
Justin Ott, CIO, Billings Clinic-Logan Health
In September 2023 when Billings Clinic and Logan Health merged to form one of the area’s largest healthcare systems, one of the first orders of business for Justin Ott – a long-time IT executive at Billings who became CIO of the newly combined health system – was determining the organization’s go-forward EHR. Prior to the merger, Billings Clinic used Cerner (now Oracle Health) since 1999, while Logan Health relied on Meditech starting in 2014. Would it be one of those incumbents, Epic, or a dark horse?
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Evaluating the EHR Landscape
“Having both organizations on a truly shared integrated medical record was probably the most important thing,” he stated. “We knew this would be key to becoming a unified health system.”
To determine the best solution, the organization evaluated three major EHR vendors: Oracle Health, Epic, and Meditech. The decision was based on three main criteria: operational impact, implementation timeline, and cost.
“We had to weigh the disruption that each system would bring, the cost of implementation, and how quickly we could make the transition,” Ott explained. “Time was of the essence. Our providers were asking, ‘Can we get this done tomorrow?’”
Why Oracle Health?
After thorough evaluation, the health system selected Oracle Health as its long-term partner. Several factors tipped the scales in Oracle’s favor, including their database integration capabilities, interoperability focus, and advances in AI.
“We are already on an Oracle database,” Ott said. “How they’re leveraging their expertise in business databases for healthcare is very intriguing.”
Ott highlighted Oracle’s AI tools as a game-changer for the organization. Billings Clinic had previously piloted Oracle’s ambient listening AI tool, which enables providers to document patient interactions automatically. “Our clinicians say it’s game-changing. They can now have dinner with their families and go to bed on time,” Ott shared. “Their work-life balance is changing for the better.”
Ott also pointed to Oracle Health’s commitment to fulfilling promises as a significant factor in their decision. “When Oracle says they’re going to do something, they follow through,” he noted. “That gave us confidence that we were making the right long-term decision.”
The Transition from Cerner to Oracle Health
Ott’s experience with Cerner provided a unique perspective on Oracle’s impact post-acquisition. Having used Cerner since 1999, he acknowledged initial concerns when Oracle acquired the company.
“The first reaction was fear—what does this mean for my organization and staff?” Ott recalled. “But once we got past the emotional reaction, we began to see the opportunities.”
According to Ott, Oracle’s approach to customer engagement set a positive tone early on. “They reached out immediately to ensure we were well-informed and involved in strategic discussions,” he said. “That alleviated a lot of the initial stress and uncertainty.”
Since the acquisition, Ott has observed significant improvements in project timelines, support, and overall collaboration. “We’re now included in strategic discussions at the Oracle Health level, which is very rewarding and inspiring,” he shared. “It’s not perfect, but it’s significantly better.”
The Importance of Interoperability
Interoperability has become a cornerstone of Oracle Health’s strategy, a focus that aligns closely with Billings Clinic-Logan Health’s goals. As a CIO, Ott emphasized the value of seamless data exchange between systems.
“The idea of true interoperability—where there are no interfaces—is music to my ears,” he said. “If we can eliminate some of those interfaces, it significantly reduces complexity and costs.”
Oracle’s ambition to serve as a universal health information exchange was another compelling factor. “They want to interact and have interoperability with anyone, whether it’s Epic, Meditech, or Oracle Health,” Ott explained. “That’s a powerful statement, and they have the ability to execute on it.”
Balancing Innovation and Integration
While the decision to standardize on Oracle Health reflects a broader commitment to integration, Ott acknowledged the importance of evaluating third-party solutions when necessary. This balance between staying in-suite and adopting bolt-on applications is a common tension in healthcare IT.
“There’s no one-size-fits-all solution,” Ott stated. “Some needs can’t be met by a single vendor, whether it’s Oracle Health or Epic. It’s our responsibility to evaluate and adopt the best solutions for patient care.”
Ott stressed the role of governance in making these decisions. “IT rarely makes decisions for the organization,” he said. “We provide recommendations, but input from clinical, financial, and other stakeholders is critical.”
This collaborative approach ensures that decisions align with organizational goals while addressing cybersecurity, cost, and operational impact. “You need subject matter experts making these decisions—not just IT or clinical teams working in silos,” Ott emphasized.
Ott’s Approach
- Unify Systems Post-Merger: A shared EHR system is essential for achieving operational cohesion and enhancing care delivery in merged organizations.
- Evaluate Vendors Thoroughly: Consider impact, cost, and timeline when choosing IT solutions. A rushed decision can create long-term challenges.
- Leverage Interoperability: Focus on solutions that reduce interfaces and promote seamless data exchange across systems.
- Prioritize Collaboration: Engage stakeholders from IT, clinical, and financial teams in governance structures to guide IT decisions.
- Adapt to Change: Address fears during vendor transitions through proactive communication and transparency.
- Empower Your Team: Rely on frontline staff and subject matter experts to provide insights that inform strategic decisions.
Innovation in Healthcare IT
As Oracle Health continues to refine its EHR platform, Ott is optimistic about the potential for AI and other emerging technologies to transform healthcare. The health system is already exploring AI-driven modules for nursing, revenue cycle management, and registration.
“Their goal is to make EHR interaction as simple as ordering something off Amazon,” Ott remarked. “That vision aligns with our commitment to improving the clinician and patient experience.”
Reflecting on his journey, Ott offered a piece of advice to fellow IT leaders: “Rely on your people—they are your best and most valuable investment.”
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