119 – AI is Eliminating Doctor Burnout and Revolutionizing Healthcare w/Seema Verma

[00:00:00] Marcus: If you enjoy this content, please take a moment to rate and review it. Your feedback will greatly impact our ability to reach more people. Thank you.

[00:00:17] Vic: Okay. Welcome to Health Further. I have a great guest today, Seema Verma, who is the reasonably new EVP and general manager of Oracle Health and Life Sciences. Seema, thanks for doing this. Really appreciate it. 

[00:00:29] Seema Verma: My pleasure. Thanks for having me back. 

[00:00:31] Vic: I think most of my audience has followed your career, but for those people that have been living in a cave and not, um, maybe just give a quick summary of your work sort of at the intersection of public policy and and corporate health.

[00:00:46] Seema Verma: Sure, so, you know, I started my career, but I would call the front lines of health care working in a health system. And this was a health system that served the indigent population. So we had community health centers, public health [00:01:00] department, long term care. And, uh, really gave me some insight into the challenges on the ground.

[00:01:06] Seema Verma: And, uh, from there I started my own consulting company. And a lot of my clients were not only health systems, but then sort of evolved into government, whether it was local government or state government. And so I spent a lot of my career, even working with tech companies and just kind of building, you know, better understanding around policy issues.

[00:01:25] Seema Verma: And during that time, I designed, at that time, Governor Mitch Daniel's health plan. Um, when he left the state of Indiana, then I helped then Governor Pence develop his health care plan. And then from there, I started helping president Trump, um, during the campaign in terms of developing his health platform.

[00:01:46] Seema Verma: And so then after the campaign, he nominated me to be the CMS administrator. So the head of, um, centers of Medicare and Medicaid services. And I did that for four years. 

[00:01:58] Vic: And during that [00:02:00] time we had the pandemic, so you got, you were 

[00:02:02] Seema Verma: in the middle of everything 

[00:02:03] Vic: as, as the world was trying to figure out what to 

[00:02:07] Seema Verma: do.

[00:02:07] Seema Verma: Right. I was on the, um, White House COVID task force and so kind of served every day on that. So beginning to end. And then, um, after my, my time in government spent a little time in private equity. And then I've been now at Oracle Health for, you know, almost two years. Trying to put into a lot of the things that I couldn't get done in government, you know, regulations only go so far.

[00:02:31] Seema Verma: And so I'm hoping to, to, um, help solve some of those problems using technology. 

[00:02:39] Vic: Excellent. So let's dive right into the, the, um, topic on everyone's mind right now, which is artificial intelligence, the LLM technology. Of course, it has incredible promise, but in health care, we need to be cautious to make sure that it's sort of channeled in the right direction.

[00:02:57] Vic: How do you think about, or how is Oracle [00:03:00] thinking about sort of leveraging AI for the providers and for the patients? 

[00:03:05] Seema Verma: Right. So let me just start by saying, I do think that is a game changer, not only for health care, but for many industries. And if you kind of go back and think about where we are, um, in 2010, right, the government mandated that we digitize health records and created incentives and spent 36 billion dollars on digitized health records.

[00:03:27] Seema Verma: And it didn't work very well, right? We did digitize the system. We created a lot of burden for providers, kind of forcing them to use these electronic health records. But then I would say that that data was kind of locked in their computers. So lack of data 

[00:03:41] Vic: out of paper digitized, but that it didn't go much further.

[00:03:45] Seema Verma: Right. It's almost like you just moved from a filing cabinet to the doctor's computer and we were kind of stuck there. And what's happened I think over this time is there's been better rules around interoperability, but then also there's just been the [00:04:00] advent of more advanced. Data analytics and now a I.

[00:04:04] Seema Verma: And so we have the ability to really analyze that data better and develop all kinds of insights. But I think what a I brings us in the short term, at least for health care is that allows us to automate. And a lot of the mundane kind of paperwork, um, tasks that we have going on, um, in the system today. So if you think about with healthcare, it's about 25 to 30 percent of the healthcare spend is just on administration, administrative costs.

[00:04:32] Seema Verma: And so I think there's an opportunity with AI, right, to, to help kind of address that side of the house, whether it's around, um, billing or making appointments or scheduling. So things that we would say You know, I think it's very clear that, you know, kind of the non clinical decision piece is very straightforward, that there's a lot of opportunities and you're seeing innovators across the board coming out with all kinds of different things.

[00:04:57] Seema Verma: And then I think the question has become [00:05:00] is what is AI's role in clinical decision making? And you kind of hear people say, oh, is. Is AI going to replace the doctor? And, you know, the short term answer to that is no. We don't see it that way. We sort of see AI as a tool. It's another tool in the bag for providers, right?

[00:05:17] Seema Verma: There's so much information out there. There's so many, um, new technologies and innovations that are coming out. So it can kind of help them condense, have more data available at their fingertips. It can also automate a lot of the mundane tasks that they have to do. So if we think about the interactions that they have.

[00:05:35] Seema Verma: With insurance companies, right? So think about prior authorization or utilization management. Just a lot of that can be automate, which I think is important. And I say that because from having run the country's healthcare system when I was at CMS, you know, there aren't these big ideas and solutions. that are going to fix the problems that we are facing today.

[00:05:58] Seema Verma: And I think to some [00:06:00] degree, the problems have gotten worse. Um, I think all of us can say we're waiting a little bit longer to get a doctor's appointment, right? Our doctors are really stressed out. They're burnt out. They're seeing more patients. The patients that they're seeing have more complex issues.

[00:06:15] Seema Verma: It's a good thing that our population is living longer, but with that comes more complexity of disease. And so there's a lot more demands on their time. And, you know, they're spending, after they're finished seeing patients, they're spending three to four hours, what we call pajama time, just doing all the paperwork to keep up with that.

[00:06:33] Seema Verma: So there's a real opportunity to improve the quality of care that we all receive, right? When your doctor has real time information about clinical trials or what's the latest innovation, or maybe They're thinking about prescribing a drug, or maybe they just want to take your profile and compare it to people that have a similar diagnosis and get some ideas of treatment options or how you are, you know, what are potential ways to address one's [00:07:00] concerns?

[00:07:00] Seema Verma: And that's where I think, again, I can be brought into. Be that tool for the provider to help their decision making. But at Oracle, we believe strongly that there should be a human in the loop. So at every turn where we're using AI, we make sure that ultimately it is the provider that's signing off. So some of the technology that we've developed is something called our clinical AI agent.

[00:07:25] Seema Verma: Really cool technology listens to the patient doctor interaction generates a note. The Oracle. Engineers develop this in 6 months using AI to actually develop and write the code as well as the product in and of itself uses AI. It's been a game changer. Our doctors love this thing, right? They're saying, gosh, we're spending less time in the electronic health record.

[00:07:48] Seema Verma: But in that case, right? It listens to the interaction, and then the doctor, it generates the note, but the doctor is the one that has to agree that this note is appropriate. So they can make changes if they want, [00:08:00] and then they hit submit. 

[00:08:01] Vic: It's really empowering or augmenting and empowering, enabling physicians and other clinicians to.

[00:08:08] Vic: Do more spend more time listening to the patient. Really? I've heard you and others at Oracle talk about we need to rely on the empathy and the judgment of the clinicians and then empower them to do more take away that pajama time where they're there at 10 at night, you know, keen in something in the into the HR, the old HR and really empower them to do what they love to do, which is really deliver empathetic care to patients.

[00:08:34] Seema Verma: And just to be able to sit and develop that relationship with the patient, right? They want to be able to look their patient in the eye. And today, a lot of our interactions are we, we see the doctor staring at their computer, they're clicking away. And we're kind of sitting there looking around the room.

[00:08:48] Seema Verma: And, you know, if you think about what's gone on in healthcare, there's been a bit of erosion of trust in the doctor patient relationship. We saw that play out, um, during COVID. [00:09:00] And I think that continues to some way, in my belief, is that part of it starts with your doctor's not even looking at you in the eye.

[00:09:06] Vic: Yeah. Well, it's even more foundational. The doctor is so burdened with administrative and data entry tasks that they don't have the time and, and, and flexibility to really interact with the patient. And I would argue that. Almost all clinicians would really like to be doing that, but they have so many momentary demands on their time that they're distressed and they're not able to.

[00:09:31] Seema Verma: Right. And I think it really takes away the joy of why they went into medicine in the first place, right? I mean, if you think about it, it's not easy to get to medical school, right? It's four years of undergrad. You take, you know, your MCATs to be able to get in, and then it's four years of medical school.

[00:09:46] Seema Verma: And then there's residency. I mean, this is not an easy road. So people that go into it. have some sort of a calling. And they don't, you know, I think it's fair to say that none of them go in with the idea that I'm going to be sitting at a computer [00:10:00] doing data entry. That is not, you know, why, why they go into it.

[00:10:03] Seema Verma: And so it really diminishes, I think, their ability to find joy in their work. Um, and you know, we, we hear about it all the time, the concept of moral injury and more and more doctors kind of leaving a little bit earlier than they would have normally. 

[00:10:18] Vic: So, so unpack maybe the The Oracle's vision or your vision for what a next generation or an upgrade of the HR system.

[00:10:26] Vic: I mean, certainly you've sort of taken the Cerner chassis, but you've, you've changed it dramatically and sort of imbued AI and other tools into it. What's how do you think about what that means? What is the new Oracle Health EHR be able to do? 

[00:10:42] Seema Verma: Let me kind of start back a little bit to explain the mission that we're on and the vision that we have.

[00:10:49] Seema Verma: You know, you'll hear Larry Ellison, who could do a lot of different things. I mean, he spent his whole career in technology and really built a lot of successful applications for whether it's banking or [00:11:00] other industries, restaurant, hospitality. And, you know, Oracle's infrastructure is in pretty much every major business that's out there.

[00:11:09] Seema Verma: So, you know, they've played that role. But I think now the thought from Larry is that he wanted to take all of that experience that he's had over these 40 years and all of the learnings and bring all of that to healthcare. And I think it was his observation, which is correct, was that if you think about it, healthcare really has not.

[00:11:30] Seema Verma: Evolved where other industries are. So if you think about banking, for example, you can get your money anywhere in the world. You can go to an ATM and you can get your access to your bank account, but when it comes to healthcare, you can't really get access to your healthcare record. And so, you know, to him, a lot of this, wow, you know, we can solve a lot of this with technology.

[00:11:50] Seema Verma: And so I think from his standpoint as the founder of the company, and he's still our CTO and chairman of the board is, you know, this is the next. [00:12:00] Vision. This is the next mission mission for Oracle to transform health care. I don't think we as a company are looking at it as one point solution. So electronic health record to us is just a point solution, but our focus is on how do we solve the overall problems in health care?

[00:12:17] Seema Verma: And so the is very important. It's the center of that because it represents that basic interaction between the provider and the patient. But in order to solve this problem, you have to go much bigger and larger, and you have to really look at an end to end solution. And so what we're able to bring to the table is some of the core infrastructure.

[00:12:36] Seema Verma: We have a database. We obviously are, you know, um, the cloud computing. Um, we also have what we call our fusion applications. So Oracle brings supply chain management, human capital management, ERP. So all of the. Financial systems that most businesses would normally have and now we're bringing that together with the electronic health record.

[00:12:58] Seema Verma: We have patient portal [00:13:00] patient accounting. And then the other big thing that that Oracle really specializes is in analytics. And so we're able to bring analytics end to end across the entire platform. So you're connecting your supply chain management to the electronic health record. So you can imagine, you know, what you're able to do when all of those systems are connected together.

[00:13:21] Seema Verma: And then we're applying AI across every single application. So that we are able to leverage the power of artificial intelligence to reduce a lot of the mundane tasks that we see in a lot of the old applications. So, if we look at the EHR, and, you know, I've been a, a vocal critic of electronic health records long before I came to Oracle.

[00:13:44] Seema Verma: And, um, in my early time in the administration, did a nationwide tour and went across the country. And I heard from providers on the front lines and the frustrations that patients were having, frustrations from innovators. And, you know, ironically, a lot of it centered [00:14:00] from the electronic health record.

[00:14:01] Seema Verma: Patients didn't have access to their data. Providers, we already kind of talked about the problems with the and so that's kind of one of the first places that we've started is the electronic record and how we can kind of create a new version of that using modern technology. And then from there, there's all kinds of things that we plan on doing.

[00:14:21] Seema Verma: But let me, let me start with just the. And getting at your question, um, what we're doing is building a modern electronic health records. If you think about it, these 1990s EHRs, um, our competitors and even Cerner's, they were built in the 1990s. And so 1990s, I don't even know that people were really using cell phones at that time.

[00:14:41] Seema Verma: Email was very early 90s. So if you think about it, the concept of building an EHR and that that platform would survive all the way into the year 2025. I mean, and that's why I think we have problems with the EHRs because they haven't been able to [00:15:00] adopt that modern technology. So what we're doing at Oracle is from the very ground up, you know, what goes into the EHR, there's not a lot of junk data, what's going in there is accurate and appropriate.

[00:15:12] Seema Verma: And it's built at the foundational level. So a lot of what we're hearing today is there's this AI model and there's this and that and it all kind of sits on top of like sort 

[00:15:22] Vic: of bolted on to this old system that isn't that good at the core. Yeah. 

[00:15:27] Seema Verma: Right. And so it's bolted on and you really hit the, the, the nail on the.

[00:15:31] Seema Verma: Or the hammer on the nail is that bolted on. And that's where we're different is that our part is that AI is embedded at every single layer. It's at the most foundational level. And so it's, it's revolutionary. So I'll give you an example. What does that mean? So one of the things that we do, which I sort of talked about the ambient, the, the kind of listening to the patient, doctor, patient interaction, and be able to do the note.

[00:15:54] Seema Verma: Yeah. The 

[00:15:54] Vic: ambient scribe, uh, use case is probably there. Fastest adopting bulldog, 

[00:15:59] Seema Verma: [00:16:00] right? And with the bolt on, it means that it's bolted on. So you get the note. Then you have to cut and paste into your E. H. R. With ours. It's all embedded. So you're it's all conversational. And so it starts with that. But then There's, you can basically use conversation to direct what you want the HR to do is you could say, hey, Oracle, bring up this lab result or tell me, you know, the last 5, um, cholesterol scores for SEMA, Verma.

[00:16:31] Seema Verma: So you're not having to hunt and, you know, going around looking for data and information, which. Doctors spend a lot of time doing, you're asking. So the whole thing starts with not only just it's going to do your note at the end of the day, but it's going to help you whatever, with any data you want, or you may say, tell me about the research on X, Y, and Z.

[00:16:50] Seema Verma: And it tells you exactly where the data comes from. So you know exactly, you know, what the source is. We also are able to do summarization. So we can take the [00:17:00] patient's full electronic health record and create a summary for the doctors. So when they walk in. They're not trying to figure out, you know, who's SEMA.

[00:17:08] Seema Verma: It's all very, it's in a nice kind of summary. So it's easy for them to then take the action. So at the end of the day, what that means is more time with patients and less time in the EHR. And then from there, all the workflows become automated, whether you're going to prescribe a drug or a test. And then it all hooks to all of our other offerings.

[00:17:29] Seema Verma: So we think about insurance companies, and let's say you order a test and it requires a prior authorization. We're automating that process, not only in the EHR, but also for the payer as well. So when they receive it on their end, you know, we're reducing the payer's administrative costs because a lot of times they get prior ops that are not filled out appropriately, or they're not even needed.

[00:17:52] Seema Verma: So it's kind of this end to end solution. It starts with the EHR, but it doesn't end there. Another thing that we're doing inside the [00:18:00] EHR, which connects to Oracle's footprint in life sciences is right in the EHR. We can say SEMA qualifies for these clinical trials. So we're connecting clinical care to clinical research.

[00:18:13] Seema Verma: And 

[00:18:14] Vic: right when the physician is talking to you or me about our health situation, they have that knowledge and they can, they can bring it up and talk to the patient about whether it would make sense or not. 

[00:18:25] Seema Verma: They can bring it up, it's right there, or they can ask for it. So things like, think about all the focus that our country has had around value based care, and it hasn't really scaled, because quite frankly, it's hard for doctors to do it, and part of the barrier is they don't have real time information.

[00:18:40] Seema Verma: You need to understand that your patient has social determinants, they have problems with transportation, maybe they're low income, and food is an issue. Well, they need to know that. information right up front, we can help them identify here's the contract. Like here's the commercial client and the contract requires you to do X, Y and Z.

[00:18:59] Seema Verma: So make [00:19:00] sure you're doing those preventative services because that's going to impact your reimbursement. So it's an, it's a whole different way of even doing value based care. Right inside the E. H. R. And the big thing is you don't need four or five point solutions, you know, and that's what we're seeing in the industry.

[00:19:17] Seema Verma: And, you know, I think providers are spending a lot of money on technology, but they're not necessarily getting the value 

[00:19:23] Vic: right out of that. So you talked about when you were here in Nashville, you talked about four. I think there were four core principles. You sort of just touched on. A. I. Seamlessly sort of permeating the entire clinical workflow to really empower clinicians.

[00:19:40] Vic: Another one was leapfrogging the competition with groundbreaking intuitive like, you are so that you just you just pick up the tool and you know how to use it. Which we're used to in consumer products, but in health care products are you typically there's a lot of training, uh, maybe talk about that. [00:20:00] So just making it intuitive for people, 

[00:20:02] Seema Verma: right?

[00:20:03] Seema Verma: I mean, if you think about it, we never got trained on how to use. Right. And even a lot of the tools out there and granted an EHR is more complex, but you know, I was really struck. My daughter started medical school this year and even before she got to medical school, so this is, you know, a month or two before they started training her.

[00:20:24] Seema Verma: On our competitors, right? And so if you think about that, like, they don't even know anything about medicine, you know, they literally have not even gotten in there. They don't even know where they're living. They don't know where their roommate is, but they already have to start training on the EHR because it's that complex and it's that hard and it shouldn't be that way.

[00:20:42] Seema Verma: So when our tools will be intuitive, they'll have the training built in. And our goal is not to have to. Spend not to have to take the doctor away from patients and as spend as little time becoming familiar with the product as well. So it's easy and intuitive and [00:21:00] quite frankly, it's the experience that we have with other modern technology that that we use today.

[00:21:06] Seema Verma: And it's just another example of how these old, antiquated systems haven't really kept up with the experiences that we all expect. Voice. 

[00:21:16] Vic: The voice interface with a physician is. Interacting with Oracle. Hey, Oracle, can you find the five most vibrant cholesterol ratings that makes it much more seamless, much more intuitive, 

[00:21:28] Seema Verma: right?

[00:21:28] Seema Verma: I mean, that's how we interact with, you know, if we think about, um, ambient tools today, right? Whether it's Alexa or something you're asking, can you find me this? Can you find that? Think about. whether it's chat GPT, you know, gone are the days where you're saying, okay, what's the, the best restaurant in this town?

[00:21:47] Seema Verma: And you're looking through all these different, you do a search and you get all these different websites. You're just asking chat GPT and you'll get a very precise thing. So we're bringing that concept into, into healthcare. 

[00:21:59] Vic: [00:22:00] Yeah. And then one of the, powerful things about Oracle's tools is what you started with.

[00:22:06] Vic: They're They're comprehensive across all of health and integrated together, but I want to touch on the patient portal because that's a, that's a really critical part of. This newly HR that the patient leaves the interaction with the doc and they have a portal that they can interact with. Of course, it's different content, but it's it's they get control over their data.

[00:22:28] Vic: It's stored in the Oracle cloud. And that really is empowering for patients in a way that they haven't had previously. 

[00:22:35] Seema Verma: Right, so I think one of the big differences sort of back up on the concept of the patient portal when I was in government, you know, I went through a kind of a personal experience where my, my husband had a major health event and we needed quick access to his health records and we couldn't get it.

[00:22:53] Seema Verma: And so I spent a lot of my time in government pushing interoperability and quite frankly requiring it. And I was very [00:23:00] clear to the health industry that patient data belongs to the patient. It's our data. It doesn't belong to the health system. It doesn't belong to. You know, some company, it belongs to the patient, and we should have access to it.

[00:23:13] Seema Verma: So, the good news is we all have better access to our health data. But what that means is we have five patient portals, right? And you go to this one, and this one, and this one, and that one. And we don't. We don't believe in that at all at Oracle. And so what we're going to be bringing is a patient portal that brings all of your health data into one place and it gives you access and the same exciting things that we're doing with the EHR, we're going to bring to the patient portal as well.

[00:23:40] Seema Verma: So the ability to search the ability to ask it questions and to have your data. What I see in today's patient portals is that they do a lot of the basic functions in terms of scheduling and, you know, getting your appointment and your lab results, but it's very helpful for that point in time interaction.[00:24:00] 

[00:24:00] Seema Verma: What it doesn't do a good job as well, if you want to get your lab results from. You know, six months ago, it's, it's harder. And, you know, for, for some of the basic things, it's easy. But let's say you had a cancer screening or you had a biopsy and the specific results are a lot harder. So we're gonna bring all of that technology.

[00:24:21] Seema Verma: I don't. I don't look at it as a patient portal. I look at it as a, as a patient engagement tool. This is a place where patients go to kind of manage their health care. Not only do they have their records, um, they can do financial transactions as well, but it's also a way to help them to give them reminders.

[00:24:39] Seema Verma: Hey, today's Monday and you have a doctor's appointment and you need to take these medications at this time. So, you know, in the early innings, you'll see it look. You know, the even the user experience will be better. Very similar to what we're bringing to the doctors will bring to the patients. And then I think, you know, we have big plans for, for what this patient engagement tool will [00:25:00] look like.

[00:25:00] Seema Verma: But we hope that it is the place that they go for all of their health care issues, not just for the interaction that they had with 1 doctor, or you 

[00:25:09] Vic: mentioned various care in the physician description. It strikes me that patients want to close gaps in care. They want to know, hey, I should be, I should be getting this this lab test done.

[00:25:23] Vic: They just are not aware a lot of times. So it would be a great engagement and educational tool that ends up closing gaps in care. In a way that is really kind of patient centered, 

[00:25:33] Seema Verma: right? And there's some there's some of that in the patient portals today, but I don't think that they do a great job. I don't know that they're necessarily meaningful.

[00:25:42] Seema Verma: So we're going to continue to iterate on that. But, you know, the frustrations that doctors have are the same that patients have. I also want to pick up on something that you talked about, which is cyber security and, you know. Oracle has a long history in [00:26:00] cyber security and just at our recent conference, the CIA came and talked about how they've been working with Oracle all of these, all of these years.

[00:26:08] Seema Verma: And so, 

[00:26:09] Vic: yeah, it was the 1st customer. 1 of the 1st customer, right? Y'all have been really focused on. Data security and cyber from the, from the inception, really 

[00:26:20] Seema Verma: right for many, many years. And so our products are really state of the art. And again, they come built in as part of our products, as opposed to something that's bolted on and.

[00:26:34] Seema Verma: That I think that's also a game changer, not only for providers, and we're hearing about all of these cyber attacks. There's been a dramatic increase. And I think for all of us, just as patients, that's scary. I mean, it was scary to me to hear about, you know, the attacks where providers weren't able to provide care, or they had to go to a paper system.

[00:26:54] Seema Verma: And so, but even for a patient, you know, how devastating that may that information is very [00:27:00] personal. It's not something that you want to share. Thank you. and who knows how that data can be used. So the protection and cyber security is really important. 

[00:27:08] Vic: Oracle has for a long time been very strong in life sciences, in clinical trials, pharmaceuticals, biotech.

[00:27:16] Vic: That is going to be now connected in and integrated with the Oracle Health platform. You talked about it with a clinical trial opportunity for a patient, but maybe just unpack that a little bit. How's that going to feel to The clinicians, how does it integrate together? How does it all work together?

[00:27:33] Seema Verma: Yeah. So if we think about today, clinical care and clinical research are very separate. And there's a big gap. We think about the number of people that participate in clinical trials is very low, you know, depending 1 to 3%. And people that are participating in clinical trials are ones that they live closer to an academic medical center.

[00:27:54] Seema Verma: So for most of us, it's, it's out of reach. And for some people, you know, I was reading an article, um, [00:28:00] this weekend in the Washington Post, and they were talking about a woman that was diagnosed with a rare form of cancer, given 18, 18 months to live. And she ended up living for five years. Her father was a physician, so he understood how to navigate the system, and she basically tried several clinical trials that she was on.

[00:28:20] Seema Verma: And most people don't know to do that, or don't have access to that. And if you think about it, without that, she wouldn't have survived. So, you know, we, we don't want clinical care in clinic. We want to kind of bring those two together, and we don't want people to not be able to take advantage of the latest advances in health care.

[00:28:41] Seema Verma: And a lot of times they just don't know, and it's not available to them. And so Oracle has had a long footprint in clinical research, and so a lot of the. New drugs that we're hearing about that they were actually developed on Oracle technology on Oracle's platform. We've been, you know, running clinical trials for many years.

[00:28:59] Seema Verma: [00:29:00] And so the, I would say the connection between our acquisition of Cerner really fit into our commitment to healthcare and innovation. And what we want to do next is bring the 2 together. So, right now, it's very separate. And the 1st thing that we're doing is around clinical trial recruitment where we can go to our pharma companies or other researchers and say, you know, we have a D identified set of data and we can help you look for.

[00:29:28] Seema Verma: patients. And so you can figure out where you might want to do a clinical trial. And what we hear from the pharmaceutical industries, they want to do more trials. They want to take them out of the big, large academic health centers, and they want a more diverse population so we can help them search and identify You're going to do a clinical trial.

[00:29:45] Seema Verma: Hey, there's a bolus of patients in this particular area, and you may want to do a clinical trial. That's kind of our short in the short term. We're doing that. Um, we're also trying to bring AI into all of the tools that we've brought to pharma [00:30:00] historically. So, if we think about clinical trial management system, we want to be able to bring AI to help automate that process as well, because they also suffer from the same issues that it charges.

[00:30:10] Seema Verma: old old technology. So we're modernizing the stack. The other exciting thing that we have going on this year is that a lot of our providers donate their data and they get access to a full data set when they do that. But we have, um, you know, over 100 million patient records that are de identified that we have consent, um, from the the provider to be able to use this data for research.

[00:30:36] Seema Verma: And I think that's kind of, it's a, it's a really exciting contribution to health care for researchers, for innovators, for, you know, quite frankly, for innovators to bring the next generation of medication. So that's kind of where we're going on, on life sciences, ultimately. I don't think it's going to be, uh, an electronic health record and an electronic data capture for clinical trials.

[00:30:59] Seema Verma: Instead of being two [00:31:00] separate systems, we see that all coming together in one system. So that's, that's a little further away. 

[00:31:06] Vic: That addition of the real world data or the actual. health records of clinicians and patients in navigating each person's health situation. You then overlay that with the researchers and new experiments, and you can enroll patients into clinical trials.

[00:31:24] Vic: We also can just learn, like you said, from that massive data set. Where to look next for the next opportunity in the next drug, 

[00:31:31] Seema Verma: right? Or maybe you can just run the clinical trial right from the EHR and you don't need an entirely different system So that every provider can participate in a clinical trial, 

[00:31:40] Vic: you know, 

[00:31:40] Seema Verma: that's sort of where where we're headed over over the long term 

[00:31:44] Vic: Okay, let's talk for a minute about interoperability.

[00:31:47] Vic: You mentioned that. How is Oracle sort of thinking about breaking down the kind of the walls and the silos and really sort of pushing more interoperability both between health [00:32:00] systems or providers that are on your system and outside that? 

[00:32:03] Seema Verma: Right. So Cerner has had a long history and commitment around interoperability.

[00:32:09] Seema Verma: So long before I got here, the organization was one of the founding companies that founded Commonwealth, which was a place for interoperability, where you could exchange data. And during my time at CMS, really doubled down on these, on these rules and required, the regulations now require more interoperability.

[00:32:27] Seema Verma: So that's built into our DNA. One of the things that we're doing is we announce, um, our participation in a QHIN, right? So this is the federal network around data exchange. And we announced that we're going to be doing our own. Now we exchange data today, but the, the participation in this would be that federal certification.

[00:32:46] Seema Verma: So we we've submitted our application. You know, from where we stand all, it should be an interoperable system so that data follows the patient in their journey, right? Whether they're moving from the doctor's office to the [00:33:00] hospital to a nursing home and Oracle is all across country. Right. Yeah. Have access to your medical record and you should be able to send your medical record to wherever you want.

[00:33:13] Seema Verma: But ultimately the patient's always in control, right? They can decide where the data goes to who it goes and also what type of data. So right inside their patient portal they can decide this data I don't want somebody else to see. I want to keep my mental health history more private or other disease conditions and I don't want to share everything.

[00:33:35] Seema Verma: So those are the kinds of tools that we'll be bringing to the table. 

[00:33:38] Vic: That empowered like more second opinions and more especially in cancer complex care because it's just easier to to get the records around. 

[00:33:47] Seema Verma: Absolutely. You know, for those of us that have tried to get a second opinion, you know, you hear the providers say, well, you'll have to come over here and let's redo all the tests and everything.

[00:33:56] Seema Verma: And so when, when that's not what you need, and it really [00:34:00] shouldn't matter where you go, I think a lot of the, um, tools and products have been very centric on, you know, one particular product, everything that we develop will be EHR agnostic. So they should be able to work with other EHRs. We recognize that it.

[00:34:14] Seema Verma: You know, patients are going to the doctor that they prefer and that they like. They're not asking the doctor, what EHR are you on? 

[00:34:21] Vic: Right. They 

[00:34:21] Seema Verma: don't care about that. They care about their doctor. And, you know, our job is to make it easier for patients and doctors. 

[00:34:27] Vic: Yeah. Yeah. Excellent. So I am a venture capitalist in my day job.

[00:34:32] Vic: And so what are the opportunities for startups in this new world that Oracle is putting together with its healthcare partners? There's a lot of needs in healthcare. Where do you see Oracle sort of really bringing great solutions to the market and it would be difficult for a startup to play and where are there opportunities to sort of fit in and, uh, could innovate around and in partnership with y'all?

[00:34:56] Seema Verma: Right. So we're, you know, we're very committed to the core [00:35:00] EHR. Our Oracle patient accounting system, we've talked about interoperability. We've talked about kind of the clinical trial pieces. So we've got, I would say those are our core pieces. Talk about supply chain management. So, you know, these are all the 

[00:35:14] Vic: EHR, all the 

[00:35:16] Seema Verma: basic elements, right?

[00:35:17] Seema Verma: The patient portal, patient accounting, our analytics tools. So those things that I would say are core to Oracle. But we're very, we understand that the transformation in health care isn't going to be done by one entity and we want to support those innovators. I heard a lot about that when I was in Washington, D.

[00:35:35] Seema Verma: C. how all of these innovators were essentially blocked from working with other and when we block innovation, we're blocking, um. Innovation and we're blocking care for patients, so we don't believe in that at all in our job. And we feel very strongly about it is to support the other innovators. So, whether it's, you know, providing more APIs, providing sandbox [00:36:00] environments for them to to do their work.

[00:36:02] Seema Verma: And we'll always have that commitment. But I think beyond those core pieces, you know, one of the areas around, I would say, the clinical decision support, uh, things that require FDA certification, you know, things that I would say, you know, are more provider focused or provided oriented in the sense of the clinical care.

[00:36:24] Seema Verma: We are, we're a technology company, right? So we're not, we're not a physician owned company, but it's hard to say at this point, this is where we are today. And I think that our strategy will evolve and grow. But, you know, suffice to say, we also want to support other innovators because we think that's important for patients and for doctors.

[00:36:44] Seema Verma: And so there 

[00:36:44] Vic: might be opportunities in a particular, uh, medical specialty. Or maybe, uh, in between like ambulatory and at home and there's back and forth and there's a need for a system combined with a service to help patients. Pieces like that might fit [00:37:00] very well with Oracle's platform. 

[00:37:02] Seema Verma: Yeah, they might.

[00:37:04] Vic: Okay. Um, you talked about, uh, sort of this overall comprehensive suite, and I'm not going to get it exactly right, but there's this redesigned electronic medical record, EHR system, there's the patient portal, there's the QM, the sort of the nationwide network and how it all trades together, then the life sciences and all the back office ERP systems, all of these very technical, Features, of course, are powerful and and sort of table stakes to get in and but I want you to talk more about how you ended the talk here in Nashville, really with much more about, um, empowering that I think it was called by calling to heal a call to heal.

[00:37:49] Vic: Sort of allowing doctors and nurses to get back to their love to your daughter, you know I'm sure she didn't go into medicine to really work with the best You know Q [00:38:00] hand in the world. She wants to help patients, right? Let me talk about how you manage that dynamic at a big ship like Oracle where the features are really important and need to be You know, QA and with security and work, but then keep that that ethos, maybe, or that feeling about empowering clinicians.

[00:38:21] Seema Verma: I think that drives really every single person at Oracle that is working on these products and solutions. We really come at it with the idea that we want to transform the health care system and we want to solve today's challenges. And the 1st thing that we're taking on is the provider burden. Um, if we can't transform the experience that our providers are having, they're not going to be able to transform care for patients.

[00:38:48] Seema Verma: And so we're starting there. We feel very strongly about it. I think it's a travesty. In terms of what we have put our providers through over the past, you know, 10 years, since we required them to use these and [00:39:00] they really were not designed for the workflows. And it has just created a lot of angst. And I think it's showing up in terms of the quality of care and the experience that we're all having as patients.

[00:39:12] Seema Verma: So that's top of mind. And that's why. We started with the clinical AI agent to be able to use that voice feature. And that's why we started with that product and it's just selling really well in the market and providers love it. And so the first piece of our journey in that transformation of healthcare is really starting with the experience for patients and providers.

[00:39:34] Seema Verma: And I think that's table stakes. And even just by doing that, you know, if the doctor is spending less time in the EHR, guess what? He's got more time for patients and he can see more patients. And that means that that actually helps solve the access problem right there. Just those two things. Um, so we're starting with those, but, 

[00:39:55] Vic: uh, energized because they like that [00:40:00] empathy, delivering care and helping the patient.

[00:40:03] Vic: Maybe they don't love the data entry side of the right. 

[00:40:06] Seema Verma: Right. Or having the interactions between insurance companies and providers are also very taxing. Right? And those, you know, a lot of those procedures and policies in place when I was at CMS, they're necessary. Right? You want to make sure you have program integrity and you're preventing abuse and fraud.

[00:40:24] Seema Verma: And so you need those interactions in place, but. Maybe there's a way to do that in a much faster, quicker way that doesn't irritate providers that are on the front lines, caring for patients. So those are, that's like the next generation, right? It's kind of first we, we sort of solve the problem of the provider patient experience and then we start, we really want to fix it.

[00:40:46] Seema Verma: Even an EHR won't fix that. We then have to go to their interactions with the providers and the provider and payer interaction. 

[00:40:53] Vic: Our American system, I mean, you, you were leading the system, but my view is that it works through [00:41:00] checks and balances. We, we have the payers in place. Intentionally to to make sure the care is appropriately done and build, but it needs to be adjudicated and processed in a way that is sort of a much more efficient, much more, much more 

[00:41:16] Seema Verma: we can reduce the friction between the two.

[00:41:19] Seema Verma: Right? And I think when you're reducing the friction. You're able to do those checks and balances in a way that isn't irritating, and it doesn't distract from patient care. It doesn't delay patient care. So there's, there's a lot of opportunities for improvement with modern technology and with AI and with cyber security all put together 

[00:41:39] Vic: good.

[00:41:39] Vic: Well, thanks for doing this. I really appreciate your time. I think. My audience is going to be really excited to learn more and just as a closing, where should they go to learn more and get involved and maybe learn about how to how to buy some of these products and start using them Oracle website or where do you recommend?

[00:41:59] Seema Verma: Right? I think the [00:42:00] website is good as well, but we're also creating opportunities. I know we're getting a lot of requests. Um, people want to see what does a new modern Oracle HR look like? And so we'll be having demonstrations across the country as well this year. 

[00:42:14] Vic: Yeah. Okay. Excellent. Well, thanks for doing this.

[00:42:16] Vic: We'll keep watching. I want to check out one of those demonstrations. Excited to see how it all evolves. 

[00:42:21] Seema Verma: I'm happy to do it. I appreciate it. Thank you, Vic. Thanks for having me.