Health systems have long known that rural patients face steeper odds when it comes to accessing care. Physician shortages have created “medical deserts” in rural America. Currently, around 43 million people live in rural areas with primary care provider shortages. In addition, many rural patients must travel outside their communities for specialty care at regional networks or facilities that partner with metropolitan health systems.
Long drives, limited public transit and stretched schedules make even routine appointments a logistical hurdle, and the consequences show up in outcomes. Rural hospitals see patients with consistently higher rates of chronic diseases such as high blood pressure, obesity, chronic obstructive pulmonary disease, diabetes, cardiovascular diseases and more.
Billings Clinic–Logan Health understands the challenges of rural healthcare delivery very well. As the largest independent Montana-based healthcare system, the organization serves patients and families across Montana, northern Wyoming and the western Dakotas. In response, Billings Clinic–Logan Health has turned to Oracle to help deliver on its mission of providing quality, compassionate care as close to home as possible.
Care coordination is critical
Billings Clinic–Logan Health consists of two tertiary care referral centers. One is a Level 1 trauma center and a comprehensive stroke center. In addition, 24 other organizations are affiliated with the health system and more will be added in the coming years.
Randy Thompson, MD, chief health analytics officer, explained that the distance between the communities the organization serves is equivalent to the distance between Washington, D.C. and Chicago.
Large distances introduce coordination challenges as patients transfer between geographically dispersed clinicians. Trauma patients often receive care at several facilities across the region and that care must be managed across different providers and specialties.
“Consider a trauma patient in one of our most distant facilities, which is 355 miles away,” Dr. Thompson said. “We have to get them to the trauma center for treatment, transfer them to a rehab facility, transition them back to the care facility closest to their hometown and ultimately discharge them home.”
Bringing innovation to rural care settings
Billings Clinic–Logan Health was formed in September 2023 through the merger of Billings Clinic and Logan Health. Following the merger, leaders identified standardization as a strategic priority, with a focus on creating a consistent experience for clinicians and patients across the system while making it easier for rural and critical access affiliates to participate in new innovations.
It was important that all critical access partners have access to the same technology and same innovation that larger facilities typically benefit from. To support this initiative, Oracle Health enabled a unified technology platform for Billings Clinic–Logan Health that is shared across the network, including critical access affiliates, creating a common foundation for care delivery.
With an integrated health record, clinicians have access to the latest data about a patient, regardless of where care is delivered across the network. Providers can now access the same patient data, order sets, technology solutions and AI innovations, to help deliver a more consistent experience to patients no matter where they receive care.
“One example of this is the rollout of Oracle Health Clinical AI Agent. We didn’t have to go facility by facility, but we could roll it out rapidly since we’re on the shared domain and can offer the same technology available to each facility. This was a huge satisfying factor for our staff,” Dr. Thompson said.
Improving care for patients and clinicians
Adopting Oracle Health technology has transformed both the patient and provider experience. Patients are now being seen faster with improved access to care and clinicians can be more effective with their time.
By implementing Oracle Health Clinical AI Agent, Dr. Thompson reports that his team saw a 38% reduction in documentation time and an 18% increase in patients seen. Many of the most active users have experienced an even greater reduction in documentation time, according to Dr. Thompson.
“The more people use it, the more time they save. In addition to reduced cognitive burden, their work-life balance has improved and we’re hoping that leads to decreased burnout. They can be more focused on the patient and not buried in the EHR,” Dr. Thompson said.
Why the right collaborator matters
Based on Billings Clinic–Logan Health’s experience, Dr. Thompson offered several lessons for organizations that are contemplating similar technology investments.
For him, it’s important to evaluate an EHR vendor’s current and future plans. Key considerations include the database, tech stack, platform strategy and AI solution integration. Oracle also standardizes the implementation approach enabling teams to work with the same systems across the organization’s vast network of providers.
Identifying a vendor that will be a true strategic partner allows Billings Clinic–Logan Health to benefit from new capabilities like Oracle Health Clinical AI Agent and more easily adopt technologies as they become available in the future, including for its rural affiliates that may not otherwise have access to such innovations.
“Oracle Health is interested in our success. They focus on understanding our workflows, so the solutions meet our needs, rather than asking us to change workflows to meet the needs of the solution,” Dr. Thompson said.
As Oracle Health develops new functionality, it also involves end users in the evaluation. Work groups consisting of nurses and physicians in the acute and ambulatory settings regularly provide feedback, which Oracle Health incorporates into new releases.
“It’s an exciting time to be in healthcare because we finally feel like technology is making our lives better,” Dr. Thompson said.” Oracle Health is interested in our long-term success. They are vested in us and we’re vested in them.”
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