Five years ago, in his then-capacity as president and chief executive officer of Geisinger, Dr. David Feinberg keynoted Day 4 of the 2016 annual Cerner Health Conference. On Tuesday, after just days on the job as Cerner's newly-minted CEO, Feinberg kicked off CHC21, which continues through Wednesday.

"In the five years since I last talked at CHC, there have been some amazing medical breakthroughs," said Feinberg in his virtual keynote address.

"In 2017, gene therapy was used to cure a teenage boy of sickle cell disease," he said. "That same year, FDA approved smart pills. They alert users if they've already taken their medication. In 2019, Google showed that artificial intelligence can detect lung cancer more accurately than radiologists with eight years of experience. And last year, a COVID-19 vaccine was researched, developed and deployed almost four years ahead of the normal timeline for a new vaccine."

But still, said Feinberg, "the noise remains. That's what we have to take to zero."

To explain what he meant by "noise," he gave a nod to Cerner's late founder and his late wife.

"Neal Patterson's wife, Jeannie, said something profound when she and Neal were fighting their battles with cancer together," said Feinberg.

He explained: "It's the noise in the healthcare system that will drag you down, she said. That noise she referred to as having to know when your last colonoscopy was instead of your doctor having that at their fingertips. It's spending seven hours in a reception area, waiting for lab results."

Feinberg added another example: "It's having me – an MD, an MBA with decades of experience as a doctor and running hospitals – yet not being able to make sense of an explanation of benefits of my healthcare, from my own health system. That's all noise."

Health IT has enabled a lot of major progress in recent years, he said, but there's still a lot of heavy lifting to do.

"Data to do more great things even faster, that's the brass ring," said Feinberg. "But to achieve that vision, fixing the EHR is job number one. The pipes are laid, which is wonderful, but we have to make it easier to get the right information to the right people at the right time to eliminate that noise."

For too many patients, "healthcare is still broken: unaffordable, biased – and largely still based on acute care rather than prevention," he said.

"COVID-19 showed the world what's wrong: Not enough focus on public health, prevention and equity. Social determinants play too large of a role in our healthcare and mortality. But we in America remain focused on fee-for-service instead of fee-for-value, or incentives that would push all of us upstream."

Feinberg acknowledged the challenges of accountable care.

"Being current on complex and changing payment models, staying on the right side of a razor-thin margin is a difficult task even for the best managed health systems and provider organizations," he said. "And one thing I've heard plenty about is how important it is for Cerner to improve our revenue cycle solution."

He said the company's new RevElate technology, unveiled just this past week, could help simplify billing for patients and providers alike, making RCM "more integrated and seamless" for Cerner customers.

Feinberg also pointed to the need for a more intense focus on EHR optimization and AI-enabled automation.

"We haven't fully reached our potential," he said. "Digitized records, for one, need to be usable. They need to be measured by how they enable caregivers to spend even more time at the bedside and less time at the terminal. Improving the usability of Cerner solutions is at the top of my list of things to get done."

He pointed to Banner Health's work with Cerner to improve intake forms and other administrative burdens, "so their nurses can spend more time helping patients and less time documenting. The work is going well, and we're on track to save 9,000 hours and eliminate 10 million clicks every year."

And he described what he sought as an ideal state for digital records.

"Records should help patients avoid unnecessary tests and medications because the record is so easy to find and understand. Records should help nurses and doctors avoid errors and suggest what treatments might be best. Records should allow all of you to understand the health of your community, who's at risk and what interventions are working. Records should predict. Records should help the world avoid, or at least minimize, the effects of the next pandemic.

"And all of this works only if we share your records with everyone you tell us to," he added. "If we use your records to improve your health, it can also improve the health of your communities – and ultimately our world."

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com
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