In June, Larry Ellison, Oracle's chairman, chief technology officer, and cofounder, joined a growing list of billionaires to make lofty promises about transforming healthcare in the US.
The software giant bought the medical-records company Cerner for about $28 billion to dramatically expand its healthcare portfolio.
Shortly after the deal closed in June, Ellison laid out a vision for how the two companies could build a "revolutionary" health-information system in the cloud, creating a way for providers and public-health officials to access patient data from across organizations.
That's a dreamy departure from today, where a person can show up to an emergency room that has no available record of their blood type.
"We're going to solve this problem," Ellison said at a company event.
At $4.1 trillion — or $12,530 worth of spending per American in 2020 — the US healthcare industry is an attractive target for companies that have transformed other sectors and need new ways to grow. Amazon just made its third-largest acquisition to buy a primary-care startup, and experts have speculated it could be used to build a Prime-like offering for people to manage their health.
But after years of pivots and flops, some of Big Tech's projects in healthcare are looking more modest. Last August, Cerner hired Dr. David Feinberg from Google, which had assembled and disassembled a whole health-related product area in three years.
Oracle isn't new to health. But it's a big undertaking to fix the lack of a shared technology infrastructure for US health records, and Ellison's statements will be tough to live up to.
One issue — how well Oracle can navigate a complicated project with the US Department of Veterans Affairs — will be its most visible test.
The VA is the nation's largest health system, caring for more than 9 million veterans at more than 1,200 healthcare facilities each year. In 2018 it signed a contract with Cerner to replace its 40-year-old electronic medical records. Cerner had already made about $2.8 billion from the project as of April, according to the US Senate Committee on Veterans' Affairs.
But delays and technical issues have plagued the VA's rollout of Cerner's technology. The VA initially won a $10 billion budget to pay Cerner with, but cost estimates have rocketed far beyond that sum such that Congress passed a bill to increase scrutiny of the program.
Citing a study set to be published by the Institute for Defense Analyses, Sen. Jon Tester said in a congressional hearing on July 20 that the lifetime cost of the deployment, upkeep, and other measures would be $50.8 billion over 28 years. The hearing was Oracle's first about the VA contract since acquiring Cerner.
It's unclear to what extent Oracle will use the VA's $10 billion budget to implement fixes and upgrades and how much of the cost Oracle will eat.
"Right now the new EHR is not getting her done," Tester said in the hearing, referring to the electronic-health-records system. He added, "I really do hope that the acquisition by Oracle is going to be a game-changer."
Oracle has set its sights on using its cloud assets to Strengthen the flow of health information. The company has said it plans to create a unified national health-records database "on top of" hospitals' individual data reams. Oracle also wants to make the records themselves more useful with voice-based search and similar tools.
"That is now our primary mission here at Oracle," Ellison said.
Before 2018, the VA was identifying some of the same problems Ellison said he wanted to fix. The Department of Defense provides medical care to troops until they become veterans, at which point the VA takes over. One goal of the VA's upgrade was to supply providers at both organizations a way to see those patients' records digitally.
But VA officials have said this goal, among others, has suffered as the Cerner rollout has dragged on. The Office of Inspector General overseeing the VA has issued more than 10 reports about several issues and more than 60 recommended fixes, a handful of which are two years old and still haven't been implemented, frustrating lawmakers.
Crashes and slowdowns of Cerner's technology have caused VA staffers to switch to pen and paper. Providers have struggled to learn the new system, leading the VA to implement more training. And a quirk of the Cerner record has sent physicians' medical orders in Spokane, Washington, to an unmanned inbox, leading to delays in care.
One of the reports described a case in which a psychiatrist's order to schedule a follow-up appointment for a patient without a home was lost in the queue. The report said the patient, who was at risk of suicide, called a crisis line four weeks later about a plan to self-harm, then was hospitalized.
The first VA facility launched Cerner's technology in October 2020, and four more have followed, but no further deployments are planned for 2022 while the VA assesses these issues. Dr. Terry Adirim, who's leading the records project for the VA, said in the hearing that there's concern about what would happen in larger, complex medical centers that perform surgeries and have intensive-care units.
To face the music on Capitol Hill, Oracle sent Mike Sicilia, an executive vice president who's leading the Cerner acquisition.
"In my latest meetings with many of you and other congressional stakeholders, your frustration with the current situation was clear," Sicilia said.
The executive said that this was Oracle's first priority and that it had already shifted its top talent, including senior engineers, to work on the VA and Defense Department's EHR system. He said Oracle's main strategy to remedy bugs and cut costs is to move the Cerner application to a modern cloud data center within nine months, if it gets permission from the government to do so.
Oracle did not respond to Insider's request to say more about how that would work, but Sicilia said the migration would come at no additional expense to taxpayers.
Asked whether Oracle knew about the magnitude of these challenges, Sicilia, nearly smiling, said there are always things you discover after the fact.
"We certainly had read things that were publicly disclosed," he said. "But there's nothing like owning something to fully understand what's going on."
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When Jurgita Kaubryte spotted a job bringing together her passion for healthcare and mathematics, she seized the opportunity. Now she’s helping Oracle Cerner grow their NHS client services within the burgeoning field of data science.
Jurgita Kaubryte’s future career path was set early in life, but she didn’t know it immediately. Coming from a family of doctors, with a pharmacist mother and a dentist father, she was passionate about healthcare.
But she was also interested in finding quantitative solutions to problems.
“My favourite subject was maths at school, and I chose economics to start my career,” she explains.
As an adult, it’s no surprise that she found her way into what Harvard Business Review once termed ‘The Sexiest Job of the 21st Century’. Working at Oracle Cerner as a senior data scientist, she is leading the expansion of their data science services to NHS clients.
Her job, which she combines with studying for a data science PhD in cancer genomics, involves developing machine learning models to support population health management by, for example, helping predict falls in the elderly and identifying people at risk of high blood pressure.
Data Science in Demand
Demand for data science has grown dramatically in the last few years, with a Royal Society 2019 report claiming that the need for workers with data science skills has tripled in five years. Oracle Cerner is no exception, says Kaubryte, who will be taking on three data science interns in September.
“Health data science is still quite new so we’re a small team currently,” she says.
“But we’re experiencing increasing demand for data science services from our NHS clients and are planning to hire more people this year.”
As well as creating predictive risk models to help NHS Integrated Care Systems (ICSs) with population health management, Kaubryte also designs new internal processes for Oracle Cerner’s data science business in the UK.
She also set up the company’s data science internship scheme in the UK, which will run for the first time this year. She says it will allow latest graduates to spend four months working on a data science project and collaborating with NHS clients.
“We are excited to open this learning opportunity to latest graduates and grow our data science team,” she says.
Four Key Competencies
When hiring data scientists, Kaubryte looks for four key competencies. These are quantitative skills, such as statistics and machine learning, and knowledge of programming languages.
Other skills, she says, include communication and visualisation.
“You need to be a storyteller because, if you can’t explain your model to clinicians and other users, it won’t be used,” Kaubryte adds.
The final competency is domain knowledge, which she sees as important to Oracle Cerner’s business. Data scientists need strong healthcare data knowledge, she says, and understanding of how NHS healthcare works.
Developing Future Skills
Kaubryte works ten-hour days, four days a week at Oracle Cerner, leaving Fridays to work on a PhD at University College London, where she is developing machine learning models on linked electronic health record and genomic data to predict and Strengthen cancer outcomes.
“It’s very challenging because I do longer hours than most people, but it’s also rewarding. I enjoy having a foot in both academia and industry,” she says.
“Through my work at Oracle Cerner, I help solve challenges in the NHS with immediate impact on current services, while through my PhD, I get a chance to contribute to long-term advances in healthcare, such as genomics research.”
Kaubryte believes having a PhD is becoming important for career development.
“A Masters [degree] is no longer enough for some jobs in data science. And my feeling is this [requirement] will become stronger [over time],” she states.
Preventing ill Health
Kaubryte was working at IBM Watson Health when she was alerted to the job at Oracle Cerner by a colleague she’d previously worked with at Telstra Health UK.
“What attracted me was that Oracle Cerner, through NHS partnerships, have access to a wealth of rich data, allowing us to make a difference in population health management,” she says.
“Preventing healthy people getting ill is the most powerful thing you can do in healthcare.”
“And now, as part of Oracle, we have access to world-class data science platforms and tools,” Kaubryte adds.
Among the projects she’s completed so far is a predictive model to help GPs identify people who will develop hypertension within the next five years. The model, developed alongside Hampshire and Isle of Wight ICS, is due to go live within the next few weeks and will support preventative services for long-term conditions.
In addition, she’s recently developed a model for predicting falls in older adults.
Forward to the Future
Later this year, Kaubryte plans to develop a predictive model to help prioritise patients waiting for elective treatment.
“It’s an exciting project because NHS waiting lists are a massive problem,” she says, quoting the statistic that a record 6.6 million people are currently awaiting treatment.
The model will use health, lifestyle, and demographic data to predict the risk of, for example, emergency admission, and rank each patient by their likelihood of future deterioration. They can then be reprioritised, if necessary, on the waiting list to get treatment faster.
Kaubryte will also be developing new techniques for visualising and explaining models, mitigating healthcare inequalities, and monitoring models to ensure their performance doesn’t decline over time.
“Even in the data science world, the importance of model monitoring is not fully understood by everyone,” she says.
“Anyone can develop a model, but ensuring it works well over time is more complex and difficult to do.”
In the future, Kaubryte believes healthcare providers will use data science to predict and prevent health deterioration and tailor treatment to patients by analysing their genetic, lifestyle and health data.
“Precision medicine is a future focus for the NHS and, through the advances in technology and emerging new data sources such as genomics, will become important for helping detect diseases earlier and providing personalised treatments,” she concludes.
Contact Oracle Cerner:
Linkedin: Oracle Cerner
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By Jef Feeley and Neil Weinberg | Bloomberg
Oracle Corp. Chairman Larry Ellison testified in a lawsuit on Wednesday that he did not call the shots at the company he co-founded and holds a 40% stake in and was not involved in discussing the acquisition at the center of the dispute.
The investor suit, brought in a Delaware court by a pension fund, accuses the 8th-richest American and others at Oracle of overpaying by $3 billion for rival software maker NetSuite Inc. in 2016. Ellison owned 47% of NetSuite at the time of the $9.3 billion deal and held about 28% of Oracle’s shares.
The Firemen’s Retirement System of St. Louis, an Oracle investor, sued Ellison and the company’s board in 2017 to challenge the acquisition. The case, known as a derivative suit, was brought on behalf of the company, so any money recovered will be returned to Oracle. The company didn’t respond to an email and phone call seeking comment on the case.
A win by the shareholders could force changes to management or the board, or result in an award that would boost the value of the company. As a significant shareholder, Ellison would benefit from any increased value in the company, but that might be offset by any amount he’d be forced to pay — although payouts are often covered by insurance, said Eric Talley, a professor at Columbia Law School who specializes in corporate and transactional law.
Appearing remotely, Ellison was pressed repeatedly on the plaintiff’s assertion that he remained Oracle’s chief decision-maker even after stepping down as chief executive officer in 2014 and becoming chief technology officer. Lawyers played clips of his successor as CEO and erstwhile boss, Safra Catz, in which she suggested Ellison continued to hold sway.
“Larry Ellison is it,” Catz was shown saying in a 2018 excerpt. “Don’t let titles fool you.”
Ellison, speaking calmly, said Oracle’s board and top managers didn’t defer to him after he stepped down as CEO, adding that there were many instances in which he did not get his way.
“The idea that these people just blindly do what I tell them is just not true,” he testified.
Under questioning earlier in the day from a defense lawyer, Ellison also said that he had recused himself from discussions at both companies related to the NetSuite acquisition.
The trial in Delaware Chancery Court got under way last week and Ellison appeared by video after some of his defense lawyers tested positive for Covid-19. Getting an executive of Ellison’s stature on the stand in a shareholder suit trial is fairly unusual, but not unique. Tesla Inc. founder Elon Musk — a friend of Ellison’s — spent two days in a Delaware court last year testifying to defend his takeover of SolarCity, which shareholders claimed he pushed for his own benefit rather than theirs. Musk won.
While not in the public eye as much as Musk, Ellison is worth $92.6 billion, according to the Bloomberg Billionaires Index. His fortune has almost doubled since 2019 as Oracle stock has jumped. He’s also benefited from owning a stake in Tesla that now exceeds $12 billion. Ellison joined the board of Tesla in 2018.
The lawsuit accuses Ellison, Oracle Chief Executive Officer Catz and director Renee James of orchestrating the combination when NetSuite’s sales were slowing because of increased competition from Oracle, damaging NetSuite’s stock price and Ellison’s personal stake. The fund also alleges a majority of Oracle directors deceived investors about Ellison’s role in the NetSuite acquisition process.
An Oracle executive floated the idea of buying NetSuite at a January 2016 Oracle board retreat at Ellison’s estate in Rancho Mirage, according to a court filing. Because of his stake in the target, Ellison recused himself from discussions about the potential deal, but didn’t leave the room, the pension fund claims.
Catz and NetSuite executives reached a deal at a price of a $109-a-share, which amounted to a more than 42% premium over the target’s share price, according to the complaint.
Ellison and the other defendants counter the company set up a special board committee to evaluate the NetSuite deal and address the conflict allegations. That group held 15 meetings about the buyout; Ellison didn’t attend any of them, according to court filings.
The committee hired the investment firm Moelis & Co to review the deal concluded the value was “fair from a financial point of view to the company,” the filings said. “Oracle’s acquisition of NetSuite, Inc. was not merely a valid exercise of business judgment; it was one of the best deals Oracle has ever made.”
Since the 2016 NetSuite deal, Oracle has acquired 22 more companies. Most recently, it paid $28.3 billion for health care records provider Cerner Corp. to try and build inroads in the health care industry, which has been comparatively slow to adopt cloud database technology.
The defense also belittled the fund’s allegations Ellison used Catz and James as his pawns to engineer the deal in a way that unduly benefited the billionaire and his family. “It would make no sense for Ellison to risk his far more significant Oracle investment — and his reputation/legacy — by causing Oracle to engage in a conflicted and value-decreasing transaction, just to save his much-smaller investment in NetSuite,” according to the brief.
To make out their case under Delaware law, the fund must prove to the judge that Oracle’s buyout of NetSuite wasn’t “entirely fair,” and Ellison, Catz and James violated legal duties to shareholders by overpaying for the software maker.
Judge Sam Glasscock III is hearing the case in Georgetown, Delaware.
The case is In Re Oracle Corporation Derivative Litigation, 2017-0337, Delaware Chancery Court (Wilmington).
More stories like this are available on bloomberg.com
©2022 Bloomberg L.P.
(Bloomberg) -- Oracle Corp. cut jobs in marketing and the US customer experience division, signaling a pullback in customer analytics and advertising services.
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Some workers were told Monday that their positions had been eliminated, according to four people with direct knowledge of the matter. Junior sales employees as well as a division sales director were among those let go, according to one former worker who lost their job and asked not to be named to avoid professional repercussions. Rumors of pending cuts had swirled through the division in latest weeks, but management said the positions were safe, one former employee said.
The customer experience division provides analytics and advertising services. It has long lagged behind the growth of the rest of the Austin, Texas-based software company. During an event last year, Executive Vice President Douglas Kehring said the unit had “historically been probably a little more disappointing than it should have been.”
The company “decided to reorganize” the customer experience group “and move on,” a former senior manager of sales engineering, whose position was cut, wrote on LinkedIn. In a separate post, another fired manager cited the restructuring for the job reductions. Some marketing positions were also cut, according to LinkedIn posts by a former senior manager and group vice president.
The job reductions come as Oracle looks to health care to spur the company’s effort in the competitive market for cloud technology. Earlier this year, Oracle completed a $28.3 billion purchase of digital medical records provider Cerner Corp., seeking customers in an industry that has been comparatively slow to adopt cloud database technology.
Oracle didn’t respond to requests for comment. The extent of the job cuts that began Monday couldn’t immediately be determined.
The shares declined less than 1% to close at $77.44 Monday in New York, and are down 11% this year.
(Updates with more details on job cuts in the fourth paragraph.)
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©2022 Bloomberg L.P.
Computer technology company Oracle has reportedly started cutting jobs in the United States as part of its previously reported plan to lay off thousands of employees. Previous reports revealed that the database giant was planning to cut $1 billion in expenses.
In a new report Monday, The Information revealed that the U.S. layoffs will affect some staffers in the San Francisco Bay area, citing a person with “direct knowledge of the matter.” The publication also reported that layoffs are expected in the coming weeks in some parts of Europe, Canada, and in India. Oracle has yet to make an official statement about the reported layoffs.
Last month, The Information reported that Oracle considered cost cuts of up to $1 billion and the plan could include thousands of jobs lost. According to the outlet, a person with direct knowledge of the situation noted that the proposal to cut jobs as part of trimming expenses “could disproportionately impact U.S.- and Europe-based workers in units such as marketing for software applications that automate customer service and ecommerce functions.”
Oracle Executive Vice President of Corporate Operations Douglas Kehring said during a 2021 event that the customer experience division had “historically been probably a little more disappointing than it should have been.”
While it is unclear which departments and how many people are being laid off, posts on an anonymous forum, The Layoff, indicated widespread job cuts in the company’s customer experience unit. One user posted “Confirming two in Oracle Analyst Relations got laid off in addition to a few others in latest weeks.” Another user said “3 people including myself from the CX Unity team got laid off. More calls coming in later in the day.”
Speaking with Bloomberg, a former employee who spoke on condition of anonymity said a division sales director and junior sales workers were let go. Four others with direct knowledge of the matter told the outlet that some employees were informed that they had been removed from their roles Monday.
The reported layoffs came less than two months after Oracle completed all the regulatory documents for its acquisition of health information technology service provider Cerner Corporation. In a blog post regarding the acquisition, Oracle Industries Executive Vice President Mike Sicilia wrote that Oracle “has a uniquely positioned opportunity to offer new solutions to a broken healthcare system.”
Oracle joins the list of tech companies laying off people or implanting hire freezes, including Twitter, Rivian, Klarna, and Google.
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