Extended Interview: Cerner Corp. President Trace Devanny

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• SUSAN DENTZER:

  I'm speaking here with Trace Devanny. And you're the president of Cerner Corp. Let's start by talking about why Cerner got the idea that needed a community to test out some of the advances, actually let me stop for just a moment.

  So what was it that led Cerner to go looking for a community in which it could test out the various principles behind the EHR and pull everything together into the HER and PHR system.

• TRACE DEVANNY:

  We've always been a company of great innovation. We're fortunate that the three founders that began this journey in 1979 are still with the company. And to that end we've always looked for, I mean we've always assumed a leadership position. It was a very active search that we conducted looking for a community that was, that was wired, connected if you will and there's not, there weren't many of those in those early days.

  And Winona actually fit the bill and having a very forward thinking leadership and a group of clinicians that were anxious to change health status. So we, being the company of great innovation, one that I think has always assumed the leadership position in our industry, gravitated toward Winona as a place to test drive many of our critical initiatives, not the least of which was the electronic health record. So it was a very nice marriage that was one of convenience in those days.

• SUSAN DENTZER:

  And to state the obvious, the reason you needed a community that was wired was . . .

• TRACE DEVANNY:

  Today health care's for the most part a very manual process. Most of the clinical processes historically have been manual — paper based. We believe that in order to change health care to transform the industry you must have a digitized medical record and they have the broadband capabilities already in place back in the mid-90s to support that, that vision.

  So they were a natural candidate in a community under 50,000 inhabitants, so that was a nice size, so we could conduct our experiment around a personal health record with folks who really understood the value and there weren't many of those in those days. So we were very fortunate that we came together.

• SUSAN DENTZER:

  And the reason the community was wired was…

• TRACE DEVANNY:

  Jerry Evans was the chairman of the board of Hiawatha Broadband, the local cable company and he had a vision for, for the community to have all of its inhabitants a part of the network, as a part of the network including the health care community of which he was chairman of the hospital, the hospital board. So he was unusual in that not only did they have the right energy around a vision, but they had the right people and the right positions to affect the change. Sixty percent of the population in those days [had] access to the Internet — very high numbers.

  Even today, I would say in the world of the Internet that would be a pretty high number. So they were well positioned to take the advantage of what we offered. We were very anxious to understand a community: what we could test — this personal health record approach as a part of a broader platform that we described as Millennium, a relational database that gives access — ubiquitous access — to patient information. So they were a very good fit; and the leadership, I think, neither one of us understood quite how hard it was going to be. But in the end I think we both had a vision. We stuck to the vision and I think we were very successful as a result.

• SUSAN DENTZER:

  What are some of the questions Cerner was hoping to answer by having this test, this experiment?

• TRACE DEVANNY:

  That's a great question. Could you in fact change health status by linking electronically everyone in the community? Could you fix many of the holes? Could you solve many of the challenges from a paper-based health care record system?

  And we believe that and we've invested heavily to support that theory. And that theory has been borne out. We really do believe that in order to change health care, you must have a digitized version or an electronic version of a health record. They were a natural because of their vision, because of their investment, they were a natural place for us to try that. I mean it began as IQ Health, which was our initial offering for personal health record, and the strength of the solution is the fact that it goes from the personal health record to an ambulatory or an outpatient setting all the way to the most acute inpatient settings.

  So it's that common platform across the community that allows ubiquitous access to that information that makes all the difference. And I think a fore-runner to what you will see in the years to come across America and across the world.

• SUSAN DENTZER:

  Now why were you thinking of starting with a personal health record ?

• TRACE DEVANNY:

  You really start in the inpatient setting and we work backwards toward the individual. The Internet wasn't as sophisticated a vehicle. It wasn't as secure, it wasn't as available as it is today.

  But we believe that a patient-centric approach, a person-centric approach is the only way to solve and to involve those individuals, the person in their care plan, so we started in the most acute settings, the ICU, … all manner of clinical venues of care and worked back into the outpatient setting and ultimately connected the dots with the availability of a personal health record.

  So we really didn't go from the inside out, and it's more difficult because not everyone has an aptitude or interest in working with the computer around their patient record. As the baby boomers become more a part of the nation's demographic, you will see more and more activities around person-centric care. People engaging in their own health care delivery process and managing that process.

• SUSAN DENTZER:

  So, to restate this, you started the process from the inpatient out, but your sense was that until the patients are involved, the system really isn't going to change.

• TRACE DEVANNY:

  Absolutely. And, and it really begins with the digitized record. Without that, without that electronic capability there is no chance to change health care. And that's why we've invested so much money and we spent our entire careers as a company looking at and working towards that end.