Let’s play Jeopardy. You say – Neal Patterson, Cerner CEO – I say – what is a futurist. On the occasion of this information technology icon’s death, let’s call him what he was. He foresaw. He invented. He drove agendas and consensuses. He was a deeply imaginative, passionate believer in a better way of doing things. In that clairvoyance, He got a lot of things right. Not every consumer knows even today what the now ubiquitous “electronic health record” or EHR is. But Neal invented it. Well, maybe not, but he envisioned it. In Cerner’s 1986 initial public offering artifacts, the term “HNA – Health Network Architecture” was present and as described, was the first description of an EHR in any literature that I know of. At this point in time the notion of an off the shelf computer system for the enterprise – to run every little aspect of a company’s business – was not only absent in health care – it was absent from business in general. Before 1990, the software application business was still in its infancy and large scale enterprise application development was still being done as unique works for hire by consulting companies of the kind Neal, Cliff (Illig) and Paul (Gorup) had come from.
I joined the company in 1993 – after the company had proven itself in the laboratory automation business – the first business that Neal and his associates could foresee and subsequently build. “HNA” was already deeply ingrained in the Company's vernacular and the culture. By 1995 when Cerner Millennium formally launched Neal began telling us a story about the future. We were all going to rebuild our software in such a way that it would support the healthcare enterprise. In the early days, it was a school-bus with no seats – a mac truck with no operating brakes – a jet plane only a few of us could fly. But Neal pulled no punches. At many subsequent annual town halls, he drew pictures of what we were encountering – “we are taking off, but look – ahead of us there are MOUNTAINS”. In 1999, Neal and the company seemed to have missed the boat. Y2K was the focus and a client couldn’t install Cerner Millennium yet and replace dead legacy stuff – Millennium was still a big, green thing and just wasn’t ready.
Then, it happened again – Neal was right about the future. Enterprise systems were important, particularly in healthcare where most organizations couldn’t run one system effectively much less a dozen plus. By the early 2000s the investment paid off. After the automation of the lab, this “enterprise” play was the next huge win for the company.
In this still early time, Neal, the Consensus building futurist, moved to co-fund a Rand Study on medical error. At public events, he began to hold up a pen declaring it “the most dangerous medical device”. He single-handedly (well, with the power of his publically traded company) alerted the public to the dangers of an un-automated medical system. People took notice, in particular, politicians. The system should intervene when medical orders are fundamentally contraindicated. It should know how to help the health system manage the individual person and the whole population of people with the power of automation.
Neal was passionate about making a difference – for individuals, and for the industry. He did personally unnatural acts – spending all day in Government Meetings for the opportunity to push his agenda that systems companies should not compete on data exchange – that a person’s health records should be available where ever they seek care. Neal wanted to change the healthcare was paid for saying frequently and publicly that he wanted to “eliminate the insurance company as we know it”.
His personal experience with the health care system – a death in his family from sepsis – his wife’s long struggle with Cancer and in the end his own battle with this disease that takes so many of us made him a singular advocate for patients. From what I know of it, in his last year, he was focused on making sure the patient becomes a full partner in health care.
As various illustrious news organizations have described Neal’s legacy recently, my sense is they missed the boat. Forbes pointed out that Cerner frequently loses to Epic and suggests most Cerner gains are because the government provided incentives for meaningful use.
These outlets have a very limited sense of history. Neal and his company wasn’t just the recipient of the value of meaningful use, he was one of its primary progenitors. He passionately believed in a “learning healthcare system” long before it became a buzzword or even a “thing”. He believed that technology could bend the healthcare cost curve like nothing else. He is the Edison of this industry.
Many times over years I had the opportunity to work closely with Neal. His passion for his work was foremost, but he was personally an extremely compassionate man as well. He saw to it that the company maintained that compassionate culture. He listened to cheeky upstarts who thought they knew better, because, HEY, they just might.
Last week was many things for me. I attended my 40th high-school reunion. If I were still at Cerner, I would be starting my 25th year. Neal Patterson was celebrated and laid to rest. On Saturday, I saw my 6th grade teacher and saw many friends I hadn't seen in years. A big milestone week. A lot of memories sprung forth - and a lot of gratitude.
I owe a personal debt to Neal Patterson and his company – my Cerner career paid for two little ivy educations and a great life here in Kansas City. But there is much more than the making of a few thousand careers that Neal can take credit for. He made his mark on information technology and healthcare like few others, bringing to life a new way of doing both. I am proud to have been present. Neal, I will miss how you could shape and see the future. I will miss how you pulled all of us along.