Developing a Digital Strategy for True Clinical Innovation

Phil:

Welcome to The CereCore Podcast where we focus on the intersection of health care and IT. From practical conversations to strategic thought leadership, let's unpack the decisions, challenges, and journey of those whose purpose it is to deliver technology that improves health care in their communities.

Today we welcome Julie Demaree to The CereCore Podcast. Julie is the executive director of clinical innovation and transformation at St. Mary's Healthcare in Amsterdam, New York. Julie began her career as a physician assistant and for more than 25 years has been working to streamline provider workflows and enhance patient care through digital strategy and technology integration. Before joining St. Mary's, she was the director of clinical informatics and data integrity at Saratoga Hospital, where she was the leader for ambulatory informatics, analytics and medical records.

She holds a master of health administration from the University of Phoenix, a postgraduate certificate in occupational medicine from Duke University and bachelor's degrees from St. Francis University and Penn State University. She is a certified professional in healthcare information and management systems and a fellow of the American Academy of Physician Assistants.

Julie, thank you for joining us today.

Julie Demaree:

Hi Phil. Thank you for inviting me to the podcast.

Phil:

Well, just a privilege to have you here and you, we always like to start these off with just a little bit of background and yours is somewhat unique. So if you wouldn't mind, tell us how things unfolded for you and perhaps describe your role there at St. Mary's.

Julie Demaree:

Sure. I would say I've been incredibly fortunate in my career to have had great leaders who saw and developed my potential where others might have seen me as a squeaky wheel. Early in my career when I raised concerns about patient experience, I was given the opportunity to participate, to be part of the solution and join a patient satisfaction committee. And later when I made suggestions about workflows, I was given the opportunity to fix it and lead the department.

While my aspirations were to be a clinician and not an administrator, I learned that I could impact more patients and maybe even help providers as an organizational leader. So there was probably a time that I was really dabbling in the EHR, but I kind of learned how to do scheduling at first and then train some providers and liked it, but I wasn't really techie. But then I was helping roll out a bunch of ambulatory practices, around 2013, we were really expanding our practice footprint at the hospital I was working. I was ordering the equipment and making policy manuals and things like that, and I found we were opening these beautiful new office spaces and bringing in new physicians.

But then I felt like we were kind of throwing them to the wolves. We didn't have any in-house expertise in the electronic health record, and they were being trained by webinar, and then there was nobody to provide at the elbow support. I just didn't feel good about it. That kind of advocate for the provider was making me feel really uncomfortable about how it was all going down. In identifying the issue to leadership I kind of talked myself into a new job, and the rest was history.

Phil:

Isn't it amazing how those things work?

Julie Demaree:

Yes. Yeah.

Phil:

Certainly when organizations find somebody that has a passion and sees an issue and says, and I've got a solution, they're like, great run with it. So that's excellent.

Julie Demaree:

Yes. And that EMR and those practices kept growing. I mean, we ended up with more than 1,000 users and with it we ended up developing an in-house support team for onboarding, analytics, a medical record department, that lasted well beyond my departure from that organization. So it really gave me an opportunity to continue to learn new skills and develop a team, and I grew with it. So that's really how I got here.

Phil:

That's excellent.

Julie Demaree:

It was a great adventure.

Phil:

That's excellent. Well, pivoting to St. Mary's Healthcare, I think y'all recently earned a top workplace award and you were I think the first acute care hospital in the region to earn this distinction since the Times Union launched that recognition program, I think, about 14 years ago. So if you wouldn't mind, tell us a little bit more about St. Mary's, about the employees there and about the community.

Julie Demaree:

Sure. This is really, our mission here is really what drew me to St. Mary's, and we are just really incredibly proud of the work that we do here. Our people are our greatest resource. And we really live the mission. I was looking for, I don't know, sort of a new passion when I came here in 2023, and you can just feel it when you walk through the halls here. So that recognition, and not only for the hospital but for our CEO, Jeff Methven, also received a leadership award in that recognition.

It just was incredible for our employees and I think it's helping show the community that it's obviously a great place to work, but it's also a great place to receive care because the people who work here like to be with each other to come to work, and I believe that really speaks to the care that you're going to receive here. It is part of our mission to give joyful service to serve our patients, and we really serve each other I think, in that same way. Obviously I can't even put into words what that recognition meant to us. Of all the employers in this huge community, the Albany region, for us to receive that recognition, just really powerful.

Phil:

No, that's excellent. And I think it is difficult to put into words. But once you see it and experience it, you know it. And I think we've all, over the course of our lives, either been in a situation, whether it's healthcare or not, where you could just tell that the passion wasn't there from the people that you were dealing with. And then all of a sudden you walk into a situation and you a different care setting, et cetera, and they're passionate and caring and bought in from a mission standpoint, a community standpoint, and it makes all the difference in the world. And ultimately that's why organizations like St. Mary's are attracting such great people. So, I think that's excellent.

Julie Demaree:

I think it's true. I hope that it is a sign that our associates just feel supported and respected and inspired to provide great care, and we're already seeing that we're getting more applicants. In the time that I've been here so many people have come back to St. Mary's. People leave to go try something else and they just come back. They come back because it's just such a great place to work.

Phil:

Sure. That's right. No, that's excellent. So you've been there now a couple of years.

Julie Demaree:

I have.

Phil:

Tell us more about some of those top areas of focus for clinical innovation and transformation. What's your approach for identifying those areas within the organization that are right for that sort of innovation or transformation?

Julie Demaree:

Sure. I think that I would probably describe my approach as three-prong. First education and, second, interoperability, and, third, how we're using data. When I first arrived here in 2023, the organization was about 18 months post go live, and they had just started their second what's called a priority pack update. St. Mary's, like a lot of organizations, had done their transition in the middle of a pandemic. But they also had moved from MEDITECH Magic just after divesting from Ascension. So as if building an EMR isn't challenging enough, I think they did it under some of the most challenging conditions, COVID, divestiture, there was just a lot going on. And our ambulatory practices actually moved from another EMR without the migration of their data. So their transition was really challenging because they didn't have the benefit of any historical structured data.

So before I arrived, our two clinical analysts, Kirsten Lennon and Kayla Conroy, had spent a lot of time working to optimize things really through education. And that education I believe is two ways. So we're educating the end user, in this case it was mostly providers, how to use the system because if you don't know how to use the tools, then you're very frustrated. But I think we were learning, they were learning as well, how our end users use the system or need to use the system, what's working, what's not working, and they were making real time changes. And that was really important in alleviating some of the pain points and really I believe regaining trust between our end users and the IT department. So that was kind of that education, and that is key to what we do every day. Making sure our end users know how to use the system and learning what's working. So a lot of at the elbow support.

To build on that, I really reviewed kind of that pick list of what was left, what haven't they been able to solve, and it really included a lot of features that our ambulatory practices particularly had lost since moving in from the previous EMR. And they were really related to interoperability, things like direct messaging, a bidirectional immunization interface, structured data that would populate a form because they didn't have a lot of structured data when they first started. So they needed to exchange data. And I think that it's not unusual for acute care hospitals and EMRs to not really understand how important that is in a primary care setting specifically. They just exchange data all day long, they're always looking for information from a recent ER visit or an outpatient lab [inaudible 00:11:32]. It's just, if you don't have that it's really hard to manage patients as they transition from one setting to the next.

So we worked on getting a lot of that information back to them in a meaningful way, and we can talk a little bit about some of those interfaces we got back. But then we also wanted to provide them with some new tools to maybe show that there was new functionality on the horizon. And so we did that in two ways. First, we engaged CereCore to come in and do an evaluation of how we had set up Expanse. We really wanted to know what we had missed, where we had opportunity. They met with us, they met with the clinicians, they met with billing and coding and everyone, and they provided us with kind of a pick list. And that was really helpful for a few reasons.

First of all, it gave us some validation that there were some things we really had done well and that were set up well. And of course that really was good for our analysts, I think to see that we were not in a terrible situation. You always hear the complaints, but there were some things that we really did well. But they also gave us an estimate of the hours it would take to do some of those builds. And that was really helpful for me at the executive level to say, these are all the things that users want, and then kind of an ROI or a cost benefit analysis. So either we do it or I pay someone to do it, but some of these things have a pretty low yield and they're going to take a lot of effort. And so that was validating as well.

The other thing that we did that I think was really valuable was we actually brought MEDITECH into a medical staff meeting that was very well attended. So we had about 75 of our doctors attend a December, 2023 medical staff meeting, and MEDITECH came and did their roadmap presentation, and that was really, really valuable. The doctors were just super excited, and I think that that gave them a lot of hope. First of all, they got to see things like chart summarization and a lot of the AI stuff that was coming. But I think they also got to see that being part of a large EMR that's used all over the world, that they had a strategy, that they had a roadmap and that there was stuff coming that was going to be really good for them. I don't think they had ever really gotten attention from an EMR vendor or been part of that kind of technological strategy.

And so that was really good for them. And they left that meeting, I guess the best way to put it is I didn't hear a lot about going back to the old EMR after that. I think that that was just really important. That was kind of a turning point for them. That was really important. And then of course, the last thing I'd mentioned was data. So of course we have to capture data to have data. But data analytics have just been very, very important as part of transformation to not only know what we need to do. But of course it also shines a light in all the dark corners and sometimes tells you a story that wasn't the story you thought was happening. So I love data.

Phil:

Indeed. No, that's excellent. And as you've been telling the story there, it certainly occurs to me that as we've gotten now into 2025, it does seem like you can't have clinical transformation without IT. The two go absolutely hand in hand, and that hasn't always been the case in our industry. And so I'm curious, maybe you could dive a little bit more into just how you've structured that inside of the organization. You talked about involving the clinicians in that roadmap, but what else has the organization just done in and around that to make sure that everything from the clinical through IT and leadership are aligned on that transformation?

Julie Demaree:

That's a great question. And so I would say this really started with our CEO who created my position and our structure here is a little bit different. So my position is part of the executive leadership team where I sit with the CIO and our CMO. And so I really added, I put it, another voice for both our IT team and our clinical team and I think that that's part of what has been helpful. So I feel like our CIO just has an incredible amount of work to focus on for security and all of the hardware and all of the interfaces and everything else going on. And our CMO has tons of things to focus on with medical affairs clinically. And then we have this space in between where we need technology and clinical to come together. And that's really the space I came into where I'm trying to optimize our IT systems to work for the clinician.

And so I think that took some of the burden off of our CIO and our CMO and I oversee our clinical analysts. And so sometimes people ask us to do things in the EMR that just don't make sense, and they didn't feel like they could say, no. I think our CIO can end up in a tough spot because he doesn't feel like he can say no to clinical people. The clinical people felt like, well, it makes sense clinically and the IT people were like, well, I don't think I can tell them no. And so I kind of have a little bit of both sides where I can say, yeah, that doesn't make sense clinically, or we can't do that in IT. And so I think that's really where I fall in the middle there.

So that's a long answer to a simple question, but I do think that our structure is different in that way and we all work together very well-

Phil:

I think that's fine. You're that bridge. You're a bridge. In some instances, you're a translator.

Julie Demaree:

That's true.

Phil:

Right? Having said [inaudible 00:18:34]-

Julie Demaree:

Well, sometimes I'm the translator and sometimes I'm the bouncer. Yes.

Phil:

Sure. Absolutely. That's excellent. Well, I know that I heard that one of the projects post go live for you guys with MEDITECH Expanse that you have been rolling out is AI based ambient listening for the providers. And obviously AI is the thing, right? It's the buzz that everybody's talking about. And so did that require a completely new approach for you guys or did it fall into your typical cadence, governance, any early lessons learned, what worked, what didn't when it came to driving that innovation?

Julie Demaree:

So I'll answer that in two parts. I'll tell you a little bit about our governance first because I did answer that with your last question when I talked about our leadership structure.

This organization developed what they call an IT governance committee after they went live with Expanse that really at first, excuse me, had a big work list of things that weren't working or things that they needed to address or change after go live. But that really has transformed into a weekly meeting and they have a request form online that you can submit changes that you want to the EHR. And that is a great group of disciplines from all over the organization, and I think that is really best practice. We meet weekly, we review everything from a desired change in a form to an additional field to moving who's going to ask something, to a whole new policy. And that works very well. It's different than the change management committee. This is really for changes in the EMR.

And I think that works very well because you never know what little change might have an implication downstream, and that's where we manage those sorts of requests and changes. We've learned that it's very important to know exactly who's going to test them so that you don't build things and then they sit in test for a long time and never go live. We've learned that it's very important to have a policy finalized before you build it so you don't have to rebuild it three times. But that really works very well. So that's part of our change management.

Our ambient AI went very smoothly. I had implemented documentation ambient AI at my previous organization, so our CEO was anxious for me to help implement that when I walked in.

Phil:

Yes. That's right.

Julie Demaree:

My previous experience though was really with an ambient solution, before it was really AI when we still had human editors. But by the fall of 2023, there were several vendors that as we know truly had AI documentation. So when I came in, we did demos with a few providers. They were really blown away to see what ambient documentation could do, and several were really excited to try it. So we picked a vendor that had integration with Expanse. We were very excited because with a restful API, we did not have to do a lot of integration. So it ended up being a really easy lift for us and we went live with 10 people. It worked very well.

I think the lesson we learned was that if we didn't have an area that had great Wi-Fi, then they would get signal loss and lost packets. And very much like users who want to use Dragon, once they start using Dragon and it doesn't work then they feel like they can't do notes even though they used to type. And once you're used to an AI generating your note and it doesn't generate a note, then you suddenly can't remember anything that just happened in the room.

Phil:

Of course.

Julie Demaree:

It's very disappointing. So we have had very good success with it. It currently is only integrated due to the outbound API, which puts the schedule into the application. And so until we go live with our new Expanse 2.2 Priority Pack 58 in the end of June, we won't have integration back in. We do actually have the same product in our other EMR, and it does have bidirectional integration, and that's been very well received. So it actually pulls the diagnosis and everything back in, and it's pretty impressive.

So that was probably one of the easiest things I've ever implemented. I tend to set expectations very low. I like to under promise and over-deliver. I do think when we have full integration we will have more people who are interested in doing it than wanted to do it initially with the need to kind of copy and paste.

The newer thing we're doing is we just started, we certainly have lots of things going on, but we're just starting to utilize bots for automation. So we just started doing that and we're going to leverage bots to do repetitive tasks in our finance department where we're really behind on posting things. And I think that that is an area that we're really under utilizing and that can really free up some of our staff to do things that require more critical thinking and, in my opinion, things that are more mentally engaging that hopefully will make their work more meaningful and retain employees. And I'm really excited about that.

Phil:

That's excellent. Yeah, there's a couple of things you mentioned there that remind me of a few other conversations I've had recently. I think, one, I love the fact that you meet on the EHR governance on a weekly basis because I think so many times people tend to get through that go live, and then they're like, phew, okay, onto the next thing. And they don't realize that no, this is a living, breathing thing and requires that constant feeding, maintenance, optimization. And so I love the cadence on that.

And then, I think just the story you told about the ambience there and then it's not, oh no, what do we do? And I think so many times people look at technology and the concept of, oh, this is going to make my life easier. There are occasions, particularly when you go live with a new EHR or a different piece of technology, sometimes technology can at least initially be seen as a burden. Well, wait a minute. I used to not have to do this, now I have to do this.

And so I'm wondering what's your experience been throughout the process of implementing new technologies and how have you dealt with some of those situations, whether it be with providers, clinicians, or just users in general because each technology's different.

Julie Demaree:

That's a tough one. I think, honestly, I think most people see technology as a burden right now, and that's the mission I'm on to change.

Phil:

Yeah, it's hard. It's hard.

Julie Demaree:

I always say that nobody went to medical school to work behind a computer or type notes or pick a diagnosis. And so I feel like I'm on a very challenging mission to turn technology into a tool, to rebrand it as a tool that is useful instead of it being a barrier. I believe it can be a tool, but I feel like it's a real challenge for me, my personal challenge to show them how it can be a tool. Some of the ways that I like to do that is to show them how the technology can present information to them in a more meaningful way. And I think that that's really important because our patients have very little tolerance. I have very little tolerance, at least, maybe I should just speak for me, for us to not be able to use the technology. I think we have all gone in an office and somebody said, oh, the computer shut down again, I can't find that, or ask us again our name [inaudible 00:27:23]-

Phil:

I'm guilty.

Julie Demaree:

... your address, or ask us the thing we just spent 20 minutes filling out on a piece of paper. I think we owe it to our patients that if we're going to make them do all these things, we have to be able to find it and use it. So I guess I work very hard to try to use the tools and try to get all of our end users to see the tools as just that technology to see it as a way to engage the patient, to try to identify what about it is a barrier and then find ways to make it less of a barrier. And sometimes that means they're not going to use all the tools that I want them to use. So there's often things that I think are just fantastic that they don't, and that's okay. But if I can find one or two things that they find are helpful, then that's a win for me. What I don't want is for them to just feel like they're fighting technology all day.

Phil:

Well, it's a hard balance that you're trying to achieve there. It's how do we implement technology drive efficiency, but at the same point not sacrifice quality of care and patient experience, which is why a lot of those things were instituted to begin with, which might be counterintuitive to efficiency. It's a tall order. How do you go about balancing that?

Julie Demaree:

I think they can coexist, but I think you have to have a very wide lens. I often see that one department thinks that something's very efficient, but whatever they're doing that is efficient creates major inefficiencies downstream for someone else.

Phil:

That's right.

Julie Demaree:

Right. Or they might be resistant to taking three more clicks to do something, what we believe is, correctly or collect the right information at the right time because they don't appreciate the impact that it has somewhere else, creating an unsafe situation. Perhaps we might send a specimen to the lab without a label or we're not forcing a physician to put their order in on their own, so they're not going to get the warning that tells them, they're not going to see the alert that we need them to see. I think those whys are very important.

But I do think that we sometimes think that we have an efficient process, but if quality or satisfaction is suffering, I'm not sure that we really have an efficient process because there's a cost to that. And that's not efficient in my opinion, if we have to do all this cleanup later with patient satisfaction or we have a bad outcome. And I think the opposite is true. If we are doing something that's great for quality and satisfaction, that is efficiency to me. So I guess a lot of it is just that we get in our own little world and it feels painful to us and we're not kind of doing a wide enough lens.

And I can think of a lot of decisions that were made during builds or workflows that we've gone back and looked at and said, we didn't understand the impact this was going to have on everybody else, or we would have made a different decision.

Phil:

Oh, yeah. No, that makes sense. So for healthcare leaders that are looking to either start or accelerate clinical innovation inside of their organizations, what first steps would you recommend? Based on your experience, any pitfalls? Just sort of how would an organization go about building that overall mindset [inaudible 00:31:25]-

Julie Demaree:

Sure.

Phil:

... drive that momentum for change?

Julie Demaree:

I think that if you're just starting to build a new EMR in general, I like to tell people don't start with what you have. I think we get stuck with how we've done things or how the current EMR works, and I think it's better to just blow it up. If you were doing a hospital merger or something, you kind of have to do that because you can't start with any one of those. And I think sometimes those are the best case scenario because you have to start over. But if you're one organization going to one EMR, we tend to want to do things how we currently do them and reproduce them. And I think that that's a real pitfall.

I think we really want to say, if we could do anything, how would we do it? And then how do we do that in this new EMR or new workflow? Because otherwise we just bring so much baggage. We've developed crazy workflows because of a paper process that we recreated electronically. And so if you're creating something new, just start over. Otherwise, we just keep bringing... Like I said, we've recreated processes that were based on some doctor that retired 80 years ago, some paper form that was required for joint commission in 1986. So I just think we miss those opportunities if we don't scrap everything.

I tell the same when I'm trying to optimize something or someone has a request. They tend to articulate their desire to me based on their understanding of what I can do or what we can build or how the system works. I'd rather them tell me what they really want and then we can tell them the options. Because that's actually how I've gotten what I've wanted over the years. If I just say, in a dream world this is how it would work, often someone can actually build that for you. But if you're limited to your own understanding of what could happen, then you never really get to where you want to go. That's the 30,000-foot word of wisdom, I guess, so to speak or approach.

I think for just keeping momentum going, that weekly meeting is so valuable. Whether you're just starting or whether you've already implemented something or whether you just want to start today and say how are we going to make things better, if you went live three years ago like we did and you just want to start optimizing things. I think getting around the table and saying, what are your pain points today? A feedback mechanism, a feedback loop is really important. We do have other feedback loops, so we have a physician steering committee that meets every other week. We have our applications analysts meet with different departments where they talk about things that are working or not.

But anything that is going to impact other departments, including like a registration field because everybody registers or a query that goes multiple places, we take it back to that IT governance committee. And that's where we really ensure that we don't make potentially unintended consequences or fix something for one department that other people would say, oh, I have that problem too. That's where we decide who the intended audience for education will be. We make sure that we roll it out at the right time. And I will tell you of all the places I've worked and all the things that we've rolled out that surprise people, people aren't surprised here. Things go live and everybody's okay because it is so well-planned. It's done [inaudible 00:35:12]-

Phil:

Right. Planned and communicated

Julie Demaree:

Very well communicated.

Phil:

Exactly. No, that's excellent. Well, it's evident, Julie, that you're just incredibly passionate about what you do. So I'd love to know just a little bit more about were there mentors in your past? Were there things that you built upon to get here? And for those individuals that are perhaps looking at, hey, I've only been in IT or I've only been in clinical and this sounds like something that I would really have a passion for. Maybe there's some insights that you could provide for someone that is looking to be that bridge inside of an organization. Just kind of words of wisdom or guidance in or around there that you could share.

Julie Demaree:

Sure. I think I started on a healthcare path and I'm passionate about patient care, probably because I was sick when I was little. I mean, I feel like I'm an advocate for others in general, my colleagues, my employees, my patients. And I like to solve problems. I certainly am fortunate to have some wonderful caring healthcare providers myself. But when I was little, when I was seven I had mono and I missed three months of school, and I would go in for my blood work all the time and they would say, do you want your mommy to come in with you? And I'd say, no, no, my mommy will cry. So I would march in there myself and get my sticker. But we also didn't have enough money to pay for healthcare when I was seven, and my mom bartered for healthcare with my pediatrician by sewing for her.

So I really grew up with a appreciation that you don't take healthcare for granted. I think that really gives me a special connection. I think that's why that mission here at St. Mary's makes me feel so at home. They really are here for the patient and the community, and I wanted to be somewhere that I felt like I was really living that mission.

As far as who invested in me or what my opportunities are, advice I could give to other people. I've just been so fortunate to have been given the opportunity to learn and grow. Not only did I say I had those leaders who saw potential in me and didn't tell me to be quiet when they probably wanted to. Instead, they gave me valuable feedback and they continued to give me more responsibilities, and those responsibilities allowed me to learn new skills. I think sometimes when we give people more responsibilities or opportunities, sometimes the question I hear sometimes is, are you going to give me more money? Are you going to re-evaluate my job? I would say that wasn't my approach. I took on a lot more responsibilities and I learned more skills, and those skills were really what prepared me for new opportunities.

And I always was told the best way to have another opportunity is to replace yourself, and so I taught my new skills to other people. So I learn new things all the time. I work with a great team that teaches me new things all the time. I would say I learned as much from my mistakes as my successes. They will tell you every time I make some mistakes I tell them, I don't want anybody else to make the same ones.

Phil:

Absolutely.

Julie Demaree:

I think if you want to grow, you have to be willing to take a leap and learn new things and just keep plugging along. And sometimes that gratification is delayed, including the paycheck. But that's my recommendation for people who want to do something new or something more is look for those opportunities to help out, and that's really been my success story.

Phil:

Well, that's excellent.

Julie Demaree:

If you're a leader, look for the squeaky wheels because sometimes they can solve problems and they might be a future leader.

Phil:

Absolutely-

Julie Demaree:

[inaudible 00:39:39] complainers.

Phil:

Sometimes it makes it a little uncomfortable, but at the same point, uncomfortable isn't necessarily a bad thing, right?

Julie Demaree:

Yeah. Sometimes they just need their energy put in the right way. Passion can be valuable if you can put it in the right direction, if you can channel it.

Phil:

Absolutely. Absolutely. Julie, thank you so much. This has been a fantastic conversation. I really appreciate your time and sharing your story and your insights with our listeners. Always love to wrap these up, was there anything that we didn't talk about that's just burning on your heart that you feel like, hey, people should also think about this?

Julie Demaree:

Well, I think it's really just who can you invest in today? Know I'm so fortunate that I had people who invested in me. So as you're working in your EMR, as you're out there working to optimize and you get that feedback, look for those people who have feedback and help them be part of the solution, and you may just be investing in the future leaders in your organization.

Phil:

That's great advice, great advice. Well, Julie, thank you so much.

Julie Demaree:

Thank you.

Phil:

Thanks for listening to The CereCore Podcast. We hope you enjoyed this conversation. Follow us on your favorite podcast platform. For more episodes, connect with us on LinkedIn, visit our US website at CereCore.net, and for those abroad, visit CereCoreinternational.net, learn more about our services and find resources. At CereCore, we are healthcare operators at heart and know the difference that the right IT partner can make in delivering quality patient care 24/7. Let's help make IT better. Here's to the journey.