Ann Fishman, with EHR TV, interviews Matt Wildman, Director, Cerner Ambulatory of Cerner.
Ann Fishman: I am Ann Fishman at HIMSS 2012. I am in the Cerner Booth with Matt Wildman, Director of Sales for Cerner Ambulatory. Matt, thank you for taking the time.
Matt Wildman: Yeah happy to be here.
Ann Fishman: Matt, what is the biggest concern that you are hearing from the physician users that Cerner has right now?
Matt Wildman: It’s a great question. They are being inundated with so many rules and regulations and things that they just don’t have a complete comprehension of and Meaningful Use stage 2, when are those regulations going to come out, what does that mean for their practice, can they achieve those standards. ICD-10, we just kind of moved through the transfer to 5010 at the beginning of the year. So all of those items are just consuming their time to go figure out what that means for their practice and how they will continue to operate in the new world.
Ann Fishman: So even though all of the regulations basically are imposed against the physicians. Is it in fact the EHR manufacturers who have to absorb the shock so to speak and make it work?
Matt Wildman: Well we believe it’s our responsibility to provide the technology for them to get them through kind of the New World Order and in providing healthcare to their patients and that’s really the partnership that we form with our clients in terms of helping them navigate this market and get them through 5010 and ICD-10 and Meaningful Use. Certainly not our core strategy in terms of where we are – we wake up every day and iterate our technology just based on those components. We are doing those as a “Meets Minimum” as a partner of our clients, but what we really spend a lot of time thinking about is kind of iterating our technology and moving it forward in a way that it creates a much more seamless user experience for the providers and allows them to practice safer medicine and treat their patients more completely.
Ann Fishman: How much of your client base is hospital and how much is standalone physician practices?
Matt Wildman: We have got about 45,000 physicians today using our ambulatory solution. Obviously, we enjoy a significant presence in the acute space across the country and so we have leveraged those partnerships to go extend our reach out into the communities and market our capabilities to those standalone affiliated providers of those hospitals but I’d say between 20,000 and 25,000 of our 45,000 physicians are standalone practices. We range anywhere from the single doc practice all the way up to 800 plus providers using our capabilities today.
Ann Fishman: Do you think Cerner is such a mega company. It’s so big that there is a misunderstanding that you will only service big enterprises?
Matt Wildman: Well part of our history. We have been focused on healthcare for the last 33 years and we have organically grown inside the acute space automating the entire continuum of a hospital. About 15 years ago, we moved out into the Ambulatory venue and it’s been a lot of time focusing on that care venue as well and I think that it gets a perception that we are working on and make ensuring that the market knows that we are a very strong player in the ambulatory market. Last year, we had an unbelievable year. We grew our network by more than 10,000 providers, grew our business more than 60% year-over-year and so we are very excited about what we see in the market, we are very excited about our position in the market, and our prospects are continuing to grow at a rapid rate.
Ann Fishman: So in the late 90s I believe, you came out with your ambulatory product Millennium and now you have Millennium Plus. Take me through the differences?
Matt Wildman: Millennium is our core architecture, patient-centered architecture following the patient across their entire healthcare experience. What we have announced this week at HIMSS is the next evolution of Millennium where we are taking the power of that Millennium architecture, moving it up into the cloud and providing fast, smart, easy technology for our providers to really automate the process that they go through to document an encounter and make that so simple and transparent that you really don’t need much training at all just to pick up the technology and start practicing. The one of the components in Millennium Plus is what we call PowerChart Touch. So we are showing our current and prospective clients this week our Native iPad application that we are developing. We are working with beta clients this month and next and it will be generally available this spring. To really take in a full encounter experience in an iPad and with just a swap of your finger document an entire encounter we think we believe that we will actually be able to document entire encounter faster than you could do it on the paper.
Ann Fishman: What do you see as the challenges for an EHR company in providing a cloud-based service? Are there special challenges from the security standpoint?
Matt Wildman: I think there is a lot of opportunity in terms of what we can do when we move the data up into the cloud and as we continue to move the market forward, what we need is more interoperability across providers. It’s a little silly that I can put my ATM card in an ATM in Las Vegas and that knows more about my personal situation than the hospital down the street here. So by moving all of this data up into the cloud, we are providing much better levels of interoperability across communities so that as a provider, I can make better treatment decisions in real time and I am actually being pushed clinically relevant information to myself at the Point of Care in a way that it just hasn’t happened before.
Ann Fishman: Do you think that solving the interoperability problem is going to be industry driven, government driven or a combination?
Matt Wildman: They got to be a combination of all of the above but our role in that is to go, prove the value and start to display these levels of interoperability across the country and just create groundswell of understanding of what the value of interoperability can provide and once there is more awareness and realism around that, I think that we will have a combination of industry and regulation impact on with the interoperability.
Ann Fishman: Do you think we are going to see a consolidation in the market and do you think that might be part of the fear that keeps interoperability from being actualized?
Matt Wildman: We have already seen a significant consolidation in the industry and we will continue to do so. With the standards getting more and more rigid, organizations that have played in this space for some time can’t – may not be able to necessarily comply with those standards. There is consolidation through mergers and acquisitions. One of the things that we saw last year that we are very excited about is our ability to go displace other competitive EMR solutions that have been in place for 10 plus years in certain circumstances. So last year, we displaced every single one of our primary competitors somewhere across the country and of the 10,000 providers that we added last year, over 2000 of them came from displacements. So we are very proud of that and what that means from our perspective is that the reaction that the market is giving to the evolution of our capabilities and what we can provide them.
Ann Fishman: What are you doing right?
Matt Wildman: Good question. We are doing a lot of things right. We still continue to learn what we do is really engage our physician community and partner with them in a way that it allows them to drive a lot of the thought leadership behind what we go do next and we got a lot of ideas and we have been working really hard over the past few years to go implement those ideas and work with our physician community to go provide the best possible technology we can to help them practice medicine and I think that’s resonated very well with our partners and that’s a key reason why we retain our clients forever. We don’t – we are displacing our primary competitors. We are not losing business to our competitors because they feel like they have got a true partner in Cerner to evolve along this journey with them.
Ann Fishman: How mobile is EHR technology going to get?
Matt Wildman: It needs to get very mobile very quickly. I think that’s a key theme of what I have seen at HIMSS this year marking around the floor. It’s just the importance of mobility, not just mobility on your cell phone, but whether it’s an iPad or – Healthcare is pervasive. It’s all around us. It doesn’t exist in a single venue at a single point in time. So the need to go have access to that clinical information wherever you may be is vitally important. Part of the Millennium Plus and PowerChart Touch is taking the Power Millennium and moving it into a mobile platform on the iPad and so we are very excited about that.
Ann Fishman: Matt, thank you very much.
Matt Wildman: Thank you.
Ann Fishman: It’s been great.
Matt Wildman: Good to be with you.
Ann Fishman: I am Ann Fishman at HIMSS 2012 with Matt Wildman, Director of Sales, Cerner Ambulatory. Thank you.
Matt Wildman: Thank you.
Speaker 1: I am going to walk you through a demo of – quickly of Cerner’s PowerChart Touch solution. What I am looking at here is the commands on our view. As you can see, I can see the patient – my entire schedule of the day, any messages or reminders that have come in, medications that might need to be reviewed. I am going to go ahead and pull out my schedule for today. I can see which patients are on the schedule for the day as well as any hospital rounds I might have. Brian Dodds is coming in today. So I am going to go ahead and select him.
From here, I can review anything that might be pertinent to Brian in terms of his problem list, his current med list. I can dive a little bit deeper into Brian’s chart and review his problems as well as historical vitals, measurements, any historical laboratory results or documents that I might need to review. I can get a little bit more detailed into Brian’s chart where I can review his demographic information. I can also view any tasks that might be assigned to me from a nurse or from an MA within the practice.
Jumping into his vitals and measurements, I can trend and graph right from the screen so I can review his Temp. I can also review his blood pressure in a graphical manner. I can tag pertinent laboratory results. So I can see here that this potassium level is something I wanted to check out. I might want to tag it for further review in my documentation. Same thing with this glucose level. I can view it and I could quickly tag it so I can review it a little bit later today.
Speaker 2: I can review his historical notes. I can see what was done, what my impression and plan looked like and always return right back to this summary screen for quick review. Brian is coming in today for an abnormal rash on his wrist. So I am going to go ahead and launch into that. I could always take a picture of it if necessary. So I can take a quick picture using the camera that’s native to that application and put that right into the chart as well. I can add that to the problem list for him. So I am going to quickly add that Contact Dermatitis right in here and make it a permanent place within his chart. Now I can go ahead and create an order. I am going to give him some Prednisone for that particular rash. So I am going to go ahead and create that order all working right here from my iPad. Simply select that order and go ahead and route it over to the pharmacy.
Now as you can see, that problem has been added to this patient’s problem list as Contact Dermatitis where I can quickly review that picture that I took as well as the order that was placed and routed electronically over to the pharmacy. So I am going to go ahead and start my note for today’s visit. I did want to point out that you can utilize Voice Recognition software as well. So a lot of physicians like to dictate their notes. You can use the hybrid model, you could dictate certain portions, use structured documentation as well as using free text and just typing directly into this application and having that information populate the screen.
I am going to go ahead and use a quick macro for my Review of Systems, mark those down as everything looks good for this particular patient again giving you the ability to use that Voice Recognition software and quickly dictate any sort of information regarding this patient’s condition. I am going to go ahead and load that picture right in here because I want that for additional documentation at a later date and include the picture into my note for today’s visit. Moving through my note, I can preview what my note is looking like. So quickly see, everything looks good for today and move right back into my note to go ahead and sign it for today’s visit.