Cerner Blogs

A health IT bootcamp for CMIOs and physicians

The Cerner CMIO/Physician Change Champion (CMIO/PCC) Bootcamp continues to be successful. The Bootcamp facilitator team delivered the first post pilot Bootcamp in the U.S. on May 29-31.

Meaningful collaboration in the health IT industry

The health IT industry faces an interesting period in time as we consider that digitizing processes is really just the first step in improving the quality of health care, increasing efficiencies, enhancing patient safety and reducing overall health care costs. For example, we’re moving toward intelligent, personalized health management systems that work to keep you healthy, rather than simply care for you when you are sick.

Upgrade Center hits major milestone

Earlier this year, the Upgrade Center achieved a huge milestone by completing its 500^th Millennium upgrade since inception in 2005. The Upgrade Center started with a small team of around 20 associates at our Oaks campus in Kansas City. Today, it has a dedicated team of more than 200 experienced associates focused completely on upgrades.

Working the way physicians do

Clinicians today face constant pressure to increase productivity and improve patient outcomes. They are also challenged by the health care industry’s transition to electronic health records from paper records.

The winner of our #NursesWeek contest is...

THANK YOU to all of our amazing entries for the Nurses Week contest. We are honored to get to work with such inspiring nurses and organizations each and every day. More than 20 Cerner clients from around the world submitted a testimonial on how they are using technology to deliver quality and innovative patient care. More than 1,600 people voted for their favorite entry.

Creating a new model for health care resource management

This month, Nursing Administration Quarterly covered the implementation of Cerner Clairvia for workforce and operations and the new business processes resulting in over nine million dollars in cost savings over a two year period within the Catholic Health Initiatives (CHI) health system.

A look at population health management: member engagement and activation

Here at Cerner, when we talk about population health management, we usually start the conversation with a simple construct. To manage the health of a population, you need to KNOW what’s happening with your population, ENGAGE with your members and providers when a course correction is needed, and provide the right tools and insights needed to MANAGE towards better outcomes.

Celebrating collaboration at Cerner

Created in 2009, uCern is our suite of collaboration tools that help close the communications loop and decrease the time between discovery and adoption.

Paving the way to improved pediatric patient safety

Earlier this month, Children's Hospitals and Clinics of Minnesota was honored with the Way Paver Award for Institutional Achievement for implementing a barcode point-of-care (BPOC) system for neonatal and pediatric care. The award recognized the culmination of a concerted effort by Children's Minnesota to improve the safety of IV medication administration to pediatric patients.

A shift in mindset around HIV treatment

This year, we’re celebrating the 20^th anniversary of the HIV Outpatient Study (HOPS). The HOPS was initiated by the CDC for purpose of describing and monitoring trends in demographics, symptoms, diagnoses, treatments, complications, outcomes and risk behaviors among persons getting outpatient care for HIV infection.

Celebrating National Medical Laboratory Professionals Week 2013

Join Cerner in celebrating National Medical Laboratory Professionals Week 2013.

Leveraging technology to increase patient safety

East Jefferson General Hospital (EJGH) is a 450-bed, state-of the-art community hospital that serves the greater New Orleans region, served by a staff of more than 3,000, including more than 650 physicians. With a focus on patient-centered care, EJGH was recognized with its third consecutive American Nurses Credentialing Center (ANCC) Magnet designation and was the first Magnet organization in Louisiana.

Cerner associates and clients collaborate in nursing informatics event

Nursing informatics is at the heart of Cerner’s mission for systemic improvement in health care delivery. Every day, this is demonstrated by our nurses and clients in the field by their devotion to excellence in patient safety and quality outcomes.

A state by state look at the cost of health care

The week, the Wall Street Journal published an article examining the per-person cost of health care by state in the United States. The data, from 2009 (latest data available), showed that health care spending averaged $6,815 per person. However, the costs vary widely from state to state, ranging from more than $10,000 per person in Washington, D.C., to just over $5,000 per person in Utah.

Welcoming Labotix to the Cerner family

Labotix…cool name. The word conjures up images of the laboratory and robots, and that is precisely what this company does. Now why would a health care IT company like Cerner buy an automation company like Labotix? The answer is very simple.

Looking back on AONE 2013

Our team had the opportunity to attend and exhibit at the American Organization of Nurse Executives (AONE) conference this past week in Denver, Colo. The event welcomes over 2,000 health care executives from facilities across the country, dozens of vendors and opportunities to learn and share with our valued clients and colleagues.

A new population health management collaboration with Advocate Physician Partners

Late last month, Cerner announced a new population health management collaboration with Advocate Physician Partners. We were proud to have Mike Englehart, president, Advocate Physician Partners, and Dr. Rishi Sikka, vice president of clinical transformation, Advocate Health Care, on stage with us at our recent investment community meeting at HIMSS13 to discuss what this collaboration will mean for the industry.

Biomarkers for personalized health care and their potential pitfalls

Recently, there has been growing focus and effort in identifying biomarkers (gene expression, protein expression, etc.) that can help predict a patient’s response to treatment options.

Examining the 2013 County Health Rankings

Earlier this week, the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute released the 2013 County Health Rankings. These rankings help illustrate what makes residents living in almost every county in the United States sick or healthy, and how counties in each state compare with one another.

The children’s EHR format from the AHRQ: Why it matters

In February 2013, the Agency for Healthcare Research and Quality (AHRQ ) released the children’s EHR format. Authorized in 2009 by the children’s health insurance program reauthorization act (CHIPRA) and developed by AHRQ and the centers for Medicare and Medicaid services (CMS), the format highlights critical elements of any EHR being used for pediatric care.

Join Cerner and be a part of the HIMSS / WEDI ICD-10 National Pilot Program

The HIMSS/WEDI ICD-10 National Pilot Program is a unique opportunity for providers and their billing services to test the changes they and their vendors have made for ICD-10 and see what impact the change to ICD-10 codes will have on claims submitted to health plans.

Using readmission rate as a quality benchmark for comparing ICUs may be misguided

It is not unusual to do a research study that has unexpected findings. But to have two such studies that also support Cerner's critical care solutions is a true gift horse. One of these studies has already been published in the January issue of Critical Care Medicine (receiving Feature Article status) and the results of the other study were recently unveiled in an oral presentation at the Society of Critical Care Medicine's annual meeting.

HIMSS13 - Day Three Recap

Here are the highlights from Day Three of HIMSS13.

HIMSS13 - Day Two Recap

Day Two at HIMSS13 started off with an excellent keynote address from Eric Topol, MD, director of the Scripps Translational Science Institute.

HIMSS13 - Day One Recap

Day one of HIMSS13 is officially in the books, and what a day it was. From an industry-shaking interoperability announcement in the morning, to a significant revenue cycle partnership notice in the afternoon, and ending with a great party this evening, it was a great first day here in New Orleans.

Talking revenue cycle with Adventist Health's Tim Reiner, Part Two

We spoke with Tim Reiner, vice president of revenue management for Adventist Health System, headquartered in Florida, about the importance of an integrated system and the steps his organization is taking to prepare for the challenges ahead.

Talking revenue cycle with Adventist Health's Tim Reiner, Part One

With new reimbursement models looming on the horizon, many health systems are racing to figure out how to adapt their current revenue cycle operations to meet the challenges those new models present, many of which have yet to be defined. What is clear is that an integrated clinical and financial system will play a key role in helping health care systems make the transition.

Why you should pay attention to HIMSS13

As physicians, we are always pulled in different directions. The patient needs my undivided attention at the same time my wife needs my undivided attention, but not before my nurse needs my attention because the electric company needs my attention. (Stop me if I’m describing a typical Saturday.)

Evangelizing user experience

In the dark ages of development great software meant packing in the functionality. People began doing more and more with their software. Updates meant even more new and exciting functionality. Sounds great, right? Of course it does, but something went horribly wrong.

Making an investment in population health management

As you’ve probably read, today we announced our intentions to acquire a company called PureWellness. Co-founders Ken Kaufman, Ron Keen and the rest of their team have developed a remarkable online health and wellness platform available to millions of individuals across the United States, and we couldn’t be more excited to work with them moving forward.

NHS Change Day – Disrupting the status quo

In my previous blog post, I discussed my approach to population health, starting with the fact that as an individual, I can change my attitude towards my own health and wellbeing. But what if a whole organisation needed to change? How would that work – can we still apply the same logic?

Introducing the CMIO/Physician Change Champion Bootcamp

Clinical culture transformation is a challenge at any level. From the change in clinical therapeutic tools (think DaVinci procedures) to diagnostic tools, crossing the chasm of change is challenging. Key to moving the process forward is leading with key clinical leadership. In the context of EHR (electronic health record) transformation, the same cultural constructs and challenges for change exist.

A paperless IT system helps us deliver world-class care

At Fort HealthCare, we’ve got plenty of reasons to celebrate. In March, we’re scheduled to receive the highest possible award from the Healthcare Information and Management Systems Society (HIMSS) at its 2013 Annual Conference and Exhibition in New Orleans. Reaching Stage 7 is quite an achievement — especially for a relatively small organization like Fort HealthCare.

Cerner and the industry loses a dear friend and health care pioneer

The Cerner community lost a great friend and leader with the passing of Dr. Jim Levin. We are all saddened to learn of Jim’s sudden passing.

Navigating Meaningful Use, ICD-10 and more at Cerner's Regulatory Alignment Summits

We are all trying to navigate the requirements and regulations of the changing health care environment. In 2013, the Regulatory Compliance Practice within U.S. Consulting is hosting several Regulatory Alignment Summits in Kansas City.

Cerner's Healthe Clinic joins LACIE

Recently, Heartland Health announced it was gifting the Lewis and Clark Information Exchange (LACIE) to the city of Kansas City. We sat down with Dr. David Nill, our chief medical officer, to get his thoughts on the announcement. During the conversation, he shared some exciting news related to Cerner's Healthe Clinic and LACIE.

Playing in Kansas City's Digital Sandbox

Cerner is a great entrepreneurial story in Kansas City (really, the nation). Our company, founded in 1979, has continued to be driven by vision, enabled by the willingness to take risks, and supported by both our clients and the Kansas City community. We’re considered a leading company at the intersection of two of the most dynamic and important industries of our time, health care and IT.

Patterson testifies at joint federal hearing on HIE

On Tuesday, Cerner CEO Neal Patterson testified before a joint hearing of the members of the federal HIT Policy and HIT Standards Committees in Washington, D.C. Patterson was part of a group of industry experts offering statements on the barriers and opportunities related to health information exchanges (HIEs) in the United States.

Visualizing the power of prevention

Realizing your health risks and taking steps to prevent potentially life-threatening conditions isn't a male or female thing, nor a young or old thing. It's a smart thing.

Health information exchange in Kansas City

Yesterday, Heartland Health announced that it is gifting the Lewis and Clark Information Exchange (LACIE) to the city of Kansas City. The organization will take on a new "co-operative competition" business model and will be governed by a provider-led collaborative of organizations.

Taking the EDIS plunge

This is the first post in a series, in which I'll chronicle our health system's implementation of FirstNet and electronic documentation from the clinician perspective. We have been a Cerner client since 1988, using PowerChart in our two acute care hospitals since 1995.

Health care in the social media age

There's no controversy in saying social media has fundamentally changed the way we approach some tasks. Need to find a reputable A/C repair shop? Check the ratings online. Need to make a reservation for dinner? Apps like OpenTable have you covered.

2013 flu season off to a nasty start

According to a recent CDC flu advisory, 41 states are experiencing widespread flu activity. This activity has resulted in more than 2,250 hospitalizations, and there have been 18 reported deaths among children from the flu.

Our top 5 posts of 2012

2012 was also a great year for our blog. We saw increased views, as well as an increase in the average time spent on each post. We're working hard to make this space an engaging, informative and, hopefully, entertaining resource for those of you interested in health care, health IT or our company. Thank you for reading!

The scalable trust story: Introducing the trust bundle

This is a tale of two forces whose combined synergies have created a perfect storm triggering an urgent call to action. Our protagonists, scalable trust and patient engagement, are driving the escalation of solutions to a long-standing problem in Direct exchange: the establishment of trust between HISPs.

A one-person population health experiment

Three things have happened to me over the last month. First, I joined a gym (actually re-joined). Second, I listened to a TED talk on sharing health data. Third, the National Institute for Health and Clinical Effectiveness (NICE) published guidance on the management of obesity.

Realizing the benefits of health IT for athletes

The offseason is here for Major League Soccer, as the Los Angeles Galaxy won MLS Cup earlier this month. However, the offseason will bring no rest for the weary as MLS prepares for its yearly medical meetings. At the January meetings in Fort Lauderdale, athletic trainers and team physicians from the 19 North American clubs meet to prioritize goals and action items for the following campaign.

Integrating behavioral health into the new health care landscape, part two

The ability to realize the goals I mentioned in my previous post by engaging and providing health care services, particularly for behavioral health populations, is contingent on improved accuracy in our ability to predict which populations are most ‘at-risk.’ Through a collaborative effort we will be better positioned to identify and stratify populations based on the risks, needs, and attributes that individuals might possess by mining and analyzing real-time data accessible through Cerner Behavioral Health.

Integrating behavioral health into the new health care landscape, part one

It’s no surprise that Cerner is committed to changing the way health care is delivered (we’ve been saying it for years). However, to truly achieve any substantive transformation in the health care system, our organization and those that we serve must embrace a new philosophy.

EHRs: Connecting the person and provider

Check out this great infographic from HealthIT.gov, illustrating the history of EHR development and how these electronic systems help connect individuals with their health information.

The ONC health IT video challenge

The ONC is gearing up for its annual meeting next week. This year’s theme is “A Meaningful Foundation for the Future of Healthcare” (you can learn more about the annual meeting and view the full schedule here).

What do you want Meaningful Use Stage 3 to look like?

As we noted back before Thanksgiving, the HIT Policy Committee has published its recommendations on Meaningful Use Stage 3 rules. Now, the official comment period on those recommendations is open.

Curing cancer via open source health information

Earlier this year, Salvatore Iaconesi was diagnosed with brain cancer. As he writes at CNN.com, Iaconesi, in a effort to help find the best "cure" possible, published his clinical records online in an effort to make his digital information "...available on the Internet, in formats that would allow people of multiple cultures, skills, professions and inclinations to access, use, recombine and redistribute it."

Meaningful Use Stage 3 coming into focus

The HIT Policy Committee recently published its recommendations on Meaningful Use Stage 3 rules. Among the recommendations are new measures and threshold increases from Stage 2. The committee also recommended removing some measures from Stage 3.

Introducing FetaLink+

The Women’s Health team is very excited to announce the 510K clearance of FetaLink+. We recognize that OBGYN providers are constantly on the go and need immediate access to key maternal and fetal information from any location. FetaLink+ is a native application for use on iPads and iPhones.

A reminder that health care is personal

This video showcases several Cerner associates as they explain why health care is personal to them. From a daughter born with heart problems, to a grandfather who lost his life due to a medication error, these associates share how health care has impacted their lives.

Success in infusion management

Children's Hospitals and Clinics of Minnesota recently implemented infusion management technology in one of their facilities. Hear Bobbie Carroll, RN, MHA, discuss the impact this technology has made.

Running your way to a healthy lifestyle

As a health company, we’re always looking for ways to both illustrate the importance of healthy, active lifestyles and support programs that contribute to helping people in our community improve, and maintain, their health status.

The importance of health literacy

As the role the person plays in health care takes on ever-increasing importance, so does the issue of health literacy. The Affordable Care Act defines health literacy as the degree to which an individual has the capacity to obtain, communicate, process and understand basic health information and services to make appropriate health decisions.

Direct Project: Does your system deliver?

Early this year, a conversation spawned between a colleague and me regarding usage of the Direct Project in workflows other than simple email. It quickly became apparent that he had a specific use case in mind and was focused on a not-so-well understood section of the Direct Project specification: disposition notifications (how the Direct Project implements quality of service [QoS]).

Bringing the power of Cerner to health sciences classrooms worldwide

There is a significant gap between the access to digital technologies in the health care provider’s workplace and the access that faculty and students have to those same technologies in a safe environments like classrooms, simulation labs and skills labs. Providing access to those technologies in safe environments provides for deliberate practice and leads to an increased understanding of the technology and how it relates to nursing practice.

The importance of usability in health IT

spoke with Mike Nill, chief operating officer, and Troy Tetzlaff, senior director of development improvement, about Cerner’s focus on usability and how we’re incorporating usability design bst practices when we work with clients to design effective solutions.

CHC 2012: Day Three/Four Recap

CHC 2012 is in the books. Thank you to all our amazing clients, associates and partners for making the conference this year a great success! Here’s a quick look back at Day 3 and Day 4 of the conference.

CHC 2012: Day Two Recap

Monday was the first full day of conference activities at CHC. And what a day it was.

CHC 2012: Day One Recap

And, we are off and running at CHC 2012!

CHC 2012: Simon Sinek shares his thoughts on health care

Simon Sinek is the author of Start With Why, and spoke during the Sunday General Session at CHC 2012. We asked him a few questions prior to his presentation.

CHC 2012: Why health care is person for John Bluford

John Bluford, president and CEO of Truman Medical Centers, will speak during the Sunday General Session on Oct. 7 at CHC 2012.

CHC 2012: Talking about the future of health care with Dr. Daniel Kraft

Dr. Daniel Kraft is speaking during the General Session at 8 a.m. on Oct. 8 at CHC.

CHC 2012: Because it's personal

On Sunday, we’ll again welcome thousands of our clients, industry partners and associates to Kansas City for the Cerner Health Conference. It’s hard for me to believe that this will be our twenty-seventh CHC.

CHC 2012: A conversation with Thomas Goetz

Thomas Goetz is one of three speakers in the opening General Session of CHC on Sunday, Oct. 7.

CHC 2012: Genes or environment?

When my brother and I were growing up, our father, Roger Fisher, cast a long shadow. He had come back from World War II convinced by the deaths of many of his best friends that there had to be better ways to solve disputes. He devoted his career to studying and practicing conflict resolution. Dinner table conversations were focused on how to reduce the risk of nuclear war or bring peace to the Middle East. We grew up knowing that it would be important to “make a difference” in our work.

CHC 2012: A warm welcome to Kansas City

Welcome to Kansas City, the City of Fountains, the Paris of the Plains and, in my opinion, the capital of the BBQ world!

The advantages of going paperless

On Mar. 27, 2007, Casa Grande Regional Medical Center (CGRMC) solidified our partnership with Cerner to implement an electronic health record (EHR), after more than a year of development work, with 15 solutions. At that time, this was the single biggest change that the facility had experienced in its twenty-three year history. Going paperless has had many advantages, but the most valuable has been to our patients.

CHC 2012: Real life HIE experiences improving patient care

Beyond federal incentives and government mandates, the increasing value of health information exchange (HIE) is apparent in today’s health care landscape. As an emergency physician at two local hospitals and the medical director for our regional HIE, the Michiana Health Information Network (MHIN), I have firsthand experience of the critical importance of health information technology in clinical practice.

CHC 2012: The who, how and why of a patient portal in a pediatric setting

Research shows that engaged patients actually get better quality health care, and can avoid potential medical errors – all important factors to improve the quality of health care in the pediatric setting. This, along with increasing patient demands for convenient access to their own health care information has led to the development of our “patient portal” MyChildren’s.

CHC 2012: Optimizing your financial performance

Health care providers face intense financial risk and uncertainty this decade due to a shifting landscape. The transformation required for the revenue cycle is critical, with complex reimbursement models and government intervention. Organizations need to move away from a traditional revenue cycle to a clinically integrated one, creating positive patient experiences, accurate translation of clinical work into billing transactions and automated claims payment.

Meaningful Use Q/A: Wendy Hayden and Scott Mincemoyer, Penn State Milton S. Hershey Medical Center

Continuing our series of posts highlighting clients who have achieved Stage 1 of Meaningful Use, we spoke with Wendy Hayden, director, CIS, and Scott Mincemoyer, manager, quality program, about what the process was like for their facility, their thoughts on Stage 2 and how Meaningful Use benefits patients.

Making a pledge to tackle View, Download, Transmit

Last week, Clay Patterson shared his thoughts on the recent Consumer Health IT Summit sponsored by the Office of the National Coordinator for Health Information Technology ("the ONC"). While he was there, I tweeted Cerner's pledge to support the View, Download, and Transmit challenge (#VDTNow) issued by Farzad Mostashari, head of the ONC.

Access, action and attitudes at the Consumer Health IT Summit

On September 10, I had the privilege to participate in the Consumer Health IT Summit sponsored by the Office of National Coordinator (ONC). The event was an opportunity to understand and celebrate the collective efforts by the ONC, patient advocates and the private sector to address the critical issue of engaging patients in their health and care.

Remembering on 9/11

I often paint at medical conferences in the back of ballrooms or on the exhibition floor. When I was painting at the HISA conference in Australia, a lovely woman came over to my easel. She looked at my work and noticed I was painting in the Cerner booth. She told me she had a story she wanted share with me about a Cerner conference she attended many years before. That story was so powerful I asked if I could paint it on her jacket so she could join The Walking Gallery. She said yes.

Achieving Meaningful Use in Pennsylvania

Continuing our series of posts highlighting some of our clients to achieve Stage 1 Meaningful Use requirements, we recently had a chance to chat with with Thomas Johnson, CIO at DuBois Regional Medical Center.

ICD-10 through the coder's lens

What a difference a day makes. Friday, August 24, 2012 the Department of Health and Human Services announced that the Federal Register being published on September 5, 2012 will finally give us the implementation date for ICD-10-CM/PCS as October 1, 2014!

CMS releases Meaningful Use Stage 2 rule

CMS today announced the final version of the Meaningful Use Stage 2 rule.

What is a vendor neutral archive?

There’s a ton of discussion in the health care industry of late as to exactly what is a vendor neutral archive (VNA). Every person that talks about VNA systems has a slightly different view of what the term means. Let’s take a step back and talk through the life cycle of clinical multimedia content generically.

Health IT explained

Curious how health IT (EHRs, PHRs, HIE, etc.) will affect your trip to a hospital or doctor's office?

Big Data: Numerousness doesn't equal value

Theories and practices about outcomes performance, decision-making, leadership and many other domains are firmly rooted in the “norm of normality,” where individual performance follows a normal distribution and any deviations from normality are seen as “outliers” that must be “fixed.” For example, actuaries’ mathematical modeling in health insurance often censors out the top and the bottom few percent of cases as “outliers.”

Achieving Meaningful Use in Massachusetts, part two

This is part two of our interview with Maureen Belley, director of information services at Lowell General Hospital. In part one, she discussed Lowell's Meaningful Use Stage 1 attestation journey. Here, she shares thoughts about Meaningful Use Stage 2 and how her hospital is preparing.

In Memoriam: Stan Nelson

The health IT community lost a true visionary and leader this past week. Stan Nelson, co-founder of the Scottsdale Institute, passed away at the age of 86.

Achieving Meaningful Use in Massachusetts, part one

We recently caught up with Maureen Belley, director of information services at Lowell General, to discuss their Meaningful Use attestation process and get her reactions to the proposed Stage 2 measures.

Innovating high tech, high touch health care

In November of 2011, the Centers for Medicare and Medicaid Services (CMS) Innovation Center announced a Health Care Innovation Challenge offering one billion dollars in funding to applicants who could implement the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and Children’s Health Insurance Program (CHIP), particularly those with the highest health care needs.

The Healthy Nevada project

Today Cerner and the community of Nevada, Mo., announced a first of its kind partnership to create a Healthy Nevada. We believe that together, we can impact the cost and accessibility of care, while improving the quality of life across a community.

The obesity battle central Missouri

The Missouri Department of Health and Senior Services reports that almost two out of every three adult Missourians are considered overweight or obese. Failing to maintain a healthy weight can have serious health consequences including chronic conditions such as high blood pressure and diabetes that compromise the quality and length of life.

A comprehensive ICD-10 assessment

What do the Mayan calendar and the ICD-10 transition date have in common? They both prophesize the end of the world, and both deadlines have been extended past their original date. OK, transitioning to ICD-10 doesn't mean the end of the world, but it does represent one the biggest changes ever to hit the health care industry. So let’s take a minute to revisit that foundational step in the preparatory process - the comprehensive assessment of risks and impact.

Choosing a partner, not a vendor

When we began thinking about what EMR we would use to meet the upcoming Federal EMR mandates, we knew we would be taking on a challenge that was larger and more significant than most of the projects we had undertaken in the past.

Platinum status and the next steps on our health journey

We are pleased to announce that once again Cerner has been selected as a Platinum level winner of the National Business Group on Health 2012 Best Employers for Healthy Lifestyles Award. This is the third year in a row that Cerner has been honored to receive the distinction because of our investment and innovative strategies to promote our members’ heath.

Meaningful Use Q&A: Sue Kurruk, Director of Quality and Risk Management, Syringa Hospital and Clinics

Meaningful Use (MU) continues to be a hot topic in health care circles, especially as debate over Stage 2 kicks into high gear. With that in mind, we had the opportunity to chat with Sue Kurruk from Syringa Hospital and Clinics about the Stage 1 attestation process, as well as what Stage 2 (and even Stage 3) might bring.

Moundview Memorial Hospital’s health IT journey

Located in central Wisconsin, Moundview Memorial Hospital is a 25-bed critical access hospital that serves a primarily seasonal tourist patient population (the Wisconsin Dells, a major tourist area, is nearby). Earlier this year, the hospital went live with a remote-hosted set of health IT solutions designed to streamline patient care. We sat down with Cindy Buchanan, MSN, MHA, chief nursing officer at Moundview, to chat about factors that contributed to their successful implementation, their Meaningful Use journey and other topics.

SCOTUS rules on Affordable Care Act

Today, the Supreme Court of the United States issued an opinion on the constitutionality of the Patient Protection and Affordable Care Act (ACA), President Obama’s signature piece of health care reform legislation, another step on the health care reform path that began in February 2009 with President Obama saying, “So let there be no doubt: Health care reform cannot wait, it must not wait, and it will not wait another year,” when addressing a joint session of Congress.

Taking the headache out of health care

In a recent article, Dr. William Harman, a family care physician with Palmetto Health in South Carolina, described his office's old paper chart system as a "headache."

The diabesity epidemic

According to Dr. Mark Hyman, diabesity is a continuum of metabolic disturbances from mild blood sugar and insulin imbalances to pre-diabetes to Type 2 diabetes. This condition affects one in every two Americans (including 40 percent of normal weight people), and can lead to heart disease, cancer and high blood pressure, in addition to diabetes.

Wellness and condition management in the workplace

As I discussed previously, onsite clinic and pharmacies are one way employers are addressing how to get, and keep, employees healthy. This location shift for traditional health care services can certainly prove beneficial for both the employer and the employee. But what about looking for ways to reduce the overall need for those services?

The meaning of Meaningful Use for patients

Meaningful Use has accelerated the adoption of EHR technology in the United States, but what does this mean for patients and the care they receive? In this video features Dr. Justin Graham, CMIO and infectious disease specialist at NorthBay Healthcare in California, discussing the benefits of Meaningful Use.

North York General Hospital's eCare project wins quality award

Congratulations go out to our client North York General Hospital in Ontario. Their eCare project (CPOE and barcode scanning) was recently honored with a 3M Health Care Quality Team Award. NYGH was the first hospital in Canada to implement barcode scanning, and the system has prevented more than 2,300 potential medication administration errors since going live.

Am I logged into my EHR? Maybe.

When we began implementing our electronic health record (EHR) system, we knew we needed to look at ways to optimize the experience for clinicians in order to make it easier for them to adopt the system. One aspect we targeted was the login process, which typically includes several different login and authentication steps before you can reach the patient’s chart. Streamlining this process was vital, as I’ve done other go-lives where the hardest problem was getting people to learn how to login.

The doctor is in…my office

The question for employers now becomes how to help their employees get healthy and stay healthy. One way that employers are pursuing this is by offering on-site care through clinics and pharmacies. It is important to note that on-site care has many advantages, but also responsibilities and risks.

The Health Datapalooza

Meaningful Use, ICD-10, ACOs and… health data? Indeed. Data, or, more precisely, what the use of data can empower, is a hot topic in health care. Our own Doug McNair weighed in recently on the idea of big data in health care, and there are plenty of other discussions taking place about how to innovate in this space.

The Walking Gallery in motion

For several years, patient rights advocate Regina Holliday has worked on the "Walking Gallery," an art project where she paints representation of health care stories and advocacy on jackets that people then wear (hence the walking part of the Walking Gallery). We've been lucky enough to host Regina as a speaker and have her contribute other content as a guest blogger.

Increasing health risks drive higher health care costs

Around Cerner we think of health care as “health AND care,” separating out each component as significant to the overall picture of well-being. Part of our “health” journey has included developing a collection of solutions and services that help both us (we are self-insured) and our employer clients manage costs and improve health-related outcomes through better coordination of care, evidence-based practice and patient education. Our overall aim is to improve the health of our, and our clients’, associates (and, when included, their dependents) through prevention, early detection, treatment and condition management and occupational health services.

Merging hospital cultures AND EHRs

Mergers can be one of the more difficult processes to manage in business. Each group involved brings their own processes, ideas and culture, aspects of doing business that have often taken years to develop. In a health care setting, especially in recent years, mergers also bring questions about technology. Which EHR system does each group use? Can they work together, or is the decision based around one system or the other? Tough questions, especially when patient care is considered.

Getting 'Stronger' at Seattle Children's Hospital

Please take a moment to check out this video from our friends at Seattle Children's Hospital. It was made by a patient at the hospital and features other patients, doctors and nurses on the hematology/oncology unit. Here's to everyone struggling with cancer getting stronger each and every day!

Cerner celebrates National Nurses Week 2012

Often described as an art and a science, nursing is a profession that embraces dedicated people with varied interests, strengths and passions because of the many opportunities the profession offers. At Cerner, we're proud to honor the impact nurses make in providing excellent patient care!

E-Health in the UAE: Benefits of a national framework

Our involvement with the UAE Ministry of Health in the creation of their future view of health care positions Cerner at the centre of e-health in the UAE. The system we are helping to create and the measurement system will provide the roadmap to help the Ministry of Health reach its destination, it helps to identify barriers and to breakdown the silos of information and processes, as well as reducing the visibility and communication issues that are slowing the transformation of health care.

The Continuous Campus

Yesterday, we held the official groundbreaking ceremony for the new campus we're building in Kansas City, Kan. Below are some pictures from this exciting event.

Celebrating National Medical Laboratory Professionals Week 2012

National Medical Laboratory Professionals Week celebrates medical lab professionals and pathologists. Cerner has deep roots in the lab space (our first solution was developed for the lab), and we're proud to say thank you to the more than 300,000 medical lab professionals around the country.

Moving beyond episodic care: Managing the health of populations

Earlier today, we announced a collaboration with Advocate Health Care, the Midwest’s largest health system and one of the top health systems in the country, based on clinical performance. Working with Advocate, we’ll develop models that help predict adverse outcomes before they occur – leading to earlier interventions and helping to improve the health of Advocate’s patient population across the continuum of care.

Big data is not (yet) big enough - part two

The value of more diverse communities’ using this data may be in the serendipitous opportunities that it creates. Not only will different communities look to new data sets with which to combine the primary data (research networks, and even social networks such as Facebook or Twitter), but they may also approach the problem from new angles.

The Direct Project: A modular view - part three

In part one of this series on the Direct Project, I discussed the backbone transport and message gateway the program uses. In part two, I explored Direct’s security and trust modules and the importance of establishing meaningful trust relationships between HISPs. In this brief, final post, I will define edge protocols and clients and briefly touch on a few policy elements that govern the day-to-day operations of Direct.

The Direct Project: A modular view - part two

In part one of this series, I dissected the Direct Project into discrete modules and provided a relatively in-depth view of the backbone transport and message gateway. In this post, I'll dive into the lifeblood of Direct: security and trust.

The Direct Project: A modular view - part one

Over the past month, I've taken on the daunting task of compiling my knowledge of the technical ins and outs of the Direct Project into an online developer's handbook to assist both my Cerner brethren and third party developers who have chosen Cerner Direct as their full-service health information service provider (HISP). As I looked back over the content, I realized there is a lot of material that is useful to a broader audience in the Direct community. So in the spirit of knowledge sharing, I'm sharing my insight (wisdom?) in a series of blog posts.

The 21st Century skill set

In my previous post on talent development, I shared a story about a young man in our Cerner Scholars program and how he was able to attain skills outside of the classroom that will directly impact his ability to secure a job. I’d like to extend this thought and dive deeper into the challenges we face if we don’t squarely tackle the fact that our education system is at risk of becoming obsolete and irrelevant.

Big data is not (yet) big enough - part one

The promise of timely and reliable evidence in sufficient quantities to statistically ‘power’ health care decisions depends on its quality, its interoperable ontological mapping of concepts (so that “apples” are really “apples”) and on the accessibility of the data on which to base discoveries and conclusions. These aspects are improving rapidly in health care Big Data recently, making that promise real. Detecting, identifying and doing analytical, descriptive-statistics procedures: there is no doubt that these must inform and define the best matches and optimal choices and improvement actions and predictive models.

National Health Framework: Proposed UAE e-health enterprise architecture

As we all know, health care is a complex system of systems, as such measurement of the effect of the enterprise architecture on a national scale in terms of benefit to UAE citizens is more difficult than looking at the financial and patient safety benefits on a single hospital or group. Additionally, the necessity for collaboration across multiple sociotechnical systems means that the predicted outcomes from analysis of component systems will not necessarily be met because of interdependencies in an open system. It is however possible in such an open system to measure specific outcomes and relate these back to specific initiatives.

Improved ICU care may lower in-hospital mortality rates

Mortality rates for critically ill patients have been declining over the last two decades in the United States. It has been suggested that the decline might be a result of less severely ill patients being admitted to intensive care units (ICUs) more often. That is, patients with less than life threatening conditions might be admitted in increasing numbers to ICUs given the expansion of ICU beds nationally.

Will we see ICD-10? Maybe...

What an intriguing world we live in. Here we sit, after exhausting efforts to encourage, develop and begin executing strategies for the ICD-10 transition, with an indefinite timeline but equally definite actuality. Most major players in the industry have shared their perspective, opinions and speculations on the delay. It is obvious to say there are individuals and groups on both sides of the discussion. My objective in this post is to stay away from opinion and focus on strategy, which requires some speculation.

National Health Framework: The UAE Vision

The Ministry of Health in the United Arab Emirates sponsored an eHealth Strategy to enable them to achieve their mission of providing efficient, world class health care that is accessible to all people through a mixture of public and private delivery channels. The scope of this strategy encompasses all the elements of the Ministry’s business processes in Defining Policy, Regulatory Affairs and Service Delivery. Achieving these goals requires that the MoH is able to interact with internal and external organisations, processes and technologies in an open and flexible manner.

A look at Meaningful Use Stage 2 NPRM

We are a little over a week into the analysis of the Meaningful Use Stage 2 Notice of Proposed Rule Making (NPRM). The intent of this post is to bring to your attention some of the broad themes, identify a few upcoming opportunities to learn more and highlight how you can get involved and have your voice heard.

HIMSS12: Q&A with Dr. Wendy Sue Swanson

We’re pleased to welcome Dr. Wendy Sue Swanson to our HIMSS12 booth (476). Dr. Swanson is a mother, practicing pediatrician and blogger at the forefront of conversations around how social media can improve health care. Dr. Swanson will be discussing how social media and technology enable care providers to create strong connections with their patients. We had a chance to sit down with her for a quick Q&A session.

HIMSS12: The next new: Millennium+

Cerner has been automating one-fifth of the U.S. economy … health care … for the past 33 years and during the first two decades we focused on how to get the information off of the paper and into the system. Over the last decade, as more of the information was digital, a shift began to occur that moved the focus towards how this information would impact the workflow if more and more information was already available. The need to filter the information contextually to the provider/patient relationship began to surface, and the workflows have started to adapt.

HIMSS12: Rising to the Slimdown Challenge

It’s no secret that the U.S. isn’t as healthy as it could, or really should, be. And, as our health care system is set up as a “react and respond” system, the unhealthier the population becomes, the more expensive health care becomes. As health care costs continue to rise, it becomes increasingly difficult to improve health outcomes. I think you’ll agree that this is a pretty vicious circle.

Walking the talk when it comes to health

Cerner has been on a health journey with our associates for the past several years. We remain committed to bringing innovative, progressive programming to our associates. Our goal is to make activities engaging, easily accessible and fun.

HIMSS12: Meaningful Use for CFOs

As the CFO of Winona Health, a community-owned, nonprofit organization responsible for meeting the region’s health care needs of Winona, Minn., one of my goals is to ensure we’re positioned to receive every dollar of funding available to us. Of course this means I’m keenly focused on meeting the government’s Meaningful Use requirements.

HIMSS12: Improving Safety, Quality and Efficiency with an Ambulatory EHR

As the electronic health record becomes standard for patient care organizations, providers must decide on a strategy to not only utilize these powerful tools, but to fully embrace the advantages they bring to health care.

HIMSS12: Why my patients love my EHR system

As a family physician in a small rural community, I’m not in the thick of the debates over health information technology. But I know something that policy-makers in Washington need to know – and consumers across the country, as well.

My patients love their electronic health records (EHRs)! They totally understand how EHRs are improving their care, making it safer and more effective. A year ago, they wouldn’t have known to ask if we were using an EHR system. But since our practice implemented them, they see the difference – and they want more.

HIMSS12: Reducing never events through the use of health IT

Truman Medical Centers operates one of Kansas City’s largest” quality safety net” hospitals, where we provide care for a high number of lower-income patients, as well as those without insurance. This care often goes uncompensated. In fact, we provided more than $108 million in uncompensated care over the course of the fiscal year in 2010. That’s a big number, and is one reason why we’re constantly looking for ways to improve the quality and efficiency of the care we provide to our patients.

HIMSS12: What does it mean to be HIMSS Stage 7?

As many of you now know, Florida Hospital Flagler will be recognized by the Healthcare Information and Management Systems Society (HIMSS) as one of 66 hospitals (out of more than 5,000) qualifying as Stage 7 on the HIMSS Analytics EMR adoption scale at HIMSS12. The dedication and hard work of the Adventist Health System (AHS) Information Services teams and the strong IT vision put forth by David Ottati, CEO, and his leadership team at Florida Hospital Flagler made this achievement possible.

HIMSS12: Electronic documentation – Faster than a speeding pen applied to paper?

In the paper world, the physician has to transcribe information from various places in the chart into a summary note. This transcription is done so other care providers can read key information without having to page through the chart. Examples of this kind of documentation are the immediate post-operative note and the discharge summary. With the advent of the EHR, paper documentation tasks have often been directly translated into electronic versions. This process does not take full advantage of the system’s ability to gather information from the electronic medical record and include it in a pre-completed note without end user intervention.

A programmatic approach to the ICD-10 transition

We’re only about a month into 2012 and there’s no doubt this is going to be a busy year from a regulatory perspective. Our Cerner family will continue to make great progress toward attesting to Meaningful Use. The first performance period for the hospital value-based purchasing program will conclude, and the pay-for-performance era will formally begin here in the United States. Hospitals will become financially accountable to 30-day readmissions. A handful of you will be well on your accountable care organization journey. While these initiatives all have a direct impact on health care organizations, we cannot overlook another initiative likely to have the broadest impact on health IT since Y2K.

Developing talent in the Knowledge Age

In November, I had the pleasure of listening to presentations from high school students participating in Cerner Scholars, a program designed for students to work at Cerner for part of their school day to receive academic credit. Their assignment for this particular evening was to present to their parents and to a select group of Cerner associates what they had been working on all semester.

A look inside the HHS’ Meaningful Use attestation data set

With the first year of Meaningful Use participation behind us, HHS has begun sharing program statistics. In fact CMS has been providing general program updates to the Health IT Policy Committee for a few months now. HHS recently released, for the first time, a Meaningful Use attestation data set. This data provides the ability to see how many eligible hospitals and eligible providers (EPs) have attested through November 2011. Further stratification can be done by vendor, state, specialty, etc. This report also distinguishes whether the certified EHR used for attestation received complete or modular certification. It’s important to consider these terms when using the HHS data to gain perspective on the HIT industry.

In the company of the brave

I wandered through the crowded reception hall. It was one of those social mixers, an after hours HIT conference reception. The room was dimly lit and wine glimmered ruby-red through champagne flutes.

Harnessing the power of semantics to improve care

In this data-driven age, the ability to quickly search and find pertinent information is invaluable. The fact that more than 50 percent of Internet users begin with a search gives a hint of the role that search can play in navigating the clinical record. Within health care, where clinicians collect information over a patient’s lifetime, the ability to quickly search through the patient’s record is imperative. New techniques, like performing a semantic search using Cerner’s Chart Search, are making it easier for clinicians to quickly find the information they need.

A physician’s perspective on HIE

I practice family medicine at Norman Regional Health System in Norman, Okla. We’re connected to SMRTNET, a health information exchange (HIE) in Oklahoma developed by Cerner in 2005. With more than 27 million health records in the system covering 2.6 million lives, the saturation of clinic, hospital and laboratory data within SMRTNET is second to none anywhere in the nation. It’s the access to this data via the HIE that is revolutionizing my practice.

Clinician involvement key to a successful health IT program

In any company, making a change in the way day-to-day operations function can be a daunting task. The right IT solutions must be identified, quickly implemented and adopted by the employees. Each part of this process presents its own specific challenges. In a health care setting, when the change affects the way clinicians practice medicine, these challenges are magnified. This is the situation Somerset Medical Center (SMC), a 355-bed regional medical center in Somerville, N.J., faced several years ago when it decided to upgrade its clinical information system.

Happy holidays!

We're going to take a small break over the holidays, but we'll be back in January 2012. Have a safe, happy holiday season and best wishes for a fantastic new year!

The Sixth Estate in the cloud, intellectual property and the limits of collaboration

There is a book (Justifying Intellectual Property) published last June by Robert Merges of Harvard and Cal-Berkeley law schools that you will want to read. It is exciting, beautifully written, and has strong relevance to discoveries and inventions that arise from observational research involving re-use of health data, including ‘panel’ or population-level data such as are stored in multi-institution EHR-derived data warehouses and HIE repositories. In the book, Merges defends the importance of strong intellectual property protections in the present populist, pervasively-interconnected, social-network-obsessed information age that is so enthralled with unfettered collaboration for collaboration’s sake.

Direct Project Connect-A-Thon: Pushing the line forward

On December 8th, I again had the privilege to organize and host a Direct Project virtual connect-a-thon. This was the fifth virtual connect-a-thon held by the Direct Project reference implementation workgroup, and the second time we’ve hosted it at Cerner. As an indication of Direct’s increasing momentum, this was the largest connect-a-thon to date, consisting of more than 20 companies, with 13 actively participating HISPs.

A simple way to improve your health

In this video, Dr. Mike Evans shares one simple thing everyone can do to improve their overall health. What is it? The answer might surprise you.

Creating a lifetime electronic health record

Delivery of a newborn is one of the top diagnoses for all hospital stays in the United States, with more than 4 million births a year. Several roles manage the maternity condition across ambulatory and acute care venues over an extended period of time. Currently, a broken medical record trail and redundant documentation dominate the management of maternity care, making it difficult for clinicians to provide a high level of care for mothers and their infants.

A Spanish health IT success story

Recently, the Healthcare Information and Management Systems Society (HIMSS) awarded Stage 6 Certification to Hospital de Dénia (Dénia, Spain). Currently, only seven hospitals in Europe have received Stage 6 recognition from the HAE (HIMSS Analytics Europe).

HIMSS Stage 6 demonstrates that Hospital de Dénia provides, among other benefits, structured and continuous clinical documentation and a closed medication cycle using a unified hospital system, Cerner Millennium, to give providers a horizontal vision of care, reduce patient risks and increase the quality of care.

Integrating the medication process – ASHP 2011

There are a lot of critical players and components involved in the process of administering the right drug and dosage at the right time to the right individual – from the doctor who orders the medication, to the pharmacist that reviews and bundles it, to the nurse who administers it. As so many factors can be impactful to the patients’ safety, it’s critical to seamlessly integrate every aspect of giving and receiving a medication safely.

RSNA 2011: Creating a visual EHR

Adding digital images to a patient’s electronic health record (EHR) greatly simplifies the problem of capturing, managing, storing, and distributing these images. There are numerous advantages to this model. Clinical efficiency and accuracy are enhanced by having access to both EHR data and images in a single location. By eliminating silos of information across various departments, IT management is also simplified. This will help keep the cost of expensive imaging procedures down and improve patient safety by eliminating the redundant request for images.

First Hand is celebrating the possible

Thanksgiving is approaching—it is a time to reflect on the past year and be thankful for the many blessings in our lives. It is also a time to keep in mind those who are less fortunate—especially children, who are the most vulnerable among us. There are so many children in this world who are unable to access even basic necessities of life, such as adequate health care. Here at Cerner, we try to do our part to help these children live full lives. The holidays are the perfect opportunity to celebrate the possible.

Driving engagement in personal health

Kansas City is feeling the weight (or lack thereof) of healthier lifestyles and happier citizens. Through the KC Slimdown Challenge, nearly 10,000 people worked together to lose 38,187 pounds. In the Community Challenge, players weighing out lost an impressive average of 9.7 pounds per player and 28% moved to a better BMI category, quite a feat for a ten week competition! The estimated cost savings to KC through this initiative is a stunning $1.5 million.

The final ACO rule... finally

Well, the final Medicare Accountable Care Organization (ACO) regulations are out, and reaction from providers is much more positive than it was when CMS initially offered up its proposed rules (here are my thoughts on the initial version of the rules). For the most part, issues that were non-starters months ago have been addressed to varying degrees by CMS: no requirement for financial risk, enhanced eligibility, better incentives, better waivers, fewer measures and more organizational flexibility.

Health care reaches into the clouds

You may not know it, but you’re likely already experienced with a new type of computing growing in popularity and application: cloud computing. If you have Web-based email, like Gmail, you’ve used cloud computing. If you’ve ordered an online movie from Netflix, you’ve used the cloud. With a cloud-based service, instead of purchasing and running a program on your computer, you log in to a Web account and use what you need. The software and/or hardware doesn’t exist on your PC or in your data center, it’s on the service’s ‘cloud’. So it’s stored on a server and delivered to you – on demand – via the Internet.

The magic triangle of patient care

As EHR adoption continues to accelerate, more and more physicians will have access to a computer (desktop, laptop, tablet, etc.) when they engage in patient care. Ideally, having such a device in the exam room should benefit the patient more than the physician. The idea is to engage them with their care and their health data.

The patient right to an access report: What will happen?

Back in June, the Office of Civil Rights (OCR) of the U.S. Department of Health and Human Services (DHHS) published the proposed rule for implementing perhaps the most challenging of the requirements of ARRA HITECH related to updating the HIPAA Security and Privacy rules. The proposed rule addressed the requirements found in Section 13405(c) of ARRA HITECH for a patient to have the right to an accounting of disclosures for disclosures made from the electronic health record of the patient’s electronic personal health information (ePHI).

Fighting sepsis with health IT

Sepsis, or blood poisoning, is a life-threatening disease that arises when the body’s response to infection injures its own tissue and organs. It affects nearly 750,000 Americans annually, resulting in a mortality rate of almost 29%. Recognition of potentially septic patterns within the first two hours of their appearance is vital to the survival of the patient. Cerner developed the St. John Sepsis agent in order to help clinicians recognize these patterns and get patients the treatment they need. Heartland Health in St. Joseph, Mo., was one of the first health care organizations to begin using the agent. Joe Boyce, CMIO at Heartland Health, recently shared some insight on why his organization decided to use the agent, and the benefits they’ve seen to this point.

The journey to becoming a patient-centered medical home

At Indiana University Medical Group, we’re really proud to have eight sites that have achieved level 3 Medical Home certification from the National Committee for Quality Assurance. A Patient-Centered Medical Home is an approach to providing comprehensive primary care. It facilitates partnerships between individuals as patients and their personal providers while providing better access to health care and increasing satisfaction. A medical home is a sophisticated primary care practice where technology is utilized with services to enhance the doctor-patient relationship and bring additional teammates into the care of patients.

CHC 2011 General Session Recap: Neal Patterson

Cerner Chairman and CEO Neal Patterson used a series of pictures to lay out his vision for the future in his CHC 2011 keynote address — at a time when Cerner clients face one wave of change after another. Federal deficits are forcing systemic changes because over the last 50 years, the cost of health care has increased faster than our gross domestic product.

Ethics and de-identified genomic plus phenotypic (health) data

During the annual Cerner Health Conference last week, several clients came up to discuss my previous post and associated essay on de-identified health data. In my essay, I basically agree with Marc Lappé and others who have asserted that medical ethics as it exists and is practiced today is different from—and historically antagonistic toward—public health ethics (‘communitarian ethics’). This point of view is covered at some length in a paper by Eric Meslin and Ibrahim Garba in the September issue of Human Genetics.

CHC 2011 General Session Recap: Dr. Wendy Sue Swanson

Blogger, mother and pediatrician Wendy Sue Swanson, MD, said doctors must start using social media to reach out to patients and parents in her General Session address Monday at the Cerner Health Conference. Citing the Pew Research Center, Dr. Swanson said 65 percent of Americans participate in a social network and 80 percent of Internet users look up health information.

CHC 2011 General Session Recap: Dr. Denis Cortese

Cerner board member Denis Cortese, MD, offered both a diagnosis and a prescription for health care in the opening address of the 2011 Cerner Health Conference Sunday evening. Dr. Cortese, the emeritus chairman and CEO of the Mayo Clinic, argued that three domains within health care — knowledge, care delivery and payers — are largely disconnected.

Kansas City has slimmed down!

Weigh-outs for the KC Slimdown Challenge have been underway since Sunday, and it’s clear that Kansas City is shedding pounds! The final stats will not be available until the Challenge ends on October 9^th, but our unofficial total is close to 40,000 pounds. That’s 20 tons, or the equivalent of a massive killer whale!

CHC 2011: A paradigm shift to wellness

We are all waiting for various federal and state health reform mandates to become final. Few have confidence that any will offer solutions that guarantee access to care while simultaneously improving the reimbursement hospitals and doctors receive for the incredible work they do. All that is certain is that uncertainty will prevail.

The New Doctor-Patient Handshake

One of my mentors in residency told me that the pediatrician handshake was different, unique, and instinctive. Instead of grasping a child’s palm firmly, the handshake is the ritual of touching the top of a baby or toddler’s head, palpating the anterior fontanelle (soft spot). Often, it’s one of the first things we do when we meet our new patients.

The continuing evolution of lab informatics

Google just turned 13 years old (9/27/1998), and I feel old. I remember toiling away as an undergrad in the engineering computer lab, using NCSA’s Mosaic as my browser and AltaVista as my main search engine. I also remember my first encounter with a laboratory information system (LIS) as a medical student, using a light pen to call up a floor census and printing out pages of labs to stuff into my pockets for rounds. EMRs were barely there, paper was everywhere. The big movement in all parts of health care IT at the time was “get the data into the computer,” and all of those printouts, paper charts, and the like slowly migrated into an electronic format.

CHC 2011: Getting to know Kansas City

Kansas City is gearing up for thousands of health care professionals to descend on the city for the Cerner Health Conference. For those coming to Kansas City for the first time, I’d like to take a moment to introduce you to our city. For those conference veterans, I’m willing to bet that you’ll learn something new about the city as well.

The Evolution of the Smart Room

Imagine an environment that is aware of your presence. Automated events occur based on your location, preferences and patterns. Daily tasks take less time or are simply no longer necessary, based upon the ability to utilize smart technology – seamlessly integrated into your everyday routine. Now, apply this smart concept to an environment focused upon providing health care and optimizing the patient experience.

Changing your lifestyle

I'm currently participating in a yearlong internal weight loss challenge at Cerner, similar to the KC Slimdown Challenge. I wanted to share the story of my journey with you in hopes that it will motivate you to make similar changes in your own life.

De-Identified Health Data Have Characteristics of Quasi-Public Goods

Cerner and many of our client institutions participate in de-identified databases that support observational and translational research. Such databases, called data warehouses, constitute a comprehensive source of de-identified, confidentiality-protected, real-world health data collected as a by-product of patient care. Cerner aggregates the data provided by participating facilities and uses stringent quality assurance processes to ensure the ongoing integrity of the information.

CHC 2011: It's time to 'Experience the Possible'

Twenty-six years ago we started the Cerner Health Conference as a way to connect with our clients and industry partners to develop innovative ways that change how health and care are delivered. Over the years we’ve had client after client share their experiences, best practices and victories with their peers and every year the successes get bigger and more impactful. This year will be no different. As the conversation turns from “what if…” to “what now…” we’re inviting our clients once again to come and Experience the Possible with us.

Practice enjoys easier way to send, receive data

When Walnut Lake Ob/Gyn wanted to automate its women’s health clinic, the practice hoped to securely send and receive electronic health information from the affiliated hospital, Detroit Medical Center. A year after going live on Cerner solutions, the practice had a new objective – securely send and receive information with patients. Dr. Michael Salesin reflects on how Cerner’s Patient Portal, IQHealth, has improved his relationship with his patients and increased efficiency in his practice.

Trading salami sandwiches for workouts during the KC Slimdown Challenge

I am so proud of the employees of the City of Kansas City for their overwhelming participation in Cerner’s KC Slimdown Challenge. I personally understand how difficult it can be to make different lifestyle choices. I’ve always enjoyed comfort food (I can’t resist the grilled salami sandwich at the Filling Station!) and relaxation more than rice cakes and exercise. Seeing our employees energized about getting healthy has renewed my own commitment to changing my bad habits.

Transitioning to ICD-10-CM/PCS is Well Worth the Effort

I recently provided an overview of electronic health records (EHRs) to a new college graduate considering employment in the field. I described how access to clinical information at the right time significantly contributes to patient safety. I highlighted how clinicians can simplify their workflow by building personalized templates among care plans, order sets and notes, which they easily customize to each patient. I outlined the great advancements that can be made by querying the information for research sake. Most of all, however, I emphasized how exciting it is to be able to empower health care providers with use of the electronic health record during an unprecedented time of growth. Several regulatory initiatives will greatly accelerate responsible sharing and deeper use of information collected within the record. While I mentored my young friend on each of the upcoming initiatives, I stressed the importance of ICD-10-CM and ICD-10-PCS.

AC-Oh No

Through some twisted events of fate, I have found myself at the cataclysmic intersection of three worlds: emergency medicine, health information technology and accountable care organizations (ACOs). I was asked a few years ago to be the CMIO for the Palmetto Health Quality Collaborative (PHQC), an ACO established by Palmetto Health in Columbia, S.C., and it has been quite amazing to realize the interrelatedness of these worlds.

The Future of Electronic Fetal Monitoring

If you had a baby in a hospital within the last 25 years, most likely you had a fetal monitor applied at some point in your labor. Electronic fetal monitoring (EFM) has become rooted in the practice of obstetrics in the United States over the last generation or so, becoming the most common obstetric procedure in the U.S. In 1980, 45% of laboring women had EFM, and by 2002, CDC reported that it was used 85.4% of the time, impacting 3.2 million live births.

Want to Live Longer? Get Active

We all recognize that taking a walk or going for a run is better for our overall health than spending that time sitting in front of the computer or the television. Sedentary lifestyles can contribute to health problems like cardiovascular disease and diabetes. Now, two recent studies are shining more light on how a more active lifestyle can help you live longer.

Reducing Health Care Costs by Rethinking Health and Care

Several words come to mind when people think about health care, one of those being “costly.” A new report from Medicare’s Office of the Actuary projects that by 2014 health care spending will grow by 8.3 percent. This rate far outpaces any projected growth in the U.S. GDP. And by 2020, the U.S. is expected to pay $4.6 trillion – yes, TRILLION – for health care services. Some of this cost is unavoidable as the Baby Boomer generation heads into retirement and begins to become heavy consumers of health care services. But there are things we can do as individuals and as employers to improve the health system and ultimately reduce costs.

The Employer Health Care Opportunity

The idea that a healthy workforce makes for a productive workforce isn’t new to employers. Occupational health, a discipline focused on health and safety in the workplace, was officially defined by International Labour Organization and the World Health Organization in 1950 and various approaches have been in place since that time. As health care costs in America rise, employers are the ones who face the brunt of these expenses. Realizing the need to both control costs and maintain a healthy workforce, many employers are expanding their view of occupational health and taking a more holistic, proactive approach to overall workplace health.

FDA Facing Huge Task in Regulating Mobile Medical Apps

The FDA has already cleared a handful of mobile medical apps used by health care professionals, such as a smartphone-based ultrasound and an application for iPhones and iPads that allows doctors to view medical images and X-rays. But to-date, the FDA has not cleared any consumer-facing mobile medical apps. Nor does it appear that the FDA realizes how big a job this will be.

Realizing the Potential of Electronic Health Records

The United States is entering a new era of health care, driven by the implementation of health information technology, specifically the electronic health record (EHR). The adoption of EHRs offers tremendous potential to improve the quality of patient care, improving patient outcomes as well as increasing the efficiency of the health care system in the United States. This technology also empowers individuals to take more control of their health by eliminating the paper chart and enabling them to have more direct interaction with their personal health information.

The Cost of Health Care in America

It’s no secret that health care costs in the United States are significant. Ask anyone who has been to the ER recently, or someone managing chronic health issues and taking several different prescription medications. Two recent reports discuss how much Americans can expect to spend on health care, and how that spend compares with other countries.

Fields to Forks: Eating Healthy at Work

This week, Cerner hosted two farmer’s market events for associates. At the events, called Fields to Forks, associates were able to purchase locally sourced fresh produce and other items. Cerner associates Emily Abernathy and Arielle Bogorad sat down for a quick Q&A to share more information on the events.

Empowering the Patient: Ridge Family Practice

Jennifer Kay, MD, physician owner of Ridge Family Practice, PC, a family clinic in Council Bluffs, IA, likens a paper medical record to handcuffs, restricting what she's able to do. Kay says, "It keeps you in the office longer hours, not allowing you to have your data nicely organized, not allowing you to access it easily." However, the practice has found the key to unlock the paper record handcuffs.

Resource Stewardship Through the Eyes of the Patient

I recently returned from a client visit and where I had the rare opportunity to have coffee with one of my long-time nursing mentors. I mentioned that I was currently working with a group on Capacity Management for Health Care and described the vision of comprehensive resource management with patient flow optimization and effective staff and resource utilization centered around the patient experience. This led to detailed discussion about how challenging it still is to measure and monitor resource utilization and effectiveness in health care.

MU Health Care and Cerner: A Digital Health Care Partnership

Earlier today the University of Missouri Health System announced they’re one of the nation's "Most Wired" hospitals according to the 2011 Most Wired Survey released in the July issue of Hospitals & Health Networks magazine. They were the only facility in mid-Missouri to make the list.

Better Outcomes Through Design: Four Questions to Ask When Designing a New Health Care Facility

Have you ever worked in a hospital that was designed and built as a box with smaller boxes inside where patients are located? Or, have you worked in a department where you received new devices and equipment that were placed in an empty location and not where you needed them to provide care? The actual building design was likely completed for the efficiency of the builder, and did not account for clinical workflow, patient comfort or any new technology integration.

Direct Project - It's Not Just About Email

While certainly a valuable application workflow to layer on top of the Direct Project, equating the output of the Direct Project to an email application does it a disservice and underestimates its potential.

Challenge Accepted: The KC Slimdown Challenge has begun

Just a few days ago, startling statistics about obesity in America were released, with Missouri and Kansas both ranked in the top 16 for adult obesity rates (30 percent and 29 percent respectively), further illustrating the need for change.

SMRTNet: The Exchange of Clinical Information in Oklahoma

SMRTNET is the largest Health Information Exchange (HIE) in the state of Oklahoma, containing nearly 2 million patient records from 45 unique contributing facilities. It is the product of a four year effort to provide a capability for medical providers to securely exchange electronic health information under federal and state law with onnections that include hospitals, physician offices, laboratory, university, Native American tribe, public health, mental health, and community health centers.

Chemotherapy: The Right Dose at the Right Time to the Right Patient

Chemotherapy regimens are undoubtedly the most complicated, potentially toxic medication order-sets that there could be. Because of this, methods to prevent mistakes involve built-in redundancy by several professional disciplines. However, prevention of mistakes often fails because of a lack of recognition of errors, communication problems, and fragmentation of care. Can the electronic ordering systems of today ameliorate these failures?

The Retirement of Google Health: What it Means for the Personal Health Record

By now, most of you know that Google has officially announced the retirement of Google Health. I’ve always thought Google was a great advocate for consumer health engagement and it's a shame to see them exit the market. At this stage in the game, any gains in the consumer health arena are gains for all parties involved and Google did a great job helping move this industry along.

For the last month and a half, since Chilmark Research declared Google Health "in stasis," I've received a lot of questions about what the sunsetting of Google Health would mean for Cerner Health, Cerner's personal health management platform. First, I think it means anyone developing a personal health record needs to stop and ask whether they're making the same choices as Google did. It also means that there is at least some population of PHR users that would really appreciate a new home for their personal health information. Beyond that, I'm not sure it means a whole lot.

Starting a Movement To Better Health

Last month, I blogged about Cerner’s weight loss challenge for our associates that resulted in nearly 20,000 pounds lost. This summer, we will be taking it to the next level with a community-wide weight loss competition. The KC Slimdown Challenge is an opportunity for small teams and area companies to compete for prizes and bragging rights with the end goal of creating a healthier Kansas City. For 10 weeks this summer, we hope to encourage 30,000 participants to team up, slim down, and get healthy.

Meaningful Use Stage 2 Timing Recommendation

Much has been written about the final recommendation that the HIT Policy Committee (HITPC) submitted to the Office of the National Coordinator (ONC) for HIT regarding the timing of Meaningful Use Stage 2. The purpose of this blog post is to restate the facts about the recommendation and discuss what this may mean to your strategy.

Balancing Your Organization's Capacity Checkbook

Managing capacity in healthcare is a complex business. The organization’s ability to balance the right resources given their capacity is vital in this new era of health care. Resources (beds, equipment, and staff) are relatively fixed in the short term. Without comprehensive systems and empirical information to go by, it’s difficult to determine whether changes to pieces and parts of the system are delivering the outcomes you expected. Utilizing fixed (and dwindling) resources to care for the dynamic health care needs of patients requires a comprehensive system. As David Pierre mentioned in his blog post, the need for healthcare services is rapidly outgrowing the supply of available resources, both providers to care for patients, and critical equipment required for treatment of their condition

Enterprise 2.0: Making health care social

On June 16th, Brice Jewell, Senior Manager of Cerner's social business initiatives, was featured in an interview with InformationWeek's The Brainyard. In the interview, Brice shares some of the successes and challenges of introducing social business tools to Cerner's clients and associates and how these efforts are furthering Cerner's mission to contribute to the improvement of health care delivery and the health of communities.

On being first: A physician's perspective on achieving Meaningful Use

When my team implemented Cerner’s Ambulatory EHR 16 months ago we were changing culture from writing paper charts to an EHR. As a physician, I had the same fears as many of my peers have, but as a staff, we did it whole heartedly and adopted the solution with the urging of our affiliated hospital, Doctors Hospital of Renaissance, which implemented Cerner Corporation’s solutions.

Choosing a Direct HISP

As the Cerner Direct team has been working with our pilots, continuing to tweak our Web Inbox and HISP (Health Information Service Provider) services, and responding to RFPs, our whiteboard has been filling up with thoughts about what we’d look for when choosing a Direct HISP. It’s time to put those thoughts in a blog post.

To be clear, our notes aren’t about choosing HISP software/services from a third party in order to become a HISP. Rather, they’re for organizations that intend to sign up with a service provider and begin securely exchanging health information, leaving the infrastructure build-out and maintenance to an organization that’s making a business of offering the services. In that sense, we’ve been thinking along the lines of choosing a cable provider or telecommunications carrier.

America's Best: Cerner Corporation

In April, Cerner founder and Vice Chairman Cliff Illig was featured in a video series sponsored by the US Small Business Administration titled America’s Best: Their Stories, Their Ways. In 1983, Cerner received a $200,000 7(a) loan and SBIC financing of $630,000 in 1986 through the Small Business Association. Now, as founder of a Fortune 1000 company with more than 8,000 employees across the globe, Illig shares the story of how Cerner started, how the founders built relationships around Kansas City to grow their business, and the important role young associates play in shaping the future of the company.

Syringa Hospital and Clinics: The journey of becoming a digital hospital

Syringa Hospital and Clinics is a rural acute care facility located in Grangeville, Idaho. In early 2011, Syringa went live with Cerner solutions and is currently working closely with Cerner’s Regulatory Compliance Team as they move toward meeting Meaningful Use. We had the pleasure of interviewing Darla Anglen-Whitley, Syringa’s EHR implementation project manager about her experiences.

Personalized health and gene-behavior interactions: The case of HDL-cholesterol and exercise

"In the clinic, if somebody has low HDL-cholesterol levels, the first thing I tell them is to get out and exercise. But genetic loci have been identified that affect HDL-cholesterol levels as well. The question is, how do these two factors work together, or work against one another, to alter HDL-cholesterol levels?" - Brendan Everett, Brigham and Women's Hospital, Harvard University

Healthcare and technology: 10 lessons from around the world

The challenge that faces health services around the world is to improve the health of their population at a cost that their economy can afford. It is well understood that impacting upon the health of a population requires a combination of individuals and communities taking more care of their own health, public health interventions such as vaccination programmes, effective primary care to manage small illnesses and diagnose major illness early, community services supporting the sick and the elderly outside of hospitals and hospitals to treat acute, long term and psychiatric illness that is too severe to be cared for outside of a hospital setting.

Becoming a health company: building healthy teams

As Cerner makes the turn to be known as a health company and not just a healthcare IT company, I am impressed by the strides we’re making. Our Healthe Living with Rewards program allows Cerner associates and their spouses earn incentive points for maintaining or improving their health, reducing the out-of-pocket costs of healthcare. The sales of healthy meals in our on-site cafes have steadily increased. There have been grassroots efforts like walking meetings and campaigns encouraging associates to take the stairs.

Introducing the Personal Health Record for Athletes

Sports injuries are unavoidable. Much like hot dogs at the ball park, vuvuzelas at the world cup, and foam fingers and face paint at a football game, injuries are part of the game and always will be.

Getting injured is easy. Tracking these injuries and managing the road to recovery is not. HealtheAthlete is a Health Management Platform that combines injury management, a Personal Health Record (PHR), and advanced reporting capabilities built specifically to manage the health of elite athletes.

Modular Certification: Out to Create Flexibility

In an earlier blog post, we discussed the impacts of the ONC policy on what it means to have to “possess” all of what is in a vendor’s complete EHR certification, and how that may impact those of our clients who look to rely on our complete EHR certifications to support their Meaningful Use attestation. We now want to turn our attention to the other avenue that is available for clients to consider in their Meaningful Use attestation as the basis for their claim for use of certified EHR technology.

Measuring Up

Ours is a world of standards. To measure the progress of anything, there needs to be a standard against which you can compare. For me, it is running. The standard I set for my first long distance run was to simply be in the field of participants who finished. I did finish, and proudly wear the tee shirt that proves it. However, that wasn’t enough, so the next challenge was to finish within a certain time. And so it goes, year by year, we all progress against our personal goals, meeting the standards we set, and re-establishing more challenging standards for the year ahead. The real feeling of accomplishment comes when we look back over years of hard work and see just how far we have come. It is exhilarating, satisfying, and it motivates us to do more.

Pushing the Edge with Standards

Standards… boring, right? You typically encounter those odd letters and acronyms when talks start about moving data between disparate healthcare IT systems or medical devices. HL7, DICOM, ASTM, IHE, LOINC, and the like serve a very important role in the HIT ecosystem by providing a common language that all parties can utilize to allow information to flow easily across systems. At Cerner, we use these standards to send, receive, and store data for our own systems, so these are not foreign concepts… but our approach is.

Award-winning collaboration: Cerner, WellSpan Health and Hospira

On April 28, 2011, Cerner was honored along with WellSpan Health and Hospira with the Collaboration Award as part of the 2011 Way-Paver Awards at the 6^th Annual unSUMMIT Conference for Bedside Bar Coding. This award is significant; it’s the first-ever Way-Paver Award to recognize collaborative efforts and results between a healthcare IT company, a hospital and a device manufacturer.

Which certifications to use for Meaningful Use attestation

Since our last blog post,we have received many questions about which certifications to use for attestation among those we have available for clients to reference on the Office of the National Coordinator's (ONC) Certified Product List (CHPL). We would like to try to clear that up a bit.

The first question clients should ask is what makes the most sense for their organization based on their circumstances and the timing of their attestation. While these categories may not precisely categorize all of our clients seeking meaningful use attestation, thinking about them in this way can be instructive.

Comprehensive Capacity Management, Supply and Demand Equilibrium is Possible and Predictable

The fundamental imbalance between resource (resource defined as: staff, beds, equipment and devices) supply and demand in healthcare is growing at an alarming rate. It has been widely documented that the aging of the US population and increasingly complex co-morbidities will add significant demand to the acute care system. Healthcare reform will add coverage to an estimated 32 million additional patients leading to an anticipated 13.1 million additional annual ED admission increase.

The Direct Project and the Consumer

There they were. My new glasses, sitting on the floor, chewed up by a tough-looking pug who didn't care. Worse, I had a schedule full of meetings the next day and didn't have a spare pair of glasses. The next afternoon, I went to a local one-hour glasses shop in my prescription sunglasses and asked them to have my eyeglass prescription faxed from my optometrist so we could get new glasses started. That's when the fun began.

Closing the Loop

In discussing the ultimate objectives of Cerner solutions, the phrase “closing the loop” is often mentioned. In research circles, this “loop” usually starts with the electronic capture of health information during the course of patient care. This information is then used to improve the management of that patient’s care. In some instances, the information is collected and de-identified in order to be used for research purposes. Research using these health data drives medical progress, from accelerating development of new therapies to informing point of care decisions. These changes are identified, their outcomes documented and evaluated for effectiveness in further research, and so on. In short, in this system, patient care drives discovery, and discovery drives patient care.

A Physician’s Road to Meaningful Use

At River Falls Medical Clinic, the basic question we ask whenever we embark on any kind of endeavor is how does this help our patients? From the day we began using Cerner’s Ambulatory Electronic Health Record solution in 2010, it was our goal to utilize the EHR to its full extent for the benefit of our workflow and the care we deliver to our patients. When the government announced Meaningful Use requirements, we were quick to notice that the proposed criteria would help us to better utilize our EHR to give our patients things they are not getting now. We eagerly jumped on board and made it our own personal goal to be prepared to “push the button” on April 18 – as one of the very first physicians in the country to be Meaningful Use certified.

NCH North Naples and the Cerner Smart Room™

Yogi Berra once famously said, “The future ain’t what it used to be.” Turns out, Yogi was right, especially in healthcare.

The future hospital won’t only be different, it will also be smarter. Proof of that can be seen on the NCH North Naples campus, where we’ve created — with our Cerner Corporation partners — a prototype hospital room of the future. With philanthropic support, it could soon be the technologically-savvy setting that is representative of NCH hospital rooms.

Accountable Care Organizations & the CMS proposed rule for the Medicare shared savings program

On March 31st, the Centers for Medicare & Medicaid Systems (CMS) released its much anticipated proposed rule for the Medicare shared savings program. The Medicare shared savings program, legislated as part of the Affordable Care Act, allows Medicare-enrolled providers to form Accountable Care Organizations (ACOs). As one of the few provisions in the Affordable Care Act that is perceived to have a chance at flattening the healthcare cost curve, the administration is keen to see successful ACOs emerge from this program. In a rare and highly-coordinated effort (that gives some hint at the visibility this initiative has within the administration), the Office of the Inspector General, Federal Trade Commission, Justice Department and the Internal Revenue Service simultaneously released clarifying guidelines or policy statements related to ACOs and the proposed rule.

At what point is it valid to apply a predictive statistical model that was developed from population studies to health decisions for an individual person?

This question was posed by a reader in response to my previous blog post about the anticonvulsant medication valproic acid and drug-induced liver injury that occurs in a modest percentage of patients where the risk disproportionately involves individuals with a particular gene polymorphism.

Measuring or predicting risk for an individual vs. measuring or predicting risk for populations is an important distinction to make. Epidemiologists call applying a population result to a person the "atomistic fallacy." The converse (applying risk that is known for an individual or for a small group to a larger population that is different from the individual or small group) is called the "ecological fallacy."

Cerner and the Direct Project: Next Steps

As a follow up to the previous Direct Project post, which highlighted the essentials of the Direct Project and included a historical account of Cerner’s involvement to date, this post will focus on our plans to leverage the Direct Project standards to solidify a network of health participants.

What Does the Complete EHR Certification Really Mean?

Recent policy clarifications made by The Office of the National Coordinator (ONC) have brought the real meaning of “Complete EHR” to the forefront, creating lively discussion within the industry. The clarifications, which were posted in the FAQ sections 17 and 21, explain that for a hospital or eligible provider to make use of any part of a vendor’s Complete EHR certification as part of their Meaningful Use requirement, the provider must “possess” all of what is in a vendor’s Complete EHR certification list.

Device Certification and the Laboratory

How do you turn a classic client pain point into an excellent way to push the technology boundaries in the lab space? Change the business model and the dialog. This is what the DeviceWorks arm of Cerner Corporation did a few years ago.

Surrounded by a rapidly expanding list of bedside devices that needed interfaces, they were trapped in an endless loop of building “one-off” interfaces at each client site. To break the cycle, this group called the proverbial “time out” and started talking directly with the device makers about building interfaces in advance of clients going to market. What happened next was truly game changing. First, our clients’ immediate pain points surrounding drivers began to subside as Cerner associates and device makers started to work together to build or enhance the interfaces needed in the field.

Striving to engage people in their health

Cerner has been working, in one form or another, on personal health solutions for many years. We've reacted with surprise when people don't end up engaging with our solutions as much as we'd hoped. Over the last year and a half, we've begun the journey to deliver a new stack of personal health solutions called Cerner Health. The Mission: create a personal health record (PHR) platform that lets people pull all their health information together in one place, and share it with their doctors, family, pharmacy, and other "health partners," as well as provide recommendations on how to live a healthier life. The Problem: most people don't know they want to do that. Or more likely, they just don't want to do that. Sure, there are people with a complex health condition or new diagnosis that provide them with an incentive to be interested in their records. However, this incentive might come too late. The person in the hospital suddenly really wishes they'd been better-managing their health records all this time.

Cerner and the Direct Project

With today’s Office of the National Coordinator announcement celebrating a major milestone of the Direct Project and the excitement Direct Project generated at HIMSS11, we will be sharing a series of posts about this exciting new approach to solving a variety of issues facing healthcare. This first post focuses on the key essentials you need to know about Direct Project, along with a historical account of the collaboration between Cerner and other industry partners that helped bring Direct Project from concept to reality.

Follow up on pediatric seizures and genomics

I received the following question via email after my recent post:

Depakene is about the only thing that has controlled my child's seizures. But the 23-times greater risk is scary. Do the POLG gene variants cause higher drug blood levels or what? Should those be monitored more often? We'd hate to stop the drug and 'fix' something that's not broken. My daughter's been on Depakene for 4 years with no problems. If she has that SNP genotype, is her risk 23 times higher, or might it be some other amount?

A Meaningful Collaboration: Glen Falls Hospital and Cerner's Regulatory Compliance Team

Glen Falls Hospital is the largest hospital between Albany, NY and Montreal, Canada as well as a comprehensive healthcare system with 28 regional facilities. Glen Falls has been working closely with Cerner’s Regulatory Compliance Practice team to implement new functionality, understand and interpret Meaningful Use regulations, and better understand gaps toward achieving Meaningful Use.

We had the pleasure of interviewing Keith Rathbun BSN, RN from the Information Services team at Glen Falls Hospital about this collaborative effort.

Video: How Methodist Le Bonheur Healthcare is increasing efficiency in the ED

With seven hospitals throughout the greater Memphis, Tennessee area, Methodist Le Bonheur Healthcare treats almost 275,000 patients through its emergency departments. Cerner FirstNet is used to help track patient care, order medicines, CPOE for the physicians, and to pull data for reports for quality. After implementing FirstNet and streamlining patient care, the impact is significant. Clinicians are able to see patients more quickly and increase turnaround time. Said Kerri Morris, RN, BSN, "We're able to do what we do best - we spend time with our patients.

Recognizing client success at HIMSS11

In the past several months, we’ve shared the stories of Children’s Hospital Boston and Carroll County Memorial Hospital. These organizations represent two very different communities, but have both reached significant accomplishments in healthcare IT – Reaching Stage 7 on the Healthcare Information and Management Systems Society (HIMSS) Electronic Medical Record Adoption Model for Children’s Hospital Boston and HIMSS Stage 6 for Carroll County Memorial Hospital.

Supporting clients, education and interoperability at HIMSS11

The Healthcare Information and Management Systems Society (HIMSS) Conference kicks off this weekend and many healthcare professionals will be headed to Orlando to take advantage of the conference’s educational and networking opportunities. While Cerner will not have a booth on the showroom floor, we are excited to support our clients and partners and to participate in important initiatives such as the interoperability showcase.

Practical genomics medicine is here now, not years away, if only you will open your eyes and look

The pursuit of the perfect end-state can drive a belief that there are limitless opportunities for improvement. Although perfection can never be fully realized, its pursuit can propel achievement of value and excellence; that is the rationale behind the Baldrige and other quality awards. The pursuit of perfection can be distinguished from ‘perfectionism’. Perfectionism is retrospective—hind-sighted and judgmental in its point of view. It devalues what has already been done because it is not perfect. By contrast, the pursuit of perfection is prospective and nonjudgmental. It asks the question, What choices and investments should we make today to move closer to the perfect end-state?

It was with these thoughts in mind that I read with dismay the post by Katherine Hobson in the Wall Street Journal health blog last week. In it, she says that real benefits of genomics and personalized medicine are still many years away, citing just-published papers in the prestigious British journal Nature. This is a nasty rumor; a cliche; a bad meme that keeps coming back like a bad penny.

DTC Genomics tests, Using your results: Pediatric seizure medication safety/prevention example

A research article published in November shows that people who have the 'GT' genotype for the single-nucleotide polymorphism (SNP) in the mitochondrial polymerase gamma (POLG) gene have a 23-fold increase in liver toxicity. For those who have two copies 'TT', the risk is even higher. As such, these genotypes confer tremendous risk on about 12 percent of people of European/Caucasian descent, and somewhat smaller percentages of people of Asian or African descent.

Bringing healthcare IT to communities of all sizes

USA Today recently ran an article highlighting a federal stimulus program developed to bring broadband Internet access to rural areas of the country. President Obama reinforced the importance of this initiative in his State of the Union address last week as a requirement for attracting and keeping business in the United States. The ability for businesses in rural areas to send and receive information as quickly as their urban counterparts is vital to their continued sustainability and ultimately to the livelihood of their communities. But it’s not just about businesses; it’s about improving access to education and healthcare as well.

Children's Hospital Boston: Supporting Clinical Excellence with Technology

In December 2010, Children’s Hospital Boston achieved HIMSS Stage 7. We had the pleasure of interviewing Daniel Nigrin, MD, MS, Senior VP for Information Services & Chief Information Officer Division of Endocrinology & Informatics Program at Children's Hospital Boston to learn more about Boston Children's success as one of healthcare IT’s early adopters.

Personalized diagnostics/prognostics: Ovarian Cancer example

A reader emailed me to ask: In follow-up to your previous blog post, is there a comparable example for women's health?

To be exactly comparable, we'd be talking about genomics-based personalized tailoring of cancer screening-related diagnostic testing normal-ranges or decision-levels, where the diagnostic involves a customary biomarker molecule that is used to assess risk of cancer and guide further evaluation or intervention.

Emergency IT Design: Trying to do the right thing

ER physicians understand the anguish and challenges of modern healthcare. We are on the frontline, taking the heat and feeling the pain. Our only defense is holding the shield of ‘trying to do the right thing.’ But this is where much of healthcare gets started, especially the ugly stuff (by nature unscheduled, unexpected and often times irresponsible).

How EHRs can improve the safety of healthcare delivery

On the morning of Nov. 19, 2010 the FDA announced the widespread recall of the popular pain relief medication, Darvocet, citing “serious and potentially fatal heart rhythm abnormalities.” Ensuring that the doctors who use our electronic health record (EHR) were aware of the Darvocet recall quickly became our highest priority that day. We needed to make sure that doctors knew about the recall so they immediately contact any of their patients who were taking Darvocet.

Personalized Medicine is not just about therapeutics, it is also about personalized diagnostics

Most people think of “personalized medicine” as choosing the best (most-effective, safest, etc.) treatment according to the details of the attributes of the person, including genetic and genomic attributes. What's not generally recognized is that personalized medicine also involves personalizing the decision-levels of diagnostic tests for the individual--taking the numerical limits of the reference ranges (“normal ranges”) of laboratory tests and vital signs and other diagnostic and monitoring procedures, and tailoring those ranges to reflect what is “normal” for persons with those specific attributes.

Becoming a Healthcare Company

At Cerner, we are broadening beyond being a healthcare IT company to becoming a healthcare company. One of the foundational components of this shift is to “walk the talk.” We’ve made considerable strides in understanding what drives the health of our own associates and, in turn, what drives healthcare expenditures.

Why would anybody want to know the genomics of wet vs. dry earwax type?

Nobody. Well, almost nobody. The real answer is that the gene (ATP-binding cassette protein, sub-family 'C' member '11'; ABCC11) that controls earwax phenotype also controls other attributes of glands in the body, and there are genetic variations in this ABCC11 gene that affect the risk of conditions and the effectiveness of treatments in those other glandular tissues.

Making Meaningful Use Meaningful

John Bluford, President and CEO of Truman Medical Centers, was the keynote speaker at Cerner’s first Meaningful Use Summit here in Kansas City last spring. During his presentation, two of his statements struck me. First: he wasn’t sure how they were going to achieve all of the MU requirements, that they had to do it, and that he was depending on Cerner and the partnership between the organizations to make it happen. And second: the doctors would not go along with the MU initiative for financial or government requirement reasons alone - there MUST be benefit to them and their patients for them to buy in.

Critical Access Hospital achieves HIMSS Stage 6 with CommunityWorks model

CommunityWorks is a division of Cerner that focuses on partnering with Community and Critical Access Hospitals. We’ve been working closely with Carroll County Memorial Hospital (Carrollton, MO) since last March and are proud to announce that CCMH become just the 4th Critical Access Hospital in the U.S. to reach HIMSS Stage 6 on the EMR Adoption Model. This puts them in the top 3.5% of all U.S. hospitals in terms of EMR adoption. CCMH went live on the CommunityWorks Millennium Software as a Service (SaaS) offering on September 1.

Information, evidence and automation to survive...and thrive

The traditional hospital strategy of increasing activity to grow revenue is defunct in this challenging economic environment. Much like the accountable care organizations (ACOs) that are being developed in the U.S., the UK will be shifting to a model of results-based payments for health providers, rewarding the quality of care provided as opposed to simply the quantity of patients treated. This change is outlined in the Liberating the NHS White Paper, which marks the start of a series of radical changes for healthcare in the UK which could add up to the greatest change in 60 years.

CPOE Success: Lucile Packard Children’s Hospital

CPOE requirements can be a hurdle for hospitals to overcome as they move towards Stage 1 Meaningful Use qualifications. However, data from a new study shows CPOE provides measureable benefit when it comes to saving lives.

Prescription doesn't seem to be effective, can doctor look at genomics test results and figure out why?

I received the following email:

My doctor put me on metoprolol [Lopressor or Toprol-XL] for my high blood pressure about 3 months ago, and increased my dose to 200 mg twice a day about a month ago, but so far it's not working. My blood pressure hasn't changed a bit. Is there something in my genomics SNP results here that can explain this? Should I expect it'll just take awhile? Should I be on a different drug? Here are my SNP microarray results. What should I ask my doctor when I go for my check-up in 2 weeks?

Encouraging Healthy Behavior in the Workplace

On November 22, Cerner was featured in a Kansas City Star article about health and nutrition in the workplace:

...Perhaps no company nationally has pushed further to tie food service to employee health than Cerner.

Even the arrangement of the chip rack in Cerner’s cafeteria is telling: Healthier baked chips get the top rack; fattier fried snacks are put at ankle height.

Also, the company, which has restyled itself from a technology firm to a health care company, is sponsoring a “Slimdown Throwdown” contest to encourage employee teams to lose weight. The prize will be an expenses-paid vacation for the winning team.

Client Spotlight: North York General Hospital

On Wednesday, November 17, 2010, North York General Hospital (NYGH) in Toronto, Canada hosted business partners and members of the provincial parliament to celebrate recent advancements in improving patient safety, culminating in the October 26th go-live of a project called eCare.

How much would exercising matter to me for weight-loss, given my genomic markers?

Well, quite a lot, actually. The article just published by Shengzu Li and Ruth Loos and colleagues at the University of Cambridge (link and pdf below) ought to provide strong encouragement to start or maintain your exercise plan. The study was conducted over a number of years and involved more than 20,000 people. It is absolutely solid and actionable, in terms of readiness to put into practice.

Changes in lifestyle, including excessive caloric intake and insufficient exercise, have caused a dramatic increase in the prevalence of overweight and obesity.

WellSpan Health: Moving Boundaries

At our annual Cerner Health Conference in October, we shared video stories about three of our clients prior to our keynote addresses. In the video above, WellSpan Health in south central Pennsylvania talks about the importance of their role in the community, their long term plan for becoming a digital hospital and their partnership with Cerner.

Genomics and effectiveness of vaccines

I received the following question via email:

I got my genomics testing done. But the company that did my testing doesn’t have any information about genomics and infections or vaccines. Are variations in vaccine effectiveness influenced at all by personal genomic variations? If so, what genes or SNPs are involved?

Yes. An effective immune response to vaccination is governed by a complex interaction of multiple genes that regulate cytokine proteins (part of our body’s inflammation process). Gene variations in the TNFA, TNFRSF1B, IL12B, and OAS1 genes have recently been found to modulate the ‘immunogenicity’ that vaccines have, which in turn relates to how well, if at all, our immune system’s B-cells and T-cells mount a response to the organisms the vaccines are directed against.

Mercy Hospital: From Flinstones to Jetsons

At the annual Cerner Health Conference in October, we shared video stories about three of our clients prior to our keynote addresses. In the video above, Mercy Hospital in Chicago talks about its decision to create an electronic infrastructure to help it more efficiently serve the needs of its lower-income population. Mercy Hospital moved so quickly with its electronic medical record (EMR) adoption, that Mercy Hospital Medical Director Dan Vicencio, MD, said “We went from Flinstones to Jetsons in about six months."

2010 Cerner Health Conference Keynote Recap: Neal Patterson

Cerner CEO Neal Patterson laid out his vision for the next decade in healthcare - one in which healthcare organizations empower individuals to maintain and improve their health. “We are going to shift the paradigm from present and react to predict and prevent,” Patterson said during his keynote address.

Federal reforms have not dealt with the fundamental issue of cost, Patterson said, which means the price of healthcare will likely double over the next decade to $5 trillion. If we, as a society, don’t stop these increases, we are not going to be able to afford the more personalized care that can come from human genome analysis.

2010 Cerner Health Conference Keynote Recap: Jane McGonigal

Games, such as chess or dice, have entertained us for centuries. But can they empower us to take better care of ourselves and engage in our health?

For Jane McGonigal, Ph.D., a game designer and futurist, the answer is a resounding “yes.” McGonigal offered her unique take on the value of games in her general session address Monday morning.

McGonigal, of Palo Alto, Calif., is internationally known for creating games that inspire global-scale collaboration and collective intelligences.

“When we are playing games, we are becoming the best version of ourselves,” said McGonigal, who drew on her own personal experience to make a point.