Dive Brief:

• On Thursday, Oracle founder and chairman Larry Ellison announced Oracle is building a "unified national health records database" on top of the thousands of separate hospital databases that exist in the U.S. today, but the interoperability bid faces notable future roadblocks and industry skepticism.
• The database’s goal is to give providers in different states and systems access to patient records in an emergency, and provide researchers with real-time information about metrics like disease incidence to help shape policy responses.
• An Oracle spokesperson declined to answer other questions about the new database’s timeline, price tag and outside access, but told Healthcare Dive it would be a “standards-based system open to all.”

Dive Insight:

Despite federal regulations meant to incentivize free electronic sharing of health data between organizations, medical data in the U.S. is highly siloed. The COVID-19 pandemic exposed numerous gaps in the U.S. medical system including the lack of aggregated data, which hamstrung public health response and led some researchers to renew efforts to create frameworks combining patient data.

Proposals to centralize medical records weren’t new prior to the coronavirus pandemic, but efforts to do so have yet to pan out.

Oracle and Cerner, both leaders in their respective fields, will benefit from economies of scale, but it’s not entirely clear what the two will bring to the table to realize this vision, according to Patrick Murta, chief platform architect at BehaVR. Previously, Murta spearheaded Humana’s interoperability platform.

“There’s nothing in the union to make that more feasible,” Murta said. “There’s a healthy skepticism that they’ll have the magic bullet to overcome any of the existing barriers to interoperability.”

Details are vague about the new project, which could reshape the nation’s healthcare interoperability landscape but is likely to run into problems including: data fragmentation and standardization, security and privacy, differing state laws and regulations and buy-in from other EHR vendors.

It’s not clear whether Oracle has reached out to other vendors to discuss the potential of adding their records.

A Meditech spokesperson said the EHR vendor has had “no formal outreach” from Oracle regarding the project, while Allscripts and Epic did not respond to requests for comment by time of publication.

Athenahealth declined to comment on whether it plans to share records with the database.

The announcement “may even provide more caution for others,” Murta said. “If you're a competitor of Cerner and they’ve now joined with an even larger organization, I don’t naturally see how that provides a good feeling to join this national database.”

Centralizing a large EHR dataset could potentially be a gold mine for Oracle, which could leverage the database for life sciences research and product development. Oracle has only shared two use cases for the new system so far. For one, it would provide anonymized data for public health officials and researchers, to to identify novel viruses, build AI models or allow a local government to see the number of available hospital beds in their city, Ellison said.

Additionally, doctors at a new hospital that doesn’t have a patient’s medical record could turn to Oracle’s database for their medical data.

“What your blood type is, what your allergies are, what drugs you’re currently taking, do you have a stent in your heart — they get all of that information instantaneously,” Ellison said Thursday at an Oracle event on the Cerner acquisition.

That future is also something the government is trying to realize with its own framework for nationwide data exchange finalized early this year. The voluntary framework would allow clinicians to query participating networks for a patient’s data.