Thankfully Business Insider Is Not Responsible for Healthcare Modernization

By Ken Glueck, Executive Vice President, OracleMay 28, 2024

Clickbait (noun): “something (such as a headline) designed to make readers want to click on a hyperlink especially when the link leads to content of dubious value or interest.”[1]

“Oracle’s deadly gamble. Larry Ellison bet $28 billion he could revolutionize healthcare. So why are so many patients dying?” reads the hyperbolic, fantastical headline recently published by Business Insider (BI).

Wow. Clickbait? One would expect that following such a headline, Business Insider would follow through with…some semblance of news?

Instead, we get the typical Business Insider formulaic story: start with a vignette, take some widely reported old news, mix in a few anonymous quotes, take other quotes out of context, ignore all facts to the contrary, present other facts entirely backwards, add some irrelevant graphics, refuse to print the company’s response, throw in the obligatory layoffs…and you have your typical Business Insider preconceived “expose.”

What’s worse, this story is nearly identical to a story published by Business Insider nearly two years ago to the day here. The regurgitated story again centers around the Department of Veterans Affairs’ (VA) electronic health record modernization program, which is a complex technology modernization effort in search of a scandal. The reason the VA needs to modernize is because its current system—VistA—was implemented during the Carter Administration. We cover all the reasons VistA is long past its prime in a blog entitled “Veteran’s Deserve Better than VistA” here. Even BI acknowledges that VistA is “outdated and vulnerable to cyberattacks.” What could go wrong with a cyberattack on the Department of Veterans Affairs? Well, lots, as Larry Ellison and Seema Verma (EVP and General Manager of Oracle Health) recently articulated in the Wall Street Journal here.

Boiled down to the basics, VistA is on-premise, fragmented, insecure technology conceived decades before the Internet. Our veterans deserve better. The modernization effort is going to provide the men and women who serve the United States a single, interoperable, secure, longitudinal record from time of enlistment to end-of-life care, following them from the Pentagon to the VA. What BI misses this time around is that by every single measure, the system is vastly improved from when BI first “reported” this identical story in July 2022.

The palaeoloxodon in the room is that the Department of Defense (DoD) has now finished successfully implementing the Cerner electronic heath record system to rave reviews. We were unaware the internet had page limits, but BI could only see fit to include 20 words of Oracle’s 124-word statement in a nearly 4,500-word story. We include the entirety of the statement below (for ease of the reader we bold everything BI ignored):

“Our veterans and the people who care for them deserve a world-class EHR system, and Oracle is delivering it. Since Oracle took over the VA’s EHR modernization project two years ago, we have made thousands of improvements to enhance the performance, reliability, and usability of the system. The technology being deployed at the VA is the same technology helping doctors and nurses provide reliable, quality care at all 3,890 DoD locations—the largest EHR implementation in the world. The recent highly successful go-live at the joint DoD and VA operated Lovell Federal Health Care Center in Chicago is a powerful demonstration of our ability and commitment to provide veterans with unsurpassed care, and we look forward to extending this success across every VA facility.

You see from our statement the fact that Oracle/Cerner was successfully deployed at nearly 4,000 DoD facilities. That part of our statement inconveniently contradicts BI’s core thesis. So they ignored it.

This story chooses as its main antagonist a software feature called the unknown queue, a function specified by the VA in the system’s design and also present in VistA. But after some issues with the unknown queue were widely reported nearly 2 years ago, the issue was resolved by Oracle in…wait for it…10 days. From that point forward, the unknown queue has not been an issue at all, so it is beyond us as to why it would form the centerpiece of BI’s new “reporting.”

And to never let the truth get in the way of a good story, BI literally turns other facts inside out. It invents this paragraph from a puff piece it wrote about the largest EHR provider, Epic, in 2020. BI parrots Epic’s misinformation:

“Epic may have been a more obvious target for Oracle, since it had a larger share of the market and dominated among large hospitals and research facilities. But Cerner, the go-to EHR for small and midsize hospitals, had a quality that would have appealed to Ellison: It was widely seen as taking a more relaxed approach to data privacy.”

This version of the truth is particularly special since everyone in the industry understands that Epic’s CEO Judy Faulkner is the single biggest obstacle to EHR interoperability. She opposes interoperability because it threatens Epic’s franchise. By contrast, Oracle believes outcomes are easier to obtain when providers can collaborate and gain insights across systems, data, and application silos. Our strategy is to build everything in a modular way that is EHR agnostic. We are continuing to deliver on the industry’s most open, interoperable EHR system and increasing our APIs by more than 300%. Privacy? Epic’s contracts expressly appropriate all patient EHR data as Epic’s own, stretching HIPAA beyond recognition, while Oracle/Cerner’s explicitly state medical centers must opt-in to any data sharing.

Business Insider could have spent its 4,500 words reporting on all of the progress made at the VA as we transparently detail here: the fact that veterans using the new EHR have a complete medical record from their DoD service to care at the VA—and even care they receive in the community. Or the fact that the recent deployment in North Chicago has exceeded expectations and gone very well. Or the successful deployment at one of the most complex medical centers, Walter Reed. Or the fact that Oracle has a new generative AI clinical digital assistant feature for the EHR that will help providers spend less time in the EHR and more with patients.

Business Insider could have chosen to cover the successful deployment in March of the new EHR to the joint VA-DoD Lovell Federal Health Care Center (Lovell FHCC) in North Chicago, where patient volumes have already returned to 90 percent of pre-deployment numbers. The emergency department is seeing patients at a number equivalent to 110 percent of pre-deployment numbers. And pharmacists have returned to 99 percent of pre-deployment numbers for outpatient prescriptions.

Overlooked in the discussion of the Lovell FHCC deployment is the fact that Lovell is the first deployment to happen under Oracle’s watch since the Cerner acquisition. Lovell FHCC has benefitted from all the updates to both performance and stability, features and workflows, and training that have occurred in the last two years. Through the course of the current reset, much of this work has been done, and as VA provides direction on further simplifications or modifications to the EHR, we are ready to quickly implement.

Because of the new EHR, veterans who go into the community for care now have interoperability with more than 90 percent of community care provider EHRs. This means the care they receive in the community is in their VA record, and their community care providers know what is in their VA record. This only makes care safer, more efficient and better for the veteran.

Business Insider ignores important veteran safety enhancements in the EHR such as the visibility of Patient Record Flags that alert clinical staff to critical issues including suicide risk, disruptive behavior and missing veterans to enable timely intervention.

Now, to the point. Healthcare is one of the largest sectors of the global economy, and everyone acknowledges it is far behind in basic IT modernization. As the BI authors acknowledge, here we are in 2024 and basic healthcare decisions are made essentially without data and in a vacuum. There is more compute put on predictive lattes at Starbucks than predictive medicine. We are committed to changing that and investing dramatically in IT tools that promote positive patient outcomes. 

That’s why Oracle is just getting started and why it is so invigorating to have BI rooting against us. It is true—as BI points out – that others have tried to modernize healthcare and failed. What BI misses is that all these same factors that caused others to fail will also cause Epic to fail. And these factors will lead to Oracle’s success.

The biggest differentiator Oracle brings to this effort is Oracle Cloud Infrastructure—scaled, secured, and autonomous. If you want to start to modernize healthcare you need to start with a modern cloud, not by supergluing on-premise systems onto AWS in hosted environments and saying cloud quickly (read, Epic).

Oracle then adds decades of expertise building complex enterprise applications in pure SaaS models. You think EHRs are complicated? Try global accounting. Generative AI didn’t commercially exist when Oracle bought Cerner, yet we are already embedding generative AI into our healthcare systems to provide ease of use and reduce practitioner fatigue. Look no further than Oracle’s new Clinical Digital Assistant to see where we are headed.

We then layer in Oracle’s expertise in other critical areas of healthcare, such as supply chain, clinical, scheduling, HCM, payments, billing, inventory and many others, and before you know it, the healthcare sector will benefit from the exact same modern efficiencies, convenience—and, by the way, outcomes—that we see across the global economy in sector after sector from IT modernization.

By comparison, Oracle has the easy job. It is the researchers, biologists, chemists, and medical specialists tasked with curing diseases who have the hard job. There is nobody who believes that more data, more analytics, and more AI will not accelerate that process. All we are doing is modernizing IT systems—and wrapping those systems in AI—to facilitate much of that work. As BI knows because it purports to cover technology, complex system modernization takes time and effort. We have no doubt our so-called “gamble” will hit big. Coming back to Business Insider’s opening vignette, Crestor may or may not have been the right statin for Mr. Ellison’s condition. The point is, in 2024 it’s time we stop guessing.