Healthcare operations within Hospital systems span multiple business functions. A typical healthcare system often runs dozens of software systems that help with Electronic Health Records, bed management, staff management, staff hours, supply chain, planning, inventory management, food management, pharmacy management, command center, lab management systems, employee training, HR, Recruitment, and many other systems. With need for safety and security paramount running efficient healthcare systems is an extremely complex process.

With the acquisition of Cerner by Oracle, there is a great opportunity to consolidate healthcare systems and utilize a common platform to run healthcare operations.

Let us consider a few use cases.

1. Point of care consumption and par levels

One of the most common transactions performed by hospital staff is recording material and items used during patient care. When these assets are identified and recorded at the point of care, patient records are updated.

Delay in inventory updates

When a hospital uses an inventory and supply management system that is not directly linked to the EHR, point-of-care data is often not moved over to the inventory management system in real-time.

Excess inventory leads to wastage.

This causes a lot of issues. Stock cannot be tracked in real-time and the consumption, when fed back in batches will be delayed. When the inventory systems are not automated, reordering of material is also often not automated. So, there is a delay in both the capture of real-time inventory as well as in ordering new refill inventory. Due to these delays hospitals often have to overstock.

Recalls and maintenance due cannot be easily tracked.

When assets are used in the EHR, but that usage is not passed back to the Biomed systems that take care of recalls and maintenance of equipment, enforcement of recalls and maintenance becomes problematic.

Par Levels

Hospitals need to make sure they have enough inventory of items for patient care. This could be instruments, wheelchairs, clinical products, and medication. The usage of par levels, for inventory can help with maintaining the minimum required amounts of inventory wherever and whenever it is needed.

When EHRs are not integrated with sophisticated inventory management systems, hospitals cannot efficiently manage the par levels.

Reporting par outages in real time

When Cerner and Oracle inventory are integrated another feature that can be turned on is par levels. Using par levels, refill requests can be generated in real-time so material can be available at the right place at the right time.

Over par materials

Locations that are over par constantly can be adjusted so the material can be appropriately repurposed.

Opportunity with Cerner-Oracle Fusion Inventory integration

When hospitals can utilize Oracle inventory in conjunction with Cerner, the point-of-care consumption transactions can be directly fed into Oracle Inventory from Cerner as inventory transactions. These transactions update inventory levels at the location and sub-inventory level. These can be used to automate procurement and refill orders by creating purchase orders or transfer transaction requests.

2. Staff prediction and planning

Missed opportunities

One of the trickiest aspects so health care is staff planning. Often hospitals find that a significant portion of their costs is staffing. When the EHR is not connected to a planning system, a host of information in the EHR that can be potentially leveraged for proper planning is wasted

Staff planning

Hospital ORs are often scheduled ahead of time. ERs are however unpredictable in nature. However, with proper planning tools, the load in the ER can be predicted using criteria such as day of the week, time of year, flu patterns, holidays, and so on. When ER is predicted, the flow into the inpatient facilities and labs can also be predicted as they are typically a portion of ER patients in addition to pre-scheduled patients.

Opportunities for Oracle Fusion Planning Integration

With this wealth of information, Oracle planning can be used to estimate the staff that is needed. By integrating Cerner with Oracle planning, real-time information can be fed in and optimized plans can be regenerated.

Hospitals often use spreadsheets for the planning process and a lot of that can be automated using Oracle planning.

3. Procurement and Supply Chain

Supplier management

Hospitals have to manage a lot of material for clinical and non-clinical processes. Hospitals have to deal with the end-to-end supply chain process of identifying suppliers, setting up contracts, setting up vendor-stocked inventory, sending out purchase orders, receiving, paying, and so on.

Material usage and planning

Similar to the use case with the point of care, inventory planning often comes down to estimating how much inventory is needed. On a periodic basis, this can be achieved using consumption numbers and patient/staff numbers from the EHR

Opportunities for Cerner — Oracle Procurement integration

Cerner material consumption and requirements can be integrated into Oracle Fusion Procurement so purchase orders can be auto-created. Hospitals often have contracts for minimum consumption from a vendor and a percentage-based allocation for vendors. Since Oracle supports these features, hospitals can benefit from these capabilities.

4. Bills of material and Operating Room Supply Chain

Surgery bill of material — procedure cards

Hospitals perform repeated surgeries of the same procedures. The material required for these surgeries is captured in surgeon preference cards. These are often in a system outside the EHR and not optimized for variances.

Opportunities for Cerner — Oracle BOM integration

Cerner preference cards and be interfaced with Oracle and surgery schedules can be set up as jobs within Oracle. This can let the hospital run master schedule planning type activities that will let hospitals know the bills of material needed for surgeries for the day and the pick list activities that are needed to fulfill the surgery requirements

Getting data in and out of Cerner

HL7 and FHIR are ideal candidates to get data in and out of Cerner. Since a lot of the Cerner Oracle fusion integration would be batch-oriented rather than manual intervention-driven, HL7 or data extracts could be an ideal way to get data into Oracle Fusion.

Openlink HL7

Cerner Openlink can be utilized to send out real-time HL7 transactions such as the following.

• ACK- General acknowledgment
• ADT — Admit, Discharge, Transfer
• ORM — Order (Pharmacy/treatment)
• ORU — Observation result (unsolicited)
• SIU — Scheduling information unsolicited

This is not an exhaustive list and a number of other HL7 transactions can be leveraged based on the use cases

Cerner CCL

In addition to real-time information streaming using HL7, often data in the Cerner Millennium database would be needed to be interfaced with Oracle Fusion. For example, block schedules or employee information could be taken from Cerner and transferred to Oracle. Cerner CCL can be utilized in this case to get data out of Cerner and into Oracle Fusion via various connectors Oracle Fusion provides to upload and interface data.

These integrations between Cerner and Oracle Fusion inventory, Supplier Management, Purchasing, Receiving, Planning, and Bills of Material can potentially transform the way hospitals manage their operations. There are other opportunities as well in the billing, revenue cycle management, and HCM areas that we can cover in another blog.