Forget EHRs. Let's Focus on AI and Interoperability Instead.

As AI weaves its way into the healthcare ecosystem, Oracle is reshaping the EHR debate to focus on collaboration and interoperability. But will everyone be willing to share?

As EHR companies ramp up their efforts to convince health systems and hospitals to sign tech contracts or switch from one platform to another, there are some who argue that the process of giving care to patients shouldn't be a business. The best business practice, they say, is sharing data and technology to ensure that patients get the best care.

That's Oracle's pitch this week at the Oracle Health and Life Sciences Summit in Orlando, and Oracle Health Life Sciences EVP and General Manager Seema Verma was its biggest cheerleader.

With a nod to Epic, the biggest player in the pool, Verma and others at the conference made an argument that the EHR platform alone isn't the key to success. The difference will be found in how that platform embraces AI.

"Not all AI products are created equally," she said, touting an Oracle AI strategy that integrates with the EHR rather than acting as a bolt-on. "No other company is taking this end-to-end approach."

And speaking of interoperability, Verma pointed out that healthcare will only succeed if ideas are shared openly.

"The future belongs to open, extensible platforms and innovation compounds," she said. "There are no walls in our garden."

[Also read: Epic's Grand AI Gamble, Can the EHR Giant Truly Build a Connected Healthcare Universe?]

The concept pushes against traditional business norms, but healthcare isn't a traditional business. Vendors work on the idea that their products and services add value to the care continuum, and that data is a commodity that can be gathered, stored, analyzed and used for profit. Sharing those services and data, as opposed to walling them off in a silo and charging for access, is anathema to common business practice.

But that may very well be where healthcare is going. Providers need access to all patient data to improve care and clinical outcomes. The emerging business plan in healthcare is to create platforms and products that facilitate data sharing, and to derive value out of making those processes seamless for both providers and consumers.

To be sure, the EHR isn't going away. But Oracle is banking on its experience in industries outside healthcare to bypass the inconsistencies and hangups of legacy platforms and deliver products that work. And to do that, Mike Sicilia, President of Oracle Industries, said the company has to practice "thoughtful co-dependent co-building."

In the only (and perhaps final) mention of Cerner, the EHR platform that Oracle acquired for $28 million in 2022 to form Oracle Health, Verma pointed out that AI tools running through legacy EHRs are using "old data" and not providing meaningful value. She said the new AI-First EHR, built from the ground up and unveiled earlier this year, has been integrated with Oracle's cloud infrastructure and data platform, as well as tools like the Oracle Semantic Database and Knowledge Graph that capture the conversation, pull in data from separate sources and make it meaningful.

"The new Oracle EHR is voice first, and the record writes itself," she said.

Verma said more enhancements will be coming out in the next couple of years, including an Autonomous Reimbursement System that's designed to apply AI to revenue cycle management (what she called "a labyrinth of the ‘80s") and, working with payers, tackle prior authorizations and denials.

The company also plans to roll out a Life Sciences AI Data Platform and suite of apps in 2027 that will address clinical trials through the EHR, enabling researchers, clinicians and even patients to work together to find the right candidates for clinical trials.

The gist of Oracle's presentation is that its healthcare platform will be open, and that anyone can be part of the ecosystem. The company even unveiled an Oracle Center of Excellence, with Sicilia pointedly noting that organizations "whose partner is our competitor" can participate.

At the end of the day, however, Oracle is still one player in a very big pond, and its vision of a connected healthcare ecosystem has to deliver before health systems and hospitals will even consider changing their EHR platforms. Oracle did get the jump on Epic when it released its AI-First EHR, and Verma noted that the company is embracing federal efforts for nationwide interoperability with plans to become a Qualified Health Information Network (QHIN).

Sicilia also made note of the speed with which organizations are adopting AI tools and using them. Now comes the hard part of seeing real value and developing programs that reduce costs and complexity, improve workflows for doctors and nurses and boost clinical outcomes.

Whether that will stem the tide of health systems embracing Epic or other EHR platforms remains to be seen. But the concept was backed by a quartet of health system executives in a separate panel. Richard Gray, MD, CEO of the Mayo Clinic's Arizona hospital, said healthcare organizations and their patients suffer when they think they have all of the answers.

"We don't know who is going to have the best idea, but we do know that Mayo Clinic isn't going to have all the best ideas," he noted.