Connecting care at home with Steve Herron, Senior Director, Long Term and Post-Acute Care, Cerner

In this episode of the Post-Acute POV, our host, Bob Anderson, VP of sales for home and hospice at MatrixCare is joined by Steve Herron, senior director of long-term and post-acute care at Cerner to have a conversation on connecting care at home.

Join Bob and Steve as they discuss the partnership between Cerner and MatrixCare, the key types of data that should be exchanged when connecting care at home, formal and informal health networks, and the importance of creating a bridge between disparate EMRs and other sources to create one longitudinal record for the patient. Listen to their discussion.

Topics discussed during today’s episode:

1. [01:30 – 04:15]: Steve provides an introduction on Cerner for listeners who may be unfamiliar and how the company became partners with ResMed.
2. [04:25 – 06:51]: Next, Steve dives into the factors that encouraged Cerner to choose MatrixCare as their EMR platform partner and how KLAS scores validated their decision.
3. [7:02 – 12:44]: When it comes to interoperability and connected care at home, Steve provides the key types of data that should be exchanged.
4. [12:53 – 15:01]: Next, the pair discuss how Cerner clients benefit from the partnership with MatrixCare.
5. [15:16 – 16:04]: Steve explains the difference between community agencies and health system clients and how both can utilize MatrixCare via Cerner.
6. [16:09 – 18:37]: Next, the pair discuss formal and informal health networks and the importance of connecting disparate EMRs and other sources to create one longitudinal record for the patient.
7. [18:41 – 22:33]: Steve describes the benefits of Healthy Intent, Cerner’s health network.
8. [22:50 – 23:44]: Lastly, Steve explains that he believes the next phase of connecting care in the market will be what we choose to do with our data.

Learn more about our integration with Cerner

Resources

• Find out more about Cerner: https://www.cerner.com/
• Listen to more episodes of the Post-Acute POV

Full transcript

Speaker 1

Hi, and welcome to the Post-acute Point of View, our discussion hub for healthcare technology in the out-of-hospital space. Here, we talk about the latest news and views on trends and innovation that can impact the way post-acute care providers work. And we take a look at how technology can make a difference in today’s changing healthcare landscape, in both home-based and facility-based care organizations, and the lives of the people they serve. Today. We hear from Bob Anderson, vice president of home and hospice sales for MatrixCare and his special guests. Let’s dive in.

Bob Anderson

Hi everyone. This is Bob Anderson, vice president of sales for the home and hospice division of MatrixCare. And I want to thank you all for joining us today. Interoperability has been a key topic, and in some cases, a challenge to healthcare providers for many years. The COVID pandemic alone has highlighted the need for disparate healthcare providers to access the same patient data, regardless of geographic location or care setting. Ultimately, having technology that can communicate seamlessly across the care spectrum drives safer, timely, and more cost-effective patient care. I’m really excited to have Steve Herron joining us today. Steve Herron is the senior director for long term and post-acute care for Cerner Corporation. So, let’s get started. Steve Herron, welcome.

Steve Herron

Thanks Bob. Great to be here.

Bob Anderson

Awesome. So, Steve, for our audience in the post-acute space who may not be familiar with Cerner, can you tell us a little bit about the company?

Steve Herron

Sure. Cerner is worldwide leader in the acute electronic health records, and manages about a third of the acuity EMR space here in the US. But we’re really much more than an EMR company. Our founder and longtime CEO, Neil Patterson, always said that healthcare is too important to stay the same. And that’s become kind of the mantra that we live by. And we list that as our corporate promise. So, we’re focused on using healthcare it as the driver to change the way healthcare works so that everyone has the opportunity to thrive.

Steve Herron

And we, of course, have solutions for provider organizations that are responsible for caring for individuals, but also for payers, governments, and even payviders who are responsible for managing a population of individuals and striving to deliver the highest quality of care at the lowest cost.

Bob Anderson

That’s interesting. Appreciate that. So, our companies have been working closely for almost two years now. Can you share a little bit about how Cerner and ResMed came to be partners?

Steve Herron

Sure. I mean, it actually… It started out of us sunsetting our Home Works application, which was the EMR we use in the home care space. But it’s not because Cerner thinks that the home care market is any less important. In fact, it’s quite the opposite. Cerner recognizes home care as more important than ever for a variety of factors. Obviously, recently, COVID-19 has really pushed the need for the ability to care for people at home, but that was really just an acceleration of an existing trend.

Steve Herron

Now, caring for people at home has been becoming more and more important here over the last decade because, first off, that’s what patients want. And when you leave the hospital, you’re not hoping to go to another institutional setting. You want to go home if it’s appropriate. So, there’s been a tremendous push to take care of more and more conditions in the home setting. But it’s also being driven to the home because of cost. For a lot of patients, it’s significantly less expensive to treat a patient in the home setting.

Steve Herron

So, as long as it’s clinically appropriate, that’s where care is going to be delivered. As I mentioned, we had our own home care EMR for about 20 years, called Home Works. And our acute care clients that owned and operated their own home care and hospice agencies used it for their EMR. At one time, it was the best in KLAS solution. But over 20 years, the architecture had aged. And we found ourselves, over the last few years, I needing to invest pretty significantly in [inaudible 00:04:04] current. So, we did a build by partner analysis. And we found that we could provide our clients a better solution more quickly by partnering rather than rebuilding on our own.

Bob Anderson

Fantastic. So, when Cerner looked into the market, I mean, what caused you to choose ResMed and MatrixCare as a partner?

Steve Herron

Well sir, clients can’t have everything on their millennium EMR platform. And then, they want the best commercially available solution out there and they want it integrated into millennium platform. And what we saw in MatrixCare was simply the best solution in the market. They had the features that our clients have been asking for, for many years, like tablet applications for caregivers. And the user interface was really good for the clinicians, the strongest that we saw. And so, we really, in our full analysis, found it to be the best solution available in the market. And that actually has been validated over the last couple of years.

Steve Herron

KLAS research has named MatrixCare best in KLAS two years in a row. And both of those happened after we announced our decision to partner with MatrixCare. So, we really felt like it reaffirmed our decision. We also saw the MatrixCare and the parent company, ResMed, had a real strong, shared philosophy with Cerner about inter-operability and the need for a patient’s data to flow with them from care setting to care setting. And that it wasn’t just lip service with MatrixCare, that MatrixCare actually has the technology, the capability, and the expertise to pull off interoperability, and to build the capabilities that we needed and that our clients expect.

Bob Anderson

What other factors do you think made MatrixCare the right choice?

Steve Herron

Well, it was a great decision on its own for the home health hospice and private duty business. But we saw some other opportunities in the rest of [inaudible 00:06:00] portfolio solutions. So, even since we’ve announced the partnership with MatrixCare, we’ve expanded to include a value added reseller program for the Brightree solution from ResMed, which covers HME, DME, and pharmacy home infusion, and again, supports our need to cover more care in the home.

Steve Herron

We’re also working with ResMed and some other key Cerner clients on integrating other solutions for the treatment of chronic respiratory issues and sleep issues. The cost associated with chronic conditions is huge. And so, we really feel like helping our clients manage the cost of treating populations that have them aligns perfectly with our mission. And we see those as real opportunities for us to take advantage of in the future.

Bob Anderson

So, when we think about interoperability, what would you say are the key types of data that should be exchanged?

Steve Herron

Well, seamless transitions of care is really the first goal of interoperability. And so, I look at it as a kind of a win/win/win scenario. It’s good for the hospital. It’s good for the home care agency, or the hospice agency. And it’s good for the patient. And for the person, it’s all about getting the right care started fast, giving them a better chance at a fast, full recovery. I mean, everybody’s had their own stories, but I always talk about the situation that happened with my dad a few years ago, where he was admitted to the hospital, diagnosed with cancer, only spent 48 hours or maybe 72 hours in the hospital, and then was discharged home. And in the process of discharging him to home, his data didn’t flow effectively to the home care agency that was going to work with him.

Steve Herron

And so, his meds were not correct. There was a lot of reconciliation. He had a lot of home meds that he was on. The communication just went poorly. And before you knew it, he was back in the hospital within 24 hours. And so, it’s those kinds of things that we’re trying to avoid by being truly interoperable and sharing data from setting to setting, and having it happen quickly, that would avoid situations like that for the patient. For the hospital, of course, they want to avoid that readmission too, because readmissions are expensive. They can mean penalties from the government. Or in some cases, the hospital can be fully on the hook for paying for that ED visitor stay. So, they’re really motivated to make sure that that person is, first off, ready to go home, and that the right information flows down that partner agency quickly, so that they can get care started fast and accurately and avoid them from coming back.

Steve Herron

And, of course, for the agency, there are several benefits. First off, they want to provide the best care. So, having a full picture of what’s going on with the patient gives them the best chance of succeeding. But we’re also dealing with a labor shortage. And getting the data efficiently into the record allows them to do their job quicker, which is a financial savings for the agency. And of course, they want to avoid ED visits and readmissions as well. And it can give them a black guy to have higher readmissions rates than their peers. That can mean lower referral volumes. And in some cases, it can cost the agency money directly in paying for the care in that other setting. And of course, for insurers payers and governments, I guess I didn’t mention them as being a potential fourth beneficiary. So, maybe it’s win/win/win/win, because by them avoiding those hospital visits, they’re saving costs. But they’re also… By sharing test results from setting to setting, they’re able to reduce costs in that respect that they’re able to just reduce… have fewer duplicative tests.

Steve Herron

When everyone can see the results of the test that took place in the previous setting, there may not be a need to perform the same test again. And then,, as far as the type of data flows that we like to see, there are a few things. One at that transition of care, we want to see things like problems, allergies, meds, immunizations, procedures, test results. All of the things that happened at that previous site need to be shared forward in order to make sure that that care is going to get started quickly. But it’s not just about what happened at the previous site. And that’s where things like CommonWell and care for quality come in. So, these national exchanges allow the agency to tap in and see, again, not what just happened at the previous site, but in all of the previous encounters that that patient has had with different providers, so being able to see what happened at a specialist that they’ve seen, or to see their last primary care visit.

Steve Herron

Get some of that information that maybe even the hospital before didn’t necessarily have. So, if you’re able to connect to CommonWell and get all of that information, you’re going to get a more complete picture of what’s been going on with that patient.

Bob Anderso

Right.

Steve Herron

And one of the things too, Bob, that we found was really important, even back with our home care application, was dealing with physician workflows. Agencies really struggle with the process of dealing with physician orders and tracking down signatures that they need both to deliver the care and to bill appropriately. So, we had actually, with our Home Works application, built a really nice interface so that the orders that are entered into the home care EMR can be delivered to the physician in their own EMR, right into their message center inbox, where they could pull up that order, sign it, and have it returned electronically back to the agency so that they don’t have to do that whole paper chase.

Steve Herron

So, when we partnered with you guys, that was really the first project we worked on together. And so, we’ve rolled out that same functionality now to our mutual clients. And again, we’re getting those same great results of just completely eliminating the paper chase and the whole manual faxing of orders with those physicians, because we’re able to do everything electronically in the workflow where they expected.

Bob Anderson

And that’s… Steve Herron, that’s a really good segue. How do you think the partnership has impacted Cerner’s clients?

Steve Herro

Well, I think it’s been great so far. We’ve had 47 clients with home health and hospice agencies that have now implemented the MatrixCare system. And that’s over just… What? 18 months that we’ve been all working together? They’re not just implementing another EMR to run their home health hospice business lines. They’re implementing a full platform that takes advantage of interoperability, from post-acute to acute settings, for smoother transition of care, and streamline the process of getting those physicians’ signatures. We’re also on the verge of releasing some additional integration capability between our applications. There’s a whole new standard that is built out there called fast healthcare interoperability resources, otherwise known as FHIR, F-H-I-R. It’s kind of the new way for multiple EMRs to be able to query each other and pull information back. We’re just in the process of releasing functionality that will allow MatrixCare clients to exchange clinical documents, using FHIR, with our millennium EMR.

Steve Herron

They’re also going to be able to actively query the millennium record for a current medication list. So, it’s not just a matter of what was the medication list during the last visit, but let’s query the hospital system to see what they list as the medication list currently. And we also allow them to query the health system to get patient identifiers, in the cases where the patient did not originate from the hospital. And so, as you know, not all of the patients that a home care agency is dealing with were discharged immediately from a hospital and admitted to the home care agency.

Steve Herron

Sometimes, they come from other environments. But we want to make sure we check with the health system, by querying the millennium database, to see if we can get a patient identifier for them, because then that allows us to do things like that physician signature workflow, with using the correct patient identifiers, even though that patient didn’t originate there.

Bob Anderso

That’s awesome. So, if I think about the marketplace itself, if I’m a community agency that’s not owned by a health system, is there any reason I would care? Or how does that benefit me?

Steve Herron

It’s a really good point, Bob. We talk a lot about our health system clients because they are so important to Cerner. But there’s nothing here that we’ve talked about so far that doesn’t apply to community agencies that are not owned by a healthcare system. If you have a partnership with a Cerner health system that is using millennium, you could implement these same interfaces by working with them as a partner.

Steve Herron

We actually have home care agencies that are working right now that implement everything that I’ve just talked about, even though they’re not owned by the health system. We feel like that data should follow that patient wherever they go in their health network, regardless of who owns the agency or manual

Bob Anderson

When you say “health network”, what do you mean by that?

Steve Herron

Okay. So, think about there being three levels that we’re talking about with the EMR. You’ve got the provider level for the person, the provider that’s giving care to that person. But there’s also an enterprise level for the health system that is managing that care across the different venues that they own. But then, there’s also a network level that reaches beyond the owned venues and into partnered providers within the community. So, at the provider level, the whole idea of the EMR was to be a place to digitize and capture the care that’s being provided, to streamline billing, and of course, to be able to share data back with the patient. At the enterprise level, the record was digitized so that they could streamline delivery of care across all the service lines within the business, and to more efficiently run the business, and avoid things like duplicated tests, et cetera.

Steve Herron

But then, at that network level, we realized, even though that the care was streamlined within the enterprise, it’s still going to be disjointed, because no one receives all of their care from a single enterprise. Care gets delivered in all kinds of settings that are parts of different enterprises. So, networks form, both formal and informal, of these enterprises and providers that need to be able to effectively share data to care for an individual. Formal networks are like those… like the ones that are driven by the insurance. I think we all know what that means when you go out of network with your insurer. But there are other types of health networks that are less formal, that are made up of various and enterprises, that are unlikely to be on the same EMR.

Steve Herron

Cerner recognized this a long time ago that, even if we doubled our market share, it still would never be a 100% Cerner EMR world. There are always going to be companies that have acquired other hospitals, companies that have partnered with other enterprises to deliver services that are outside of their capabilities. And they’re not all necessarily going to be on the same platform. So, that’s why we actually developed and launched what we call Healthy Intent, which is a health network platform, which allows us to take in data from disparate EMRs and other sources, and to create one longitudinal record for the patient, and rolled up views of the data for the providers, enterprises and network levels.

Bob Anderson

So, what is the benefit of Healthy Intent?

Steve Herron

Well, there’s many. But if you kind of break it down at those different levels, if you’re a patient, the benefit of Healthy Intent is that it’s creating one longitudinal record of care for you that you could access through your portal. And of course, that longitudinal record of care then is available to your caregivers, gives them that better picture of what’s been going on with you as well, and allows them to provide better care for you. At the provider level, it’s the foundation for running new intelligence models.

Steve Herron

We want to run intelligence models to help predict negative patient events, and to give that provider an opportunity to intervene and avoid things like transfers, falls, sepsis, and other negative events that could impact their patients. At the enterprise level, it’s about helping to monitor provider performance and predict negative outcomes. And of course, at the network level, it’s going to allow you to better monitor utilization of resources, to monitor cost and quality. And of course, those are the essential elements of the transition to value based care.

Bob Anderson

Okay. Great. So, what do you see as the next phase of interoperability for the market?

Steve Herron

Well, over the last decade, a ton of work was put into digitizing the health records. Meaningful use obviously drives huge adoption of the EMR by the acute name dilatory providers. And even though we didn’t get the same money in the long-term post-acute care segments, it actually… Efficiency has driven us to implement EMRs as well. And of course, some of the required assessments, like the Oasis that have to be done, have driven you to implement some form of EMR. And even the successor of meaningful use, which was changed to being called promoting inter-operability, it kind of took the next step of driving standards, to make it possible to share records with patients and with other providers across the networks.

Steve Herron

But I think the next evolution is really in what we do with all of that data. We all know the story about the music industry and how it became digitized. But we used to all own CDs, and we played them in our CD player or Disc man. And it was just all about you picking and knowing which music you wanted to buy, and own, and play. And of course, when we digitized all those to MP3s, it was one thing just to digitize it, and now be able to carry it on smaller iPod instead of your disc man. But that wasn’t the real transformative thing. The transformative thing was when now I play that MP3 through a service like Pandora. And Pandora knows that when I listened to a Garth Brooks song, that they know that, through their algorithms, there’s a good chance that I’m also going to like a Johnny Cash song.

Steve Herron

And so, they serve up to me additional things that I might not have even thought about that are probably appropriate to me. And the more I dial in and interact with Pandora, it learns more what I like, and it plays that kind of music. And really, it’s that kind of predictive, personalized service that we need in healthcare. So, we’re using EMR data now to start to predict and help providers prevent negative events like I mentioned earlier. We can build intelligence models off of that EMR data and social data to predict who’s most likely to be readmitted to the hospital, who isn’t recovering at the pace we would expect them to, and even who might fall or develop sepsis. Having access to these prevention algorithms is going to allow caregivers to know where to focus their attention so they can really maximize the value of their care.

Bob Anderson

So Steve Herron, when we think about interoperability, it’s… For many, it’s an afterthought when they’re thinking about an EHR. But shouldn’t this be one of the top requirement items on a provider’s checklist for an EHR, no matter what the care setting is?

Steve Herron

Absolutely. I mean, I hope that I’ve made the points there that it really is… I guess I went win/win/win, but we added a fourth win today. So, across the patient, the provider, the enterprise, the payer, across the board, everyone benefits when we can start care faster and accurately, to provide the best care, but also then to avoid the negative events that can happen as a result.

Steve Herron

So, we’re talking about higher quality of care and safety, lower costs, and of course, patient and caregiver satisfaction, which really is what we’re trying to do as we deliver health care. So, think interoperability is just one of those key things that has to become just the way we operate so that we can help people lead healthier lives.

Bob Anderson

Well, Steve Herron, we value our partnership with Cerner. It’s been fantastic, two years, working with you all. What we are doing together has definitely impacted care positively, as well as the care providers and making their lives a lot easier as they go through their day to day working with patients. So again, I want to thank you for your time today. And I look forward to our partnership moving forward.

Steve Herron

Couldn’t agree more, Bob. Appreciate you having me on the day. And I’m really looking forward to continuing what we’ve done, over the last two years, over the next decade or more.

Bob Anderson

Sounds great, Steve Herron. Thank you very much

Speaker 1

That concludes the latest episode of the Post-acute Point of View from MatrixCare. We have a lot of guests and topics coming up that you won’t want to miss, so be sure to subscribe. If you’ve enjoyed today’s podcast, and if you have a topic you’d like us to discuss, leave us a review. To learn more about MatrixCare and our solutions and services, visit matrixcare.com. You can also follow us on LinkedIn, Twitter, and Facebook. Thank you for listening. Be well. And we’ll see you next time.