As the dust settles from this past week's mammoth $1.3 billion merger, Siemens Health Services CEO John Glaser tells Healthcare IT News what led up to the Cerner deal, how his experience as a health system CIO could help smooth integration challenges and what to expect – from the two companies specifically and electronic health records in general – over the months and years to come.

[See also: Cerner to buy Siemens health IT unit]

Q: What were the factors -- both within your respective companies, and across the healthcare landscape -- that made this the right deal for Siemens and the right deal for Cerner?

A: The basic strategic rationale was that if you look at the pressures that providers are facing, both in the U.S. and also oversees -- reimbursement pressures, quality pressures, being asked to create systems of care and manage populations -- you look at all that stuff and you realize that if you really want to be a very effective enterprise health IT supplier to them, you've got to have substantial resources. Development resources, services resources with the capability to be doing cloud, technical resources to deal with personal devices, all kinds of stuff.

[See also: John Glaser on healthcare transformation]

And you're also going to be better off if you have a global footprint where you can learn from disease management efforts in Scandinavia, or telehealth efforts in emerging economies. So it's clearly going to become -- if you do it well, at the enterprise level -- a game where large numbers of resources are going to be critical. So when we looked at that on the Siemens side, we could do that organically -- we're pretty good size now, but we'd have to get a lot larger if we wanted to to it well. Or we could combine resources with somebody else. And that led to the initial conversation with Cerner about acquiring Health Services. And I think they had similar views. As talented and full of smart people as they are, they're going to need additional resources if they're going to do this well.

IT is critical to (Siemens) but the IT we really need is the IT that's closer to the imaging modalities and the laboratory stuff, the IT that helps with visualization of images, IT that helps with interpreting the genome. So (Siemens) is going to concentrate our resources closer to the technology that is essential to us, and then take the health IT assets we have, combine it with Cerner, which will help collectively achieve the type of resource potency we'd like to have. We'v also put in place this alliance; we still want to explore and do innovative work -- bring IT together with imaging, diagnostic equipment, etc. So that was the rationale, fundamentally: this is going to be a much more complex, sophisticated challenge, even harder later than it is now.

Q: So it was Siemens that first approached Cerner to feel them out about a sale?

A: There's been a relationship between the two organizations over the years. We were having meetings when I first got here (in 2010) with Cerner. There's been back-and-forth explorations of this idea: how do we work together? I think it's one of those conversations where it's hard to know where the idea started. It's one that had been brewing over time. Certainly it was earlier this calendar year where it started to get more serious.

Q: What's next? What are the first few items on your to-do list in the coming weeks?

A: The concerns right now are, fundamentally, reaching out to the customer base, letting them know what's going on, and also reaching out to the staff, telling them what this all means, talking to people about what the plan is. There are limits. Until we clear certain regulatory hurdles there's only so far in certain conversations we can go. And there still needs to occur -- and will occur, later this fall -- a deeper product and service conversation, about how we merge the two organizations. But right now a lot of it has been outreach.

The second thing that's started is that we, as a business, get a lot of support from Siemens Corporate Services -- IT, legal, HR, stuff like that. And by closing, which we hope will be Q1 of calendar year 2015, we need to transition that to Cerner. So a lot of work has to go off: moving email accounts, and people's 401(k)s, etc. That's the second thing that needs to go on. But later this fall we'll start the product/service-type planning and see what the combined direction should be.

Q: For existing Siemens clients, what's in this deal for them? And what sort of early feedback have you heard from customers?

A: They appreciate and understand the scale argument, because it's parallel to one in healthcare itself: People are creating health systems, hospitals are joining forces and bringing in physician groups ... they understand that basic scale or size at which they'll be able to better serve populations.

They also have a lot of respect for Cerner. A lot of their basic questions are, 'What does this mean for the product, what are the expectations going forward?'

So what we have, and this was discussed by Neal Patterson, is a commitment to support and advance Soarian for at least 10 years. So that gives people a lot of confidence. Their immediate concern obviously, is, 'Are we going to have to go hard left in one or two years?' And the response is, 'You don't need to do that at all. … You can continue to move ahead on your implementations.' So that's been the conversation, and overall I think people are pleased.