Cerner

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Great Place To Work

This year’s Fortune 500 marks the 68th running of the list.

Fortune 500

This year’s Fortune 500 marks the 67th running of the list.

F500-2021-490-Cerner

The company's electronic health records system helps connect health care professionals to patient data in more than 27,000 medical facilities around the world. In May, when presenting the company's earnings results for the first quarter of 2021, chairman and CEO Brent Shafer announced that he would be stepping down but would remain until the Board of Directors identified his replacement.

For an astounding 13th straight year, Apple claims the top spot in Fortune’s annual ranking of corporate reputation, based on a survey of almost 3,800 executives, directors, and analysts.

World's Most Admired Companies

This year's Fortune 500 marks the 66th running of the list.

The supplier of health devices, services, and information with nearly 30,000 associates around the globe has been working with its clients to track, forecast, and prepare for outbreaks of COVID-19.

Here are the World's Most Admired Companies for 2019 as ranked in their industries. See who made the list.

This year's Fortune 500 marks the 65th running of the list.

Here are the World's Most Admired Companies for 2018 as ranked in their industries. See who made the list.

This year's Fortune 500 marks the 64th running of the list.

Here are the World's Most Admired Companies for 2017 as ranked in their industries. See who made the list.

This year's Fortune 500 marks the 63rd running of the list.

Here are the World's Most Admired Companies for 2016 as ranked in their industries. See who made the list.

This year's Fortune 500 marks the 62nd running of the list.

Business insiders have spoken: Asked which companies they most admire, more than 4,100 executives, directors, and analysts chose these top 50 All-Stars.

This year's Fortune 500 marks the 61st running of the list. Wal-Mart claims the top spot again. See who made the list.

Wal-Mart stayed on top as its sales crept closer to half-a-trillion dollars. Apple moved into the top five. And UnitedHealth Group continued its steady climb. 

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Cerner Company Profile, Stock Price, News, Rankings

legacy

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Cerner Company Profile, Stock Price, News, Rankings | Fortune

Each and every patient, in the view of the congress believes as I do, the patient has the right to access their own health care, for whatever reason they want. I was stunned when my son for a year was battling stage four glioblastoma. The vice president of the United States of America, a lot of you were very cooperative, couldn't get his records. It was a absolute nightmare. [ MUSIC ] When the government invested all his money and electronic health record, there was tons of excitement, the promise of really transforming medicine for the better. People were so excited about that and what happened with the very quick adoption of electronic health record was some of this software was not actually ready to be implemented in health setting. There're clear benefits, but there're also some challenges and one of these really big challenges was usability and safety. And usability is How effectively efficiently and satisfactorily the technology can be used the core design of [ UNKNOWN ] usability can actually led to direct patient safety consequences. There's a balance on the one hand they're all these positives that could be accomplished through system that really work. But yeah, if you have software breakdowns and nobody's monitoring them closely to make sure that they don't keep happening, you could in fact have very very severe repercussions from that. Tara Delaplane is the mother of Brooke Delaplane who is a 13 year old girl with a number of medical problems who had to make frequent trips to the hospital for treatment. [ UNKNOWN ] was 16 years old, and unfortunately we lost her, but she was just a beautiful soul, absolutely beautiful soul in and out. and she had a very tough life, medically and physically. I couldn't even tell you how many times she was in the hospital in her lifetime. But it was a lot. We had Brooke going in to the hospital for a routine EEG, it's a 24 hour study that will test her brain waves and while we were there The hospital gave her two doses of a probiotic that had dairy in it. And Brooke is severely allergic to dairy. So she had two severe allergy reactions while we were there. She went into complete respiratory distress. Her lung collapsed. And while I was there, and this was going on I was researching on my iPad, what could be happening and I was the one that realized that they gave her a product that had dairy in it. Tara argued that they have this electronic health record system that has in the system somewhere that her daughter was allergic to milk, yet she was given a drug that contained that ingredient. They had said that the milk is an inactive ingredient and they can't warn about everything and that they denied that there was anything wrong with their product, and that was thier position With these sorts of cases it's hard to assign blame. Is this a human error? Can you blame it on the technology that's supposed to be smart enough in flagging allergies? The great hope electronic health records that it would be able to catch these sorts of events. From what we understood, this is not the only hospital that uses this type of software. So it is everywhere, it's nationwide. And it breaks my heart just to think that there are other patients that are going through this. [ MUSIC ] So beyond the safety risks with EHRs, we found that patients really struggle to get their medical records, and that's especially the case when they've had something happen to the hospital and they're trying to get information on what might have happened This EEG is a video and an audio clips of the entire thing and I had recommended that they watch it so that they can see exactly what went on with my daughter. When we tried to get a copy of it, they told us that it was already erased and they only held on to any seizure activity. So we weren't able to get a copy of it. We ended up going to a lawyer. Patients today are expected to be the experts at their care and put it all together and know who to listen to and who to work with and who to find. I think most patients have never seen an electronic health record. It's not something that we think about on a daily basis. Probably not something we want to be thinking about on a daily basis. But because we're starting to see this association between electronic health record usability and safety and potential patient harm there, this is a really important issue. I've yet to find a patient in five years ever get the records [ UNKNOWN ] they were required to do so in electronic format without prolonged litigation of several Leaders to get it. The patient has to be their advocate. Why not give the patient the opportunity to catch something that somebody missed? Patients struggle to get their medical records for several reaons. For hospitals it's not in their best business interest to share records, that's what a lot of people argue. they want to keep their patients within the system and that makes them hesitant to share patient data with other hospitals. The other issue is hospitals don't love to talk about safety issues within their walls. But in reality the reason why patients really struggle to get their health record is a mystery it was something that Widespread option VHR's are supposed to make happen and we have yet to see it. Electronic data it seems like it would be so promising on so many levels. I know for us we were hoping that we would have one focal point that would bring all of Brooke's records together from so many specailists. But it proved to be that we really couldn't get access to all of that. So I still think there's such a long way to go in terms of electronic data for anyone that walks through those doors. They deserve to be protected and they deserve better treatment than what my daughter had in those two days. [ MUSIC ] [ BLANK_AUDIO ]

Broken Records: Patients

Health

Electronic Health Records' potential for patient care seemed limitless - but in reality technical and design flaws have led to serious patient risk.

A secure interoperable health records system can save time, and money, and improve the quality of healthcare in many ways. I'm excited. I am excited. But, in accounts records, they can better coordinate care. It is increasing your ability to collect data, but somebody has to pit it in. If poorly designed, or implemented health IT will not bring these benefits. How many of you [ UNKNOWN ] Love our EHRs, and couldn't living withour it. Any of you? [ MUSIC ] We're hearing the frustrations of doctors across the country. These electronic health care records weren't necessarily built to help doctors, so doesn't necessarily flow within their clinical work flow and so it's actually creating more work for them. Doctors are concerned that They're spending more time clicking and pasting and and type in than they are looking at their patients and interacting with their patients and learning about them and trying to, you know, treat them The HR had the potential, I think to make them more productive and sort of making visible some of this complexity but in fact they have surface that and made it I think, more annoying the doctor and that leaves them to be less satisfied. The user experiences defy logic and surprise me for why they are so cumbersome to use. When I meet a new patient it's like opening a book to page 200 and being asked to write page 201. Maybe on top of that Pages 25 to 50 are mysteriously ripped out, pages 75 to 90 are out of order, and pages 100 to 110 are shuffled. You can get to the point where you say, you know what? I've had enough of this, and I'm too stressed out, I'm too burned out, I'm worried about making a mistake, I'm worried about hurting a patient. I'm gonna say, forget it, I'm gonna retire. I think the hardest part of patient care shouldn't be data collection or data entry. That part should be taken care of by the system, so that then we can focus our attentions on the things that really matter Like making decisions for patients and communicating with patients. A [ UNKNOWN ] that's burned out is more likely to make an error when doing their job. And what that means is patients could unintentionally be harmed because of that error. In electronic health records you hear a lot of complaints [ UNKNOWN ] but these long pull- down menues, where you have to pull down, and there's all these, Potentials and you can click the wrong one. If you're a physician and you're placing order for Tylenol, you might search for Tylenol by typing that in to the search menu in the electronic health record. And in some systems, we may do that, you get 86 different results back for Tylenol. And there's some serious consequences to that beyond just the frustration of having to look for the medication that you want. It introduces what we could call cognitive burden Which is that you have to process all this information every time and be really careful about the information that you're selecting. And that wears our clinicians out. And the second, because of that burden, is that it's very likely that an error might be made. You might select the wrong medication because the list is so complex. The more clicks there are, and the busier healthcare professionals are, sometimes people will just click through without being as thorough as they should be, which, kinda, negates the whole purpose of why these alerts are there in the first place. The problem is that they're just inundated with data They feel like it's overload and shut off the warnings as opposed to embracing them. Which might sound silly to people who aren't sitting in a computer all day. But for people who do this and would rather be spending time with their patients, if it takes 30 clicks just to order a really simple medicine Sometime the alert fatigue can become overbearing. [ MUSIC ] Burnout is such a crisis because these professionals are, their job is one of the most high steaks in america. They're working with humans and our health and if they're not You know, satisfied or engaged at work, that's a real problem for all of us patients. Earlier in this year, the Harvard School of Public, as well as the Massachusetts Medical Society declared physician burnout a public health crisis. Some 78 percent of physicians, according to one study, suffer from symptoms of physician burnout, and that's a really bad thing when we have A large majority of doctors in America that are feeling disengaged or really frustrated at work and not totally in their game. [ MUSIC ] So the good news is that pretty much everyone acknowledges these problems exist. There's lots of innovations going on Here on the system, so developers are coming into this space and trying to build onto the existing systems to make them more efficient, to make them work better. One researcher in Washington DC, Rajwat Rani, he studies human factors or basically how humans interact with technology. He is trying to bring public awareness to this issue of errors in electronic health records and The need to make the systems more usable. So when we're looking at electronic health record usability and safety, we use several different methods to study what's happening. And one thing that we do is, we use what's called eye tracking technology. And that's really important for us because it helps us understand where they're allocating their attention, what are the things that they're paying attention to, what are the things that might be distracting and how do those relate to potential errors that might happen? We also use some technology that's physiological sensor devices. A little bit of stress is good, a lot of stress is bad and that contributes to this burnout challenge. And so, these sensors allow us to see what tasks are being performed and which ones are associated with higher stress levels. The key piece here is we move forward is that we keep the human element in mind. And we wanna make sure that it stays human centric, that the technology is built to meet the needs of patients, and is also built to meet the needs of physicians, nurses, and even other care providers. [ MUSIC ] Progress is slow and that can be frustrating, and I think it's easy to focus on the negatives and on what's missing from our electronic records. I am hopeful with the right focus, and really understanding what the problems are, and the right leadership, that we can make progress You know the electronic records have improved a lot of things for patients and providers, but we're still pretty far away from a universally shared system of records. [ MUSIC ]

Broken Records: Doctors 

The deeply flawed Electronic Health Record system in America has contributed to the "burnout" epidemic among medical professionals.

It's now been ten years since the EHR incentive program was created, yet we still do not have adequate levels of interoperability. So we can sequence the entire human genome, but we still can't get much more than a print out, a fax, or CD- ROM when we leave the doctor's office. But often we are delivering care with a fractured medical record. The electronic health record unfortunately was introduced As a halfway technology [ SOUND ] The promise was that everybody in America would be able to have their own personal electronic health record. You would be able to Monitor your health more closely you'll be able to communicate back and forth with your doctor. And for most people that hasn't really happened. The whole goal, one of the major goals of converting paper records to electronic charts was ease of data entry and retreiving data so that this can be shared in a straight forward way. The question is, why is it so hard to get your information? And it's on a computer, it shouldn't be so hard to print and get it. Interoperability is the term the industry uses for do these systems Communicate with each other, can they share health data with each other. And right now we're trying to get to a very basic level of interoperability which is to send and share very basic data sets. The idea that all the information in one system Can be shared with another is a long ways off. The idea of interoperability is to have sort of a seamless national system in which health data can be shared by vast quantities. Both for the treatment of diseases and for the ease at which you can have your records sent, or someone can send the records on your behalf. That could save your life. The inoperability problem is one that's been more intractable than I expected. And so, I think we probably should have thought about ways at the beginning, require it at least for some aspects, for safety to require it because the economic incentives are such says that it's really hard to make that happen on it's own. We have hundreds of different electronic vendors in this country. And they often all operate independently. Why should Epic, this huge company, have to share its information with BMR2 or whatever you wanna call this local one? Historically, there have been a lot of proprietary coding systems that were built as part of products. There are about five or six well- known companies, all of whom Invested millions and millions of dollars trying to get that information correct, and that knowledge is propietarian and they rightfully don't wanna give it up. While most doctors offices and hospitals have gone paperless, and they use electronic records, those records are not shared or integrated with other facilities. Essentially whereas your information was in a filing cab but now is in an electronic filing cab. So, we don't have a system where data is traveling seamlessly with the patient as they go through the healthcare system. Hospitals don't want their patients to be able to go across the street for competitor really easily. And so, they make their computers not share all the information because they don't want the patients delete. When I first started in this role, I think I had this naive expectation that all of the information that I wanted and needed to properly take care of patients would be available to me in an easily accessible formats. It didn't take long before I figured out that's not all the case. In order to get information about our patients we need to do a lot of slew thing and a lot of light work and a lot of obtaining outside records and information. And that process can be very cumbersome and it can take a long time. There were so many very quick installations of this equipment to recoup this stimulus money, there were doubts and questions, and still are questions whether, in fact, the requirements were being met by some of these vendors. Very careful checks have to be done to make sure that the patient safety checks are operating properly. If I've got data coming in from another system and there's something wrong in that data, that's misinterpreted in my system. Now all of the fancy clinical decision support systems that I just spent huge amounts of money and time on are gonna misfire. And it's either gonna not tell me to do something when it needs to, or it's gonna tell me to do something when I shouldn't. And you know, that's dangerous. You could kill somebody. There's been a lot of examples in which the electronic health workers have mixed up patients and put information about one patient in the wrong file. You get other situations in which doctors order a test and then by some kind of a software glitch it disappears before it gets sent to the lab and so. The doctor could be waiting around for test results and not realize that the test never got to the lab. So there are a couple of important things that need to happen to improve EHR's building and safety. So the first one is, we have to have more effective EHR usability and safety testing. The second important pieve is that Many of the contracts that exist between EHR vendors and provider organizations, healthcare provider organizations, contain language that are often termed gag clauses. That prevent the open communication and sharing of usability and safety challenges There's just been a culture of complete secrecy in this industry. Which has prohibited a lot of people from honestly talking about the problem ,. There's confidentiality clauses that say pretty threateningly that, you're not to share any information about how much you paid this system, about any problems you see with this system and You can't really call your buddy at another hospital and say we installed such and such system and man it's garbage. The companies say thejy're protecting intellectual property but many safety experts say this really is preventing widespread learning on the safety risks. The driver of everything. The most important person in this entire story is the patients. And just like doctors and nurses should have access to all of their information in a way that they can make informed healthcare decisions, patients need access to their own information too, so they can manage that properly, bring it to other providers, or just have it for their own sake and their own knowledge. If we could somehow find a way to put the patients first. Then the opportunity is there. Because if everything is recorded, and everyone listens to flags and warnings, then they'll catch things we can't even dream of. And that's fantastic. [ MUSIC ] [ BLANK_AUDIO ]

Broken Records: Broken Promises

Years after their adoption, electronic health records still haven't lived up to their potential.

The story of the interoperable electronic health record starts in 1998. By computerizing health records, we can avoid dangerous medical mistakes, reduce costs. We wil make the immediate investments necessary to ensure that within five years, all of America's medical records are computerized. Further the use of technology in improving our Health care system. Electronic medical records just make sense. [ MUSIC ] In the midst of the great recession, there was a giant opportunity to spend money in America to help us get out of that recession called the American Reinvestment and REcovery Act. And in that Act, With an opportunity for healthcare to have a section which offers doctors incentives to buy and then use our healthcare records. Obma represented a new way of thinking on a lot of fronts, and one of them was technology. This was something that he saw as long overdue that every other industry was computerized. And it was so outrageus and stupid that That we have all these paper files sitting in file cabinets that are doing nobody any good. So what Obama did is he decided to put money behind it. The economic recovery plan I'm propsing will help modernize our health care system and that won't save jobs, it will save lives. We will make sure that every doctors office and hospital in this country is using cutting edge technology. And electronic medical records so that we can cut red tape, prevent medical mistakes, and help save billions of dollars each year. And so in 2009, the federal government, Congress, passed what was called the HITECH Act. It stands for the Health Information Technology For Economic and Clinical Health Act. The goal of HITECH was by 2015, every single perswon in America will have a electronic health medical record that will be transferable. So the goal is to improve patient safety. And to create a system of easily accessible information that can be As useful as possible for providers to make safe and informed healthcare decisions for their patients. [ MUSIC ] [ MUSIC ] I'm pleased and excited to say that the registration process is now open for health care providers to obtain significant incentive payments for adoption and meaningful use of electronic health records. Is part of the process of promoting electronic health records a certification program with setup. And, that certification and program provided essentially rules by which technology needed to be developed in order for it to be tied to reimbursement payments by the federal government. For doctors to get the federal payments for adopting electronic health records, they had to prove that they were using the electronic health records. In a meaningful way. If they bought a [ UNKNOWN ] health record and year one, showed that they used. In year two, used it to more effectively affect patient outcomes, and then in year three, to really be a more effective doctor. > To receive incentive payments, physicians and hospitals had to buy systems certified to federal government specifications Providers assumed the certified systems would be high quality and meet program requirements. Well, we certainly thought when you provide $ 44 billion in incentive for people to buy software products that the industry's gonna grow a lot, and not suprisingly there was a lot of growth in the industry after the HITECH Act was enacted. The requirements that were there in terms of meaningful use The time frames that were there, a lot of things got built that were built to check the box of meeting that and getting it out the door in time, so people would be certified to meet that. And so when things like that happen, when you rush, unintended consequences can be one of the downstream effect of causing someone to do that. So there was software that didn't work the way that the company said it did. They had taken shortcuts in order to meet government requirements, and so there were actual software defects. There was tons of requirements and regulation, but I think the critics might say that they weren't the right Regulations. I think that they needed to make sure that the products were in fact safe and they needed to rapidly, in the view of critics, rapidly investigate any failures to make these systems better. Poor EHR design and poor implementations of the systems have really led to some horrible Cases of suffering, injury or death. [ MUSIC ] The hope was that the program would improve care, coordination and reduce costs. The evidence suggests these goals haven't been reached. A medical economic survey last year found nearly 70 % of physicians say their Electronic health record systems have not been worth it. One physician wrote we used to see 32 patients a day with one tech and now we struggle to see 24 patients a day with four techs. And we provide worst case. But nobody could dispute that putting all that money out there did in fact get people to install this equipment. But it wasn't just about installing computers in doctor's office it was about all these other things like having interact ability, having ability to forge vast amount of data to find new treatment is. Disease. So there were all these other things and those are the things that really haven't been accomplished. [ MUSIC ] [ BLANK_AUDIO ]

Broken Records: How We Got Here

When the American healthcare system began to transition to Electronic Healthcare Records, policy makers saw a future full of potential and possibility.

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