Health IT giant Cerner has been drawing attention in recent weeks for its numerous new strategic collaborations with companies including Qualcomm, Apple, Geisinger Health System and xG Health Solutions. Curious about the strategy behind the company's increased partnerships, Healthcare Dive caught up with Cerner senior vice president and chief strategy officer Joanne Burns to talk about collaboration and the role of IT in the broader healthcare ecosystem.
How Cerner views partnerships
In selecting organizations to pair with, the company looks for industry and client partners that are both complementary and ready to implement Cerner solutions in real-time. "When developing things we want to know we're going to have adoption and usage pretty quickly, because if you don't, you really don't know that what you've developed or done makes sense," Burns says.
"We can have a great idea with Qualcomm or Apple or another industry partner, but if someone won't actually pilot it and give us the feedback, then it probably doesn't make a lot of sense to go do it," Burns said.
The takeaway from Cerner is that healthcare IT has to be about outcomes. "It's not just turning stuff on, or how many clinicians are using my thing," Burns says. It's about how patients lives are changed and how organizations are achieving their strategic goals, she says. "We're more about partnering with you on strategic outcomes, and technology is a path to do that."
"We have started thinking about ourselves as not just a healthcare IT company," Burns says, "but as a health and care company with a real focus on wellness." They see technology as a strategic enabler rather than a goal in itself.
Burns notes that as it looks toward leveraging technology to achieve goals, Cerner is now aiming to serve the needs of not only hospitals and other providers, but of employers, federal and state governments and individuals—especially now that people are becoming active in managing their healthcare and wellness.
Inside the four walls
Burns describes Cerner's strategy as a set of four concentric rings, with the innermost circle being the traditional healthcare partners who would use healthcare IT such as hospitals and clinics—"the space everyone thought we would play in," Burns says. "We call it inside the four walls."
The first ring
The focus here is on the overarching efforts in the healthcare setting, such as reducing readmissions, improving quality, increasing efficiencies and driving down costs. Many of Cerner's robust partnerships around those efforts are in the device connectivity space, Burns says, and go through their lesser-known certified partners program.
Burns points toward infusion pumps as an example. Cerner's CareAware platform allows data to come directly from those devices into the EMR without any intervention, and allows providers to program them directly through the EMR.
An example of a client partner in this core market is Intermountain Healthcare in Utah, which is helping Cerner create what it refers to as the next generation of electronic medical record. They are developing new care process models and looking at how to enable them within the EMR, Burns says.
Through smart algorithms built into the system, providers will get help deciding the best course of action for a specific patient. She gives the example of a possible pneumonia patient, and a provider tasked with deciding whether to do a chest x-ray, to order lab work, admit them to a general care unit, send them home, to the ICU, etc. "You don't want every clinician assuming they know the answer to that on their own," she says.
"Through the care process model and what we see in the EMR, it really drives the care to a standard, vs. allowing each clinician to maybe make an uneducated guess," Burns said.
The second ring
Cerner has been focusing on the trend toward organizational mergers, which give healthcare systems more control over the continuum of care. While they envision one EMR as being the best model when possible, they also recognize that "we can't be everything to everybody," Burns says. "Given that there will always be niche specialties, the EMR starts to become more of a core platform than a core proprietary EMR."
Toward that end, Cerner has looked to partnerships that facilitate the adoption of industry standards. Expectations are pinned on SMART-on-FHIR for easy implementation of software applications across open EMR platforms like their Cerner Millennium.
"There are a lot of different people that contribute niche applications that should be able to sit within the EMR so that a clinician can utilize the best tools available within their specialty," Burns says. Geisinger Health is an example, and they elected to work with Cerner despite being on a different EMR, Burns notes. Through that partnership, Geisinger is creating applications that Cerner is going to place within their EMR. "Because they're both standards based it's basically plug and play," Burns says.
She also points toward Cerner's role in the Argonaut Project, in which healthcare IT suppliers, client partners and industry organizations have come together to establish how to leverage SMART-on-FHIR standards across the industry.
The third ring
Healthcare organizations are affiliating, partnering and communicating in ways they didn't before, and the issue of interoperability is only increasing.
"Never will everyone be on the same EMR, and we know that," Burns says. "So you've got to figure out then, how do you get to true interoperability so the data is able to flow in a meaningful way?"
As Cerner started thinking about interoperability between EMRs, one of the core problems they set out to tackle is patient identification, and a few years ago they helped form the Commonwell Health Alliance in partnership with other IT vendors. Ultimately the goal is for patients to own their records, rather than the provider giving the care, Burns says. For Cerner, Commonwell is a cornerstone to interoperability strategy.
Population health also resides in this circle—specifically, utilizing patient data in a meaningful way. Cerner's big data platform, Healtheintent, can sit above disparate EMRs to pull together information. As an example, they have an ongoing relationship with Advocate Healthcare in Chicago that is working to create smart predictive algorithms. One of the concepts is to look at all patients with a specific chronic illness to predict the likelihood of readmission for a particular patient, and whether or when to intervene. "Knowing when to intervene or not can keep costs down and decrease readmissions," Burns notes.
The fourth ring
The final circle in Cerner's view is people at home. The company sees a future where patients are not just seen as patients but as people who want to take more responsibility for their care, health and wellness.
Ultimately the goal is to optimize around the most independent level at which people can live, Burns says—by ensuring that as homes get more wired, the home itself is a place that Cerner can gather data and drive predictive algorithms. The partnership with Qualcomm illustrates the potential for utilizing in-home technology such as motion sensors to determine whether someone may have fallen or stopped following their normal routine.
"Partnering with Qualcomm allows us to get right into the home and get that data and get it seamlessly uploaded into our Healtheintent program, which can then start doing these algorithms," Burns says.
Further in this space, Cerner is looking toward advancing patient portal capabilities. "We envision a future where it becomes less about a patient portal and more about a consumer or person portal," Burns says.