How NetSuite Helps OPIE Software Improve Patient Care 

00:00:00:00 - 00:00:42:02 

Unknown 

Welcome to Perspectives on Health and Tech podcast. Brought to you by Oracle Health. In this series, we have conversations on creating a seamless and connected health care world where everyone thrives. Let's get started. Welcome to perspective Oracle Health and Life Science podcast. I'm your host today Danny Gladden. I'm a licensed clinical social worker and general manager of behavioral health and social care here at Oracle Health. 

00:00:42:04 - 00:01:13:15 

Unknown 

As we step into the month of May, we recognize Mental Health Awareness Month, a time to raise awareness, reduce stigma, and highlight progress in mental health care. I'd also like to give a special shout out to our nurses across Canada and the U.S. as we celebrate National Nursing Week. Thank you for your unwavering dedication and compassion. Social workers and nurses make great teams. 

00:01:13:17 - 00:01:45:04 

Unknown 

Today, we're honored to be joined by a leader in mental health care innovation. Please welcome Doctor Gillian Strudwick from Kim H. The center for Addiction and Mental Health, Canada's largest mental health and addiction teaching hospital and one of the world's leading research centers in its field. So, Jillian, welcome. Before we dive into big topics here, can you introduce yourself and tell us a little bit about the great workhappening at Kim? 

00:01:45:06 - 00:02:12:14 

Unknown 

Thank you, Danny, and thank you for the opportunity to be a part of this great podcast. So I might break this into two sections. First, I'll introduce myself, and then I'll tell you a little bit about the organization that I'mfortunate to work for. So I'm Doctor Jillian Strudwick, I'm a registered nurse, and I've worked primarily in mental health clinical settings here in Toronto, Canada, and also in other parts of Canada and internationally. 

00:02:12:16 - 00:02:41:21 

Unknown 

Currently, I am the inaugural Chief Clinical Informatics Officer at Kam H, representing our nurses and all of our non physician health disciplines like social work. And I have a couple of other hats as well. So one is that I'mthe head scientist of the Digital Mental Health Lab. And I'm also the scientific director of our Digital Innovation Hub, which is about really accelerating our work in this digital sphere and research practice, education and beyond. 

00:02:41:22 - 00:03:10:04 

Unknown 

So that's about me. But I'll move on to talking about Kim H. So Kim H is CAMH, the center for Addiction and Mental Health, and it's Canada's largest mental health and addictions teaching hospital. We think Kim and I think there's lots to suggest that we're we're true in saying this, that we're world leading research and education center in mental health, and we're located right in the heart of downtown Toronto. 

00:03:10:05 - 00:03:35:20 

Unknown 

But we serve people across our province, Ontario and across the country as well. So in terms of a few numbers that I'll share with you. We've had, just over 16,000 emergency department visits in the last year. Over 40,000 patients that were treated. Over 80,000 virtual care appointments. And I'll, I'll provide a few more numbers here as well. 

00:03:35:21 - 00:03:59:20 

Unknown 

Almost 8000 rtms visits, 60 million and new research funds and more than a thousand articles published. I think you get the point that there's a lot going on at camp, and it's a great place to be. You know, I have been on your campus a number of times and always appreciate that your campus is right in the heart of of Toronto. 

00:03:59:22 - 00:04:31:11 

Unknown 

In, in, in a bustling area. And I think there's there's no greater way to reduce stigma than, you know, placing, such a well-respected, mental health and addiction treatment organization right in the heart of the city. Whereas if you go to many other communities, you'll kind of see the mental health hospitals and treatment providers kind of on the outskirts of town, really appreciate, campus role right there in the heart of, Toronto. 

00:04:31:13 - 00:04:55:13 

Unknown 

And I think this goes into something, Jillian, you speak about passionately, which is the idea that mental health treatment is social justice for our audience. Tell us what you mean by that. Why is it an important lens? Social justice. Which you view your work? Yeah. I think it's a quite an important point that you bring up, Danny. 

00:04:55:15 - 00:05:24:18 

Unknown 

And it's something we're really proud of. Talking about that mental health work is social justice work. And so, part of doing social justice work is to be informed in this space. And part of being informed is understanding that mental illness disproportionately affects marginalized communities, who are also often facing barriers to things like accessing care. And this could be due to racism, poverty, stigma, geography. 

00:05:24:18 - 00:05:59:06 

Unknown 

And I could continue. So on and so forth. So and Kim H. We see mental health is deeply rooted in social justice because access to care, dignity and treatment and prevention are, are not, equitably distributed. Kim advocates for policies and systems change that ensure mental health care is not a privilege, but but a right. And so that's really our social justice lens, framing and shaping the last few statements that I made. 

00:05:59:08 - 00:06:31:01 

Unknown 

So, we have done some work more recently, in the last couple of years on dismantling anti-Black racism, which has become a more formalized organizational commitment. And so I'll just read a section from one of our documents around dismantling anti-Black racism. And, excuse me for it sounds like I'm reading here because I'm reading from a document, but, system, systemic anti-Black racism is a barrier to high quality health care for black patients at Kim H. 

00:06:31:01 - 00:06:57:09 

Unknown 

And across the health care system, the data lay bare with those in black communities have signaled for decades discrimination and oppression based on race delays, care and harms individuals on their way to recovery. Racism also has a negative impact on the quality of work life for black staff. Beyond the damaging emotional and psychological consequences. It limits their career trajectory and it goes on from there. 

00:06:57:11 - 00:07:30:21 

Unknown 

And so I bring this out as one of the many initiatives that the organization is committed to. And as a result ofthis commitment, this public commitment. You can read what I just read on on our website, Kamchatka, that there's a number of activities that the organization is doing everywhere, from doing offering more culturally appropriate therapies to education for staff, staff, support groups, creations of processes that support equity, lots of advocacy work with the government. 

00:07:30:23 - 00:07:58:14 

Unknown 

And so a lot of this work is ongoing. But this gives you sort of a more grounded, more concrete example of some of the the ways in which we look at social justice as being so related to mental health. My goodness, you know, the, the, the social work, the social worker in me is just grinning from ear to ear, as you describe, you know, the foundation in which camp is, is caring for folks. 

00:07:58:14 - 00:08:34:14 

Unknown 

You know, I'm, still like, licensed, clinician. And I'm licensed in Missouri and Alaska. And, you know, particularly I think about, state like Alaska, with a disproportional number of folks who are part of, who are Alaska Native. And we see, you know, those communities so much generational trauma and the impact, you know, and the impact that oppression, you know, has on, sort of repeating traumatic occurrences across the generations. 

00:08:34:14 - 00:09:04:15 

Unknown 

And so, so very important, I think, an important perspective to look at the, the experience of mental health and the treatment of mental health through, social justice lens. Jillian, I just appreciate that that, that that is a focus of, Kim H. And I'm, I'm sure the indigenous populations, your organization works with, you see a similar, you know, similar experience in the those in the, in Alaska here. 

00:09:04:17 - 00:09:32:18 

Unknown 

Now, as we pivot here thinking about, you know, you're you're I think the work you're describing from a social justice perspective is innovative. It seems like Kim is always at the cutting edge of innovation. We're a technology company. And so, you know, from a technology innovation perspective, what do you seeing? What's Kim H doing? Great question, Danny. 

00:09:32:18 - 00:10:14:05 

Unknown 

And because of my various roles at the organization, I get excited about this kind of a question. And it also describes the work that I'm doing every day with my colleagues, with our patients, their family members, and others across the organization. So yes, we're always interested in how we can use technology and to innovate with technology, but we do that so we can achieve various things, and the things that we want to achieve are being able to improve access to care so we can see more patients because, probably unlike or not unlike various organizations in the rest of Canada and in the US, we have long waiting lists for care. 

00:10:14:07 - 00:10:39:21 

Unknown 

The second is to be able to improve the quality of care. And not to say that care isn't good already, but more that as we learn and develop evidence and get feedback from our clinicians, from our patients, we can then integrate that into care. So that's the second piece. The third is to improve the patient experience. And the fourth is to really personalize care. 

00:10:39:22 - 00:11:03:06 

Unknown 

So when we think about how we innovate with technology, we're really looking to see if we can do those four things. And yes, there's other I'll, you know, other reasons. You invest in technologies for various efficiencies and cost savings. But I'm going to talk about more work, on that. The earlier four points that I described. So maybe I'll provide a couple of concrete examples. 

00:11:03:06 - 00:11:31:05 

Unknown 

The first one is thinking about and the opportunity that we have by embedding wearables into to, care processes. So these are things like aura rings or Fitbits. You know, it doesn't matter which company it is. There's lots of wearables out there, but embedding them into care processes so we can look at, sleep and activity, which are often impacted when people have symptoms of depression or anxiety. 

00:11:31:07 - 00:11:55:17 

Unknown 

And so we hope I can use this information to better understand someone's individual patterns, which could really help us tailor their treatments, as you can imagine. But also be able to identify early when a treatment may be starting to take some effect, or an early warning sign, or an indicator of someone potentially falling ill or relapsing. Lots of potential in that space. 

00:11:55:17 - 00:12:26:15 

Unknown 

And where we're getting going, primarily in the research domain in the wearable space. So that's sort of one concrete example. Another concrete example is rtms. So Kim H has been a leader in the space and doing brain stimulation research for a number of years. Our TMS and case, listeners aren't familiar with it. It's a noninvasive treatment. It uses magnetic fields to stimulate very specific regions of the brain. 

00:12:26:17 - 00:12:52:15 

Unknown 

And it's been shown to be particularly effective for people with treatment resistant depression. So these are individuals who have not responded well to medication or therapy alone. And so to date, we've had about 8000 individuals last year who have received our TMS. So we're thinking about it from advancing the science, treating individuals, of course, and doing lots of advocacy work. 

00:12:52:17 - 00:13:19:15 

Unknown 

The third example I'll provide is around the app space. So there's a lot if you were to type in depression or anxiety into any app library, you're going to see lots and lots of apps, most of which don't have a scientific backing to them. Some of which may actually be a waste of time to engage in. And so it's also really hard to make sense of that app landscape. 

00:13:19:17 - 00:13:51:14 

Unknown 

And so we've been working to develop and integrate into clinical care processes, apps that have that evidence based behind them and have some sort of a portal or interface with clinicians. So that the data can be used for care purposes. So we've got one called my change plan, for smoking, cessation of behavioral modifications. We've got one called app for independence, which is a platform for supporting people with complex behavioral and mental health conditions. 

00:13:51:14 - 00:14:25:15 

Unknown 

And it's currently used for recovery process with individuals with psychosis and schizophrenia and now opioid use disorders. And then we also have another app called Hope by Kim Age, which is a safety planning intervention for people at risk for suicide. So there's you know, that doesn't, cover all the ads, but gives you a sort of a flavor of the various apps that we've been working on so that there's the credibility, the science, and the engagement and feedback loop, for those particular areas. 

00:14:25:17 - 00:14:49:06 

Unknown 

And then finally, that last one I want to talk about is our electronic health record. So we use, Oracle Health platform. And we're really thinking about how we can optimize our use of it for the best experience for clinicians and patients alike, including this concept of open notes through our patient portal. So where patients can see their notes and so. 

00:14:49:10 - 00:15:30:09 

Unknown 

Well, if you're in the US and thinking, well, this is the normal form for us, it's not quite the norm for folks in other countries. It's optional in Canada to share mental health notes. And so we're showing some real leadership by identifying how best we can do that and opening up our notes. So I'll just close on this topic, Danny, by just saying that importantly, we're taking a human centered approach and we're doing this work, whether it be an apps, wearables with our EHR or that we're co-designing with patients and clinicians to ensure that they're usable and they meet the needs that are the most pressing needs, but also that we deliver and implement 

00:15:30:09 - 00:16:00:06 

Unknown 

technology that allows us to provide compassionate care. Because I think when we think about technology, it'soften this sort of antithetical approach to compassion and really wish we are showing that to be able to deliver compassionate care in this day and age, we have to be innovative in our use of technology. Well, what a what, just what a robust list of, of innovation. 

00:16:00:06 - 00:16:27:05 

Unknown 

You know, the committee is, is sponsoring. I'm not not at all surprised, Gillian, knowing you're knowing your history. You know, Gillian, maybe a part two to this conversation. Separate a separate podcast can be sort of on the intersection of social justice and technology. You know, we, we regularly describe some justphenomenal innovation, consumer facing innovation. 

00:16:27:07 - 00:16:55:00 

Unknown 

And, and yet we know that there's, there's consumers of care, that don't always get to take advantage of the latest and greatest innovation, the, the wearables or access to a device to allow, you know, portal or, or ortelehealth, you know, lack of hardware, lack of bandwidth, lack of sort of knowledge or trust in the available tools. 

00:16:55:00 - 00:17:26:18 

Unknown 

So, you know, maybe we can well, bookmark that, I think for another day. But in the area of innovation, you know, so cam was part of our clinical AI work group for behavioral health. This was a year long process. You know, Oracle's been an AI space for, for for many, many, many years. You know, I'm sitting in a marriott right now where, you know, I used Oracle tools to check in and to engage with, the Marriott staff. 

00:17:26:18 - 00:17:50:19 

Unknown 

And so Oracle knows a thing or two about AI. And it's taken what they know about AI and applied it to health care. And we Oracle Health and Cam and others have taken that and and morphed it for behavioral health. Soour clinical AI agent today is available in the US in behavioral health used across a number of behavioral providers. 

00:17:50:19 - 00:18:18:23 

Unknown 

I think to date we've had nearly 20,000, medication management notes, that were documenting documented using Oracle Health's clinical AI agent. So what's MH thinking about, from an AI perspective? Oh, we'rethinking about lots from an AI perspective. And I will just note that while you're sitting at a marriott, I'm sitting at the hospital right now and on the overhead speaker is a code being called the. 

00:18:18:23 - 00:18:49:04 

Unknown 

Apologies if you can hear that. We are really quite excited about the potential for AI and what it could bring for things like research, education, of course clinical care and how we operate and potentially achieve some efficiencies. So I think there's a whole bunch of areas where we see the potential for AI. We're fairly early on, early on in our journey, but we're setting up all the right infrastructure so that we can accelerate more quickly. 

00:18:49:06 - 00:19:18:04 

Unknown 

The first is that we recently launched just this month, a BMO chair in artificial intelligence and mental health. So that's a research chair role specifically for AI in mental health. And I believe it's the first and only in Canada at this time. So Doctor Tristan glittered as the, inaugural chair. He's an AI computer scientist, researcher and engineer, highly collaborated with, clinicians. 

00:19:18:04 - 00:19:45:03 

Unknown 

I think we have high expectations for what, this role will achieve. We're also hiring for an AI scientist. So from a research perspective, I think we expect big things. And I'll have more to report back on Danny, in the not too distant future around that one. In terms of education, we currently have a digital mental health, and I certificate program, which is free and currently available on our website. 

00:19:45:03 - 00:20:10:07 

Unknown 

So, folks here who are listening are welcome to go to Kamchatka and hook and can navigate to finding the digital Mental health and AI certificate program. And that's really thinking about mostly for clinicians who are working in this space where there's more AI tools available for them to develop their competencies and thinking about how to use them within their clinical practice. 

00:20:10:07 - 00:20:52:06 

Unknown 

And so and we're getting sort of our baseline of folks ready so that, we're able to really, accelerate in this space. And then, I'll just mention one thing. Lastly, and while we don't have anything concrete yet to share the the potential of AI scribes and ambient scribes and using this sort of technology to free up our documentation, time for essentially all clinician types is of big interest, not just the documentation, but also other tools like being able to do note summarization, querying the electronic health record of the patient record. 

00:20:52:08 - 00:21:13:09 

Unknown 

So I think all of these sorts of things are interesting for us. And our clinicians would jump on at scale. These sorts of things can have a big impact. And I'll give you an example. Not too long ago, we did a fairly small change in our EHR and IT result, and that was about nurses reducing their documentation time. 

00:21:13:10 - 00:21:44:08 

Unknown 

We took out some particular areas of a power form. It resulted in a couple of seconds per power form that nurses were not documenting anymore. But when we calculated the total time savings over the course of the year for nurses, it was the equivalent of a full time nurse by just doing that small change. And so if we think about that's just a really small example, that we saved a full 1.0 full time equivalent of nursing time. 

00:21:44:10 - 00:22:14:00 

Unknown 

If we did that at scale by using ambient scribes, by doing things like note summarization and querying, we could really take that to the next level and save large amounts of time, which we hope, could really support clinicians in being even more engaged, less burnout, you know, the list goes on. So, of course, in doing any of this work in AI, we need to be mindful of risk and bias ethics. 

00:22:14:02 - 00:22:38:09 

Unknown 

So there's a lot to be mindful of there. And sharing. We keep mental health care human. And so we're really making sure we're getting this right. We're starting our journey to ensure that we have all these various safeguards in place. But I will say it's a really exciting place to be. There's some very cool tools coming out, and I can't wait to get my hands on them. 

00:22:38:11 - 00:23:10:05 

Unknown 

Yeah. Jillian, we are so excited. You know, our psychiatrists, psychiatric nurse, practitioners, nurses, social workers, case managers, therapist all benefiting today from use of Oracle Health's clinical AI agent. So thank you for sharing those insights. Now, before we close, we want to remind our listeners that if you or someone you know is struggling, help is available in the US, you can call or text 988 20 473 65 988. 

00:23:10:05 - 00:23:40:12 

Unknown 

The Suicide and Crisis lifeline in Canada. Also 988 20 473 65. It is, interestingly enough, 988 in Canada is provided and managed by Kam H. To ensure that no one has to face a crisis alone, trained responders are there for support. Doctor Gillian Strobel, thank you for sharing your insights and for the work you and chemistry doing every day to make mental health care better, smarter, and more just. 

00:23:40:14 - 00:24:09:23 

Unknown 

And thank you to our listeners for tuning in. Take care of yourselves and each other. That's all for this episode of Perspectives on Health and Tech Podcast. Be sure to subscribe to catch all our future episodes! For more information from industry experts, visit oracle.com, forward Slash Health and oracle.com/life Hyphen Sciences, or follow Oracle Health and Oracle Life Sciences on social media. 

00:24:10:00 - 00:24:21:19 

Unknown 

Thank you for listening and join us again for the next insightful episode of Perspectives on Health and Tech.