In my Oracle CloudWorld '23 kickoff, I polished the case for industry-focused applications over generalized ERP. No surprise - healthcare figures prominently in this at CloudWorld.
For the second consecutive year, Larry Ellison made the imperative to change healthcare a core feature of his keynote - though this time, AI was at the center of Ellison's message to attendees also (My colleague Derek du Preez gave his take on the keynote in Larry Ellison's Oracle AI vision extends well beyond the enterprise, it's a vision for big world problems).
During our pre-event interview, Oracle's Steve Miranda detailed the financial supply chain announcements, and why those matter for Oracle healthcare customers. But there was a welcome twist: an emphasis on how customers can - and should - derive deeper value from cloud applications well after go-live. Granted, that's not easily done, nor does it land in your lap - but it's a major pre-occupation of my diginomica content. For Miranda's part, he basically guaranteed customers would be ready for those discussions here. So were they?
On CloudWorld day one, my interview with Elina Petrillo, VP HR Technology and Service Center, Northwell Health, pulled these themes together. Northwell Health is a nonprofit healthcare network. It is also New York State's largest healthcare provider and private employer, with more than 81,000 employees.
My stubbornness about post-go-live benefits does have one risk: minimizing the importance of a successful go-live. Northwell Health's go-live was anything but easy. As Petrillo told me:
We were in the midst of Oracle implementation for HR for 70,000 employees. Every single module in the Oracle suite except for time and attendance was in scope. And in the matter of two weeks, our project was moved remote.
There was a moment of truth: should such an ambitious project carry on amidst these conditions? Petrillo:
In December of 2020, we ultimately made this decision and said, 'We're not going to be able to pull any frontline leaders into any kind of training - but we're gonna go live.' And so we went live on January 4 2021.
'Big bang' means every single employee, every single facility, every single module, at the same time. Recruitment and payroll was the most important modules for us to support and make sure it's working. Obviously, these are the frontline people that were saving people's lives. They had to be paid on time and accurately. Recruitment was experiencing a significant number of increased activity.
There was a short term imperative: create better self-service HR experiences.
Our main drivers were to implement Employee Self Service. And then we also did Manager Self Service.
Petrillo's team faced so much project adversity, they called 2021 "the year of survival." Beyond the remote installation, they faced the inevitable change management issues - and the difficulty of remotely educating employees on the new system. But they got through it - only to face a new curveball:
In 2022, we did close to nine different mergers and acquisitions. So that was kind of a whirlwind of mergers and acquisition activities as well.
Shifting from pandemic go-live to the "year of innovation"
But now we're in 2023, and the project theme is shifting again:
We want to call this the year of innovating. We're looking at automation - Oracle digital assistant; we're looking into implementing Booster, which will continue with our theme of improving applicant candidate experience, because our turnover rate has come down... But you know, we're still looking for very specific skills. That's just not easy to get in today's marketplace.
Now comes my ERP-must-change question: has this project helped you serve your own customers (patients) better? Petrillo responded:
Number one is: everyone wanted to move to the cloud. So we accomplished that. Number two is: ultimately, especially my HR technology group, thinking about: how do you consume new enhancements? What kind of operating model are you going to implement?
But, going back to your question: how do we improve our patient care? How we improve patient care is: you make less work for frontline workers, so they can spend more time with patients. Mobile is a big deal, right? So the managers would be able to approve, or request physicians to approve requisitions online.
Whatever outcomes you achieve, you have to do that within the context of governance constraints: "Healthcare is highly regulated; it's also complex - so we have some constraints as well."
Want to serve your constituents better? Then your leadership needs better information:
Our quest to provide insights to our leaders in the business, to make good decisions about how to run the business. We're a not for profit organization - labor costs continue to go up. You have to make some really tough choices, and try to have most of your labor costs spent on frontline people, not in the back office.
One crucial area for Northwell Health that has improved: employee retention. Petrillo explains:
We're one of the top' Fortune companies to work for.' We pivoted from just doing a new employee engagement survey into more listening tours, you and very specific pulses on specific topics. We're we're constantly listening and trying to adjust.
Aborbing new Fusion Cloud functionality each quarter is welcome, but it does bring challenges:
It's helping that we're kind of put on a cloud diet. Four times a year there is a release. We try to look at ourselves and say, 'How we are adapting those releases, or bringing value to the organization, or are we just doing legal and regulatory things.' So we have very specific matrixes that we tracking.
We started to work around OKRs, really looking at the outcomes and creating objectives in the beginning of the year. What we're learning is that healthcare is constantly switching priorities, and it has impact on projects that we deliver, and outcomes that ultimately come from those projects.
The wrap - can generative AI take the transformation further?
Petrillo says Northwell Health is now embarked on a "huge digital transformation." How big? They plan to take almost forty different applications, and move them into one EMR system.
It's going to be quite transformative. But now, the question is how seamlessly I were going to integrate it with other platforms.
Petrillo has declared 2023 as their "year of innovation" - so what does that look like?
Innovative solutions that meet people where they are - like someone wants to work flexible shifts; someone wants to work more regular shifts; someone wants to make extra money; someone wants to make extra money that's close to home. And how do you also provide some guardrails that people are safe? That our patients are safe? Also: how do you create cost effective solutions? Because the fact is during COVID, the rates for clinicians and agency have been astronomical. That's not a sustainable model.
So can generative AI help with these innovation goals?
We have a team that's syndicated to security, privacy. That's why we're excited about generative AI, but we're also thinking about the security, how ethical are some of the things that we're going to put in place?
This is the push/pull of generative AI for the enterprise; balancing the opportunity and risk mix.
It's a kind of conflicting place. On one hand, you have to move in really quickly, to be able to create those efficiencies, and take advantage of all the new stuff that's coming out. On the other hand, you have to be really thoughtful. When you're a New York based company, there are new laws coming out of states and feds. You don't want to start the investment, start to roll out and bring it to a full stop because there is a new law that prevents you from doing this or that.
With that in mind, what does Petrillo think of Oracle's generative AI plans for FusIon HCM?
We're looking at AI and recruitment. And to my point, just being very thoughtful and careful about how we implement it - and make sure that we don't bring in biases or selective recruitment. We're implementing Oracle's Digital Assistant; we're incredibly excited about the fact that we could create our own, within the walls of Northwell, a specific personality of our chatbot. It's really important for us to come off empathetic and humanistic in the way we provide the answers. It is really important to provide accurate answers as well. But we excited, because now we are able to provide the services 24/7.
And then going back to the topic that we talked about, in the beginning - how do you have frontline people do less work? Performance reviews are required in healthcare by regulatory agencies. So how do we help our leaders to have an initial draft to help them write? How do you make HR to be more efficient, and write more inclusive job descriptions? I think that's the simple stuff.
Then there are more advanced AI-for-HR use cases, such as dynamic skills, where you can invest a considerable amount into skills development:
The question that everyone should be asking is: do they work? You put people through training or skill them, are managers are still holding onto the talent? How effective are those development programs? Did the implementation of generative AI bring in the value that you were looking for?
One thing I'm sure of: these are the right questions. I have a hunch that Petrillo's "year of innovation" is going to extend well into 2024, and probably beyond.