Why a big health system stuck with Oracle for its EHR

While several big health systems have switched to Epic in recent years, others have bucked that trend by staying loyal to their longtime EHR companies.

Take King of Prussia, Pa.-based Universal Health Services, which has over 400 hospitals and outpatient centers and about $14 billion in annual revenue. The publicly traded health system cemented its relationship with Oracle Health (formerly known as Cerner) last year when it selected the company as its unified EHR across its acute care and behavioral health hospitals.

Becker's talked to UHS CIO Eric Goodwin about how that relationship has developed, where he anticipates it going from here, and why UHS is an EHR outlier.

Question: How long has Universal Health Services used Oracle Health as its primary EHR, and why did UHS select the vendor in the first place?

Eric Goodwin: Since 2009, Universal Health Services has worked with Cerner/Oracle Health as our primary healthcare technology partner. For our UHS acute care division hospitals, the legacy Cerner system has provided an excellent clinical systems platform and our staff have customized the system to optimize provider workflows.

In 2023, UHS announced the design and rollout of the Oracle EHR for our behavioral health division. With this expansion, UHS will have access to a single, unified EHR in acute and behavioral health facilities across the United States to better inform care decisions and help improve patient safety practices. As with our acute care hospitals, we will be able to innovate and customize the system to meet the unique needs of our behavioral health providers.

Q: What have been the benefits of that EHR?

EG: Three things come to mind. First, the Oracle EHR operates well at scale, meaning the system can appropriately handle the thousands of patient encounters that occur each day in our hospitals. Second, the tools embedded in the system enable our informaticists to customize the decision support and documentation workflows for our providers and clinical teams. And third, Oracle is beginning to deliver additional enhancements that we view as a priority.

The near-term roadmap for enhancements is promising: namely, using generative artificial intelligence in the clinical setting, addressing long-standing revenue cycle challenges, and improving our consumer's digital experience. We are excited to see the benefits of these investments by Oracle.

Q: Have there been any challenges with the EHR?

EG: In recent years we have been disappointed by the lack of progress in enhancing the EHR, particularly in the areas of revenue cycle and consumer experience. Under the legacy Cerner organization, we believe development in these areas materially lagged other alternatives in the market. That's why we are cautiously optimistic about Oracle's new roadmap and commitment to improving the product.

Q: Why do you think UHS is an outlier on this list, as it is one of only a handful with Oracle Health as its primary EHR and most of the biggest systems are on Epic?

EG: Both the Oracle and Epic platforms are solid, and we actually have experience with both companies. The leadership teams at both companies are dedicated to success and continuing to improve their products. UHS' view is that success with the EHR is driven by how the systems are tailored and adopted within the hospitals. UHS invested in a full-time chief medical information officer and three other full-time physicians to direct and ensure our customizations left us with a superior product compared with other EMRs.

In fact, our UHS customizations have been so successful at improving physician productivity, clinical outcomes and reducing expenses that other health systems have contracted with us for these enhancements. We continuously measure "clicks" and satisfaction by our clinical teams and optimize the system on an ongoing basis. This has remained our focus, continuously improving the features and functions in support of our clinical teammates and patients.

Q: Does UHS have any plans to change EHRs or its EHR strategy?

EG: Oracle's EHR product roadmap addresses our major concerns, and we'll work with Oracle to deliver on those important enhancements. When combined with UHS' expertise in customizing and developing on the platform, such as with our physician mobile app, we believe we are well positioned for continued success.

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