Cerner began as PGI in 1979 and changed its name in 1984 after hiring advertising executives to come up with a new name. They chose "Cerner", which comes from Latin and other languages meaning things like "to discern" and "to blossom". In 1986, Cerner went public with its IPO, allowing initial investors to profit and increasing confidence in the company. By going public, Cerner was able to extend stock options to employees to share in the company's success. Cerner's stock has grown tremendously since its IPO, demonstrating the company's strong financial performance over the decades.
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M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
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There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
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Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
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VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
2. From PGI -> Cerner (& Lillig -> Patterson)
• In 1984 when PGI was taking PathNet to market, they realized the
name lacked a little bit of pizazz (to put it mildly…), so they hired
a trio of advertising executives to come up with a hot new name.
• Looking for a name that had both health and technology in it, the
trio came up with a number of creative possibilities, such as:
– Automated Information Management, Inc. (AIM) & Novus
(ironic how both were later used at SMS: AIM was their
Advanced Implementation Methodology, and Novus ≈ Novius)
• Neal rejected both, and the ad gurus produced a list of foreign
words for him to consider, one of which caught the eye of Jeanne
Lillig, PGI’s 7th employee, who went into Neal’s office and picked:
– Cerner – which comes from the Latin “cernere,” meaning to
discern or sift. In Spanish it means “to blossom” and in French
“ to encircle.” So after 5 years, PGI became Cerner, and Jeanne
underwent a name change too when she later married Neal!
3. Ups and Downs…
• Most HIS vendors eventually take their firms public so the initial
investors (and lucky employees who are given stock and/or
purchase options) can cash in on their success. A few exceptions:
– Meditech and Epic, two of the biggest and longest success
stories in our biz, have kept themselves private – what their
potential worth would be in a public offering is staggering…
• Almost every other leading HIS vendor is publicly traded
(McKesson, Siemens, Allscripts, GE, NextGen, CPSI…), and Neal
and Co. were no exception, joining the public bandwagon. Cliff
Illig gave three primary reasons for their IPO in October, 1986:
1. Initial investors expected it to gain a return on their capital.
2. Going public increases prospects confidence in the vendor
3. Like SMS, Cerner extended generous stock options to valued
employees so they could share in the largess (and risks!)
4. What If??
• I mused back in the episode on SMS’ Initial Public Offering (# 11
at hispros.com) how much the few hundred penny-a-share stocks
I was given in 1969 would have been worth today after all the
stock splits and revenue growth, up to their sale to Siemens...
• Well, thanks again to April Martin, here’s Cerner’s math:
“How much would a single $16 share of Cerner stock purchased in the IPO be
worth today? Here are a few scenarios using yesterday’s $47.49 close:
– If you bought one $16 share in 1986, it would be worth $3,039 today.
– If you invested $400 for 25 shares, they would be worth $75,984 today.
– If you were flush enough to be able to invest $10,000 in Cerner in 1986
(buying 625 shares), those shares would be worth $1,899,600 today.
Here’s how you calculate it: take the initial dollar amount invested, divided
by the $16 price to give you a number of shares. Then double that number
of shares 6 separate times for the number of stock splits that have
occurred since going public. Then multiply the resulting number of shares
by the stock price at the close of whatever business day you want.”
5. On The Other Hand…
• Anyone who remembers the year 2008 knows there is a downside
to these incredible profits too – my pension still hasn’t recovered!
• Indeed, one of the saddest memories of my career was serving as
President for Sentry Data in the mid-80s under the tutelage of
Sheldon Dorenfest who took it over and obtained Chapter XI
protection while we tried to find a buyer (#21 at hispros.com).
• Sentry (née DATX) was a red-hot minicomputer vendor who’s
stock went up into the $20 range after their IPO, but then tanked
due to a number of factors, until bankruptcy took it to pennies.
• I remember taking a call one day from
a broker who had steered his clients
into investing in Sentry, and wanted to
know what the prospects looked like. I
just mumbled vague and uncertain
generalities until he got the idea…
6. This One’s Been A Winner!
• In Cerner’s case, it’s been all positive however, as shown in the
chart below of the annual revenue for the top 13 HIS vendors that
over the past 20+ years (Cerner in appropriately dark green).
7. National Media Recognition
• Within two years of taking PathNet to
market, Cerner had signed agreements
with 41 clients, while revenue and # of
employees jumped four-fold. This caught
the eye of Bill Child’s Healthcare
Computing and Communications rag, the
source of HIS vendor info back then.
• Playing on a classic line from Butch Cassidy
and the Sundance Kid, HC&C entitled a 1986
feature article on Cerner “Who Are These
Guys At Cerner Corporation?” The article
quoted Terry Armstrong of the giant chain
HCA who had picked PathNet earlier: “We
looked at all the Lab systems on the market
and found PathNet to be most functional.”
8. Super LIS Sales Track Record
• By the end of the 80s, Cerner was dominating LIS competition as
shown in this table from the Dorenfest 3000 Data Base of 1990:
9. How Did They Do It?
• Many of these LIS competitors were hardly pushovers, especially:
#2 Sunquest – who after a few years of ownership change under
Misys, is now back as a major player in the LIS niche today.
#3 Meditech – who started out as an LIS vendor and whose Lab
suite runs standalone in many hospitals with “foreign” HIS-es.
#6 Citation – who’s LIS led the 1980s’ microcomputer revolution
in small hospitals with their IBM PC servers and Novel LAN.
• To see just how Cerner beat these
erstwhile competitors, next week we’ll
step back in time to re-trace a detailed
LIS search our firm conducted for a
large hospital about 20 years ago.
• All of the steps we followed back then
still apply to buying an EHR today, so it
should be an informative story.