

So, I mean, it's it's, you know, a huge joy factor for physicians. It's career extending, it's work life balance. You know, it's patient safety. It's all of it. I mean, the notes are better as we review, you know, previous physician notes who we continually had to be like, hey, these notes aren't up to par. We need more in there.

00;22;03;18 - 00;22;42;17

Unknown

It's from a billing, safety, legal standpoint, whatever it was, those aren't conversations we need to have anymore because it's just ambient me doing it. And that's just what I would say is the more quote unquote simple of the products that's coming, you know, coming out. And it's already had just such a huge impact. I love that. And one of the key goals at Oracle, as we've taken on this health care journey is really for technology to become an aid to clinicians, to patients, and as opposed to a hindrance as its historically existed.

00;22;42;19 - 00;23;02;13

Unknown

Dr. Macfarlane, you spoke to this a little bit earlier. I'd be curious to your lines on this not only now, but moving forward as we as a closing question, does a guide does the journey that we're on with Oracle Health, does I feel like a member of the team to actually become that assistant or or just another observer?

00;23;02;16 - 00;23;22;21

Unknown

You know, I think it does. I was talking with someone the other day and I kind of made the analogy to the airline industry and I kind of see, you know, the physician career and what I envision it is we're going to become truly more like a pilot. And the air is the airplane that we're flying, that it does a whole lot of things for us, right?

00;23;22;21 - 00;23;45;22

Unknown

I'm there for takeoff. I'm collecting the patient information, I'm interviewing the patient, doing the exam, getting the correct, the stuff I'm trained for. I'm collecting the healthdata, using my expertise and training to elicit the important information I collect that I help make clinical decisions. And then the AI is doing all the automated stuff. Once we'retaken off, it's helping me with their maintenance.

00;23;45;22 - 00;24;10;02

Unknown

What do they do when all the automated stuff that I really shouldn't be using my brain power for? I don't need to be memorizing all the rules around immunization intervals, colonoscopy intervals. The AI is doing that for me, understanding that also patients are unique and unexpected. Unexpected things happen just like, you know, turbulence, mid-air. Something happens. I can intervene just like a pilot can intervene, and then I'm there for the landing.

00;24;10;02 - 00;24;31;13

Unknown

We get all the data and information back. The air is helping me give me feedback and telling me what things are happening and what things to maybe zoom in on, and then I can help make the clinical decision and help, you know, make the unique treatment plan for the patient. Understanding that the air just has the data that's put in, the patient has data that they'rebringing into the room.

00;24;31;13 - 00;24;49;09

Unknown

And I can help synthesize all of that and help, quote unquote, land the plane and help deliver that patient care. So that's kind of how I see the future, where it's doing a lot of very important things, but things that doesn't necessarily need the expertise of a physician to do. Yeah, that's that's a really good summary of that.

00;24;49;09 - 00;25;19;04

Unknown

And, you know, the more involved we get with the AI, the more we see the potential possibilities of AI, because I think we're already signed up for like 15 beta test solutions. And every time we have a conversation, we think of additional use cases coming down the road that I could help with. And so now we're getting to the point where we need to really be thoughtful about A.I. governance.

00;25;19;07 - 00;25;47;06

Unknown

And as far as I can tell, everybody's struggling with that whole concept of A.I. governance and how do we make sure that that we're delivering, you know, safe products and safe care from an AI perspective? And that's that's I think a hot button for most organizations is how do they do that better? But I think we're getting to that point where the system can help us and many things, and we're just starting with K but the new RB part of that.

00;25;47;06 - 00;26;10;06

Unknown

But ultimately, you know, having the system take every new piece of input, information that it comes at it, consider it in the context of the patient. And if it identifies an insight, we should know about that. Even if we haven't seen the patient, haven't seen the result, haven't seen that piece of information, if it impacts potentially the patient, we should know about it so we can then act on that.

00;26;10;06 - 00;26;35;06

Unknown

And so I think we're getting there. It's really exciting. We're all about safe travel here at Oracle. That's so. So Ashley, we'll have you close us out. As as health care organizations consider, you know, Oracle health for the future. What guidance would you give them you know in the the broader consideration of someone like Larry Ellison, what he really is out to go achieve?

00;26;35;08 - 00;26;57;24

Unknown

You know, I think obviously making sure that you have a clear vision for where you want your organization to go and why you're making the change and I think anchoring that decision as well in terms of what do you need today as well as where you're going in the future, if you think about, I'll say the competition or the rest of the the legacy laws that are out there.

00;26;57;26 - 00;27;23;00

Unknown

They're all what Dr. McFarland, Dr. Thompson has described, they're heavy on burden on the clinician because they're relying on them to do all the cognitive load decision making without really presenting meaningful information. And I really think that it's important for organizations as they're assessing their strategies for an are is how are how are those hours and other systems applying AI is it a bolt on that?

00;27;23;00 - 00;27;47;27

Unknown

I typically see the rest of the industry doing and trying to figure out how do they retrofit a AI that can only go an inch deep in supporting their needs, or are they really thinking about it, how Oracle's thinking about it, where it's woven at every single layer of the application to the data in the services. So that's allowing organizations to really transform how they manage care.

00;27;48;00 - 00;28;12;26

Unknown

An example I give is, you know, how do you best search for information in structured, unstructured data? Right? That's the power of the Oracle database is allowing us to do that. And so also thinking about the breadth and depth of the problems that organizations are looking to solve for, it might be clinical workflows today, it might be financials, tomorrow, it might be how are you stitching your supply chain together?

00;28;12;29 - 00;28;39;19

Unknown

So making sure that you're also thinking about in our system that can connect all of these threads together holistically and have the data to compute all the while in a safe, secure cloud that OCI can bring. So I think as we kind of round out to where Larry's vision is, right, Larry's has stated multiple times that it's a moral obligation for us to fix health care.

00;28;39;22 - 00;29;04;09

Unknown

And he knows that this is a long play, a long game that we're going to be in. And it's the commitment that you also want to make sure as an organization that you're hedging your wagon to an organization that also has that same commitment behind it that is willing to go on this journey with you. And I think that speaks volumes, too, to Larry and what he's doing and how he's helping to transform health care across the globe.

00;29;04;12 - 00;29;29;22

Unknown

Thanks, Ashley, and thanks for your leadership in that journey. It's a bold vision that I know we're out to go to go conquer. So thank you for leading charge. And I want to pay Special thanks to Dr. McFarland and Dr. Thompson for your partnership, for your time here today and for your leadership in that journey as well. You've been very influential to our teams continuing to move the meter forward on the innovation journey where we're out to go achieve.

00;29;29;24 - 00;29;57;24

Unknown

That's all for this episode of Perspectives on Health and Tech podcast. Be sure to subscribe to catch all of our future episodes. For more information from industry experts, visit Oracle dot com Forward slash health and Oracle dot com forward slash life hyphen Sciences. Thank you again 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.

While science and technology have driven remarkable breakthroughs, they've also created unintended barriers between clinical research and care. The complexity and cost of research limit trials to only the most well-resourced hospitals. As a result, just 3% of patients and providers participate, and doctors often lack access to or the ability to act on life-changing therapies at the point of care. Oracle is closing this gap—embedding clinical trials, evidence-based insights, and innovative therapies directly into electronic health records. The vision: every hospital research-ready, every patient encounter fueling discovery, and therapeutic innovation reaching patients where and when it matters most.

Featuring:

· Moderator: Raj Modi, Senior Director, Global Customer Centre of Excellence, Life Sciences, Oracle

· Panelist: Maria Clark, Market Development Associate Greenphire-Suvoda, Patient Advocate for Cystic Fibrosis Foundation

· Panelist: Christopher P. Boone, Ph. D., Group Vice President, Research Services, Health & Life Sciences, Oracle

Listen as they discuss:

o Why therapeutic innovation often stops short of the point of care—and what it takes to close that gap

o How aggregating genomic, clinical, and real-world data at scale — safely and securely — is key to unlocking this future and driving personalized medicine

o How embedding trials, insights, and therapies into the EHR will reshape access to cutting-edge treatments, lowering cost, and improving outcomes

o How the industry is approaching this shift—and what progress is already underway

Notable quotes:

"Because of these CFTR modulators, patients like myself are living longer than ever before. I am only 23 years old and when I was born my life expectancy was early 20's." – Maria Clark

"We have to reimagine our own business processes and really put the needs and preferences of the patients at the center of everything we do." – Christopher P. Boone, Ph. D.

CTA:

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Episode Transcript:

Raj Modi:

Hello and welcome to from bench to bedside bringing therapeutic innovation closer to patients. I'm Raj Modi and I'll be your host today. This conversation speaks directly to Oracle's vision for health and life sciences. Despite all the advances we've seen in medical research over the last few decades, there's still a significant gap between scientific discovery and care delivery. And today we're going to explore how we close that gap by embedding research directly into care utilizing unified data. Connected systems and AI. I'm joined today by two fantastic guests who bring both deep expertise and lived experience. First, we have Dr. Chris Boone, who's the group vice president for Oracle Research Services. Chris is a recognized leader in real world evidence and health data innovation. And also joining me is Maria Clarke:, who is a passionate patient advocate who lives with cystic fibrosis and also works tirelessly in our industry helping organizations better understand and support research participants. Chris and Maria, welcome. Thank you both for being here.

Chris Boone:

Thank you, Raj. It's great to be here.

Maria Clarke:

Thank you. So happy to be here.

Raj Modi:

Let's dive into the discussion. Maria, let me start with you. You've written very powerfully about your experience living with cystic fibrosis. When people talk about patient centered research, what does that really mean to you, and how far off are we as an industry from making that real?

Maria Clarke:

Well, I believe this collaborative model, you know, ensures that studies are designed, conducted and interpreted with direct input from patients reflecting on their real-world experiences, their needs and priorities. This ensures you know, patients are full collaborators, not just subject ID numbers you know, in a database. Real humans with real stories and you know, research that better reflects real needs, helps promote trust, and leads to more effective personalized care.

Raj Modi:

That's really powerful, Maria. Thank you for sharing. You've read some raised some really pertinent points here. As a follow up to you, when it comes to access, whether that's clinical trials or the latest treatments, what barriers have you personally faced in your journey and what needs to change?

Maria Clarke:

So accessing care even you know when I'm fortunate enough to have, you know, insurance and advanced medications, it still comes with its own set of hurdles. For instance, you know ordering medications can be complicated, and you know, once appointments are coordinated, the burden of traveling to the clinic and missing work or school for you know, 5 plus hours can be extremely overwhelming. I mean, for instance, yesterday I was at the clinic for five plus hours participating in a research study. It's a long term study. It's like a five year study. I've been involved in with the Children's Hospital of Philadelphia and I was working remotely the whole day while getting tests done and blood drawn. And after all that, you know, had to drive home very weak, especially on the school for those who are from the Philadelphia area. It's pretty brutal after a long day in the clinic so.

Raj Modi:

Maria, that's a, that's a, that's a significant burden on, you know, on your participation into research. Chris, let me bring you in here. You've spent your career at the intersection of policy evidence and strategy from the industry side - how should we be thinking about patient centered research? How do we move from theory to something that actually involves patients in the study design, in access decisions, and in outcomes.

Chris Boone:

That's a phenomenal question and I will say this, Maria, I was in Philadelphia last week and got to experience the traffic that you guys have there first hand. So I, I empathize, in fact, you were driving home after such a pretty intense treatment and and all of that. So it's tough, but I think it's a it's a perfect example that I think embodies all the things that we need to consider as industry as we're becoming you know as as we take it to your point Raj from theory to actual practice, we've been talking about this whole notion of patient centered approaches for a very long time. But I think in my in my mind what it means is that we align the business strategies and the entire, sort of drug development process around the needs and the preferences and outcomes of of patients that are most afflicted with these particular. You know we've we've we've talked that nauseam about, you know, you'll hear a lot about patient driven or patient centric R&D or clinical trials and all these things. But you know just hearing stories like Maria is very Maria is is very powerful because it reminds us that there are real people on the other side of that who have priorities who are, who are prioritizing, you know, sort of the the side effects of these therapies or the inability to drive home after a 5 hour procedure and and just improving the overall quality of life. So I think that we have to start really pivoting our thinking to - how do we design trials in light of all the the advancements we've made in, in digital technologies to the advancements we made even in in sort of scientific outcomes research? You know, I think about, you know there was a big wave of of interest over the last several years of this idea of decentralized trials was sort of was born, out of the was born out of the pandemic and and you know the idea of doing these things virtually was it was definitely embraced, I think about the the notion of utilizing to your point, Raj, real-world evidence and and patient reported outcomes more so in in in trial design and trial data collection more so than we ever did. One of the interesting things about the trial itself that people often forget is that I think randomized special trials are are still the gold standard for for for evidence generation, but they're very limited too, right? And I think that there's a lot that happens outside the walls of these sort of controlled trials that you know it's data that's reflecting the everyday lives of patients that we need to capture that's typically captured through, whether it be their health records or whether it be in this case, wearables or or any other sort of patient generated health data. So I think as the world we start to really pivot to you know, to this, this idea of patient centric, you know sort of drug development or therapy development, I think that we have to sort of reimagine our own business processes and and we and and really put the the needs and the preferences of patients at the center of everything that we do.

Raj Modi:

Thanks, Chris. And you know to follow up on that, there's a huge buzz right now about AI. What's your perspective on AI? I mean, how does AI help with things like identifying eligible patients, surfacing biomarkers, enabling more personalized treatments?

Chris Boone:

Oh, hey, you know what, man? I I know there's a significant amount of fear and and skepticism about the sheer ability of AI, you know? But but I I'm I'm a believer. I'm a fan. I thought it was something that the industry needed for a very long time and it and it is and and honestly, I think the expanded use of AI is is a patient centered approach. Because what we're effectively trying to do is personalize and get closer to precision medicine by utilizing all the available data that's out there utilizing many of the you know whether it's generative AI and natural language processing or other AI approaches to really get closer to what it takes to drive to positive outcomes for patients, right. And and I think that what you gave some perfect examples, the the identification of of biomarkers which then feeds into trial design which that trial design can then feed into carefully identifying the appropriate patients and patient you know cohorts or populations that will be most suitable for these types of trials and and honestly which would allow those particular patients that would have some sort of response to that particular therapy which we can learn a lot from. I I can see the the use of AI and so many use cases throughout the entire life cycle of a patient journey and and an entire life cycle of of a of a therapy. Right? And and I think that it it gets us closer to precision medicine. I think it gets us closer to this idea truly of a learning health system which we all strive for. And and I think that for patients like Maria, we would be able to sort of I I think you believe it or not it it sort of it sounds kind of counterintuitive to say that I think AI will get us closer to a place of empathy and compassion for patients, you know, and building trust that I feel like we need to have. And this whole patient centered approach, but I do believe that to be the case.

Raj Modi:

Maria, let me bring you in there. Empathy and compassion. What's your perspective? You know, how do you feel about the role of AI and generative AI? Large language models which have become incredibly popular recently. What's your perspective on that?

Maria Clarke:

I mean, personally, you know when I can clearly see how my data is used and when I'm included in that process and when there's real accountability, then I can trust the system. And that trust makes me more willing to share, which ultimately leads to better care and stronger research outcomes.

Raj Modi:

So Maria, I'm I'm I'm hearing a thumbs up from you on on on AI. Of course, AI is nothing without data, Chris, real-world data is now a major part of how regulators and clinicians make decisions. Can you talk a little bit about that? And also, can you talk about how Oracle is helping customers turn real world data into real-world evidence?

Chris Boone:

Yeah, yeah, I think. You know, as you think about this idea of real-world data, the real value of it and and, so the challenges that it was trying to address had a lot to do with how do we better capture sort of the patient experience. How do we sort of track the progression of a disease or our patient experience beyond the clinical trial? How do we sort of, how do we create a more, it's more equitable access. Because while Maria lives in Philadelphia, she has access to the Children's Hospital of Philadelphia, there are folks that live in remote parts of Pennsylvania who may not have that same access and and honestly, we we we are not, we haven't effectively designed these sort of accessible trials the way we need to in order to do that. Where I see the world of of of RWE coming in, especially from the patient experience of those that are are are suffering from, if we wanted to use CF as an example, I think it's the AI sort of allows us to sort of aggregate and analyze all the data from all these various sources, which are very important, right? I mean, we have a number of CF patient registries out there. There is the EHR data that we know there's a data from the trial and then of course there is that patient reported data. That data is generated from from RWE and what we're able to do with that is sort of track what the long term impacts and outcomes are of these different therapies, how it affects the quality of life for many of of the patients. And oftentimes, I think when it comes to patients that are dealing with particularly rare diseases is that honestly, once that therapy goes sort of in a what we call the post marketing phase or the post authorization phase, meaning that once it's actually approved by the FDA, you sort of lose sight of those patients, right? Because there's not that longitudinally across from the trial experience to what they're dealing with in the real world. And so I think the the the the power of real world evidence in this case is really sort of to strengthen what we can do sort of in a post approval world and post approval engagement and really tracking the progression of you know and the sort of how the outcomes of those therapies ensuring to Maria's point that there's a level of trust and and sort of open communication from patients as they're tracking their own experiences on a daily basis, and they're reporting it, and it's being captured and actually analyzed along with the other data that's being collected and hopefully it starts to get to this point of really personalizing, you know, I like to call it the the end of one trial of The Walking clinical trial where we're really getting specific to individuals and tailoring our trial protocols for their specific needs. And and and if you're talking about CF, which is has a you know a host of subgroups, those specific mutations of CF you know are important.

Raj Modi:

Yeah, Maria, let me bring you in here. What's your perspective on real world evidence and what does it mean when we say that we wanna reflect the true lived experience of patients?

Maria Clarke:

So you know, when I hear real world evidence as a patient advocate, it resonates deeply. It means, you know, capturing the lived experiences of real people in everyday life, not just what's happening, you know, in tightly controlled clinical trials. It's about evidence that reflects real settings, you know, diverse populations and real needs, ensuring health decisions are meaningful, inclusive, and patient focused.

Raj Modi:

Thanks, Maria. That's that's really insightful. We've covered a lot today. I just want to thank you both for such a thoughtful and inspiring conversation. Before we close Maria and Chris, if listeners want to reach out to you, where could they find you?

Maria Clarke:

Yes, so I am very open on LinkedIn. I post a lot about my experiences as a patient and working within the industry, especially like different feature stories on blogs or news, articles, any of that sort so you can find me on LinkedIn. It's my name: Maria Clark. And I also have an Instagram for specifically cystic fibrosis and my experience is as a patient. So for anyone out there that is interested in learning more about CF or has CF, that is Marias dot dot miracles so you can find me there or on LinkedIn and I'm happy to connect.

Raj Modi:

Excellent. Thanks Maria, Chris. How can people reach out to you?

Chris Boone:

Yeah, I'll go the same. I mean, I think LinkedIn is is a great a great resource or a great tool to to, to, to connect with me. You can find me data hippie on LinkedIn that's truly, truly my handle. And I'm also data hippie on YouTube and data hippie on X. So if you're interested if you use those platforms. I'm I'm available there as well.

Raj Modi:

Wow, you're both so social media savvy. That's amazing. Both again, for for, for the podcast. I've really enjoyed this conversation. Thank you to our listeners. And remember, innovation only matters in this industry if it reaches patience when and where they need it. To learn more, I'd encourage you to read Seema Verma's recent article on LinkedIn which is called AI and the feature of Precision Medicine and also explore what Oracle is doing to embed research directly into the heart of clinical care. Thanks for tuning in and we'll see you next time.

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.

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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.