In the two years that Zane Burke has been president of Cerner Corp., the company has grown through the acquisition of Siemens Health Services. In addition to assimilating this acquisition, Burke also is trying to strengthen Cerner’s position within the industry.
As part of Burke’s vision for the company, Cerner is participating in initiatives that will advance interoperability and otherwise help healthcare organizations gain value from health IT systems.
At the recent CHIME15 Fall CIO Forum, Burke – newly elected to CHIME’s Board of Trustees – answered questions about some of his efforts in leading Cerner.
Interoperability has gained increased attention in recent weeks. What is the significance of this?
It’s going to be more important to have information no matter where the person is. As payment models evolve, information is the only way to manage care house-to-house, for each person. Technology will evolve and operations will evolve to be more patient-centric, so it’s crucial to get data to where the patient is. Technology is a very important component of solving the issues that face healthcare. We have to provide access to that data, no matter where the patient is.
What’s the latest on interoperability initiatives in which Cerner is participating?
These have to start fundamentally with the belief that healthcare information is the person's information, and not the software supplier’s and frankly not the provider’s. There needs to be a fundamental shift in how we all think about interoperability. There are a number of constituents who need that data to do the best job possible for the patient. We support CommonWell, which now has 30-plus members, including vendors that represent more than 70 percent of the acute EMR market. CVS is signing up, and also the Social Security Administration is signing up. Can we go faster? Maybe, but given that the idea is only 30 months old, it’s tracking well. Just the legal agreements alone take a lot of work, but we know that this is how we're going to exchange information. Now CommonWell is starting to extend out, Ascension just signed in, and it’s the largest not-for-profit chain in the country. I'm pleased that this progress is continuing.
What is your standpoint on interoperability, and how does this impact what Cerner is doing?
It starts out with the philosophy that let's all agree that the information should flow. Once you start with that, you can start to tackle other things, like the governance aspects. This is about getting those patients their data. SMART on FHIR is more of an open approach for how you make information available. FHIR has great promise to share information when it’s needed, within existing workflows. Cerner is the first to release a production version of apps based on HL7’s FHIR version 1.1, and Cerner clients are now beta testing third-party apps within their EHRs. When you look at the journey of Geisinger Health System and how they manage population health, that's how you're going to solve broad-scale problems. How do we ensure you get the best outcome at the lowest cost? How do we manage the health status of each person? It takes all of us coming together to make that happen.
How do you account for the coming together of diverse parties within the industry to work on interoperability?
I think our industry's evolving. I see healthcare organizing as an industry to solve some of those big challenges. It’s better solved in the private sector than through public regulation. The progress is exciting; there’s so much going on that it’s a question of how you keep all the balls in the air. We have to keep it a priority, both as providers and software companies. We have an obligation to the country; we, as an industry, accepted the money from our taxpayers through the Meaningful Use Incentive Program, and there is an obligation that we give back something tangible on that investment.
Meeting new federal regulations, especially those surrounding Meaningful Use, is fairly involved and demanding, for providers and vendors alike. How does Cerner deal with these regs, both before they come out and after?
We engage in the process early on. We’re involved in the industry to develop the standards that government adopts. We're working with ONC and CMS to understand how they're thinking about issues through our associates’ work in the FACAs. As we go through the phases of the Meaningful Use program, we’re trying to be as proactive as we can. We do go through an analysis of the rules as they come out to determine what are the regulatory requirements, and what do we have to do from a development and regulatory perspective to support our clients. It's the new normal, it's the price of admission, it's what you're going to do in this industry. Cerner also plans to continue to innovate beyond the regulatory elements. That's the power of our scale. Regulatory matters are only one of many things we want to focus on. The more you invest for the future, the more ready we are for the regulatory environment.
How is Cerner working with professional organizations in the industry? Why do you see this as important?
We’re supportive of many of the industry associations, including CHIME and ACHE, which we’ve been using to groom our own associate base. CHIME has done a great job of creating a professional track for CIOs, and given we have CIOs filling roles at over 20 different organizations today, this is helpful with their continued development. We had a one-day CHIME Boot Camp at Cerner in September for our CIOs, and some of these same individuals are driving toward becoming Certified Healthcare CIOs (CHCIOs) through CHIME. In the area of healthcare leadership, ACHE is important because it cultivates professional leadership in the industry through their Fellows program. Participation in CHIME and ACHE by Cerner associates helps them become much more relevant at the professional level and much more well-rounded healthcare executives. Cerner has been steering our dollars toward education. It really makes a difference and positions us as a steward of the industry.
These are exciting times within the healthcare IT space. What do you think the industry will look like in the near future?
I think interoperability will be ubiquitous in the next three to five years. I don't think anyone will compete on interoperability. I hope that it's the industry that sets the direction, and that we all rally around that. If the industry doesn't do it, government will. I also see that the EHR will be the lab system of today; they’ll handle high transaction volumes, and lots of the real work will be done on top of those transactions. Work will be done in a different layer that combines information from different EHRs, PBM data and more; the strategic layer will be above the EMR. We won't talk about the electronic health record anymore. We'll talk about a healthcare system that has the community information needed to take care of the population at the system level.
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