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Cerner

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FY2008 Annual Report · Cerner
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The ABCs of systemic 
healthcare reform

2008 Annual Report

On the Cover
At Cerner, we believe strategic investments in healthcare information technology (HIT) could save the United States 
healthcare system $500 billion each year. Today, the U.S. is poised to make its biggest investment ever in HIT. Cerner has 
a blueprint for how we should connect employers, governments, providers, researchers and, most importantly, individuals—
linkages that will make healthcare safer and more affordable for all of us. To learn more about our vision for coordinated, 
evidence-based care, please visit www.cerner.com/ABCs. 

ANNUAL REPORT 2008

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 Table of Contents: Annual Report 2008 
Board of Directors 
Leadership 
Letter to Our Shareholders 
 Appendix: Cerner’s Business Model and Financial Assessment 

Form 10-K 
  Business and Industry Overview 

  Risk Factors 

  Properties 

  Selected Financial Data 

  Management’s Discussion and Analysis of Financial Condition and Results of Operations 

Independent Auditor’s Report 

  Consolidated Balance Sheets 

  Consolidated Statements of Operations 

  Consolidated Statements of Changes in Equity 

  Consolidated Statements of Cash Flows 

	 Summary	of	Significant	Accounting	Policies	

  Business Acquisitions 

  Receivables 

  Property and Equipment 

Indebtedness 

Interest Income (Expense) 

  Stock Options and Equity 

  Foundations Retirement Plan 

Income Taxes 

  Related Party Transactions 

  Commitments 

  Segment Reporting 

  Quarterly Results 

Stock Price Performance Graph 
Corporate Information 

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  Board of Directors

Neal L. Patterson  
  ■	Chairman	of	the	Board	and	Chief	Executive	Officer,	Cerner	Corporation

Clifford W. Illig
  ■	Vice	Chairman,	Cerner	Corporation

Gerald E. Bisbee Jr., Ph.D.
  ■	Chairman,	President	and	Chief	Executive	Officer,	ReGen	Biologics,	Inc.,	Franklin	Lakes,	NJ

The Honorable John C. Danforth
  ■	Partner,	Bryan	Cave	LLP,	St.	Louis,	MO 
	 ■	Ambassador	to	the	United	Nations,	July	2004–January	2005 
	 ■	U.S.	Senator	-	Missouri,	1976-1995

Michael E. Herman
	 ■	General	Partner,	Herman	Family	Trading	Company,	Kansas	City,	MO	 
	 ■	President,	Kansas	City	Royals	Baseball	Club,	1992-2000

William B. Neaves, Ph.D.
	 ■	President	and	Chief	Executive	Officer,	The	Stowers	Institute	for	Medical	Research,	Kansas	City,	MO

William D. Zollars
  ■	Chairman,	President	and	Chief	Executive	Officer,	YRC	Worldwide,	Overland	Park,	KS

4

 Leadership

Cerner Executive Cabinet

Neal	L.	Patterson	▪	Chairman	of	the	Board	and	Chief	Executive	Officer
Clifford	W.	Illig	▪	Vice	Chairman
Earl	H.	“Trace”	Devanny,	III	▪	President
Michael	R.	Nill	▪		Executive	Vice	President	and	Chief	Engineering	Officer
Jeffrey	A.	Townsend	▪	Executive	Vice	President
Michael	G.	Valentine	▪		Executive	Vice	President	and	General	Manager,	

United States

Paul	N.	Gorup	▪	Senior	Vice	President	and	Chief	of	Innovation
Marc	G.	Naughton	▪	Senior	Vice	President	and	Chief	Financial	Officer
Julia	M.	Wilson	▪	Senior	Vice	President	and	Chief	People	Officer 
Thomas	P.	Herzog	▪	Vice	President,	IT	and	Medical	Device	Technologies
Bill	D.	Wing	▪	Vice	President,	Healthe	Employer	and	Government

Cerner Executive Management

Zane	M.	Burke	▪	Senior	Vice	President,	United	States	Client	Relationships
John	B.	Landis	▪	Senior	Vice	President,	Client	Operations
Shellee	K.	Spring	▪	Senior	Vice	President,	PowerWorks
Robert	J.	Campbell	▪	Vice	President	and	Chief	Learning	Officer
Kimberly	K.	Hlobik	▪	Vice	President,	Lighthouse
J.	Bryan	Ince	▪	Vice	President,	Health	Economy
Gay	M.	Johannes	▪	Vice	President	and	Chief	Quality	Officer

Catherine	E.	Mueller	▪	Vice	President,	Client	Experience
J.	Randall	Nelson	▪	Vice	President,	Life	Sciences
David	W.	Sides	▪	Vice	President,	Worldwide	Consulting
Randy	D.	Sims	▪	Vice	President,	Chief	Legal	Officer	and	Secretary
Kevin	S.	Smyth	▪	Vice	President	and	Chief	Information	Officer
Jacob	P.	Sorg	▪	Vice	President,	National	Practices

Client Organization

Jude	G.	Dieterman ▪  Senior	Vice	President,	Cerner	Corporation	and	President,	 

Client Development

Richard	J.	Flanigan ▪  Senior	Vice	President,	Cerner	Corporation	and	President,	

Academic and Children’s
Michael	C.	Neal ▪  Senior	Vice	President,	Cerner	Corporation	and	President,	 

Marcos	Garcia ▪ Vice	President	and	General	Manager,	Spain
Richard	W.	Heise ▪ 	Vice	President	and	General	Manager,	 

Australia and New Zealand
Robert	J.	Shave ▪  Vice	President,	Cerner	Corporation	and	President,	 

Cerner Canada

West

John	T.	Peterzalek ▪  Senior	Vice	President,	Cerner	Corporation	and	President,	 

East

Richard	M.	Berner ▪ Vice	President	and	General	Manager,	Middle	East

Bruno	N.	Slosse ▪ Vice	President	and	General	Manager,	France	and	EMEA
Donald	D.	Trigg	▪	Vice	President	and	General	Manager,	United	Kingdom
Amanda	J.	Green ▪ Managing	Director,	Ireland
Brian	P.	Sandager ▪ General	Manager,	Germany

Intellectual Property Organization

Douglas	S.	McNair,	M.D.	&	Ph.D. ▪  Senior	Vice	President, 

Knowledge	and	Discovery

Ryan	R.	Hamilton ▪	Vice	President,	Intellectual	Property	Development
David	P.	McCallie,	Jr.,	M.D.	▪	Vice	President,	Medical	Informatics
Rama Nadimpalli ▪	Vice	President	and	General	Manager,	Cerner	India

5

 
To Cerner’s Shareholders, Clients and Associates: 

Every	year,	this	letter	provides	an	opportunity	to	report	Cerner’s	annual	progress	and	provide	updates	of	material	events	that	took	
place	during	the	year.		On	most	occasions,	I	also	use	this	letter	to	reflect	on	the	major	trends	we	believe	have	affected	our	company.

In	summary,	the	year	2008	was	one	in	which	Cerner	delivered	solid	performance	despite	a	very	challenging	environment.		Below	
are	highlights	of	Cerner’s	2008	performance,	with	3-,	5-	and	10-year	compound	annual	growth	rates	for	many	of	the	financial	
metrics	included	to	provide	a	longer-term	perspective.

	   Revenue	grew	10%	to	$1.68	billion,	with	long-term	growth	rates	of	13%,	15%	and	18%.

	   Our operating margin1	increased	150	basis	points	to	16.6%,	up	from	12.6%	and	9.3%	three	and	five	years	ago.

	   Net earnings1	grew	26%	to	$183	million,	with	long-term	growth	rates	of	29%,	34%	and	23%.

	   Earnings per share1	grew	25%	to	$2.19,	with	long-term	growth	rates	of	26%,	30%	and	20%.

	   Bookings	grew	2%	to	$1.54	billion,	with	long-term	growth	rates	of	11%,	14%,	and	16%.		In	2008,	29%	of	bookings	came	

from clients without a Cerner Millennium®	footprint,	reflecting	strong	competitiveness.

	   Revenue	backlog	grew	7%	to	$3.49	billion,	with	long-term	growth	rates	of	18%,	23%	and	22%.

	   Cash	flow	from	operations	grew	3%	to	$282	million,	with	long-term	growth	rates	of	7%,	16%	and	47%.		Free	cash	flow,	

defined	as	operating	cash	flow	less	capital	expenditures	and	capitalized	software,	was	an	all-time	high	of	$104	million,	an	
$80	million	increase	from	2007	free	cash	flow	of	$24	million.

	   Despite	solid	financial	results,	Cerner’s	stock	price	ended	the	year	at	$38.45,	declining	32%	in	2008,	which	was	better	than	

the	broader	market	(NASDAQ	Composite	Index	and	S&P	500	down	41%	and	38%,	respectively),	but	still	disappointing.		The	
3-,	5-	and	10-	year	compound	annual	growth	rates	for	Cerner’s	stock	are	-5%,	15%	and	11%,	respectively.		These	returns	are	
significantly	greater	than	the	returns	over	the	same	time	frames	for	the	NASDAQ	Composite	Index	(-11%,	-5%,	-3%)	and	S&P	
500	(-10%,	-4%,	-3%).

Operationally,	we	had	a	very	productive	year	creating	value	for	healthcare	organizations	around	the	globe	by	implementing	new	
Cerner®	 solutions,	 upgrading	 existing	 solutions	 to	 the	 newest	 releases	 and	 improving	 operational	 performance.	 	 Our	 suite	 of	
information	solutions	and	services	is	the	broadest	and	deepest	in	healthcare,	and	we	have	the	largest	and	most	diverse	group	of	
clients,	including	leading	health	systems,	hospitals,	clinics,	physician	practices,	laboratories,	pharmacies,	home	health	agencies,	
employers	and	consumers.		

1		Operating	margin,	net	earnings	and	earnings	per	share	reflect	adjustments	compared	to	results	reported	on	a	Generally	Accepted	Accounting	Principles	

(GAAP)	basis	in	our	10-K.		Non-GAAP	results	should	not	be	substituted	as	a	measure	of	our	performance	but	instead	should	be	used	along	with	GAAP	results	as	

a	supplemental	measure	of	financial	performance.		Non-GAAP	results	are	used	by	management	along	with	GAAP	results	to	analyze	our	business,	make	strategic	

decisions,	assess	long-term	trends	on	a	comparable	basis	and	for	management	compensation	purposes.		Please	see	the	appendix	to	this	letter	for	a	reconciliation	of	

these	items	to	GAAP	results.

1979

1982

Neal	Patterson,	Paul	Gorup,	
and Cliff Illig leave Arthur 
Andersen	&	Co.	to	form	their	
own company

PathNet® is installed in 
the	lab	at	St.	John	Medical	
Center	in	Tulsa,	Oklahoma

1983

29 associates

1984

1986

1987

Cerner	secures	$1.5	million	
venture capital funding 
from First Chicago Capital 
Corporation

Cerner goes public on 
NASDAQ (CERN)

$17 million of revenue

149 associates

Cerner listed as one of Inc. 
magazine’s	100	fastest-
growing companies

6

 
 We	advanced	our	powerful	LightsOn NetworkSM,	connecting	more	of	our	client	base	in	2008,	providing	a	near	real-time	surveillance	
system	that	enables	clients	to	proactively	optimize	system	performance	for	more	than	2	million	Cerner Millennium	users.		In	2008,	
the LightsOn Network	monitored	and	analyzed	the	performance	of:

	   19.5	billion	application	transactions

	   2 billion clinician orders

	   1.2	billion	clinician	chart	reviews

CernerWorks™,	 our	 managed	 services	 organization	 that	 offers	 clients	 the	 ability	 to	 avoid	 upfront	 hardware	 costs	 and	 ongoing	
technology	 risks	 by	 using	 Cerner’s	 state-of-the-art	 data	 centers,	 while	 also	 providing	 unparalleled	 system	 performance,	 had	
another	strong	year.

	   Revenue	grew	32%	to	$200	million,	with	continued	strong	profit	contributions.

	   We	continued	to	deliver	system	availability	approaching	“four	nines”	or	99.99%,	less	than	one	hour	of	unplanned	downtime	

per	year.

	   The	number	of	users	being	supported	by	our	data	centers	exceeded	100,000,	and	the	number	of	beds	in	our	supported	

client	locations	is	now	more	than	90,000,	representing	more	than	10%	of	U.S.	healthcare.

	   We	signed	our	first	global	hosted	client	in	France,	which	we	will	host	in	a	French	data	center	in	partnership	with	HP.

	   Our	client	satisfaction	is	outstanding,	with	100%	of	clients	surveyed	by	KLAS	indicating	they	would	recommend	CernerWorks 

services	for	application	hosting.

Our	market	presence	continues	to	grow	throughout	the	globe.		Cerner	solutions	are	licensed	by:

	   More	than	2,100	hospitals	worldwide,	with	29%	of	U.S.	hospitals	using	one	or	more	Cerner solutions

	   More	than	3,300	physician	practices	representing	more	than	30,000	physicians	in	the	U.	S.

	   More	than	500	ambulatory	facilities	such	as	laboratories,	ambulatory	centers,	cardiac	facilities,	radiology	clinics	and	

surgery centers

	   Nearly 600 home health facilities

	   Nearly	1,500	retail	pharmacies

1990

Revenues surpass 
$50 million

1992

1993

1994

1995

1997

2 for 1 stock split (May 12)

2 for 1 stock split (March 1)

1,000	associates

2 for 1 stock split (August 7)

2,000	associates

Cerner	Vision	Center	opens

Revenue surpasses $100 
million

7

As	we	have	communicated,	our	long-term	growth	plan	is	to	move	the	boundaries	of	Cerner	beyond	our	core	practice	of	automating	
healthcare delivery into new areas such as connecting medical devices and  helping  employers  reduce healthcare costs while 
improving	quality.

	   We	made	good	progress	with	our	CareAware® MDBus	Device	Connectivity	Architecture,	which	creates	interoperability	
standards and technology to connect the hundreds of different types of medical devices found in healthcare venues 
with	the	electronic	medical	record	(EMR).		We	doubled	our	MDBus™	device	driver	library,	continuing	to	solve	significant	
interoperability	issues	with	the	more	complex	medical	devices	such	as	anesthesia	devices,	infusion	pumps,	ventilators,	
laboratory	devices	and	the	increasingly	computerized	hospital	bed	systems.

	   We	advanced	our	Smart	Room	concept	in	which	we	extend	the	CareAware architecture to connect other technologies 

common	in	the	healthcare	environment,	such	as	HVAC,	lighting,	entertainment	and	Internet.		We	also	launched	our	Smart	
Semi,	a	traveling	Smart	Room.	It	made	93	stops	and	had	nearly	9,000	client	attendees	in	2008,	having	a	meaningful	
impact on the sales and pipeline for CareAware	solutions.

	   We	brought	our	first	employer-based	health	center	client	live,	helping	redefine	the	way	employers	connect	their	employees	to	
healthcare.		Cisco	Systems	of	San	Jose,	Calif.,	opened	their	LifeConnections	Health	Center	in	November	2008.		The	health	
center,	staffed	by	eight	providers	and	numerous	other	personnel,	is	available	to	approximately	40,000	of	Cisco’s	employees	
and	dependents.	It	is	one	of	the	largest	employer	clinics	in	the	United	States.

Investment	in	intellectual	property	is	our	core	strategy	to	drive	organic	growth.		Our	objective	is	always	to	improve	the	performance,	
capabilities	 and	 the	 human	 experience	 with	 our	 current	solutions,	 but	 we	 also	 drive	 innovation	 in	 healthcare	 by	 creating	 new	
solutions	for	both	new	and	existing	markets.		We	are	creating	and	investing	in	new	platforms	to	move	Cerner	beyond	our	core	
markets	of	today.		In	2008,	our	development	organization	had	one	of	the	most	productive	years	in	our	history.

	   We	delivered	Cerner Millennium	Release	2007.18,	which	provided	more	than	2,200	major	enhancements,	including	new	

features	and	improved	functionality	and	workflow	for	existing	solutions.

	   As	previously	discussed,	we	significantly	advanced	the	capabilities	of	our	CareAware	architecture.

	   We Introduced MPages™,	a	Web-based	platform	that	enables	clients	to	create	customized	views	of	Cerner Millennium data 
and	access	from	any	external	browser	including	smart	phones	and	mobile	devices.		The	MPages platform improves clinician 
productivity	and	satisfaction	by	providing	them	with	interactive,	visually	rich	views	that	bring	forward	clinically	relevant	data.

	   We	invested	significant	work	in	our	Healthe™	architecture,	further	developing	Cerner’s	version	of	“cloud	computing”	for	
healthcare.		We	believe	this	architecture	will	become	a	prominent	platform	to	innovate	new	methods	of	care	delivery	
for	clients	around	the	world	and	new	business	models	for	Cerner.		Among	other	services,	this	is	the	way	the	consumer	
ultimately	interacts	with	healthcare	delivery,	in	both	traditional	and	future	delivery	models.

Overall,	2008	was	a	very	successful	year	for	Cerner.		Internally,	we	continued	to	prepare	for	a	coming	era	when	most	healthcare	
delivery	organizations	will	reach	a	new	threshold	and	be	digitized,	at	least	in	their	core	processes.		For	reasons	we	discuss	later	
in	this	letter,	we	believe	this	digital	threshold	will	occur	sooner	rather	than	later,	by	the	middle	of	the	next	decade.		As	we	have	
discussed	in	past	shareholder	letters,	nothing	about	our	business	is	easy.		Our	clients	are	our	lifeblood,	and	they	exist	inside	a	
complex	adaptive	system	we	call	healthcare.		It	is	easy	to	be	focused	on	the	latest	changes	in	the	environment,	consumed	by	the	
requirements	of	the	present.		There	is	never	a	clear	roadmap	indicating	where	to	invest	for	the	future.		I	give	Cerner	points	for	being	
able	to	stay	focused	on	our	future,	even	while	dealing	with	the	demanding	present.

1999

HNA Millennium® Phase 1 
is completed

Cerner makes Fortune list 
of	“Best	100	Companies	to	
Work	For”

2000

3,000	associates

2001

Revenue surpasses  
$500 million

2002

4,000	associates

2003

2004

Cerner and Atos Origin 
awarded	U.K.	National	
Health	Services	Choose	 
and Book contract

Cerner celebrates 25th 
anniversary

Cerner ranks third among 
software companies in the 
Wall Street Journal’s Top 
50	Returns	over	a	five-year	
period

5,000	associates

8

 
 In	2008,	staying	future-focused	was	no	small	task.		The	“demanding	present”	just	happened	to	include	an	economic	crisis	of	
worldwide	proportions.

The Worldwide Economic Crisis and Healthcare Organizations

We	are	in	the	midst	of	the	broadest	and	deepest	economic	recessions	in	modern	history.		While	the	roots	of	the	recession	can	be	
traced	back	more	than	a	year,	the	United	States	quietly	entered	recession	in	December	2007,	a	fact	suspected	but	not	known	until	
almost	a	year	later.		Throughout	2008,	the	picture	progressively	worsened.	The	ensuing	credit	crisis	and	lack	of	access	to	credit	
caused	consumers	to	spend	less,	which	led	to	a	plummet	in	business	activity,	and	even	greater	fear.		By	the	end	of	the	year,	the	
world	was	in	full-fledged	economic	crisis.

While	demand	for	healthcare	services	does	not	closely	follow	more	traditional	consumer	and	industrial	cycles,	the	overall	business	
environment	does	ultimately	affect	healthcare	providers.		As	the	year	progressed,	the	impact	of	the	economy	started	to	show	up	
in healthcare in the form of increasingly bearish hospital spending forecasts and a series of poor earnings reports by companies 
that	sell	into	healthcare.		Cerner	was	not	immune	to	the	effects	of	this	challenging	environment—there	was	some	impact	on	our	
results	in	2008.		Overall,	however,	we	delivered	solid	results	and	fared	much	better	than	most	other	companies.

In	our	existing	and	prospective	client	base,	the	impact	of	the	economy	has	been	negative.		While	we	continue	to	see	healthcare	
delivery	 organizations	 that	 are	 doing	 fairly	 well	 operationally,	 with	 demand	 for	 their	 services	 not	 significantly	 impacted	 by	 the	
recession,	many	are	dealing	with	a	reduction	in	their	foundation	investment	portfolios	caused	by	the	general	financial	market	
decline.	 	 Another	 financial	 challenge	 is	 maintaining	 strong	 cash	 balances.	 	 Many	 health	 systems	 use	 a	 large	 cash	 balance	 to	
enhance	their	debt	rating	and	maintain	a	lower	cost	of	capital.		Hardship	also	comes	from	the	increasing	rolls	of	uninsured,	which	
drive	up	the	amount	of	uncompensated	care.		Organizations	with	a	large	dependence	on	Medicaid	populations	are	being	impacted	
by	the	troubling	financial	condition	of	many	state	governments.

The	 effect	 of	 these	 challenges	 is	 that	 healthcare	 organizations	 are	 becoming	 more	 selective	 about	 where	 they	 invest	 capital,	
resulting	in	a	focus	on	strategic	spending	that	generates	a	return	on	their	investment.		Many	healthcare	information	technology	
(HIT)	solutions	are	viewed	as	being	highly	strategic,	much	more	than	other	possible	uses	of	capital,	such	as	investing	in	the	next	
version	of	an	MRI	machine.		HIT	investments	often	remain	in	the	plans	even	after	budgets	have	been	cut.		HIT	solutions	also	play	
an	important	role	in	healthcare	by	improving	safety,	efficiency	and	reducing	cost.		Most	healthcare	providers	also	recognize	that	
they	must	invest	in	HIT	to	meet	current	and	future	regulatory,	compliance	and	government	reimbursement	models.		Healthcare	
information	technology	is	strategic;	this	helps	insulate	Cerner.

In	 addition	 to	 the	 strategic	 value	 of	 HIT,	 Cerner’s	 size,	 scale	 and	 geographic	 diversification	 also	 help	 us	 deliver	 solid	 results	 in	
challenging	times.		The	large	size	of	our	U.S.	client	base	and	our	deep	strategic	relationships	with	our	clients’	senior	executives	
creates	an	excellent	platform	to	align	closely	and	help	them	adjust	to	the	current	conditions.		The	depth	and	breadth	of	our	solutions	
and	services	creates	more	stability	because	we	have	more	avenues	to	help	our	clients	than	more	narrowly	focused	HIT	companies.

American Recovery and Reinvestment Act of 2009

The	current	U.S.	Congress	has	spoken:		Investment	in	HIT	is	strategic,	and	they	have	funded	the	creation	of	a	digitized	healthcare	
system.		In	stark	contrast	to	the	near-term	challenges	associated	with	the	current	economic	environment,	we	believe	the	Health	
Information	Technology	for	Economic	and	Clinical	Health	(HITECH)	provisions	in	the	American	Recovery	and	Reinvestment	Act	of	
2009	(ARRA),	which	became	law	on	Feb.	17,	2009,	could	represent	the	largest	opportunity	in	the	history	of	our	industry.		This	
potential,	combined	with	the	hostile	economic	climate	creates	a	type	of	“bipolar”	business	environment	for	Cerner	in	2009.

2005

2006

2007

2008

Revenues surpass $1 billion

2	for	1	stock	split	(Jan.	10)

Revenues	surpass	$1.5	billion

Free Cash Flow surpasses $100 million

Cerner signs contract with 
Fujitsu	for	southern	region	
of	NHS	Connecting	for	
Health	program	in	England

Nearly	7,000	associates

Introduced CareAware® device 
architecture and line of devices

Cerner signs contract with BT for London 
region	of	NHS	program

First Cerner Millennium® site in France

Delivered Cerner Millennium 2007 
software	release,	containing	more	new	
features than any prior release and setting 
a new quality standard

Shipped	first	production	units	of	
RxStation™ medication dispensing 
devices; 25 clients purchase MDBus™ 
device connectivity

Delivered new Cerner ProVision® PACS 
Workstation

Opened	new	Data	Center	at	World	
Headquarters

Signed	first	clients	in	Spain	and	Egypt;	
opened	office	in	Dublin,	Ireland

Acquired Etreby Computer Company  
(retail pharmacy solutions)

9

Smart	Semi,	a	mobile	hospital	room	of	
the	future,	introduced	and	made	93	stops,	
hosting	nearly	9,000	client	attendees

Signed	first	agreement	for	the	 
Smart Room

Expanded footprint in Middle East with 
signing	of	Ministry	of	Health	in	 
United Arab Emirates

Signed	first	hosted	client	in	France

Signed	first	client	in	Latin	America

First client health center opened on Cisco 
campus	in	San	Jose,	CA	

Key	provisions	of	the	ARRA	designate	an	investment	of	approximately	$35	billion2	to	advance	the	adoption	of	HIT.		The	investment	
is predominantly directed toward Medicare and Medicaid to provide incentive payments for hospitals and physicians  to adopt 
qualified	 electronic	 health	 record	 (EHR)	 technology.	 	 It	 is	 estimated	 that	 approximately	 half	 of	 the	 incentive	 dollars	 will	 go	 to	
hospitals	and	half	to	eligible	professionals	(primarily	physician	practices).

To	qualify	for	incentive	payments,	healthcare	providers,	physician	practices	and	hospitals	must	meet	eligibility	requirements	and	
demonstrate	“meaningful	use”	of	a	certified	electronic	health	record	system.		The	legislation	provides	flexibility	for	the	Secretary	of	
the	Department	of	Health	and	Human	Services	(HHS)	to	further	define	meaningful	use	of	an	EHR,	but	it	initially	has	been	defined	
to	include	the	use	of	e-prescribing,	the	reporting	of	clinical	quality	measures	and	the	use	of	EHR	technology	to	improve	quality	
of	care	through	care	coordination.		Additionally,	the	legislation	clarifies	that	a	qualifying	EHR	system	must	have	the	capacity	to	
capture	demographic	information	about	the	patient,	record	a	medical	history,	provide	clinical	decision	support,	allow	for	physician	
order	entry,	facilitate	quality	reporting	and	be	interoperable.

Approach Virtually Assures a Digitized U.S. Health System by Mid-Decade

Hospitals	and	eligible	 professionals	can	qualify	for	incentive	payments	beginning	 in	 2011.		 Eligible	 professionals	must	qualify	
by	2012	and	hospitals	by	2013	to	receive	the	maximum	incentive	payments	over	a	four-year	period.		The	incentive	payments	
are	designed	to	fund	a	meaningful	portion	of	the	upfront	investment	by	hospitals	and	physician	practices.	These	payments	are	
estimated	at	$4	million	per	hospital	and	$44,000	per	eligible	professional.		The	amount	of	the	incentive	declines	if	they	do	not	
qualify	by	2013.		While	the	“carrot”	associated	with	qualifying	for	incentives	is	attractive,	the	“stick”	begins	to	be	used	in	2015,	
at	which	time	hospitals	and	eligible	professionals	begin	to	be	penalized	with	lower	Medicare	reimbursements	if	they	are	not	yet	
meaningful	users	of	a	certified	EHR	system.

We	believe	few	healthcare	organizations	will	ignore	these	powerful	incentives.		They	virtually	guarantee	that	the	core	U.S.	healthcare	
system	will	be	largely	digitized	by	2014-2016.		Analysts	currently	estimate	that	less	than	10%	of	hospitals	and	physicians	currently	
meet	the	standards	necessary	to	receive	incentives	and	avoid	penalties.		The	opportunity	is	substantial.		It	is	difficult	to	estimate	
the	exact	timing	and	amount	of	the	impact	on	our	business,	but	we	believe	it	will	be	a	positive	contribution	to	our	core	business,	
probably	beginning	in	the	last	half	of	2009.

More	importantly,	we	also	believe	this	magnitude	of	investment	could	create	the	level	of	systemic	change	in	the	U.S.	healthcare	
system	needed	to	address	a	number	of	serious	issues,	creating	a	more	efficient,	safer	and	higher	quality	system	for	our	families,	
communities	and	nation.

Risks of Derailing the Impact

It	is	important	to	highlight	the	ways	this	course	of	action	by	the	U.S.	government	could	get	off	path.		I	believe	one	of	the	largest	
ones	has	been	averted	already:		If	the	ARRA	only	funded	healthcare	organizations	that	had	not	yet	invested	in	technology,	it	would	
have	been	a	mistake.		Instead,	it	rewards	organizations	that	have	been	first	down	this	path	as	early	adopters.		In	reality,	these	early	
adopters are the part of the healthcare system that will make the biggest difference and be the source of the greatest innovations 
using	their	IT	investment.		The	HITECH	funds	under	the	ARRA	will	be	used	to	complete	their	journey.

As	mentioned,	the	HITECH	legislation	creates	the	concept	of	“meaningful	use.”		There	could	be	pressure	to	dumb	down	this	definition	
and	make	it	easy	for	any	healthcare	organization	that	has	a	computer	to	qualify	for	the	funds.		Capitulating	to	this	pressure	would	
be	 a	 mistake.	 	 This	 is	 too	 large	 of	 an	 investment	 by	 the	 U.S.	 taxpayer	 to	 create	 a	 low	 bar.	 	 The	 transformational	 elements	 of	 IT	
in	healthcare	come	from	achieving	a	high	bar.		The	high	bar	is	what	eliminates	avoidable	medical	errors,	unnecessary	waste	of	
resources,	inappropriate	variance	in	medical	decisions	and	outcomes,	needless	delays	in	detection	and	treatment	of	disease,	and	
costly	friction	that	squanders	available	funds.

There	are	other	ways	this	investment	could	be	weakened.		But	we	prefer	to	address	these	by	describing	what	is	possible	if	the	
investment	is	made	wisely.

2		The	$35	billion	designated	for	incentives	is	before	estimated	penalties	for	those	that	do	not	comply	and	before	expected	savings	from	a	more	efficient	healthcare	

system	and	higher	corporate	tax	receipts	from	businesses	that	will	spend	less	on	healthcare	in	a	more	efficient	system.		The	net	amount	of	the	incentives	is	

approximately	$17	billion.

10

 
 The ABCs of Systemic Healthcare Reform
The	direction	of	the	$2.3	trillion	current	U.S.	healthcare	system	is	clearly	unsustainable.		
Our	healthcare	spending	growth	has	outpaced	the	rest	of	our	economy	for	40	years,	and	
it	is	on	pace	to	double	in	the	next	10	years,	when	spending	will	exceed	20%	of	our	overall	
GDP.	 	 (For	 the	 record,	 every	 other	 G8	 country	 has	 a	 similar	 growth	 rate,	 so	 it	 is	 not	 as	
though	they	have	figured	something	out	that	we	missed.		They	just	have	a	different	starting	
point.)		The	Obama	administration	is	making	healthcare	reform	a	priority,	using	strategic	
investment	in	HIT	as	a	key	element	in	the	effort	to	transform	the	system.

There  is  a  present  convergence  of  forces  that  could  lead  to  real  healthcare  reform  this 
next	decade	with	HIT	leading	the	way.		We,	as	a	society,	have	been	handed	a	significant	
opportunity,	and	we	cannot	afford	to	waste	it.		At	Cerner,	we	believe	it	is	always	very	important	
to	begin	any	long	journey	with	the	end	in	mind.		With	the	unprecedented	investment	that	
is	going	to	be	made,	citizens	should	be	asking	what	type	of	change	will	be	created	with	
a	completely	digitized	healthcare	system,	and	how	society	should	benefit.		While	no	one	
asked	for	our	opinion,	I	felt	compelled	to	write	Cerner’s	view	of	the	direction	of	reform	and	
the	future	state	of	such	a	healthcare	system.		As	you	might	imagine,	we	see	systemic	change.		Our	position	is	in	my	short	paper	
called The ABCs of Systemic Healthcare Reform.		A	couple	of	comments	on	what	it	is	not.		It	is	not	a	comprehensive	solution	to	
all	of	the	healthcare	issues	that	must	be	solved—for	example,	how	to	provide	benefits	to	the	uninsured	population—but	it	creates	
the	platform	to	enact	these	types	of	changes.		It	is	also	not	a	peer-reviewed	paper—you’re	not	going	to	see	this	in	Health Affairs 
next	month—but	it	does	contain	some	evidence	to	support	it.		Entrepreneurs	are	not	researchers.		We	do	not	study	problems,	we	
fix	them.		But	we	do	also	read	scholarly	journals	from	time	to	time.

As	an	impatient	entrepreneur,	here	is	what	I	believe	and	what	I	propose	should	be	the	benefit	to	society	for	their	investment	in	
healthcare	information	technology.		For	the	full	version	of	the	ABCs	with	sources,	go	online	to	www.cerner.com/ABCs.

We	believe	that	up	to	$500	billion	per	year	could	be	saved	in	the	U.S.	healthcare	system	by	fully	digitizing	and	optimizing	healthcare	
delivery.		Up	to	$300	billion	of	this	savings	can	come	from	modernizing	how	we	deliver	care	and	an	additional	$200	billion	by	
modernizing	how	we	pay	for	care.		Many	of	our	clients	have	objected	to	past	efforts	to	reduce	healthcare	costs	because	U.S.	policy	
has	simply	been	to	reduce	the	amount	paid	to	hospitals	and	doctors,	introducing	chaos	in	the	industry.		However,	most	healthcare	
executives	with	whom	I	have	spoken	believe	that	the	ABCs,	as	described	below,	would	produce	powerful	positive	systemic	benefits	
for	healthcare	delivery.		With	the	right	blueprint,	almost	everyone	can	agree	about	how	to	improve	the	system.

The	first	three	steps	are	currently	underway	with	many	of	our	clients.		Progress	starts	when	we	(A)utomate the current healthcare 
delivery	processes	and	workflows	by	fully	implementing	EMRs.		A	2005	RAND	study	suggests	this	can	yield	$77-100	billion	in	
recurring	 savings	 when	 broadly	 adopted.	 	 Next,	 we	 must	 (B)ase	 treatment	 decisions	 on	 evidence,	 not	 anecdote	 and	 memory.		
It	takes	approximately	17	years	for	new	evidence	to	make	it	into	routine	practice	of	care.		A	2003	study	published	in	the	New 
England Journal of Medicine	found	that	Americans	receive	the	recommended	care	only	about	half	of	the	time.		Basing	decisions	
on	evidence	will	drive	this	important	cause	of	variance	out	of	healthcare.		Although	there	is	no	single	study	to	estimate	the	total	
savings,	there	are	numerous	smaller	studies	that	suggest	significant	savings.		I	believe	the	annual	savings	could	be	in	the	range	
of	another	$100	billion.		Then,	(C)oordinate	care	across	the	fragmented	pieces	of	healthcare.		The	2005	RAND	study	suggests	
this	step	could	return	$82-100	billion.

The	first	three	of	the	ABCs	have	the	potential	to	reduce	annual	U.S.	healthcare	spending	by	$300	billion.		However,	a	sizable	
opportunity	for	savings	and	improvement	remains.		We	must	(D)isrupt	the	incoherent	claim-based	payment	system	with	healthcare	
e-commerce	that	determines	eligibility	and	pays	at	the	point	of	service.		Shifting	healthcare	administration	costs	from	31%	to	an	
achievable	21%	would	save	another	$230	billion	annually.

Achieving	the	four	objectives	above	could	potentially	save	the	United	States	$500	billion	annually.		With	reform	as	our	objective,	
though,	I	think	we	would	be	short-sighted	not	to	ask	for	two	additional	steps,	which	I	believe	are	foundational	to	lasting	systemic	
change.		It	is	important	that	we	(E)volve to	consumer-controlled	Personal	Health	Records	(PHRs).		Every	American	should	own	his	or	
her	own	Personal	Health	Record	and	determine	who	can	access	it	and	under	what	circumstances.		The	PHR	becomes	the	source	of	
medical	information	for	anyone	who	needs	to	treat	the	person.		The	PHR	also	would	allow	for	advanced	uses	of	“cloud	computing”	
concepts	that	would	work	on	behalf	of	the	person.		And	last,	(F)inancial innovation must come in the form of new business models 
for	paying	physicians.		Today’s	approach	pays	healthcare	providers	based	on	the	volume	of	procedures	they	perform.		At	a	time	when	

11

most	of	our	healthcare	spending	relates	to	chronic	conditions,	there	is	a	desperate	need	for	incentives	to	keep people healthy and 
out	of	doctors’	offices	and	hospitals.		We	pay	for	sick	care	today;	in	the	future,	we	must	add	the	concept	of	health	care.

Healthcare	reform	has	been	attempted	in	every	American	generation	in	the	past	century,	by	presidents	Roosevelt	(both	of	them),	
Truman,	Nixon	and	Clinton.		In	2009,	we	arrive	at	this	point	again,	this	time	with	a	convergence	of	events,	some	extra	incentive	to	
get	it	right.		We	do	believe	we	can,	by	leveraging	this	IT	investment,	create	a	systemic	change	in	healthcare,	and	that	change	can	
drive	$500	billion	out	of	the	annual	cost	of	healthcare.		Rather	than	baby	boomers	like	me	“busting”	the	system,	we	can	leave	
behind	a	modern,	affordable,	frictionless,	high-quality	healthcare	system	for	generations	to	come.

A	great	deal	needs	to	be	decided	in	the	next	two	years.		Personally,	I	believe	the	ABCs	are	a	narrative	of	the	right	direction;	the	
challenge	with	each	step	is	that	we	need	to	articulate	the	benefits	to	us	as	individuals,	to	physicians,	hospitals,	healthcare	delivery	
systems,	government,	employers,	insurance	companies—to	all	who	will	be	involved.		There	are	a	lot	of	stakeholders.	What	we	need	
now	is	a	vision	for	how	the	new	healthcare	system	serves	us	as	individuals,	as	families	and	as	communities.

Now	is	the	right	time	to	talk	about	what	we	want	for	future	generations.		I	have	presented	my	version.

Cerner and the Next Decade—Our 2020 Vision

For	 the	 better	 part	 of	 three	 decades,	 Cerner	 has	 grown	 organically	 by	 articulating	 a	 vision	 of	 a	 future	 state	 for	 healthcare	
organizations	and	society.		As	we	finish	2009,	three	major	milestones	will	have	been	achieved.		The	first	milestone	will	come	
as	we	finish	our	first	decade	of	the	21st century	and	arrive	at	the	threshold	of	the	second.		While	this	is	just	a	passing	of	time,	
let’s	not	forget	Y2K	was	a	mere	10	years	ago.		Back	then,	there	was	a	fear	that	computers	would	cease	to	function	as	the	clock	
turned	to	this	new	millennium.		Now	10	years	later,	in	our	2008	Annual	Report,	we	are	describing	how	and	when	all	of	the	U.S.	
healthcare	system	will	be	completely	digitized.		The	first	decade	has	been	hard	but	very	good	to	Cerner	and	its	associates,	clients	
and	shareholders.		The	next	one	will	change	the	face	of	the	HIT	and	the	healthcare	industry.

The	second	milestone	will	be	the	30-year	anniversary	of	the	moment	when	Paul,	Cliff	and	I	sat	together	at	a	picnic	table	in	Kansas	
City’s	Loose	Park,	dreaming	and	planning	what	type	of	company	to	start.		We	have	lived	the	American	Dream.		Along	the	way,	we	
have	also	created	a	lot	of	jobs—careers	for	our	associates—almost	8,000	high	quality,	new	and	ongoing	jobs.		Today,	we	are	the	
largest	non-governmental	employer	on	the	western	side	of	Missouri.		In	the	next	decade,	we	expect	to	see	a	continuation	of	rapid	
growth	of	jobs	inside	Cerner.		Finally,	the	third	milestone	is	that	the	end	of	the	Electronic	Medical	Record	era	in	the	United	States	
is	now	in	plain	sight.		By	law,	we	should	have	a	digital	healthcare	system	at	some	point	in	the	next	decade.

This	should	create	the	basic	question,	what	is	next?		If	you	care	to,	go	back	and	read	the	past	five	to	10	annual	reports.		We	have	
already	answered	this	question,	and	we	believe	Cerner	is	as	well	or	better	prepared	for	the	next	era	as	any	company	in	healthcare.		
Here	is	a	quick	review	of	why	we	are	excited	about	the	coming	era.

In	 2006	 in	 this	 letter,	 we	 introduced	 the	 five-box	 model	 that	 is	
still	 our	 blueprint	 for	 this	 next	 decade.	 	 By	 way	 of	 refresher,	 the	
center  box  is	 the	 U.S.	 healthcare	 market,	 a	 $2.3	 trillion	 market	
with  healthy  compound  annual  growth  rates  that  will  cause  it  to 
double	by	2019.		The	second box represents the global markets 
for	 digitizing	 healthcare	 delivery,	 where	 we	 have	 clients	 in	 more	
than	 25	 countries	 on	 six	 continents.	 	 The	 third  box  represents 
the	 medical	 device	 industry,	 which	 will	 increasingly	 become	 a	
part	 of	 the	 HIT	 industry.	 	 The	 fourth  box	 is	 the	 Pharma	 industry,	
where the transparency created by a digital healthcare system will 
fundamentally	change	the	discovery	of	new	knowledge,	the	ways	
to design and conduct clinical trials and surveillance systems for 
medicines	in	active	use.		Finally,	a	fifth box holds the opportunity 
to	completely	redesign	the	fundamental	commerce	of	healthcare,	
eliminating the friction that consumes more than 30% of precious 
resources,	 connecting	 governments,	 employers	 and	 consumers	
directly	 with	 their	 healthcare	 professionals,	 facilitating	 the	 whole	
process	based	on	personalized	needs	of	the	individual.

12

 
The	opportunities	beyond	our	core	business	today	are	very	exciting	and	provide	us	much	more	opportunity	than	we	presently	enjoy.		
But	our	core	business	environment	in	the	U.S.	should	be	healthy	well	into	the	next	decade.		The	discussion	above	regarding	the	
ARRA	accelerates	some	of	the	work	we	thought	would	happen	throughout	the	decade	into	the	first	half.		We	have	always	said,	
however,	that	the	core	EMR	is	only	a	beginning.		It	is	the	infrastructure	that	will	enable	a	host	of	sophisticated	future	benefits.		
Healthcare	delivery	is	very	difficult	and	complex,	which	creates	numerous	opportunities	to	create	vertical	solutions	addressing	
the	needs	dictated	by	every	major	medical	condition	and	procedure,	as	well	as	the	health-related	needs	of	every	person,	group	
and	society.

We	enter	this	new	decade	with	a	2020	vision.		And	our	opportunity	has	never	been	greater.

The	past	has	been	written.		The	present	is	a	function	of	the	quality	of	decisions	that	have	been	made	up	until	now.		The	future,	
however,	can	be	changed	today.		Imagining	and	investing	in	the	future	is	the	root	of	innovation.		Unlike	other	organizations	that	
define	themselves	by	what	they	have	done,	we	define	ourselves	by	what	we	are	going	to	do.		We	think	that	is	the	best	strategy	for	
long-term	success.	

NEAL	L.	PATTERSON
FOUNDER
Chairman	&	Chief	Executive	Officer

CLIFFORD	W.	ILLIG
FOUNDER
Vice	Chairman

PAUL	N.	GORUP
FOUNDER
Senior	Vice	President	&	Chief	of	Innovation

EARL	H.	DEVANNY,	III
President

JEFFREY	A.	TOWNSEND
Executive	Vice	President

MICHAEL	R.	NILL
Executive	Vice	President	 
&	Chief	Engineering	Officer

MICHAEL	G.	VALENTINE
Executive	Vice	President 
&	General	Manager,	United	States

MARC	G.	NAUGHTON
Senior	Vice	President
&	Chief	Financial	Officer

JULIA	M.	WILSON
Senior	Vice	President	
&	Chief	People	Officer

13

 
  Appendix: Cerner’s Business Model and Financial Assessment

Introduction

This	appendix	is	our	annual	discussion	of	our	business	model	and	financial	performance.	Note	that	some	of	the	results	in	this	
discussion	reflect	adjustments	compared	to	results	reported	on	a	Generally	Accepted	Accounting	Principles	(GAAP)	basis	in	our	
Form	10-Ks	on	file	with	the	Securities	and	Exchange	Commission	(SEC).	Non-GAAP	results	should	not	be	substituted	as	a	measure	
of	 our	 performance	 but	 instead	 may	 be	 used	 along	 with	 GAAP	 results	 as	 a	 supplemental	 measure	 of	 financial	 performance.	
Non-GAAP	results	are	used	by	management	along	with	GAAP	results	to	analyze	our	business,	make	strategic	decisions,	assess	
long-term	trends	on	a	comparable	basis	and	for	management	compensation	purposes.	Please	see	the	end	of	this	appendix	for	a	
reconciliation	of	non-GAAP	items	to	GAAP	results.

The Cerner Business Model

The core of Cerner’s business model is the creation of intellectual property (IP) in the form of software and other types of digital 
content.	 Our	 software	 is	 bundled	 with	 other	 technologies	 and	 services	 to	 create	 complete	 clinical	 and	 business	 solutions	 for	
healthcare	providers.	In	short,	we	build	it,	sell	it,	deliver	it	and	support	it	for	healthcare	provider	organizations	around	the	world	
(“it”	in	this	context	refers	to	the	solutions	Cerner	creates	for	healthcare	organizations).	In	our	opinion,	we	have	a	healthy	business	
model	that	has	improved	over	the	last	several	years.	Below	is	a	graphical	representation	of	Cerner’s	business	model	showing	a	
top-to-bottom	flow	of	how	we	convert	new	business	opportunities	and	our	backlog	into	revenue	and	earnings.	

At the top of our model is our Sales Pipeline	of	potential	future	business	opportunities	we	have	identified	in	the	marketplace.	Our	
pipeline has increased substantially over the past 
several	years,	reflecting	both	a	strong	domestic	and	
global market for our solutions and our leadership 
position  in  the  healthcare  information  technology 
marketplace.

New Contract Bookings: $1.5 billion

Support
Contracts

Sales Pipeline

During	 each	 quarter,	 we	 sign	 new	 contracts	 to	
deliver	 our	 solutions	 to	 clients.	 These	 contract	
signings  are  reported  as  New  Contract  Bookings 
and become part of our Contract Backlog.	A	typical	
new contract will impact our revenues in the current 
quarter	and	for	the	next	several	quarters,	or	even	
years,	depending	on	how	the	licenses,	technology,	
subscriptions/transactions,	managed	services	and	
professional	services	are	delivered.	

Almost  all  of  our  client  contracts  will  also  contain 
for  Support  Contracts 
provisions 
in  which 
Cerner  agrees  to  provide  a  broad  set  of  services 
that  support  our  clients’  use  of  our  solutions  in 
demanding	clinical	settings.	This	support	includes	
addressing technical issues related to our software 
and providing access to future releases of licensed 
software.	We	also	provide	support	and	maintenance	
agreements for third party software and hardware 
that	we	resell	to	our	clients.

Contract Backlog: $2.9 billion

Support Backlog: 
$580 million

Licensed
Software
$255M

System Sales 

Technology
$172M

Total 2008 Revenue = $1,676M

Services, Support & Maintenance  

Subscriptions/
Transactions
$95M

Professional
Services
$444M

Managed
Services
$200M

Support &
Maintenance
$472M

Note: Total Revenue 
includes $38M 
of reimbursed 
travel revenue

x88%

x12%

$223M

$21M

x50%

$47M

x29%

x26%

$129M

$52M

x72%

$340M

Contribution Margin % 

Total 2008 Contribution Margin =
$812M (48% of Revenue)

Contribution Margin $

Less:
Indirect Costs

R & D
16% of revenue
($269M)

SG & A
14% of revenue
($241M)

($510M)
($29M)*

Operating Margin

+

D&A

=

$273M, 17%

$170M

EBITDA
$443M
27%

*Operating Margin calculation excludes $29M UK Revenue and Margin Catch Up ($273M/$1,647M = 17%). 

Less: Taxes &
Net Int. Exp./Other Income

Taxes
($93M)

Net Interest
Exp./Other Income
$3M

($90M)

Continuing	 with	 our	 top-down	 business	 model	
flow,	 the	 value	 of	 the	 new	 contract	 bookings	 and	
support contracts rolls into our Contract Backlog 
and  Support  Backlog,	 respectively.	 Even	 though	
almost	all	of	our	systems	are	in	service	for	decades,	
our  reported  Support  Backlog  only  includes  the 
expected  value  for  one  year  of  support  revenue 
for	 all	 of	 our	 client	 support	 contracts.	 We	 have	 historically	 reported	 the	 value	 of	 these	 backlogs	 because	 we	 believe	 they	 are	
important	 to	 our	 shareholders’	 ability	 to	 interpret	 the	 overall	 health	 of	 our	 business.	 Our	 total	 backlog	 (signed	 contracts	 with	

Earnings Per Share
$2.19

÷
83M
Shares

Net Earnings

$183M

14

 unrecognized	revenues	and	one	year	of	support	for	all	support	contracts)	ended	2008	at	approximately	$3.5	billion	and	grew	at	
healthy	compounded	annual	rates	of	18%,	23%	and	22%	over	the	past	3,	5	and	10	years.

At	the	core	of	our	business	model	are	our	various	revenue	streams	and	the	contribution	each	stream	makes	toward	the	profitability	
of	Cerner.	The	contribution	is	stated	as	the	recognized	revenue	less	the	direct	cost	to	produce	that	revenue.	On	our	business	model,	
we	have	depicted	six	revenue	categories	that	roll	into	the	two	revenue	line	items	on	our	income	statement.	Licensed Software,	
Technology and Subscriptions/Transactions make up the System Sales	line	of	our	income	statement,	and	Professional Services,	
Managed Services and Support & Maintenance make up the Services, Support & Maintenance	line.	Here	is	a	description	of	
each	revenue	stream:	

	   Licensed Software. We	develop	and	license	IP	(our	architectures,	application	software,	executable	and	referential	

knowledge,	data	and	algorithms)	to	our	clients.	Our	standard	license	is	perpetual—providing	our	clients	permanent	rights	
to	use	the	software	they	purchase.	This	approach	contrasts	with	the	approach	of	most	of	our	competitors	who	are	always	
trying	to	sell	“upgrades”	to	their	clients.	We	believe	our	approach	is	part	of	the	reason	we	have	so	many	long-term	client	
relationships—some	longer	than	25	years.	We	recognize	revenues	from	licensed	software	as	we	achieve	pre-defined	client	
engagement	milestones,	such	as	delivery	and	installation	of	our	software.	In	2008,	licensed	software	revenue	grew	7%	and	
represented	15%	of	total	revenue	with	a	profit	contribution	of	88%.		

	   Technology. We	bundle	licensed	software	with	other	companies’	IP	(e.g.,	that	of	HP,	IBM,	Microsoft,	Oracle)	in	the	form	of	

sublicenses	to	create	complete	technology	solutions	for	our	clients.	We	also	resell	bundled	computer	equipment	(hardware)	
from	technology	companies	to	create	a	completely	functional	system.	We	recognize	revenues	from	technology	resale	as	the	
equipment	is	delivered	to	our	clients.	In	2008,	these	revenues	grew	1%	and	represented	approximately	10%	of	total	revenue	
with	a	profit	contribution	of	12%.	Even	at	lower	margins	than	the	rest	of	our	revenue	streams,	technology	resale	is	valuable	
to	Cerner	as	it	is	a	driver	of	other	high	margin,	high	visibility	revenue,	such	as	technical	services,	sublicensed	software	
support,	and	equipment	maintenance.	As	discussed	in	past	years,	the	resale	of	hardware	has	been	impacted	by	a	trend	
of our clients electing to have Cerner host their Cerner Millennium® systems instead of buying the hardware upfront from 
us	and	hosting	it	themselves.	This	trend	shifts	revenue	from	the	Technology	element	of	our	revenue	stream	to	Managed	
Services.	This	is	a	fundamentally	good	trend	as	a	lower	margin	one-time	revenue	stream	is	replaced	by	a	higher-margin	
and	longer-term	managed	services	revenue	stream.	We	believe	traditional	technology	sales	will	continue	to	be	pressured	by	
this	trend,	but	we	have	been	building	new	channels,	such	
as relationships with device manufactures to resell their 
devices to our clients as part of our CareAware™ solutions 
initiative.	We	also	expect	this	business	model	to	benefit	as	
sales of our RxStation™ medication dispensing units ramp 
up	in	coming	years.	

Cerner 2008 Revenue Mix

Managed
Services
12%

	   Subscriptions/Transactions. Another method by which 

we provide IP is based on a subscription model that has a 
periodic	usage	charge.	This	is	the	primary	way	we	package	
and	provide	medical	knowledge,	which	changes	based	
on research and can be updated independently from the 
software	in	which	it	is	embedded.	Also	included	in	this	
category of revenue is our Electronic Data Interchange 
(EDI)	transaction	revenue.	EDI	is	the	electronic	transfer	
of	data	between	healthcare	providers	and	payers.	Both	
the subscription and transaction revenue streams are 
generally	recognized	monthly,	and	in	2008	they	grew	4%	
and	represented	6%	of	total	revenue	with	a	profit	contribution	of	50%.

Subscription/
Transaction, 6%

Professional
Services
27%

Support &
Maintenance
28%

Technology
10%

Licensed
Software
15%

Reimbursed
Travel, 2%

	   Professional Services. We	provide	a	wide	range	of	professional	services	to	assist	our	clients	in	the	implementation	of	our	

information	systems	in	their	organizations.	These	services	are	in	the	form	of	project	management,	technical	and	application	
expertise,	and	education	and	training	of	our	clients’	workforce	to	assist	in	the	construction	and	implementation	of	our	
systems.	We	recognize	revenues	associated	with	these	consulting	activities	as	they	are	provided	to	our	clients.	In	2008,	
these	revenues	grew	1%	and	represented	approximately	27%	of	total	revenue	with	a	profit	contribution	of	29%.	The	growth	
of	this	revenue	in	2008	was	impacted	by	a	slowdown	in	our	projects	in	England	and	slightly	lower	billable	headcount	in	the	
U.S.	Additionally,	some	of	the	slowdown	in	services	revenue	is	attributable	to	the	success	of	business	efficiency	initiatives	

15

that have allowed us to continue meeting our clients’ services needs without increasing headcount; this has been a positive 
for	our	clients	and	competitively	because	it	brings	down	the	total	cost	of	ownership	of	our	systems.

	   Managed Services. Through our CernerWorks™	organization,	we	offer	a	set	of	technical	services	that	include	Remote	

Hosting,	Application	Management	Services,	Operational	Management	Services	and	Disaster	Recovery.	Remote	Hosting	is	
the	largest	of	these	offerings,	and	it	involves	Cerner	buying	(out	of	cash	flows)	the	necessary	equipment,	installing	it	in	one	
of	our	data	centers	and	operating	the	entire	system	on	the	client’s	behalf.	The	revenues	for	this	service	and	our	charge	for	
the	equipment	are	recognized	monthly	as	we	provide	the	services.	Most	of	our	clients	choose	to	own	their	own	software	
license,	so	that	portion	of	the	revenue	is	unchanged.	Cerner	owns	the	equipment,	however,	instead	of	selling	it	upfront	to	
the	client;	this	impacts	the	technology	resale	portion	of	the	revenue	as	discussed	above.	A	significant	opportunity	for	Cerner	
in	the	future	is	expanding	the	capabilities	of	CernerWorks	services	to	take	on	more	of	our	clients’	IT	functions.	In	2008,	
Managed	Services	revenue	grew	38%	and	represented	12%	of	total	revenue	with	a	profit	contribution	of	26%.

	   Support & Maintenance. The	final	portion	of	our	revenue	comes	from	the	ongoing	support	and	maintenance	services	we	
provide	after	our	systems	are	in	use	by	our	client	organizations.	Almost	all	of	our	clients	contract	for	these	services.	Clients	
with	support	contracts	get	24x7	access	to	our	Immediate	Response	Center,	which	serves	as	our	“emergency	room”,	as	well	
as	access	to	a	very	knowledgeable	base	of	associates	in	our	Immediate	Answer	Center	for	less	urgent	issues.	In	addition,	
our	clients’	support	payments	give	them	ongoing	access	to	the	latest	releases	of	our	IP.	Cerner	also	provides	support	for	
sublicensed	software	and	maintenance	for	third	party	hardware.	In	2008,	support	and	maintenance	revenue	grew	19%	and	
represented	approximately	28%	of	total	revenue	with	a	profit	contribution	of	72%	(note	that	this	profit	contribution	is	before	
a	charge	for	research	and	development,	which	is	treated	as	an	indirect	expense).	

The	revenue	categories	discussed	above	add	up	to	98%	of	total	revenue.	The	remaining	2%	is	revenue	from	reimbursed	travel	
expenses	related	to	Cerner	associates	traveling	to	client	locations.	This	revenue	has	a	zero	margin	as	it	is	simply	a	pass-through	
of	our	client-related	travel	expenses	that	are	billed	to	our	clients,	but	which	we	are	required	to	report	as	revenue.

The two large indirect expenses in our business model are the costs of our Research and Development (R&D),	which	was	equal	
to	16%	of	revenue	in	2008,	and	the	indirect	portion	of	Selling, General and Administrative (SG&A)	activities,	which	represented	
14%	of	revenue	in	2008.	Cerner	has	a	long	history	of	investing	heavily	in	R&D	and	using	that	investment	to	systematically	expand	
markets	to	create	organic	growth.	We	expect	to	invest	at	least	$1	billion	in	R&D	over	the	next	four	to	five	years,	an	investment	
we	believe	is	unmatched	in	our	industry.	Over	the	next	several	years,	we	expect	the	industrial	strength	of	our	Cerner Millennium 
architecture	and	the	enactment	of	several	initiatives	designed	to	leverage	our	R&D	investments	to	slow	the	rate	of	increase	in	
R&D	spending,	while	continuing	our	strong	record	of	innovation	and	organic	growth.	Similarly,	we	expect	to	take	advantage	of	our	
scalable	business	infrastructure	to	reduce	the	rate	of	increase	in	SG&A	spending	to	below	our	revenue	growth	rate.	We	expect	this	
leverage	to	help	improve	operating	margins	without	impacting	our	ability	to	develop	and	deliver	new	solutions	to	our	clients.

In	2008,	our	overall	operating	margin	of	$273	million	was	16.6%	of	revenue.	This	excludes	$29	million	in	revenue	and	margin	
catch-up	recognized	in	2008	as	part	of	the	ongoing	project	with	our	partner	BT	in	the	United	Kingdom.	The	remaining	items	in	our	
business	model	are	taxes	and	net	interest	expense	and	other	income,	which	totaled	$90	million	in	2008,	leaving	$183	million	of	
net	earnings,	or	$2.19	of	earnings	per	share.	

Assessment of 2008 Financial Results

We	 continued	 to	 focus	 on	 three	 key	 financial	 objectives	 in	
2008:	 growing	 the	 top	 line,	 expanding	 operating	 margins	
and	generating	free	cash	flow.	

Growing the Top Line

Cerner	has	delivered	good	revenue	growth	over	the	long	term.	
Both our new business bookings and revenue have grown at 
double-digit	compound	annual	rates	over	the	past	3,	5	and	
10-year	time	horizons.	In	2008,	we	grew	our	revenue	at	10%	
in	a	challenging	economic	environment.	Notably,	our	global	
business had another very strong year with revenue growing 
27%	and	increasing	from	19%	to	22%	of	total	revenue.

In	 2009,	 the	 challenging	 economic	 environment	 may	 keep	
our	top-line	growth	below	double-digit	rates,	but	we	believe	
we	can	still	deliver	solid	growth	as	HIT	purchases	continue	

)
s
n
o

i
l
l
i

M
$
(
e
u
n
e
v
e
R

$400

$350

$300

$250

$200

$150

$100

$50

0

16

Global Revenue
Percentage of Total Revenue

‘02

‘03

‘04

‘05

‘06

‘07

‘08

25%

20%

15%

10%

%
o
f

T
o
t
a

l

5%

0%

 
 
 
 
 
 to	be	viewed	as	more	strategic	than	most	other	expenditures.	HIT	investments	offer	a	good	return	on	investment,	improve	safety,	
quality	 and	 efficiency,	 and	 help	 providers	 meet	 regulatory,	 compliance	 and	 government	 reimbursement	 models.	 Cerner	 also	
benefits	from	having	an	extensive	client	base	and	being	well-positioned	to	continue	gaining	market	share.	Additionally,	building	on	
our	global	momentum	and	continuing	to	expand	into	new	strategic	areas	provides	Cerner	many	avenues	for	growth.	Longer-term,	
the	HIT	incentives	included	in	the	American	Recovery	and	Reinvestment	Act,	which	became	law	on	February	17,	2009,	represent	
a	significant	opportunity	for	top-line	growth.

Expanding Operating Margins

In	February	2004,	we	mapped	out	our	path	from	the	2003	level	of	9%	operating	margins	to	our	target	of	20%.	We	have	made	
very	good	progress	since	then,	with	our	operating	margin	expanding	over	700	basis	points	to	16.6%	in	2008.	Our	2008	progress	
was	mostly	in	line	with	what	we	communicated	last	year.	We	are	targeting	20%	operating	margins	as	we	exit	2009,	with	a	goal	of	
achieving	20%	for	the	full	year	in	2010.

In	February	2009,	we	updated	our	path	to	20%	operating	margins	to	reflect	actual	results	for	2008.	Below	is	a	description	of	the	
key	elements	of	our	path	to	achieving	20%	operating	margins.

Path to 20% Operating 
Margins

Business Model

2005

2006

2007

2008

2009E

2010E

Actual Contribution Margin

Estimated 
Contribution Margin

‘09-’10 Cumulative 
Impact on Operating 
Margin

Key Assumptions
  ~8% revenue growth

Licensed Software

Technology

  Excludes Options 

Subscription/Transaction

Expense

Professional Services

Managed Services

Support	&	Maintenance

				R&D	(%	of	Total	Rev.)

				SG&A	(%	of	Total	Rev.)

Operating Margin

85%

13%

37%

27%

25%

62%

(18%)

(15%)

13%

84%

11%

43%

27%

25%

65%

(18%)

(15%)

13%

89%

12%

49%

29%

25%

69%

(17%)

(15%)

15%

88%

12%

50%

29%

26%

72%

(16%)

(14%)

17%

88%

13%

51%

30%

26%

73%

(16%)

(14%)

18.5%

88%

14%

52%

31%

26%

74%

(15%)

(14%)

20%

0 bp

35 bp

20 bp

94 bp

0 bp

103 bp

54 bp

36 bp

342 basis points

Highlights	of	the	margin	expansion	drivers	include:

	   Increase profitability of Support & Maintenance.	We	expect	this	to	contribute	approximately	103	basis	points	to	Cerner’s	
operating	margin.	As	we	have	continued	to	harden	the	Cerner Millennium	platform,	our	incremental	cost	to	support	each	
additional	client	has	declined.	We	expect	this	to	continue,	which	will	allow	us	to	expand	the	profitability	of	this	highly	visible	
revenue	stream.

	   Improving Professional Services Margins from 29% in 2008 to 31% by 2010.	We	expect	this	to	contribute	approximately	
94	basis	points	to	Cerner’s	operating	margin.	We	will	continue	to	leverage	our	Solutions	Center	implementation	approach,	
which	has	higher	margins	than	traditional	on-site	projects.	And	ongoing	efficiencies	are	expected	from	initiatives	such	as	our	
Bedrock™	technology,	which	automates	much	of	the	implementation	and	management	of	our	Cerner Millennium information 
platform,	and	MethodM®	implementation	approach,	which	provides	standardized	processes	during	implementation.	These	
initiatives	are	significantly	reducing	the	implementation	costs	for	Cerner	and	our	clients	while	delivering	more	predictable	
outcomes,	allowing	for	margin	expansion	and	a	competitive	advantage	in	the	marketplace.

	   Leverage R&D investments, bringing R&D as a percentage of revenue down from 16% to 15% by 2010. We	expect	this	
to	contribute	approximately	54	basis	points	to	Cerner’s	operating	margin.	Leveraging	our	significant	R&D	investment	and	
common	platform	should	allow	us	to	continue	our	record	of	innovation	while	growing	R&D	spending	at	a	rate	that	is	slower	
than	our	top-line	growth	rate.	The	key	to	doing	this	will	be	our	ability	to	extend	our	solutions	to	new	revenue	opportunities,	
such	as	the	global	marketplace,	without	significant	incremental	costs.	Our	operations	in	India,	which	augment	our	U.S.-
based	development	organization,	will	also	contribute	to	our	ability	to	control	the	growth	of	R&D	spending.

	   Leverage Sales, General and Administrative expenses.	We	expect	this	to	contribute	approximately	36	basis	points	to	

Cerner’s	operating	margin.	We	have	built	a	scalable	business	infrastructure	that	should	allow	us	to	keep	our	SG&A	spending	
growth	rate	lower	than	our	top-line	growth	rate.

	   Increase profitability of Technology Resale. We	expect	this	to	contribute	35	basis	points	to	Cerner’s	operating	margin.		
The primary driver of this will be focusing on getting better margins on hardware sales and increasing the mix of higher 
margin	sublicensed	software	as	a	percent	of	total	technology	resale.

	   Expand Margins and grow revenue in Subscriptions/Transactions Business Model. We	expect	this	to	contribute	20	

basis	points	to	Cerner’s	operating	margin.	This	business	model	is	relatively	immature,	but	has	good	growth	potential,	and	
we	expect	it	to	become	more	profitable	as	it	grows	and	the	fixed	costs	associated	with	supporting	it	are	spread	over	a	higher	
revenue	base.

17

A key point regarding our margin expansion strategy is that we are executing it while our business model is transitioning to more 
visible	 and	recurring	revenue	components.	For	example,	 in	 2000,	 approximately	55%	 of	Cerner’s	revenue	(before	reimbursed	
travel)	came	from	what	we	consider	visible	or	recurring	sources	such	as	Professional	Services,	Managed	Services,	Subscriptions/
Transactions	and	Support	&	Maintenance.	In	2008,	74%	of	our	revenue	came	from	these	sources.

Earnings Growth

With	10%	top-line	growth	and	strong	margin	expansion,	we	grew	our	earnings	26%	in	2008.	Our	3,	5	and	10-year	compound	
annual	earnings	growth	rates	of	29%,	34%	and	23%,	respectively,	reflect	our	ability	to	drive	long-term	earnings	growth.	Going	
forward,	our	top-line	strategies	coupled	with	continued	focus	on	productivity	enhancements	and	margin	expansion	position	us	
well	for	continued	good	earnings	growth.

Generating Cash Flow

A	healthy	business	generates	cash	flow.	Perhaps	our	most	significant	improvement	over	the	past	few	years	has	been	in	our	cash	
flow	performance.	2008	was	a	record	year	of	cash	performance	with	$282	million	of	operating	cash	flow	and	$104	million	of	free	
cash	flow	(operating	cash	flow	less	capital	expenditures	and	capitalized	software).	The	$104	million	of	free	cash	flow	represents	
a substantial improvement from the 2007 level of $28 million as capital expenditures decreased from 2007 levels due to the 
completion of a CernerWorks	data	center	facility	and	decreased	spending	on	other	office	facilities.	Capital	expenditures	in	2009	
are	expected	to	increase	over	2008	levels,	but	we	are	still	expecting	strong	free	cash	flow.

Stock Price

At	Cerner,	we	manage	the	company,	not	the	stock	price.	In	the	short	term,	the	stock	price	can	be	influenced	by	many	factors	beyond	
our	control,	but	we	believe	in	the	long	term	it	will	closely	reflect	the	quality	of	our	decisions.	We	believe	it	is	important	for	our	
shareholders	that	we	focus	on	delivering	strong	long-term	results,	
but we also understand the importance of delivering consistently 
against	short-term	targets.

Operating Cash Flow
Free Cash Flow

$300

$250

The weak broader economy impacted almost all companies and 
stocks	in	2008,	with	the	NASDAQ	Composite	Index	and	S&P	500	
declining	41%	and	38%,	respectively.	And	despite	solid	financial	
results,	Cerner’s	stock	price	finished	the	year	down	32%,	which	
is	 better	 than	 the	 broader	 market	 but	 still	 disappointing.	 When	
measuring	 Cerner’s	 stock	 performance	 over	 the	 5-,	 10-	 and	
20-year	 periods	 using	 compound	 annual	 growth	 rates,	 the	
returns	are	15%,	11%	and	20%,	respectively.		These	returns	are	
significantly	greater	than	the	returns	over	the	same	time	frames	
for	the	NASDAQ	Composite	Index	(-5%,	-3%	and	7%)	and	S&P	500	
(-4%,	-3%	and	6%).

$200

$150

$100

$50

$-

$(50)

‘00

‘01

‘02

‘03

‘04

‘05

‘06

‘07

‘08

*FCF = Operating CF less Capital Expenditures and Capitalized Software

18

 
Reconciliation of 2008 GAAP Results to Non-GAAP Results*

($ in millions except Earnings Per Share)

GAAP Operating Earnings

Share-based	compensation	expense

Research	and	Development	write-off

Revenue and Margin catch up related to London Contract

Adjusted Operating Earnings

GAAP Net Earnings

Share-based	compensation	expense

Income	tax	benefit	of	share-based	compensation

Third Party Supplier Settlement

     Tax Effect

Revenue and Margin catch up related to London Contract

     Tax Effect

Adjusted Net Earnings (non-GAAP)

Operating 
Earnings

Revenue

Operating 
Margin %

279

$

1,676

16.6%

15

8

(29)

273

$

$

(29)

1,647

Net 
Earnings

189

15

(6)

8

(3)

(29)

8

183

16.6%

Diluted 
Earnings 
Per Share

2.26

0.18

(0.07)

0.10

(0.04)

(0.34)

0.10

2.19

$

$

$

$

$

$

$

$

$

* The above reconciliation of GAAP Net Earnings to Adjusted Net Earnings has been updated from the printed version of the Annual Report to replace incorrect information. 

The incorrect information was only in this table. There have been no changes to GAAP or Adjusted Net Earnings.

*More detail on these adjustments and management’s use of Non-GAAP results is in our 2008 Form 10-K and 8-Ks

19

 
20

 
ANNUAL REPORT 2008
FORM 10-K

21

 
(cid:58) 

(cid:134) 

UNITED STATES 
SECURITIES AND EXCHANGE COMMISSION 
WASHINGTON, D.C. 20549 

FORM 10-K 

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE 
SECURITIES EXCHANGE ACT OF 1934 

For the fiscal year ended: January 3, 2009 
OR 
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE 
SECURITIES EXCHANGE ACT OF 1934 

For the transition period from ____________ to ____________ 

Commission file number:  0-15386 

CERNER CORPORATION 
(Exact name of registrant as specified in its charter) 

Delaware 
(State or other jurisdiction of 
Incorporation or organization) 

2800 Rockcreek Parkway 
North Kansas City, MO 
(Address of principal executive offices) 

43-1196944 
(I.R.S. Employer 
Identification No.) 

64117 
(Zip Code) 

(816) 221-1024 
(Registrant’s telephone number, including area code) 
None 
(Former name, former address and former fiscal year, if changed since last report) 
Securities registered pursuant to Section 12(b) of the Act: 
Common Stock, $.01 par value per share 
(Title of Class) 

NASDAQ Stock Market 
(Name of exchange on which registered) 

Securities registered pursuant to Section 12(g) of the Act:  None 

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. 

Yes [X] 

No  [  ] 

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Exchange Act. 

Yes [  ] 

No  [X] 

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 
1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such 
filing requirements for the past 90 days. 

Yes [X] 

No  [  ] 

Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein, and will not be contained, to 

the best of registrant's knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment 
to this Form 10-K.  [X] 

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting 

company.  See definition of “accelerated filer,” “large accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act. 

Large accelerated filer [X]      Accelerated filer [   ]  Non-accelerated filer  [   ] 

Smaller reporting company [  ] 

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). 

Yes [   ] 

No  [X] 

As of June 28, 2008, the aggregate market value of the registrant’s common stock held by non-affiliates of the registrant was $3,185,026,997 

based on the closing sale price as reported on the NASDAQ Global Select Market. 

Indicate the number of shares outstanding of each of the issuer’s classes of common stock, as of the latest practicable date. 

Class 
[Common Stock, $.01 par value per share] 

Outstanding at February 20, 2009 
80,327,565 shares 

DOCUMENTS INCORPORATED BY REFERENCE 
Document 

Proxy Statement for the Annual Shareholders’ Meeting to be held May 22, 2009 (Proxy Statement) 

Parts Into Which 
Incorporated 

Part III 

22 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PART I 
Item 1. Business 
Overview 
Cerner  Corporation  (“Cerner”  or  the  “Company”)  is  a  Delaware  business  corporation  formed  in  1980.  The  Company’s  corporate 
headquarters are located at 2800 Rockcreek Parkway, North Kansas City, Missouri 64117. Its telephone number is 816.221.1024. The 
Company’s Web site address, which is used by the Company to communicate important business information concerning the Company, 
can be accessed at:  www.cerner.com. The Company makes available free of charge, on or through its Web site, its annual report on Form 
10-K, quarterly reports on Form  10-Q, current reports on Form 8-K and all amendments to those reports as soon as reasonably practicable 
after such material is electronically filed with or furnished to the Securities and Exchange Commission. 

Cerner is a supplier of healthcare information technology (HIT) solutions, healthcare devices and related services. Organizations ranging 
from single-doctor practices, to hospitals, corporations, and local, regional and national governments use Cerner® solutions and services to 
make healthcare safer, more efficient and of higher quality. 

The Company’s software solutions have been designed and developed on the unified Cerner Millennium® architecture. This person-centric 
solution  framework  combines  clinical,  financial  and  management  information  systems.  It  provides  secure  access  to  an  individual’s 
electronic  medical  record  at  the  point  of  care  and  organizes  and  proactively  delivers  information  to  meet  the  specific  needs  of  the 
physician, nurse, laboratory technician, pharmacist or other care provider, front- and back-office professionals and even consumers.   

The Company’s CareAware™ architecture extends these links by connecting information from various devices to the clinician workflow and 
electronic medical record.  

Cerner also offers a broad range of services, including implementation and training, remote hosting, operational management services, 
support and maintenance, healthcare data analysis, clinical process optimization, transaction processing, employer clinics and employer 
health plan third party administrator (TPA) services.   

The Healthcare and Healthcare IT Industry 
The  turbulence  in  the  worldwide  economy  has  impacted  almost  all  industries.    While  healthcare  is  not  immune  to  economic 
cycles, we believe it is more resilient than most segments of the economy.  The impact of the current economic conditions on 
our existing and prospective clients has been mixed.  We continue to see organizations that are doing fairly well operationally, 
but  many  are  dealing  with  a  reduction  in  their  foundation  investment  portfolios  caused  by  the  general  market  decline.    In 
addition,  organizations  with  a  large  dependency  on  Medicaid  populations  are  being  impacted  by  the  challenging  financial 
condition of many state governments. 

The result of these challenges is that healthcare organizations are becoming more selective regarding where they invest capital, 
resulting in a focus on strategic spending that generates a return on their investment.  In the current environment, many HIT 
solutions are viewed as being more strategic to healthcare organizations than other possible purchases because the solutions 
offer  quick  return  on  investment.    HIT  solutions  also  play  an  important  role  in  healthcare  by  improving  safety,  efficiency  and 
reducing cost. And most healthcare providers also recognize that they must invest in HIT to meet current and future regulatory, 
compliance and government reimbursement models.   

Overall,  while  the  economy  has  certainly  impacted  and  could  continue  to  impact  our  business,  we  believe  there  are  several 
macro  trends  that  are  good  for  the  HIT  industry.    One  example  is  the  continued  need  to  curb  the  growth  of  U.S.  healthcare 
spending, which is estimated at more than $2 trillion or 17 percent of our Gross Domestic Product.  In the U.S., politicians and 
policy makers agree that the current rate of growth of our healthcare system is unsustainable. And leaders of both parties say 
the  intelligent  use  of  information  systems  will  improve  health  outcomes  and,  correspondingly,  drive  down  costs.    They  cite  a 
2005 study by  RAND Corp., which found  that the widespread  adoption of HIT in the U.S. could cut healthcare costs by $162 
billion.  Although policy experts have different opinions on the rates of HIT adoption and how quickly benefits can be realized, 
there is consensus that HIT has the potential to contribute to significant cost savings. 

Another  positive  for  the  U.S.  healthcare  and  HIT  industries  is  the  fact  that  the  Obama  administration  appears  likely  to  follow 
through on campaign commitments to pursue broad healthcare reform aimed at improving healthcare’s systemic issues. The 
American  Recovery  and  Reinvestment  Act,  which  became  law  on  February  17,  2009,  includes  more  than  $19  billion  to  help 
healthcare  organizations  modernize  operations  through  the  acquisition  and  wide-spread  use  of  HIT.  While  Cerner  does  not 
expect  an  immediate  boost  from  these  HIT  provisions,  the  longer-term  potential  could  be  significant.  Our  large  footprint  in 
hospitals  and  physician  practices,  together  with  our  proven  ability  to  deliver  value,  positions  us  well  to  benefit  from  these 
incentives. Additionally, the Act is expected to provide states with badly needed Medicaid dollars, which should help improve the 
financial health of hospitals and potentially free them to make HIT investments.  

It is also important to note that most other countries are also grappling with increasing healthcare spending, safety concerns 
and inefficient care, a fact that creates a favorable international market for HIT solutions and related services. 

23 

 
 
 
 
 
 
 
 
 
 
 
 
 
In summary, while the current economic environment has impacted our business, we believe the fundamental value proposition 
of  HIT  remains  intact.    And  the  HIT  industry  will  likely  benefit  from  the  increased  recognition  by  healthcare  providers  and 
governments that HIT contributes to safer and more efficient healthcare. 

Cerner Vision  
Cerner’s vision has evolved from a fundamental thought: Healthcare should revolve around the individual, not the encounter. This concept 
led to Cerner’s vision of a Community Health Model and the creation of the unified Cerner Millennium architecture, the Company’s person-
centric, enterprise-wide solution framework. The Community Health Model encompasses four steps: 

Automate the Care Process 
Cerner offers a longitudinal, person-centric electronic medical record, giving clinicians electronic access to the right information at the right 
time and place to achieve the optimal health outcome. 

Connect the Person 
Cerner  is  dedicated  to  building  a  personal  health  system.  Medical  information  and  care  regimens  accessible  from  home  empower 
consumers  to  effectively  manage  their  conditions  and  adhere  to  treatment  plans,  creating  a  new  medium  between  physicians  and 
individuals. 

Structure the Knowledge 
Cerner is dedicated to building systems that help bring the best science to every medical decision by structuring, storing and studying the 
content surrounding each care episode to achieve optimal clinical and financial outcomes. 

Close the Loop 
Incorporating a medical discovery into daily practice can take as long as 10 years. Cerner is dedicated to building systems that implement 
evidence-based medicine, reducing the average time from the discovery of an improved method to the change in the standard of care. 

As our vision evolves, Cerner expects medicine will become increasingly personalized and technology more accessible. As such, we are 
creating new solutions for large user communities, including strategies to: 

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(cid:131) 

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Connect all stakeholders in the healthcare system, including payers (employers and governments), providers and consumers 

Remove clinical, financial and administrative friction 

Create a secure, transparent and open network for data sharing to improve disease management and facilitate personalized 
medicine 

Achieving this vision will require continued leverage of the Cerner Millennium architecture and ongoing expansion of our solutions and 
services, as discussed below. 

Cerner Strategy and Execution 
The Company’s business strategies are anchored by our industry-leading solution and device architectures, the breadth and depth of our 
solutions and services, and, most importantly, the success of our clients. 

Leveraging these strengths, Cerner is working to increase market penetration in both the domestic and global markets by: developing and 
cross-selling innovative solutions, devices and services to existing and new clients; offering physician practices high-value solutions with low 
up-front and recurring costs; using clinical databases to help pharmaceutical companies monitor safety and speed drug approval; reducing 
healthcare friction for employers and connecting healthcare devices. 

Examples of these strategies include: 

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(cid:131) 

(cid:131) 

Health plan TPA services; and employer-based, primary care clinics and other innovative solutions (HealtheSM employer services) 

Healthcare device innovation, including Cerner’s CareAware device connectivity platform and RxStation™ medication dispensing 
devices 

A consulting practice that works with clients to discover relationships among healthcare processes and outcomes (Millennium 
Lighthouse® clinical process optimization) 

Solutions and services that leverage the clinical data captured in the digital healthcare environment to help discern relationships 
between pharmaceutical therapies and resulting clinical outcomes (Health Facts®) 

A low-cost, high-value suite of remote-hosted offerings for physician practices’ clinical and revenue cycle needs (PowerWorks®) 

Technology that enables clients to import audio, video and still images into electronic medical records (Cerner Imaging) 

As  we  work  to  improve  these  solutions,  devices  and  services,  we  remain  focused  on  making  implementations  more  efficient  and 
predictable. Our goal is to reduce the total cost of ownership for our clients.  By automating the implementation and management of the 
Cerner Millennium platform through Bedrock, together with our best-practice implementation approach, MethodM®, we can reduce the 

24 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
total hours of effort needed to implement a system while also making the outcome more predictable. We also can reduce the upfront 
hardware costs and ongoing technology risks through our remote-hosted, managed services offering, CernerWorks™.  

Additionally, we offer a surveillance system called the LightsOn NetworkSM that identifies system performance issues in real time and has 
the  ability  to  predict  issues  that  could  create  system  vulnerability.  With  more  than  300  participating  clients, LightsOn  has  become  an 
evidence-based network that enhances system performance and allows our clients to maximize the value they gain from our systems. 

Through  these  strategies  above  and  our  ongoing  focus  on  improving  our  clients’  experience,  we  aim  to  deliver  the  optimal  client 
experience, nurturing important relationships with existing clients and creating opportunities to establish new ones.  

Software Development  
Cerner continues to build upon the success of the Cerner Millennium 2007 software release that became generally available in late 2006. 
Our  client  base  has  been  rapidly  adopting  the  release,  and  based  on  feedback  from  clients,  Cerner  decided  to  leverage  the  Cerner 
Millennium 2007 platform for all future innovations and enhancements through the end of the decade. Understanding the effort involved 
with major release upgrades and the impact on our clients, this strategy will allow clients already using Cerner Millennium 2007 to take 
advantage of new enhancements and functionality without requiring a major code upgrade.  

We  commit  significant  resources  to  developing  new  health  information  system  solutions.  As  of  January  3,  2009,  approximately  2,300 
associates  were  engaged  in  research  and  development  activities.  Total  expenditures  for  the  development  and  enhancement  of  our 
software solutions and RxStation medication dispensing devices were approximately $291,368,000, $283,086,000, and $262,163,000 
during  the  2008,  2007  and  2006  fiscal  years,  respectively.  These  figures  include  both  capitalized  and  non-capitalized  portions  and 
exclude amounts amortized for financial reporting purposes.  

As discussed above, continued investment in research and development remains a core element of Cerner’s strategy. This will include 
ongoing enhancement of our core solutions and development of new solutions and services. 

The Company is committed to maintaining open attributes in its system architecture to achieve operability in a diverse set of technical and 
application environments. The Company strives to design its systems to co-exist with disparate applications developed and supported by 
other suppliers.  

Sales and Marketing   
The  markets  for  Cerner  HIT  solutions,  healthcare  devices  and  services  include  integrated  delivery  networks,  physician  groups  and 
networks,  managed  care  organizations,  hospitals,  medical  centers,  free-standing  reference  laboratories,  home  health  agencies,  blood 
banks, imaging centers, pharmacies, pharmaceutical manufacturers, employers and public health organizations. To date, a substantial 
portion  of  system  sales  have  been  in  clinical  solutions  in  hospital-based  provider  organizations.  The  Cerner  Millennium  architecture  is 
highly  scalable.  Organizations  ranging  from  several-doctor  physician  practices,  to  community  hospitals,  to  complex  integrated  delivery 
networks, to local, regional and national government agencies use our Cerner Millennium solutions.  

We design all Cerner Millennium solutions to operate on HP or IBM platforms, allowing Cerner to be price competitive across the full size 
and  organizational  structure  range  of  healthcare  providers.  The  sale  of  a  Cerner  software  health  information  system  usually  takes 
approximately nine to 18 months, from the time of initial contact to the signing of a contract.  

Our executive marketing management is located in our North Kansas City, Missouri headquarters, while our client representatives are 
deployed across the United States and globally. In addition to the U.S., the Company, through subsidiaries and joint ventures, has sales 
associates  and/or  offices  in  Australia,  Canada,  England,  France,  Germany,  China  (Hong  Kong),  India,  Ireland,  Malaysia,  Saudi  Arabia, 
Singapore, Spain and the United Arab Emirates. Cerner’s consolidated revenues include non-U.S. sales of $368,518,000, $290,677,000 
and $207,367,000 for the 2008, 2007 and 2006 fiscal years, respectively. 

The Company supports its sales force with technical personnel who perform demonstrations of Cerner solutions and services and assist 
clients in determining the proper hardware and software configurations. The Company's primary direct marketing strategy is to generate 
sales  contacts  from  its  existing  client  base  and  through  presentations  at  industry  seminars  and  tradeshows.  Cerner  markets  the 
PowerWorks solutions, offered on a subscription basis, directly to the physician practice market using telemarketing and through existing 
acute care clients that are looking to extend Cerner solutions to affiliated physicians. Cerner attends a number of major tradeshows each 
year  and  sponsors  executive  user  conferences,  which  feature  industry  experts  who  address  the  HIT  needs  of  large  healthcare 
organizations. 

Client Services   
Substantially all of Cerner's HIT software solutions clients enter into software maintenance agreements with us for support of their Cerner 
systems. In addition to immediate software support in the event of problems, these agreements allow clients the use of new releases of 
the Cerner solutions covered by maintenance agreements. Each client has 24-hour access to the client support team located at Cerner's 
world headquarters in North Kansas City, Missouri and the Company’s global support organization in England. 

Most  Cerner  clients  who  buy  hardware  through  Cerner  also  enter  into  hardware  maintenance  agreements  with  Cerner.  These 
arrangements  normally  provide  for  a  fixed  monthly  fee  for  specified  services.  In  the  majority  of  cases,  Cerner  subcontracts  hardware 

25 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
maintenance  to  the  hardware  manufacturer.  Cerner  also  offers  a  set  of  managed  services  that  include  remote  hosting,  operational 
management services and disaster recovery. 

Backlog  
At January 3, 2009, Cerner had a contract backlog of approximately $2,907,762,000 as compared to approximately $2,712,195,000 at 
December 29, 2007. Such backlog represents system sales and services from signed contracts that have not yet been recognized as 
revenue. At January 3, 2009, the Company had approximately $141,014,000 of contracts receivable compared to $129,604,000 at the 
end of 2007, which represents revenues recognized but not yet billable under the terms of the contract. At January 3, 2009, Cerner had a 
software support and maintenance backlog of approximately $580,915,000 as compared to approximately $541,095,000 at December 
29,  2007.  Such backlog  represents  contracted  software  support  and  hardware  maintenance  services  for  a  period  of  12  months.  The 
Company estimates that approximately 38 percent of the aggregate backlog at January 3, 2009 of $3,488,677,000 will be recognized as 
revenue during 2009.  

Competition   
The market for HIT solutions, devices and services is intensely competitive, rapidly evolving and subject to rapid technological 
change.    Our  principal  existing  competitors  in  the  healthcare  solutions  and  services  market  include:  Computer  Programs  and 
Systems,  Inc.,  Eclipsys  Corporation,  Epic  Systems  Corporation,  GE  Healthcare  Technologies,  iSoft  Corporation  (an  IBA  Health 
Group  Company),  McKesson  Corporation,  Medical  Information  Technology,  Inc.  (“Meditech”),  Misys  Healthcare  Systems  and 
Siemens Medical Solutions Health Services Corporation, each of which offers a suite of software solutions that compete with 
many of our software solutions and services.  Other competitors focus on only a portion of the market that Cerner addresses.  
For example, competitors such as Capgemini, Computer Sciences Corp., Deloitte LLP, IBM Corporation and Perot Systems offer 
HIT services that compete directly with our consulting services.  Allscripts-Misys Healthcare Solutions, Inc., athenahealth, Inc., 
eClinicalWorks, Inc., Emdeon Corporation and Quality Systems, Inc. offer solutions to the physician practice market but do not 
currently  have  a  significant  presence  in  the  health  systems  and  independent  hospital  market.    We  view  our  principal 
competitors in the healthcare device market to include: Cardinal Health, Inc., McKesson Corporation, Omnicell, Inc. and Royal 
Philips Electronics; and we view our principal competitors in the healthcare transactions market to include: Accenture, Emdeon 
Corporation, McKesson Corporation, ProxyMed, Inc. (d/b/a MedAvant Healthcare Solutions) and The TriZetto Group, Inc., with 
almost  all  of  these  competitors  being  substantially  larger  or  having  more  experience  and  market  share  than  us  in  their 
respective  market.    In  addition,  we  expect  that  major  software  information  systems  companies,  large  information  technology 
consulting service providers and system integrators, start-up companies, managed care companies and others specializing in 
the healthcare industry may offer competitive software solutions, devices or services.  The pace of change in the HIT market is 
rapid  and  there  are  frequent  new  software  solutions,  devices  or  service  introductions,  enhancements  and  evolving  industry 
standards and requirements.  We believe that the principal competitive factors in this market include the breadth and quality of 
solution and service offerings, the stability of the solution provider, the features and capabilities of the information systems and 
devices, the ongoing support for the systems and devices and the potential for enhancements and future compatible software 
solutions and devices. 

Number of Employees (“Associates”) 
As of January 3, 2009, the Company employed approximately 7,500 associates worldwide. 

Operating Segments 
Information about the Company’s operating segments may be found in Note 14 to the financial statements. 

Geographic Areas 
Information about the Company’s geographic areas may be found in Item 7 Management’s Discussion and Analysis of Financial 
Condition and Results of Operations below and in Note 14 to the financial statements. 

Item 1A.  Risk Factors 
Risks Related to Cerner Corporation 
We may be subject to product-related liabilities.  Many of our software solutions, healthcare devices or services (including life 
sciences/research services) provide data for use by healthcare providers in providing care to patients.  Although we maintain 
liability  insurance  coverage  in an  amount  that  we believe  is  sufficient  for  our  business,  there can  be  no  assurance  that  such 
coverage will cover any particular claim that has been brought or that may be brought in the future, prove to be adequate or that 
such coverage will continue to remain available on acceptable terms, if at all.  A successful material claim brought against us, if 
uninsured or under-insured, could materially harm our business, results of operations and financial condition.  Product-related 
claims could damage our reputation, cause us to lose existing clients, limit our ability to obtain new clients, result in revenues 
loss, create potential liabilities for our clients and us and increase insurance and other operational costs. 

We may be subject to claims for system errors and warranties. Our software solutions and healthcare devices, particularly the 
Cerner  Millennium  versions,  are  very  complex.    Our  software  solutions  and  healthcare  devices  may  contain  coding  or  other 
errors, especially when first introduced.  We have discovered errors in our software solutions and healthcare devices after their 
introduction.  Our software solutions and healthcare devices are intended for use in collecting and displaying clinical information 
used  in  the  diagnosis  and  treatment  of  patients.    Therefore,  users  of  our  software  solutions  and  healthcare  devices  have  a 
greater sensitivity to errors than the market for software products and devices generally.  Our client agreements typically provide 

26 

 
 
 
 
 
 
 
 
 
 
warranties  concerning  material  errors  and  other  matters.    Failure  of  a  client's  Cerner  software  solutions  and/or  healthcare 
devices to meet these warranties could constitute a material breach under the client agreement, allowing the client to terminate 
the agreement and possibly obtain a refund and/or damages, or might require us to incur additional expense in order to make 
the software solution or healthcare device meet these criteria.  Our client agreements generally  limit our  liability arising from 
such  claims  but  such  limits  may  not  be  enforceable  in  certain  jurisdictions  or  circumstances.    Although  we  maintain  liability 
insurance coverage in an amount that we believe is sufficient for our business, there can be no assurance that such coverage 
will cover any particular claim that has been brought or that may be brought in the future, prove to be adequate or that such 
coverage will continue to remain available on acceptable terms, if at all.  A successful material claim or series of claims brought 
against us, if uninsured or under-insured, could materially harm our business, results of operations and financial condition.   

We  may  experience  interruption  at  our  data  centers  or  client  support  facilities.    We  perform  data  center  and/or  hosting 
services  for  certain  clients,  including  the  storage  of  critical  patient  and  administrative  data.    In  addition,  we  provide  support 
services to our clients through various client support facilities.  We have invested in reliability features such as multiple power 
feeds,  multiple  backup  generators  and  redundant  telecommunications  lines,  as  well  as  technical  and  physical  security 
safeguards, and structured our operations to reduce the likelihood of disruptions.  However, complete failure of all generators, 
impairment of all telecommunications lines, damage (environmental, accidental, intentional or pandemic) to the buildings, the 
equipment  inside  the  buildings  housing  our  data  centers,  the  client  data  contained  therein  and/or  the  personnel  trained  to 
operate such facilities could cause a disruption in operations and negatively impact clients who depend on us for data center 
and system support services.  Any interruption in operations at our data centers and/or client support facilities could damage 
our reputation,  cause us to lose existing clients, hurt our  ability to obtain new clients, result in  revenue  loss, create potential 
liabilities for our clients and us and increase insurance and other operating costs. 

Our proprietary technology may be subject to claims for infringement or misappropriation of intellectual property rights of 
others, or may be infringed or misappropriated by others.  We rely upon a combination of license agreements, confidentiality 
procedures,  employee  nondisclosure  agreements,  confidentiality  agreements  with  third  parties  and  technical  measures  to 
maintain the confidentiality and trade secrecy of our proprietary information.  We also rely on trademark and copyright laws to 
protect our intellectual property rights in the United States and abroad.  We continue to develop our patent portfolio of U.S. and 
global  patents,  but  currently  have  a  limited  number  of  issued  patents.    Despite  our  protective  measures  and  intellectual 
property rights, we may not be able to adequately protect against copying, reverse-engineering, misappropriation, infringement 
or unauthorized use or disclosure of our intellectual property. 

In addition, we are routinely involved in intellectual property infringement or misappropriation claims and we expect this activity 
to continue or even increase as the number of competitors, patents and patent enforcement organizations in the HIT market 
increases,  the  functionality  of  our  software  solutions  and  services  expands,  and  we  enter  new  markets  such  as  healthcare 
device innovation, healthcare transactions and life sciences.  These claims, even if not meritorious, are expensive to defend.  If 
we become liable to third parties for infringing or misappropriating their intellectual property rights, we could be required to pay 
a  substantial  damage  award,  develop  alternative  technology,  obtain  a  license  and/or  cease  using,  selling,  licensing, 
implementing and supporting the solutions, devices and services that violate the intellectual property rights. 

We  are  subject  to  risks  associated  with  our  non-U.S.  operations.    We  market,  sell  and  service  our  solutions,  devices  and 
services globally.  We have established offices around the world, including in: the Americas, Europe, the Middle East and the 
Asia  Pacific  region.    We  will  continue  to  expand  our  non-U.S.  operations  and  enter  new  global  markets.    This  expansion  will 
require significant management attention and financial resources to develop successful direct and indirect non-U.S. sales and 
support  channels.    Our  business  is  generally  transacted  in  the  local  functional  currency.    In  some  countries,  our  success  will 
depend in part on our ability to form relationships with local partners.  There is a risk that we may sometimes choose the wrong 
partner.  For these reasons, we may not be able to maintain or increase non-U.S. market demand for our solutions, devices and 
services. 

Non-U.S.  operations  are  subject  to  inherent  risks,  and  our  future  results  could  be  adversely  affected  by  a  variety  of 
uncontrollable and changing factors.  These include, but are not limited to: 

(cid:131)  Greater difficulty in collecting accounts receivable and longer collection periods 

(cid:131)  Difficulties and costs of staffing and managing non-U.S. operations 

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(cid:131) 

(cid:131) 

The impact of global economic conditions 

Unfavorable or changing foreign currency exchange rates 

Legal  compliance  costs  and/or  business  risks  associated  with  our  global  operations  where  local  laws  and  customs 
differ from those in the U.S. 

Certification, licensing or regulatory requirements  

Unexpected changes in regulatory requirements 

Changes to or reduced protection of intellectual property rights in some countries 

Inability to obtain necessary financing on reasonable terms to adequately support non-U.S. operations and expansion 

27 

 
 
 
 
 
 
 
 
(cid:131) 

Potentially adverse tax consequences and difficulties associated with repatriating cash generated or held abroad in a 
tax-efficient manner. 

(cid:131)  Different or additional functionality requirements 

(cid:131) 

(cid:131) 

(cid:131) 

Trade protection measures 

Export control regulations 

Service provider and government spending patterns 

(cid:131)  Natural disasters, war or terrorist acts 

(cid:131) 

(cid:131) 

(cid:131) 

Labor disruptions that may occur in a country 

Poor selection of a partner in a country 

Political conditions which may  impact sales or threaten the safety of  associates or our continued presence  in these 
countries 

Our  failure  to  effectively  hedge  exposure  to  fluctuations  in  foreign  currency  exchange  rates  could  unfavorably  affect  our 
performance.  We utilize derivative instruments to hedge our exposure to fluctuations in foreign currency exchange rates. Some 
of these instruments and contracts may involve elements of market and credit risk in excess of the amounts recognized in the 
Consolidated  Financial  Statements.  For  additional  information  about  risk  on  financial  instruments,  see  Item 7 Management’s 
Discussion and Analysis of Financial Condition and Results of Operation under Market Risk.  Further, our financial results from 
non-U.S. operations may be negatively affected if we fail to execute or improperly hedge our exposure to currency fluctuations. 

Our success depends upon the recruitment and retention of key personnel.  To remain competitive in our industries, we must 
attract,  motivate  and  retain  highly  skilled  managerial,  sales,  marketing,  consulting  and  technical  personnel,  including 
executives,  consultants,  programmers  and  systems  architects  skilled  in  the  HIT,  healthcare  devices,  healthcare  transactions 
and  life  sciences  industries  and  the  technical  environments  in  which  our  solutions,  devices  and  services  are  needed.  
Competition  for  such  personnel  in  our  industries  is  intense  in  both  the  United  States  and  abroad.    Our  failure  to  attract 
additional qualified personnel to meet our non-U.S. personnel needs could have a material adverse effect on our prospects for 
long-term growth.  Our success is dependent to a significant degree on the continued contributions of key management, sales, 
marketing, consulting and technical personnel.  The unexpected loss of key personnel could have a material adverse impact on 
our  business  and  results  of  operations,  and  could  potentially  inhibit  development  and  delivery  of  our  solutions,  devices  and 
services and market share advances.   

We rely significantly on third party suppliers.  We license or purchase intellectual property and technology (such as software, 
hardware and content) from third parties, including some competitors, and incorporate software, hardware, and/or content into 
or sell it in conjunction with our solutions, devices and services, some of which are critical to the operation and delivery of our 
solutions, devices and services.  For instance, we currently depend on Microsoft and IBM Websphere technologies for portions 
of the operational abilities of our Millennium solutions.  Our remote hosting business also relies on a single or a limited number 
of  suppliers  for  certain  functions  of  this  business,  such  as  Oracle  database  technologies,  CITRIX  technologies  and  CISCO 
network technologies.     

Most  of  the  software  licenses  we  have  expire  within  one  to  five  years,  can  be  renewed  only  by  mutual  consent  and  may  be 
terminated if we breach the terms of the license and fail to cure the breach within a specified period of time.  Most of these 
third  party  software  licenses  are  non-exclusive;  therefore,  our  competitors  may  obtain  the  right  to  use  any  of  the  technology 
covered by these licenses and use the technology to compete directly with us.   

If any of the third party suppliers were to change product offerings, cease actively supporting the technologies, fail to update 
and enhance the technologies to keep pace with changing industry standards, encounter technical difficulties in the continuing 
development of these technologies,  significantly increase prices or terminate our licenses or supply contracts, we would need 
to seek alternative suppliers and incur additional internal or external development costs to ensure continued performance  of 
our  solutions,  devices  and  services.  Such  alternatives  may  not  be  available  on  attractive  terms,  or  may  not  be  as  widely 
accepted  or  as  effective  as  the  intellectual  property  or  technology  provided  by  our  existing  suppliers.  If  the  cost  of  licensing, 
purchasing  or  maintaining  the  third  party  intellectual  property  or  technology  significantly  increases,  our  gross  margin  levels 
could  significantly  decrease.  In  addition,  interruption  in  functionality  of  our  solutions,  devices  and  services  as  a  result  of 
changes in third party suppliers could adversely affect future sales of solutions, devices and services. 

We intend to continue strategic business acquisitions, which are subject to inherent risks. In order to expand our solutions, 
device offerings and services and grow our market and client base, we may continue to seek and complete strategic business 
acquisitions  that  we  believe  are  complementary  to  our  business.  Acquisitions  have  inherent  risks  which  may  have  a  material 
adverse  effect  on  our  business,  financial  condition,  operating  results  or  prospects,  including,  but  not  limited  to:  1)  failure  to 
successfully  integrate  the  business  and  financial  operations,  services,  intellectual  property,  solutions  or  personnel  of  an 
acquired business and to maintain uniform standard controls, policies and procedures; 2) diversion of management’s attention 
from other business concerns; 3) entry into markets in which we have little or no direct prior experience; 4) failure to achieve 
projected synergies and performance targets; 5) loss of clients or key personnel; 6) incurrence of debt and/or assumption of 

28 

 
 
 
 
 
 
 
 
 
known  and  unknown  liabilities;  7)  write-off  of  software  development  costs,  goodwill,  client  lists  and  amortization  of  expenses 
related  to  intangible  assets;  8)  dilutive  issuances  of  equity  securities;  and,  9)  accounting  deficiencies  that  could  arise  in 
connection  with,  or  as  a  result  of,  the  acquisition  of  an  acquired  company,  including  issues  related  to  internal  control  over 
financial  reporting  and  the  time  and  cost  associated  with  remedying  such  deficiencies.    If  we  fail  to  successfully  integrate 
acquired  businesses  or  fail  to  implement  our  business  strategies  with  respect  to  these  acquisitions,  we  may  not  be  able  to 
achieve projected results or support the amount of consideration paid for such acquired businesses. 

Risks Related to the Healthcare Information Technology, Healthcare Device and Healthcare 
Transaction Industry 
The  healthcare  industry  is  subject  to  changing  political,  economic  and  regulatory  influences.    For  example,  the  Health 
Insurance  Portability  and  Accountability  Act  of  1996  (HIPAA)  continues  to  have  a  direct  impact  on  the  healthcare  industry  by 
requiring identifiers and standardized transactions/code sets and necessary security and privacy measures in order to ensure 
the  appropriate  level  of  privacy  of  protected  health  information.  These  regulatory  factors  affect  the  purchasing  practices  and 
operation of healthcare organizations.  Federal and state legislatures have periodically considered programs to reform or amend 
the U.S. healthcare system at both the federal and state level and to change healthcare financing and reimbursement systems.  
These  programs  may  contain  proposals  to  increase  governmental  involvement  in  healthcare,  lower  reimbursement  rates  or 
otherwise  change  the  environment  in  which  healthcare  industry  participants  operate.    Healthcare  industry  participants  may 
respond by reducing their investments or postponing investment decisions, including investments in our solutions and services.  

Many healthcare providers are consolidating to create integrated healthcare delivery systems with greater market power.  These 
providers  may  try  to  use  their  market  power  to  negotiate  price  reductions  for  our  solutions  and  services.    As  the  healthcare 
industry consolidates, our client base could be eroded, competition for clients could become more intense and the importance 
of landing new client relationships becomes greater. 

The  healthcare  industry  is highly  regulated  at  the  local,  state  and  federal  level.   We  are  subject  to  a  significant  and  wide-
ranging  number  of  regulations  both  within  the  U.S.  and  elsewhere,  such  as,  regulations  in  the  areas  of:  healthcare  fraud,  e-
prescribing, claims processing and transmission, medical devices, the security and privacy of patient data and interoperability 
standards. 

Healthcare Fraud 
Federal and state governments continue to increase their scrutiny over practices involving healthcare fraud affecting healthcare 
providers  whose  services  are  reimburse  by  Medicare,  Medicaid  and  other  government  healthcare  programs.  Our  healthcare 
provider clients are subject to laws and regulations on fraud and abuse which, among other things, prohibit the direct or indirect 
payment or receipt of any remuneration for patient referrals, or arranging for or recommending referrals or other business paid 
for in whole or in part by these federal or state healthcare programs.  Federal enforcement personnel have substantial funding, 
powers and remedies to pursue suspected or perceived fraud and abuse. The effect of this government regulation on our clients 
is difficult to predict.  Many of the regulations applicable to our clients and that may be applicable to us, are vague or indefinite 
and  have  not  been  interpreted  by  the  courts.  They  may  be  interpreted  or  applied  by  a  prosecutorial,  regulatory  or  judicial 
authority in a manner that could broaden their applicability to us or require our clients to make changes in their operations or 
the way in which they deal with us. If such laws and regulations are determined to be applicable to us and if we fail to comply 
with  any  applicable  laws  and  regulations,  we  could  be  subject  to  sanctions  or  liability,  including  exclusion  from  government 
health programs, which could have a material adverse effect on our business, results of operations and financial condition. 

E-Prescribing 
The  use  of  our  solutions  by  physicians  for  electronic  prescribing,  electronic  routing  of  prescriptions  to  pharmacies  and 
dispensing  is  governed  by  state  and  federal  law.    States  have  differing  prescription  format  requirements,  which  we  have 
programmed  into  our  software.    In  addition,  in  November  2005,  the  Department  of  Health  and  Human  Services  announced 
regulations  by  CMS  related  to  “E-Prescribing  and  the  Prescription  Drug  Program”  (“E-Prescribing  Regulations”).    These  E-
Prescribing Regulations were mandated by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.  The 
E-Prescribing Regulations set forth standards for the transmission of electronic prescriptions.  The final regulations adopted two 
standards effective January 2006.  A second and final set of additional e-prescribing transaction standards was published on 
April  2,  2008  and  becomes  effective  on  April  1,  2009.    These  standards  are  detailed  and  significant,  and  cover  not  only 
transactions between prescribers and dispensers for prescriptions but also electronic eligibility and benefits inquiries and drug 
formulary  and  benefit  coverage  information.    Our  efforts  to  provide  solutions  that  enable  our  clients  to  comply  with  these 
regulations could be time-consuming and expensive.   

Claims Transmissions 
Certain of our solutions assist our clients in submitting claims to payers, which claims are governed by federal and state laws.  
Our solutions are capable of electronically transmitting claims for services and items rendered by a physician to many patients’ 
payers for approval and reimbursement.  Federal law provides civil liability to any person that knowingly submits a claim to a 
payer,  including  Medicare,  Medicaid  and  private  health  plans,  seeking  payment  for  any  services  or  items  that  have  not  been 
provided to the patient.  Federal law may also impose criminal penalties for intentionally submitting such false claims.  We have 
policies and procedures in place that we believe result in the accurate and complete transmission of claims, provided that the 
information given to us by our clients is also accurate and complete.  The HIPAA security, privacy and transaction standards, as 

29 

 
 
 
 
 
 
 
 
 
discussed  below,  also  have  a  potentially  significant  effect  on  our  claims  transmission  services,  since  those  services  must  be 
structured and provided in a way that supports our clients’ HIPAA compliance obligations. 

Regulation of Medical Devices 
The United States Food and Drug Administration (the "FDA") has declared that certain of our solutions are medical devices that 
are actively regulated under the Federal Food, Drug and Cosmetic Act ("Act") and amendments to the Act.  Other countries have 
similar regulations in place related to medical devices, that now or may in the future apply to certain of our solutions.  If other of 
our solutions are deemed to be actively regulated medical devices by the FDA or similar regulatory agencies in countries where 
we do business, we could be subject to extensive requirements governing pre- and post-marketing requirements including pre-
market notification clearance.  Complying with these medical device regulations on a global perspective is time consuming and 
expensive.  Further, it is possible that these regulatory agencies may become more active in regulating software that is used in 
healthcare. 

There have been nine FDA inspections at various Cerner sites since 1998.  Inspections conducted at our world headquarters in 
1999 and our prior Houston, Texas facility in 2002 each resulted in the issuance of an FDA Form 483 that we responded to 
promptly.  The FDA has taken no further action with respect to either of the Form 483s that were issued in 1999 and 2002.  The 
remaining seven FDA inspections, including inspections at our world headquarters in 2006 and 2007, resulted in no issuance of 
a Form 483.  We remain subject to periodic FDA inspections and we could be required to undertake additional actions to comply 
with  the  Act  and  any  other  applicable  regulatory  requirements.    Our  failure  to  comply  with  the  Act  and  any  other  applicable 
regulatory  requirements  could  have  a  material  adverse  effect  on  our  ability  to  continue  to  manufacture  and  distribute  our 
solutions.  The FDA has many enforcement tools including recalls, seizures, injunctions, civil fines and/or criminal prosecutions.  
Any of the foregoing could have a material adverse effect on our business, results of operations and financial condition. 

Security and Privacy of Patient Information 
State and federal laws regulate the confidentiality of patient records and the circumstances under which those records may be 
released. These regulations govern both the disclosure and use of confidential patient medical record information and require 
the  users  of  such  information  to  implement  specified  security  measures.  Regulations  currently  in  place  governing  electronic 
health data transmissions continue to evolve and are often unclear and difficult to apply. 

HIPAA  regulations  require  national  standards  for  some  types  of  electronic  health  information  transactions  and  the  data 
elements  used  in  those  transactions,  security  standards  to  ensure  the  integrity  and  confidentiality  of  health  information  and 
standards  to  protect  the  privacy  of  individually  identifiable  health  information.    Covered  entities  under  HIPAA,  which  include 
healthcare  organizations  such  as  our  clients,  our  employer  clinic  business  model  and  our  claims  transmission  services,  were 
required  to  comply  with  the  privacy  standards  by  April 2003,  the  transaction  regulations  by  October 2003  and  the  security 
regulations  by  April 2005.    As a  business  associate  of  our  clients  who  are  covered  entities,  we,  in  most  instances,  must also 
ensure compliance with the HIPAA regulations as it pertains to our clients. 

Evolving  HIPAA-related  laws  or  regulations  could  restrict  the  ability  of  our  clients  to  obtain,  use  or  disseminate  patient 
information.  This could adversely affect demand for our solutions if they are not re-designed in a timely manner in order to meet 
the requirements of any new interpretations or regulations that seek to protect the privacy and security of patient data or enable 
our  clients  to  execute  new  or  modified  healthcare  transactions.  We  may  need  to  expend  additional  capital,  software 
development  and  other  resources  to  modify  our  solutions  and  devices  to  address  these  evolving  data  security  and  privacy 
issues. 

Interoperability Standards 
Our clients are concerned with and often require that our software solutions and healthcare devices be interoperable with other 
third party HIT suppliers.  Market forces or governmental/regulatory authorities could create software interoperability standards 
that  would  apply  to  our  solutions,  and  if  our  software  solutions  and/or  healthcare  devices  are  not  consistent  with  those 
standards, we could be forced to incur substantial additional development costs to conform.  The Certification Commission for 
Healthcare Information Technology (CCHIT) has developed a comprehensive set of criteria for the functionality, interoperability 
and security of various software modules in the HIT industry.  CCHIT, however, continues to modify and refine those standards.  
Achieving  CCHIT  certification  is  becoming  a  competitive  requirement,  resulting  in  increased  software  development  and 
administrative expense to conform to these requirements.  If our software solutions and healthcare devices are not consistent 
with  these  evolving  standards,  our  market  position  and  sales  could  be  impaired  and  we  may  have  to  invest  significantly  in 
changes to our software solutions and healthcare devices. 

We operate in intensely competitive and dynamic industries, and our ability to successfully compete and continue to grow 
our  business  depends  on  our  ability  to  respond  quickly  to  market  changes  and  changing  technologies  and  to  bring 
competitive  new  solutions,  devices,  features  and  services  to  market  in  a  timely  fashion.    The  market  for  healthcare 
information  systems,  healthcare  devices,  healthcare  transactions  and  life  sciences  consulting  services  are  intensely 
competitive, dynamically evolving and subject to rapid technological and innovative changes.  Development of new proprietary 
technology or services is complex, entails significant time and expense and may not be successful.  We cannot guarantee that 
we will be able to introduce new solutions, devices or services on schedule, or at all, nor can we guarantee that errors will not be 
found in our new solution releases, devices or services before or after commercial release, which could result in solution, device 
or service delivery redevelopment costs and loss of, or delay in, market acceptance.   

30 

 
 
 
 
 
 
 
 
 
 
Certain of our competitors have greater financial, technical, product development, marketing and other resources than us and 
some of our competitors offer  software solutions that we do  not offer.  Our  principal existing competitors are set forth  above 
under Part I, Item 1 Competition.  

In  addition,  we  expect  that  major  software  information  systems  companies,  large  information  technology  consulting  service 
providers and system integrators, start-up companies and others specializing in the healthcare industry may offer competitive 
software solutions, devices or services.  We face strong competitors and often face downward price pressure.  Additionally, the 
pace  of  change  in  the  healthcare  information  systems  market  is  rapid  and  there  are  frequent  new  software  solution 
introductions,  software  solution  enhancements,  device  introductions,  device  enhancements  and  evolving  industry  standards 
and requirements.  There are a limited number of hospitals and other healthcare providers in the U.S. HIT market.  As costs fall, 
technology improves, and market factors continue to compel investment by healthcare organizations in solutions and services 
like ours, market saturation in the U.S. may change the competitive landscape in favor of larger, more diversified competitors 
with greater scale.   

Risks Related to Our Stock 
The ongoing adverse financial market environment and uncertainty in global economic conditions could negatively affect 
our business, results of operations and financial condition.  Our operating results may be impacted by the health of the global 
economy.  Adverse economic conditions may cause a slowdown or decline in client spending which could adversely affect our 
business and financial performance.  Our business and financial performance, including new business bookings and collection 
of our accounts receivable, may be adversely affected by current and future economic conditions (including a reduction in the 
availability of credit, higher energy costs, rising interest rates, financial market volatility and recession) that cause a slowdown or 
decline in client spending.  Further, the ongoing global financial crisis may also limit our ability to access the capital markets at 
a time when we would like, or need, to raise capital, which could have an impact on our ability to react to changing economic 
and  business  conditions.    Accordingly,  if  the  global  financial  crisis  and  current  economic  downturn  continue  or  worsen,  our 
business, results of operations and financial condition could be materially and adversely affected. 

Our quarterly operating results may vary which could adversely affect our stock price.  Our quarterly operating results have 
varied  in  the  past  and  may  continue  to  vary  in  future  periods,  including,  variations  from  guidance,  expectations  or  historical 
results or trends.  Quarterly operating results may vary for a number of reasons including accounting policy changes, demand 
for  our  solutions,  devices  and  services,  the  financial  condition  of  our  clients  and  potential  clients,  our  long  sales  cycle, 
potentially  long  installation  and  implementation  cycles  for  larger,  more  complex  and  higher-priced  systems  and  other  factors 
described in this section and elsewhere in this report.  As a result of healthcare industry trends and the market for our Cerner 
Millennium solutions, a large percentage of our revenues are generated by the sale and installation of larger, more complex and 
higher-priced  systems.    The  sales  process  for  these  systems  is  lengthy  and  involves  a  significant  technical  evaluation  and 
commitment  of  capital  and  other  resources  by  the  client.    Sales  may  be  subject  to  delays  due  to  changes  in  clients'  internal 
budgets,  procedures  for  approving  large  capital  expenditures,  competing  needs  for  other  capital  expenditures,  availability  of 
personnel resources and by actions taken by competitors.  Delays in the expected sale, installation or implementation of these 
large  systems  may  have  a  significant  impact  on  our  anticipated  quarterly  revenues  and  consequently  our  earnings,  since  a 
significant percentage of our expenses are relatively fixed.  

Revenue  recognized  in  any  quarter  may  depend  upon  our  and  our  clients’  abilities  to  meet  project  milestones.    Delays  in 
meeting these milestone conditions or modification of the project plan could result in a shift of revenue recognition from one 
quarter to another and could have a material adverse effect on results of operations for a particular quarter.   

Our revenues from system sales historically have been lower in the first quarter of the year and greater in the fourth quarter of 
the year, primarily as a result of clients’ year-end efforts to make all final capital expenditures for the then-current year. 

Our  sales  forecasts  may  vary  from  actual  sales  in  a  particular  quarter.    We  use  a  “pipeline”  system,  a  common  industry 
practice, to forecast sales and trends in our business.  Our sales associates monitor the status of all sales opportunities, such 
as the date when they estimate that a client will make a purchase decision and the potential dollar amount of the sale.  These 
estimates  are  aggregated  periodically  to  generate  a  sales  pipeline.    We  compare  this  pipeline  at  various  points  in  time  to 
evaluate  trends  in  our  business.    This  analysis  provides  guidance  in  business  planning  and  forecasting,  but  these  pipeline 
estimates  are  by  their  nature  speculative.    Our  pipeline  estimates  are  not  necessarily  reliable  predictors  of  revenues  in  a 
particular  quarter  or  over  a  longer  period of  time,  partially  because  of  changes  in  the  pipeline  and  in  conversion  rates  of  the 
pipeline into contracts that can be very difficult to estimate.  A negative variation in the expected conversion rate or timing of the 
pipeline into contracts, or in the pipeline itself, could cause our plan or forecast to be inaccurate and thereby adversely affect 
business  results.    For  example,  a  slowdown  in  information  technology  spending,  adverse  economic  conditions  or  a  variety  of 
other factors can cause purchasing decisions to be delayed, reduced in amount or cancelled, which would reduce the overall 
pipeline conversion rate in a particular period of time.  Because a substantial portion of our contracts are completed in the latter 
part of a quarter, we may not be able to adjust our cost structure quickly enough in response to a revenue shortfall resulting 
from a decrease in our pipeline conversion rate in any given fiscal quarter(s). 

The trading price of our common stock may be volatile.  The market for our common stock may experience significant price 
and  volume  fluctuations  in  response  to  a  number  of  factors  including  actual  or  anticipated  variations  in  operating  results, 
rumors about our performance or solutions, devices and services, changes in expectations of future financial performance or 

31 

 
 
 
 
 
 
 
 
 
 
estimates of securities analysts, governmental regulatory action, healthcare reform measures, client relationship developments, 
changes occurring in the securities markets in general and other factors, many of which are beyond our control.  As a matter of 
policy, we do not generally comment on our stock price or rumors. 

Furthermore, the stock market in general, and the markets for software, healthcare and information technology companies in 
particular,  have  experienced  extreme  volatility  that  often  has  been  unrelated  to  the  operating  performance  of  particular 
companies.    These  broad  market  and  industry  fluctuations  may  adversely  affect  the  trading  price  of  our  common  stock, 
regardless of actual operating performance. 

Our  Directors  have  authority  to  issue  preferred  stock  and  our  corporate  governance  documents  contain  anti-takeover 
provisions.  Our Board of Directors has the authority to issue up to 1,000,000 shares of preferred stock and to determine the 
preferences,  rights  and  privileges  of  those  shares  without  any  further  vote  or  action  by  the  shareholders.    The  rights  of  the 
holders  of  common  stock  may  be  harmed  by  rights  granted  to  the  holders  of  any  preferred  stock  that  may  be  issued  in  the 
future.  

In addition, some provisions of our Certificate of Incorporation and Bylaws could make it more difficult for a potential acquirer to 
acquire  a  majority  of  our  outstanding  voting  stock.  These  include  provisions  that:  provide  for  a  classified  board  of  directors, 
prohibit shareholders from taking action by written consent and restrict the ability of shareholders to call special meetings.  We 
are also subject to provisions of Delaware law that prohibit us from engaging in any business combination with any interested 
shareholder for a period of three years from the date the person became an interested shareholder, unless certain conditions 
are met, which could have the effect of delaying or preventing a change of control.  

Factors that May Affect Future Results of Operations, Financial Condition or Business  
Statements made in this report, the Annual Report to Shareholders of which this report is made a part, other reports and proxy 
statements  filed  with  the  Securities  and  Exchange  Commission,  communications  to  shareholders,  press  releases  and  oral 
statements  made  by  representatives  of  the  Company  that  are  not  historical  in  nature,  or  that  state  the  Company's  or 
management's intentions, hopes, beliefs, expectations or predictions of the future, may constitute "forward-looking statements" 
within the meaning of Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”).  Forward-looking 
statements  can  often  be  identified  by  the  use  of  forward-looking  terminology,  such  as    "could,"  "should,"  “will,”  "intended," 
"continue," "believe," "may," "expect," "hope," "anticipate," "goal," "forecast," “plan,” “guidance” or “estimate” or the negative of 
these words, variations thereof or similar expressions.  Forward-looking statements are not guarantees of future performance or 
results.    They  involve  risks,  uncertainties  and  assumptions.    It  is  important  to  note  that  any  such  performance  and  actual 
results,  financial  condition  or  business,  could  differ  materially  from  those  expressed  in  such  forward-looking  statements.  
Factors that could cause or contribute to such differences include, but are not limited to, those discussed in this Item 1A. Risk 
Factors and elsewhere herein or in other reports filed with the SEC.  Other unforeseen factors not identified herein could also 
have  such  an  effect.    We  undertake  no  obligation  to  update  or  revise  forward-looking  statements  to  reflect  changed 
assumptions, the occurrence of unanticipated events or changes in future operating results, financial condition or business over 
time. 

Item 2.  Properties  
World Headquarters 
Our  world  headquarters  offices  are  located  in  a  Company-owned  office  park  in  North  Kansas  City,  Missouri,  containing 
approximately 992,877 gross square feet of useable space (the “Campus”), inclusive of the new data center and clinic buildings 
described below.  As of January 3, 2009, we were using all of the useable space for our U.S. corporate headquarters operations.  

In June 2007, the Company completed construction of the world headquarters Technology Center, a 135,161 square foot data 
center facility on the Campus.   We deliver remote hosting, disaster recovery and other services to our clients from this facility.    

In February 2006, we completed construction on the Campus of a 13,136 square foot addition to the 2901 Rockcreek Parkway 
building to house Healthe Clinic, a wholly-owned subsidiary, which provides primary care medical services for our associates and 
their family members.   

In 2004, we purchased approximately 12 acres of unimproved real estate adjacent to the Campus for campus expansion. This 
land was purchased to provide a secondary entry into the Campus and to provide for future building development as needed. 
The  first  phase  of  development  was  a  roadway  extension  and  second  entry  point  into  the  Campus.  The  second  phase  of 
development is the data center facility described above. Future development of this land is undetermined at this time.  

Other Properties 
In February 2007, we entered into a long-term lease for 480,700 gross square feet of property located in Kansas City, Missouri.  
This office space, known as the Innovation Campus, houses associates from our intellectual property organizations.  In April and 
August 2007, additional space was added to this lease so that the Innovation Campus now consists of 791,940 square feet, 
including the daycare facility listed below. 

32 

 
 
 
 
 
 
 
 
 
 
 
 
 
In  July  2007,  we  entered  into  a  lease  for  36,800  gross  square  feet  of  property  located  in  Kansas  City,  Missouri,  near  the 
Innovation Campus, which is the home for our Innovation Kids Learning Center, providing on-site daycare for Cerner associate 
families. 

In June 2005, we purchased 263,512 gross square feet of property located in Kansas City, Missouri.  The office space, known 
as  the  Cerner  Oaks  Campus,  houses  associates  from  the  CernerWorks  group  and  associates  of  Cerner’s  wholly-owned 
subsidiary, Healthe Exchange.   

We also own property located along the north riverbank of the Missouri River, approximately two miles from the Campus.  This 
property consists of a 96,318 gross square foot building and a 1,300-car parking garage.  The building has been renovated for 
use as a corporate training, meeting and event center for the Company and third parties.  We have also made use of the parking 
garage to meet overflow-parking demands on the Campus. 

As  of  the  end  of  February  2009,  the  Company  leased  office  space  in:  Beverly  Hills  and  Garden  Grove,  California;  Denver, 
Colorado;  Overland  Park,  Kansas;  Waltham,  Massachusetts;  Minneapolis  and  Rochester,  Minnesota;  Kansas  City,  Missouri; 
Beaverton,  Oregon;  Blue  Bell,  Pennsylvania;  and  Vienna,  Virginia.    The  Company  operates  one  of  its  data  centers  in  leased 
space in Lee’s Summit, Missouri. Globally, the Company also leases office space in: Brisbane, Sydney and Melbourne, Australia; 
London-Ontario,  Canada;  Hong  Kong,  China;  London,  England;  Paris,  France;  Herzogenrath  and  Idstein,  Germany;  Bangalore, 
India; Dublin, Ireland; Kuala Lumpur, Malaysia; Riyadh, Saudi Arabia; Ngee Ann City, Singapore; Barcelona and Madrid, Spain; 
and, Abu Dhabi and Dubai, United Arab Emirates.    

In  2008,  our  Birmingham,  Alabama;  Bel  Air,  Maryland;  Charlotte,  North  Carolina;  and  Brussels,  Belgium  and  Slough,  England 
offices were closed as we relocated many associates and/or the necessary business functions to other Company offices. 

Item 3.  Legal Proceedings 
We have no material pending litigation.  

Item 4.  Submission of Matters to a Vote of Security Holders 
No  matters  were  submitted  to  a  vote  of  the  shareholders  of  the  Company  during  the  fourth  quarter  of  the  fiscal  year  ended 
January 3, 2009. 

33 

 
 
 
 
 
 
 
 
 
PART II 
Item 5.  Market for the Registrant’s Common Equity and Related Stockholder 
Matters and Issuer Purchases of Equity Securities   
The Company's common stock trades on The NASDAQ Global Select MarketSM under the symbol CERN.  The following table sets 
forth the high, low and last sales prices for the fiscal quarters of 2008 and 2007 as reported by The Nasdaq Stock Market®.   

At February 20, 2009, there were approximately 1,145 owners of record.  To date, the Company has paid no cash dividends and 
it does not intend to pay cash dividends in the foreseeable future.  Management believes it is in the shareholders' best interest 
for the Company to reinvest funds in the operation of the business. 

(c) In March 2008, the Company’s Board of Directors authorized a stock repurchase program for $45 million of our Common 
Stock.  The stock repurchase activity for the quarter ended January 3, 2009 is as follows: 

These  repurchased  shares  are  recorded  as  treasury  stock  and  are  accounted  for  under  the  cost  method.    No  repurchased 
shares have been retired.   

34 

 
 
 
 
 
 
 
 
 
 
 
Item 6.  Selected Financial Data 

(1)  Includes  share-based  compensation  expense  recognized  in  accordance  with  Statement  of  Financial  Accounting 
Standards  No.  123R.    The  impact  of  including  this  expense  is  a  $9.5  million  decrease,  net  of  $5.6  million  tax 
benefit, in net earnings and a decrease to diluted earnings per share of $.11 in 2008, a $10.2 million decrease, 
net of $6.0 million tax benefit, in net earnings and a decrease to diluted earnings per share of $.12 in 2007 and 
a $11.7 million decrease, net of $7.3 million tax benefit, in net earnings and a decrease to diluted earnings per 
share of $.14 in 2006. 

(2)  Includes  expense  related  to  a  settlement  with  a  third  party  provider  of  software  related  to  the  use  of  the  third 
party’s software in the Company’s remote hosting business.  The settlement included compensation for the use of 
the  software  for  periods  prior  to  2008  as  well  as  compensation  for  licenses  of  the  software  for  future  use  for 
existing and additional clients through January 2009.  Of the total settlement amount, the Company determined 
that  $5.0  million  should  have  been  recorded  in  prior  periods,  primarily  2005  through  2007.    Based  on  this 
valuation,  2008  results  include  an  increase  of  $8.0  million  to  sales  and  client  service  expense,  a  decrease  of 
$5.0 million to net earnings, and a decrease of $.06 to diluted earnings per share that are attributable to prior 
periods. 

(3)  Includes  a  research  and  development  write-off  related  to  the  RxStation  medication  dispensing  devices.    In 
connection with production and delivery of the RxStation medication dispensing devices, the Company reviewed 
the  accounting  treatment  for  the  RxStation  line  of  devices  and  determined  that  $8.6  million  of  research  and 
development  activities  for  the  RxStation  medication  dispensing  devices  that  should  have  been  expensed  was 
incorrectly capitalized.  The impact of this charge is a $5.4 million decrease, net of $3.2 million tax benefit, in net 
earnings  and  a  decrease  to  diluted  earnings  per  share  of  $.06  in  the  year  ended  December  29,  2007.    $2.1 
million of this $5.4 million after tax amount recorded in 2007 related to periods prior to 2007.   

(4)  Includes a $3.1 million tax benefit recorded in 2007 related to periods prior to 2007.  The tax benefit relates to 
the over-expensing of state income taxes, which resulted in an increase to diluted earnings per share of $.04 in 
the year ended December 29, 2007.   

(5)  Includes  an  adjustment  to  correct  the  amounts  previously  reported  for  the  second  quarter  of  2007  for  a 
previously disclosed out-of-period tax item relating to foreign net operating losses.  The effect of this adjustment 
increases tax expense for the  year  ended December 29, 2007, by $4.2 million and  increases January 1, 2005 
retained earnings (Shareholders’ Equity) by the same amount.   

35 

 
 
 
 
 
   
 
  
 
 
 
(6)  Includes  a  tax  benefit  of  $2.0  million  for  adjustments  relating  to  prior  periods.    This  results  in  an  increase  to 

diluted earnings per share of $.02. 

(7)  Includes  a  tax  benefit  of  $4.8  million  relating  to  the  carry-back  of  a  capital  loss  generated  by  the  sale  of  Zynx 
Health  Incorporated  (“Zynx”)  in  the  first  quarter  of  2004.    The  impact  of  this  refund  claim  is  a  $4.8  million 
increase in net earnings and an increase in diluted earnings per share of $.06 for 2005. 

(8)  Includes a charge for the write-off of acquired in process research and development related to the acquisition of 
the medical business division of VitalWorks, Inc.  The impact of this charge is a $3.9 million decrease, net of $2.4 
million tax benefit, in net earnings and a decrease to diluted earnings per share of $.05 for 2005. 

(9)  Includes a gain on the sale of Zynx.  The impact of this gain is a $3.0 million increase in net earnings and increase 

to diluted earnings per share of $.04 for 2004. 

(10) Includes a charge for vacation accrual of $3.3 million included in general and administrative.  The impact of this 
charge  is  a  $2.1  million  decrease,  net  of  $1.2  million  tax  benefit,  in  net  earnings  and  a  decrease  to  diluted 
earnings per share of $.03 for 2004. 

Item 7.  Management's Discussion and Analysis of Financial Condition and Results of 
Operations 
The  following  Management  Discussion  and  Analysis  (“MD&A”)  is  intended  to  help  the  reader  understand  the  results  of 
operations and financial condition of Cerner Corporation (“Cerner” or the “Company”). This MD&A is provided as a supplement 
to, and should be read in conjunction with, our financial statements and the accompanying notes to the financial statements 
(“Notes”).  

Management Overview 
Cerner  primarily  derives  revenue  by  selling,  implementing  and  supporting  software  solutions,  clinical  content,  hardware, 
healthcare  devices  and  services  that  give  healthcare  providers secure  access  to  clinical,  administrative  and  financial  data  in 
real time, allowing them to improve the quality, safety and efficiency in the delivery of healthcare.  We implement the healthcare 
solutions as stand-alone, combined or enterprise-wide systems. Cerner Millennium® software solutions can be managed by the 
Company’s clients or in the Company’s data center via a managed services model.  

Cerner’s  fundamental  strategy  centers  on  creating  organic  growth  by  investing in  research  and  development  (R&D)  to  create 
solutions and services for the healthcare industry.  This strategy has driven strong growth over the long-term, as reflected in five- 
and ten-year compound annual revenue growth rates of 15% or more.  This growth has also created a very strategic client base 
of more than 6,000 hospital, health system, physician practice, clinic, laboratory and pharmacy clients around the world.  Selling 
additional solutions back into this client base is an important element of Cerner’s future revenue growth.  We are also focused 
on driving growth through market share expansion by replacing competitors in healthcare settings that are looking to replace 
their current HIT partners or those who have not yet strategically aligned with a supplier.  We also expect to drive growth through 
new initiatives that reflect our ongoing ability to innovate such as our CareAware™ healthcare device architecture and devices, 
HealtheSM employer services, physician practice solutions and solutions and services for the pharmaceutical market.  Finally, we 
expect continued strong revenue contributions from the sale of our solutions and services outside of the U.S.  Many non-U.S. 
markets have a low penetration of HIT solutions and their governing bodies are in many cases focused on HIT as part of their 
strategy to improve the quality and lower the cost of healthcare.   

Beyond  our  strategy  for  driving  revenue  growth,  Cerner  is  also  focused  on  earnings  growth.    Similar  to  our  history  of  growing 
revenue, our net earnings have increased at more than 20% compound annual rates over five- and ten-year periods.  We believe 
we can continue driving strong levels of earnings growth by continuing to grow revenue while also leveraging key areas to create 
operating margin expansion.  The primary areas of opportunity for margin expansion include: 

(cid:131) 

(cid:131) 

(cid:131) 

becoming more efficient at implementing our software by leveraging implementation tools and methodologies we have 
developed that can reduce the amount of effort required to implement our software;  

leveraging  our  investments  in  R&D  by  addressing  new  markets  (i.e.,  non-U.S.)  that  do  not  require  significant 
incremental R&D but can contribute significantly to revenue growth; and,   

leveraging our scalable business infrastructure to reduce the rate of increase in general and administrative spending 
to below our revenue growth rate. 

We are  also focused on increasing cash flow  by growing earnings, reducing the use of working capital and controlling capital 
expenditures.  While 2007 was a year of heavy capital investment because of investments in a new data center to support our 
rapidly growing hosting business and purchasing new buildings to accommodate growth in our associate base, capital spending 
decreased in 2008 and we expect capital spending in 2009 to remain at levels below our 2007 spending.   

36 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Results Overview 
In  a  challenging  economic  environment,  we  continued  to  execute  on  our  core  strategies  to  drive  revenue  growth,  expand 
operating margins, grow earnings and generate good cash flow in 2008.  The 2008 results included strong levels of earnings, 
and cash flow and solid new business bookings.  New business bookings revenue in 2008, which reflects the value of executed 
contracts  for  software,  hardware,  professional  services  and  managed  services  (hosting  of  software  in  the  Company’s  data 
center) was $1.54 billion, which is an  increase of 2% when compared to $1.51 billion in 2007.  The 2007 bookings exclude 
bookings related to the Company’s participation in the National Health Services (NHS) initiative to automate clinical processes 
and  digitize  medical  records  in  England  in  the  amount  of  $97.8  million.    Revenues  for  2008  increased  10%  to  $1.68  billion 
compared  to  $1.52  billion  in  2007,  driven  primarily  by  an  increase  in  support,  maintenance  and  services  revenues.    2008 
revenues  and  margin  include  a  cumulative  catch-up  adjustment  recognized  in  the  fourth  quarter,  in  the  amount  of 
$28,640,000,  resulting  from  a  significant  change  in  an  accounting  estimate  related  to  the  Company’s  contract  in  London  as 
part of the NHS initiative to automate clinical processes and digitize medical records in England. 

The  2008  net  earnings  increased  48%  to  $188.7  million  compared  to  $127.1  million  in  2007.    Diluted  earnings  per  share 
increased 48% to $2.26 compared to $1.53 in 2007.  The 2008 and 2007 net earnings and diluted earnings per share reflect 
the impact of accounting pursuant to Statement of Financial Accounting Standards (SFAS) No. 123R, “Share-Based Payment,” 
which requires the expensing of stock options.  The effect of accounting under SFAS 123R reduced the 2008 net earnings and 
diluted earnings per share by $9.5 million and $0.11, and the 2007 earnings and diluted earnings per share by $10.2 million 
and $0.12, respectively.  2008 net earnings also include the catch-up of margin adjustment related to the Company’s contract 
in London.  The after tax effect of this catch up increased 2008 net earnings and diluted earnings per share by $20,600,000 
and  $0.24,  respectively.    In  addition  to  the  benefit  from  the  catch-up  adjustment,  the  growth  in  net  earnings  and  diluted 
earnings  per  share  was  driven  primarily  by  continued  progress  with  the  Company’s  margin  expansion  initiatives,  particularly 
expanding  the  profitability  of  support  and  maintenance  revenue,  leveraging  R&D  investments,  and  controlling  sales,  general, 
and  administrative  expenses.    Our  2008  operating  margin  was  17%,  and  would  have  been  15%  without  the  catch-up 
adjustment, compared to 13% in 2007, and we remain on target to achieve our long term goal of 20% operating margins.  

We had cash collections of receivables of $1.73 billion in 2008 compared to $1.65 billion in 2007, with the increase driven by 
increased billings.  Days sales outstanding increased to 92 days for the quarter ended January 3, 2009 compared to 90 days 
for the quarter ended December 29, 2007.  Operating cash flows for 2008 were $281.8 million compared to $274.6 million in 
2007. 

This year also included progress on our strategic initiatives that, while not yet material to our current results, are an important 
part  of  our  longer-term  growth  strategy.  For  example,  we  had  several  sales  and  implementations  of  our  CareAware  MDBus™ 
healthcare device connectivity solution that allows medical devices to be connected to an electronic medical record through a 
USB-like  connection.    We  also  made  progress  with  our  employer-focused  initiatives,  with  our  first  health  center  client,  Cisco 
Systems,  opening  their  LifeConnection  Health  Center  in  November  2008.    This  is  a  fully-automated  employee-based  health 
center based on Cerner’s own successful on-campus model that has led to improvements in quality, efficiency, and access to 
care for Cerner’s associates and their dependents. 

The Company’s fiscal year ends on the Saturday closest to December 31.  Fiscal year 2008 consisted of 53 weeks and fiscal 
years 2007 and 2006 consisted of 52 weeks each.   

Healthcare Information Technology Market Outlook 
We have provided a detailed assessment of the healthcare information technology market under Part I, Item 1, The Healthcare 
and Healthcare IT Industry. 

Results of Operations 
Year Ended January 3, 2009, Compared to Year Ended December 29, 2007 
Revenues increased 10% to $1,676,028,000 in 2008, compared with $1,519,877,000 in 2007.  The revenue composition for 
2008  was  $522,373,000  in  system  sales,  $472,579,000  in  support  and  maintenance,  $643,317,000  in  services  and 
$37,759,000 in reimbursed travel.  The Company’s net earnings increased 48% to $188,658,000 in 2008 from $127,125,000 
in 2007.  The effects of SFAS No. 123R, which requires the expensing of stock options, decreased net earnings in 2008 and 
2007 by $9,503,000, net of $5,641,000 tax benefit and $10,159,000, net of $6,030,000 tax benefit, respectively.   

As  discussed  in  the  results  overview  and  more  fully  described  in  the  Operations  by  Segment,  2008  revenues  and  margin 
included a cumulative catch-up adjustment recognized in the fourth quarter, in the amount of $28,640,000, resulting from a 
significant  change  in  accounting  estimate  related  to  the  Company’s  contract  in  London.    The  majority  of  the  catch-up 
adjustment revenue was included in support, maintenance and services.   

(cid:131) 

System  sales  revenues  increased  4%  to  $522,373,000  in  2008  from  $500,319,000  in  2007.    Included  in  system 
sales are revenues from the sale of software, hardware, sublicensed software, deployment period licensed software 
upgrade rights, installation fees, transaction processing and subscriptions.  The increase in system sales was driven by 
growth in licensed software, sublicensed software, and subscriptions.       

37 

 
 
 
 
 
 
 
 
  
 
(cid:131) 

Support,  maintenance  and  services  revenues  increased  14%  to  $1,115,896,000  in  2008  from  $982,780,000  in 
2007.    Included  in  support,  maintenance  and  services  revenues  are  support  and  maintenance  of  software  and 
hardware, professional services excluding installation, and managed services.  A summary of the Company’s support, 
maintenance and services revenues in 2008 and 2007 is as follows: 

(cid:131) 

The $58,250,000, or 10%, increase in services revenue was primarily attributable to growth in CernerWorks managed 
services.    The  $74,866,000,  or  19%,  increase  in  support  and  maintenance  revenues  is  attributable  to  continued 
success at selling Cerner Millennium applications, implementing them at client sites, and initiating billing for support 
and maintenance fees. 

(cid:131)     Contract backlog, which reflects new business bookings that have not yet been recognized as revenue, increased 7% 
in  2008  compared  to  2007.    This  increase  was  driven  by  growth  in  new  business  bookings  during  the  past  four 
quarters, including continued strong levels of managed services bookings that typically have longer contract terms.  In 
the second quarter of 2008, contract backlog was reduced by approximately $178,000,000 as a result of the contract 
withdrawal by the prime contractor in the southern region of England.  A summary of the Company’s total backlog for 
2008 and 2007 follows: 

The cost of revenues was 18% of total revenues in both 2008 and 2007.  The cost of revenues includes the cost of reimbursed 
travel  expense,  sales  commissions,  third  party  consulting  services  and  subscription  content,  computer  hardware  and 
sublicensed software purchased from hardware and software manufacturers for delivery to clients.  It also includes the cost of 
hardware  maintenance  and  sublicensed  software  support  subcontracted  to  the  manufacturers.    Such  costs,  as  a  percent  of 
revenues,  typically  have  varied  as  the  mix  of  revenue  (software,  hardware,  maintenance,  support,  services  and  reimbursed 
travel) carrying different margin rates changes from period to period.  Costs of revenues does not include the costs of our client 
service personnel who are responsible for delivering our service offerings, such costs are included in sales and client service 
expense. 

Total  operating  expenses,  excluding  cost  of  revenues,  increased  6%  to  $1,101,080,000  in  2008  from  $1,035,684,000  in 
2007.  Accounting pursuant to SFAS 123(R), which results in the expensing of share-based compensation, impacted expenses 
in 2008 and 2007 as indicated below: 

(cid:131)     Sales and client service expenses as a percent of total revenues were 43% in both 2008 and 2007. These expenses 
increased  9%  to  $715,512,000  in  2008,  from  $657,956,000  in  2007.    Sales  and  client  service  expenses  include 
salaries  of  sales  and  client  service  personnel,  depreciation  and  other  expenses  associated  with  our  CernerWorks 
managed  service  business,  communications  expenses,  unreimbursed  travel  expenses,  expense  for  share-based 
payments, sales and marketing salaries and trade show and advertising costs. The increase was primarily attributable 
to  growth  in  the  managed  services  business,  including  $8,014,000  of  expense  recorded  in  the  second  quarter  of 
2008  for  a  settlement  with  a  third  party  provider  of  software related  to  the  use  of  the  third  party’s  software  in  this 
business.   

(cid:131) 

Total  expense  for  software  development  in  2008  increased  1%  to  $272,519,000,  from  $270,576,000  in  2007.  
Expenditures  for  software  development  in  2008  reflect  continued  development  and  enhancement  of  the  Cerner 
Millennium  platform  and  software  solutions  and  investments  in  new  initiatives,  such  as  RxStation  medication 

38 

 
 
 
 
 
 
 
 
 
 
 
 
 
dispensing  devices.    Included  in  2007  software  development  expense  is  $8.6  million  of  research  and  development 
activities  for  the  RxStation  medical  dispensing  device.    $3.4  million  of  this  amount  recorded  in  2007  is  related  to 
periods  prior  to  2007.    A  summary  of  the  Company’s  total  software  development  expense  in  2008  and  2007  is  as 
follows: 

(cid:131)  General  and  administrative  expenses  as  a  percent  of  total  revenues  were  7%  in  2008  and  2007.  These  expenses 
increased 6% to $113,049,000 in 2008 from $107,152,000 in 2007.  This increase was due primarily to the growth 
of the Company’s core business and increased presence in the global market.  General and administrative expenses 
include salaries for corporate, financial and administrative staff, utilities, communications expenses, professional fees, 
the transaction gains or losses on foreign currency and expense for share-based payments.   The Company recorded a 
net transaction gain on foreign currency of $9,858,000 and $3,691,000 in 2008 and 2007, respectively.   

Net  interest  income  was  $3,056,000  in  2008,  compared  with  net  interest  income  of  $1,269,000  in  2007.    Interest  income 
increased to $13,604,000 in 2008 from $13,206,000 in 2007, due primarily to higher returns received from our investments 
in auction rate securities.  Interest expense decreased to $10,548,000 in 2008 from $11,937,000 in 2007, due primarily to a 
reduction in long-term debt.  

Other  expense  was  $510,000  in  2008,  compared  to  other  expense  of  $1,385,000  in  2007.    As  a  result  of  the  Company 
entering  into  a  settlement  agreement  with  an  investment  firm  relating  to  auction  rate  securities,  Other  expense  in  2008 
includes  the  recognition  of  a  gain  of  $19,860,000  for  a  put-like  feature.   This  gain  was  offset  by  the  recognition  of  an  other-
than-temporary impairment loss recorded on the Company’s auction rate securities due to a reclassification of these securities 
from available-for-sale to trading.  

The Company’s effective tax rate was 33% and 38% in 2008 and 2007, respectively.  This decrease is primarily due to a higher 
than normal rate in 2007.  The increase in the effective rate in 2007 was primarily due to recognition of a valuation allowance 
in the third quarter of 2007 on certain of the Company’s foreign tax loss carryforwards.  Such additional tax expense in 2007 
was  partially  offset  by  a  tax  benefit  for  adjustments  relating  to  prior  periods.    The  tax  rate  for  2008  was  slightly  lower  than 
normal due to strong income levels from global regions that have lower tax rates.   

During the second quarter of 2007, the Company determined that due to a change in circumstances in the quarter, it is more 
likely  than  not  that  certain  tax  operating  loss  carry-forwards  in  a  non-U.S.  jurisdiction  would  not  be  realized  resulting  in  the 
recognition of a valuation allowance totaling approximately $7,982,000.  The 2007 valuation allowance was used in 2008 to 
offset a reduction in the operating loss carry-forward for the non-U.S. jurisdiction. 

Tax expense for 2007 and 2008 include benefits of approximately $3,125,000 and $2,879,000, respectively, for corrections 
relating to prior periods.   

39 

 
 
 
 
 
 
 
 
 
 
 
  
Operations by Segment 
The Company has two operating segments, Domestic and Global.   

The following table presents a summary of the operating information for the years ended 2008 and 2007: 

Domestic Segment 
The  Company’s  Domestic  segment  includes  revenue  contributions  and  expenditures  associated  with  business  activity  in  the 
United States.   

Operating earnings increased 7% to $720,342,000 in 2008 from $675,156,000 in 2007.  

(cid:131) 

(cid:131) 

(cid:131) 

Revenues  increased  7%  to  $1,307,510,000  in  2008  from  $1,227,434,000  in  2007.  This  increase  was  primarily 
driven by growth in managed services and support and maintenance. 

Cost of revenues was 17% and 18% in 2008 and 2007, respectively.  The decline was driven primarily by a lower level 
of hardware sales.  

Operating expenses increased 9% for 2008, compared to 2007, due primarily to growth in managed services.  

Global Segment 
The Company’s Global segment in 2008 and 2007 includes revenue contributions and expenditures linked to business activity 
in  Aruba,  Australia,  Austria,  Belgium,  Canada,  Cayman  Islands,  Chile,  China  (Hong  Kong),  Egypt,  England,  France,  Germany, 
India, Ireland, Malaysia, Puerto Rico, Saudi Arabia, Singapore, Spain, Sweden, Switzerland and the United Arab Emirates.  

Operating earnings increased 72% to $147,681,000 in 2008 from $85,955,000 in 2007.  

(cid:131) 

Revenues increased 27% to $368,518,000 in 2008 from $290,677,000 in 2007.  This increase was primarily driven 
by  an  increase  in  sales  in  Europe  and  the  Middle  East.    Global  revenue  includes  work  related  to  the  Company’s 
participation  in  the  NHS  initiative  to  automate  clinical  processes  and  digitize  medical  records  in  England.    Prior  to 
2008, the revenues related to this effort were accounted for using a zero margin approach of applying percentage of 
completion  accounting  resulting  from  the  Company’s  inability  to  accurately  estimate  the  work  effort  required  to 
complete  the  project  as  well  as  the  determination  of  fair  value  for  the  support  services  and  other  elements  which 
would not be accounted for in accordance with the percentage of completion accounting methodology. London is one 
of two regions in England in which the Company is participating.  As it relates to the London arrangement, during 2008 
the Company established fair value of the undelivered elements of the arrangement that are not subject to percentage 
of  completion  accounting.   Also,  during  the  fourth  quarter  of  2008  the  Company  realized  a  significant  milestone  in 

40 

 
 
 
 
 
 
 
 
 
 
London  which  significantly  enhances  the  Company’s  ability  to  make  reliable  estimates  of  the  work  effort  for  the 
remainder  of  the  contract.   These  events,  combined  with our  experience  since  the  contract  signed  in  2006  and  our 
experience  in  the  Southern  region  of  England,  allowed  the  Company  to  conclude  that  reasonably  dependable 
estimates of work effort could be produced and allow for margin recognition.  As a result, the Company’s fourth quarter 
2008  revenues  included  a  cumulative  catch-up  adjustment,  resulting  from  the  significant  change  in  accounting 
estimate,  in  the  amount  of  $28,640,000  which  represents  the  margin  on  the  contract  which  had  been  previously 
deferred  as  a  result  of  the  zero  margin  approach  of  applying  percentage  of  completion  accounting.    The  remaining 
margin  attributed  to  the  services  subject  to  SOP  81-1 will  be  recognized  over  the  remaining  service  period  until  the 
services are complete and amounts allocated to the other support services subject to SOP 97-2 will be recognized over 
the relevant support periods.  The contract expires in 2014. 

(cid:131) 

(cid:131) 

(cid:131) 

The  other  region  in  England  the  Company  is  participating  in  is  the  Southern  region.    During  the  second  quarter  of 
2008, the contract with Fujitsu, the prime contractor in the Southern region of England, was terminated which had the 
effect  of  automatically  terminating  the  Company’s  subcontract  for  the  project.    A  transition  services  agreement  was 
signed during the third quarter of 2008 that provides for ongoing services for the Trusts that already have live systems 
for  which  margin  was  recognized.    No  formal  timeline  has  been  set  for  addressing  the  implementations  at  the 
remaining Trusts, but the Company currently expects to play an ongoing role in this region.  Margin recognized in 2008 
was not significant. 

Cost  of  revenues  was  19%  and  18%  in  2008  and  2007,  respectively.    The  higher  cost  of  revenues  was  driven  by  a 
higher mix of hardware revenues in 2008. 

Operating  expenses  for  the  year  ended  January  3,  2009  decreased  less  than  1%,  compared  to  the  year  ended 
December 29, 2007. 

Other Segment 
The  Company’s  Other  segment  includes  revenues  and  expenses  which  are  not  tracked  by  geographic  segment.    Operating 
losses  increased  6%  to  $589,138,000  in  2008  from  $557,028,000  in  2007.  This  increase  was  primarily  due  to  increased 
research and development and general and administrative spending and a settlement with a third party supplier in the second 
quarter of 2008 related to the prior period usage of their software in the Company’s remote hosting business.  The third party 
supplier settlement increased Other segment expense by $8,014,000 in the second quarter of 2008.   

Year Ended December 29, 2007, Compared to Year Ended December 30, 2006 
The Company’s net earnings increased 16% to $127,125,000 in 2007 from $109,891,000 in 2006.  The effects of SFAS No. 
123R,  which  requires  the  expensing  of  stock  options,  decreased  net  earnings  in  2007  and  2006  by  $10,159,000,  net  of 
$6,030,000 tax benefit and $11,746,000, net of $7,275,000 tax benefit, respectively.   

Revenues increased 10% to $1,519,877,000 in 2007, compared with $1,378,038,000 in 2006.  The revenue composition for 
2007  was  $500,319,000  in  system  sales,  $397,713,000  in  support  and  maintenance,  $585,067,000  in  services  and 
$36,778,000 in reimbursed travel.   

(cid:131) 

(cid:131) 

System  sales  revenues  decreased  1%  to  $500,319,000  in  2007  from  $505,743,000  in  2006.    Included  in  system 
sales are revenues from the sale of software, hardware, sublicensed software, deployment period licensed software 
upgrade rights, installation fees, transaction processing and subscriptions.  The slight decrease in system sales was 
primarily  attributable  to  a  decrease  in  software  revenue,  which  was  largely  offset  by  an  increase  in  hardware, 
sublicensed software, and subscriptions revenue.  We believe the decline in software revenue was primarily caused by 
much of our client base being focused on upgrading to the Cerner Millennium 2007 release.  Cerner generally sells a 
perpetual  license,  so  our  clients  do  not  have  to  pay  new  license  fees  when  they  upgrade  to  a  new  version  of  our 
software, so the focus by much of our base on implementing the upgrade impacted our software sales.   

Support, maintenance and services revenues increased 18% to $982,780,000 in 2007 from $833,244,000 in 2006.  
Included  in  support,  maintenance  and  services  revenues  are  support  and  maintenance  of  software  and  hardware, 
professional  services  excluding  installation,  and  managed  services.    A  summary  of  the  Company’s  support, 
maintenance and services revenues in 2007 and 2006 is as follows: 

The $92,239,000, or 19%, increase in services revenue was attributable to growth in CernerWorks managed services 
and increased professional services utilization rates.  The $57,297,000, or 17%, increase in support and maintenance 
revenues was attributable to continued success at selling Cerner Millennium applications, implementing them at client 
sites, and initiating billing for support and maintenance fees. 

41 

 
 
 
 
 
 
 
 
 
(cid:131) 

Contract backlog, which reflects new business bookings that have not yet been recognized as revenue, increased 24% 
in  2007  compared  to  2006.    This  increase  was  driven  by  growth  in  new  business  bookings  during  the  past  four 
quarters, including continued strong levels of managed services bookings that typically have longer contract terms.  A 
summary of the Company’s total backlog for 2007 and 2006 follows: 

The  cost  of  revenues  was  18%  of  total  revenues  in  2007  and  21%  in  2006.    The  cost  of  revenues  includes  the  cost  of 
reimbursed  travel  expense,  sales  commissions,  third  party  consulting  services  and  subscription  content,  computer  hardware 
and sublicensed software purchased from hardware and software manufacturers for delivery to clients.  It also includes the cost 
of hardware maintenance and sublicensed software support subcontracted to the manufacturers.  Such costs, as a percent of 
revenues,  typically  have  varied  as  the  mix  of  revenue  (software,  hardware,  maintenance,  support,  services  and  reimbursed 
travel) carrying different margin rates changes from period to period.  The decline in cost of revenues as a percent of revenue 
was primarily associated with lower commissions and third party costs on licensed software sales and a higher mix of support, 
maintenance and services revenues, which have a lower cost of revenue. 

Total operating expenses, excluding cost of revenues, increased 12% to $1,035,684,000 in 2007 from $920,901,000 in 2006.  
Accounting pursuant to SFAS 123(R), which results in the expensing of share-based compensation, impacted expenses in 2007 
and 2006 as indicated below: 

(cid:131) 

(cid:131) 

Sales and client service expenses as a percent of total revenues were 43% and 42% in 2007 and 2006, respectively. 
These  expenses  increased  14%  to  $657,956,000  in  2007,  from  $578,050,000  in  2006.    Sales  and  client  service 
expenses  include  salaries  of  sales  and  client  service  personnel,  communications  expenses,  unreimbursed  travel 
expenses, expense for share-based payments, sales and marketing salaries and trade show and advertising costs. The 
increase was primarily attributable to growth in CernerWorks managed services business.  

Total expense for software development in 2007 increased 10% to $270,576,000, from $246,970,000 in 2006.  The 
increase  in  aggregate  expenditures  for  software  development  in  2007  was  due  to  continued  development  and 
enhancement  of  the  Cerner  Millennium  platform  and  software  solutions  and  investments  in  new  initiatives,  such  as 
RxStation medication dispensing devices.  Included in 2007 software development expense is $8.6 million of research 
and development activities for the RxStation medical dispensing device.  $3.4 million of this amount recorded in 2007 
is related to periods prior to 2007.  A summary of the Company’s total software development expense in 2007 and 
2006 is as follows: 

(cid:131)  General  and  administrative  expenses  as  a  percent  of  total  revenues  were  7%  in  2007  and  2006.  These  expenses 
increased 12% to $107,152,000 in 2007 from $95,881,000 in 2006.  This increase was due primarily to the growth 
of the Company’s core business and increased presence in the global market.  General and administrative expenses 
include salaries for corporate, financial and administrative staff, utilities, communications expenses, professional fees, 
the transaction gains or losses on foreign currency and expense for share-based payments.   The Company recorded a 
net transaction gain on foreign currency of $3,691,000 and $3,764,000 in 2007 and 2006, respectively.   

42 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Net  interest  income  was  $1,269,000  in  2007,  compared  with  net  interest  expense  of  $697,000  in  2006.    Interest  income 
increased  to  $13,206,000  in  2007  from  $11,877,000  in  2006,  due  primarily  to  higher  yields  on  cash  and  short  term 
investments.  Interest expense decreased to $11,937,000 in 2007 from $12,574,000 in 2006, due primarily to a reduction in 
long-term debt.  

Other expense was $1,385,000 in 2007, compared to other income of $2,074,000 in 2006.  Included in 2006 other income is 
a gain recorded in the first quarter of 2006 related to the renegotiation of a supplier contract that eliminated a liability related to 
unfavorable future commitments due to that supplier. The Company was able to renegotiate the contract to eliminate certain 
minimum volume requirements and reduce pricing to market rates leading to the elimination of the previously recorded liability.  

The  Company’s  effective  tax  rate  was  38%  and  34%  in  2007  and 2006,  respectively.    The change in  tax  rate  was  principally 
related to the creation of a valuation allowance in a non-U.S. jurisdiction in 2007.   

During the second quarter of 2007, the Company determined that due to a change in circumstances in the quarter, it is more 
likely  than  not  that  certain  tax  operating  loss  carry-forwards  in  a  non-U.S.  jurisdiction  would  not  be  realized  resulting  in  the 
recognition of a valuation allowance totaling approximately $7,982,000. 

Tax expense for 2007 and 2006 includes benefits of approximately $3,125,000 and $1,994,000, respectively for adjustments 
to correct certain tax items relating to prior periods. 

Operations by Segment 
The Company has two operating segments, Domestic and Global.   

The following table presents a summary of the operating information for the years ended 2007 and 2006: 

Domestic Segment 
The  Company’s  Domestic  segment  includes  revenue  contributions  and  expenditures  associated  with  business  activity  in  the 
United States.   

Operating earnings increased 11% to $675,156,000 in 2007 from $607,003,000 in 2006.  

43 

 
 
 
 
 
 
 
  
 
 
 
 
 
(cid:131) 

(cid:131) 

(cid:131) 

Revenues  increased  5%  to  $1,227,434,000  in  2007  from  $1,166,662,000  in  2006.  This  increase  was  primarily 
driven by growth in managed services and support and maintenance. 

Cost  of  revenues  was  18%  and  22%  in  2007  and  2006,  respectively.    The  decline  was  driven  primarily  by  lower 
commissions  and  third  party  costs  on  licensed  software  sales,  lower  hardware  sales,  and  a  higher  mix  of  support, 
maintenance and services revenues, which have a lower cost of revenue.  

Operating expenses increased 7% for the year ended December 29, 2007, as compared to the year ended December 
30, 2006, due primarily to growth in managed services.  

Global Segment 
The Company’s Global segment in 2007 and 2006 includes revenue contributions and expenditures linked to business activity 
in  Australia,  Austria,  Belgium,  Canada,  Cayman  Islands,  China  (Hong  Kong),  Egypt,  England,  France,  Germany,  India,  Ireland, 
Malaysia, Puerto Rico, Saudi Arabia, Singapore, Spain, Sweden, Switzerland and the United Arab Emirates.  

Operating earnings increased 42% to $85,955,000 in 2007 from $60,572,000 in 2006.  

(cid:131) 

(cid:131) 

(cid:131) 

Revenues  increased  40%  to  $290,677,000  in  2007  from  $207,367,000  in  2006.    Approximately  one  third  of  this 
increase was driven by an increase in revenue from the Company’s participation in the National Health Service (NHS) 
initiative to automate clinical processes and digitize medical records in England.  The increase in global revenue was 
also  driven  by  growth  in  several  other  countries,  including  Malaysia,  Australia,  Egypt,  France,  Spain  and  the  United 
Arab  Emirates.    Revenue  related  to  the  NHS  initiative  that  was  being  accounted  for  at  zero  margin  totaled 
$96,000,000  and  $71,000,000  for  the  2007  and  2006  fiscal  years,  respectively.    These  revenues  did  not  affect 
operating earnings as the Company was accounting for them at zero-margin using a zero margin approach of applying 
percentage of completion accounting until either the software customization and development services are completed 
or the Company is able to determine fair value for the support services.   

Cost  of  revenues  was  18%  and  19%  in  2007  and  2006,  respectively.    The  lower  cost  of  revenues  was  driven  by  a 
slightly higher mix of support, maintenance and services revenues, which have a lower cost of revenue.   

Operating expenses for the year ended December 29, 2007 increased 41%, compared to the year ended December 
30, 2006, primarily due to hiring personnel for the projects in England and supporting growth in other global regions.  

Other Segment 
The  Company’s  Other  segment  includes  revenues  and  expenses  which  are  not  tracked  by  geographic  segment.    Operating 
losses increased 11% to $557,028,000 in 2007 from $501,408,000 in 2006. This increase was primarily due to an increase in 
operating expenses such as software development, marketing, general and administrative, share-based compensation expense 
and depreciation. 

44 

 
 
 
 
 
 
 
Liquidity and Capital Resources 
The  Company's  liquidity  is  influenced  by  many  factors,  including  the  amount  and  timing  of  the  Company's  revenues,  its  cash 
collections  from  its  clients  and  the  amounts  the  Company  invests  in  software  development,  acquisitions  and  capital 
expenditures.   

The  Company’s  principal  source  of  liquidity  is  its  cash,  cash  equivalents  and  short-term  investments.    The  majority  of  the 
Company’s cash and cash equivalents consist of money market funds.  At January 3, 2009 the Company had cash and cash 
equivalents of $270,494,000, short-term investments of $38,400,000 and working capital of $517,650,000 compared to cash 
and  cash  equivalents  of  $182,914,000,  short-term  investments  of  $161,600,000  and  working  capital  of  $530,441,000  at 
December 29, 2007.      

At  January  3,  2009,  more  than  10  percent  of  total  net  receivables  represent  accounts  receivable  and  contracts  receivable 
related to a contract with Fujitsu that was terminated in the second quarter of 2008 when Fujitsu withdrew from the National 
Health Service (NHS) initiative to automate clinical processes and digitize medical records in the Southern region of England.  
The Company expects to collect these receivables in full based on the terms of the contract. 

At January 3, 2009, the Company held auction rate securities with a par value of $105,300,000 and an estimated fair value of 
$85,440,000.  In February and March 2008, liquidity issues in the global credit markets resulted in the progressive failure of 
auctions representing all the auction rate securities held by Cerner.  These conditions persisted through the remainder of 2008 
and into 2009.  In November 2008, the Company entered into a settlement agreement with the investment firm that sold the 
Company its auction rate securities.  Under the terms of the settlement agreement the Company received the right to redeem 
the securities at par value during a period from mid-2010 through mid-2012.  The right to redeem the securities is being treated 
similar  to  a  put  option,  which  the  Company  has  elected  to  measure  under  the  fair  value  option  of  Statement  of  Financial 
Accounting  Standards  No.  159  (SFAS  No.  159),  “The  Fair  Value  Option  for  Financial  Assets  and  Financial  Liabilities.”    The 
Company’s  valuation  model  resulted  in  a  pre-tax,  estimated  value  of  $19,860,000  for  the  value  of  the  put-like  settlement 
feature, which such gain was recognized through other income.  

Concurrently with the recognition of the put-like feature, the Company transferred the auction rate securities from available-for-
sale to trading securities.  As a result of the transfer, the Company recognized a pre-tax, other than temporary impairment loss 
of  approximately  $19,860,000  in  other  income.    The  recording  of  the  put-like  feature  and  the  recognition  of  the  other  than 
temporary impairment loss on the securities resulted in no impact to the Consolidated Statements of Operating Earnings for the 
year ended January 3, 2009.   The Company anticipates that any future changes in the fair value of the put-like feature will be 
offset  by  the  changes  in  the  fair  value  of  the  related  auction  rate  securities  with  no  material  net  impact  to  the  Consolidated 
Statements of Earnings.  For a more detailed discussion of the auction rate securities situation, please refer to Note (7) to the 
consolidated  financial  statements.    Cerner  does  not  expect  the  auction  failures  to  impact  the  Company’s  ability  to  fund  its 
working capital needs, capital expenditures or other business requirements. 

Cash Flows from Operating Activities 
The  Company  generated  cash  of  $281,802,000,  $274,565,000,  and  $232,718,000  from  operations  in  2008,  2007,  and 
2006,  respectively.    Cash  flow  from  operations  increased  in  2008  due  primarily  to  the  increase  in  net  earnings  which  was 
partially  offset  by  changes  in  working  capital.    The  Company  has  periodically  provided  long-term  financing  options  to 
creditworthy clients through third party financing institutions and has directly provided extended payment terms to clients from 
contract  date.    These  extended  payment  term  arrangements  typically  provide  for  date  based  payments  over  periods  ranging 
from 12 months to seven years.  Pursuant to SOP 97-2, because a significant portion of the fee is due beyond one year, we have 
analyzed  our  history  with  these  types  of arrangements  and  have  concluded  that  we do  have  a  standard  business  practice  of 
using extended payment term arrangements and have a long history of successfully collecting under the original payment terms 
for arrangements with similar clients, product offerings and economics without granting concessions.  Accordingly, we consider 
the  fee  to  be  fixed  and  determinable  in  these  extended  payment  term  arrangements  and,  thus,  the  timing  of  revenue  is  not 
impacted  by  the  existence  of  extended  payments.    Some  of  these  payment  streams  have  been  assigned  on  a  non-recourse 
basis to third party financing institutions. The Company has provided its usual and customary performance guarantees to the 
third party financing institutions in connection with its on-going obligations under the client contract.  During 2008, 2007, and 
2006,  the  Company  received  total  client  cash  collections  of  $1,729,526,000,  $1,646,584,000,  and  $1,457,603,000, 
respectively,  of  which  approximately  5%,  5%,  and  7%  were  received  from  third  party  client  financing  arrangements  and  non-
recourse payment assignments, respectively.  The days sales outstanding increased to 92 days for the quarter ended January 3, 
2009 compared to 90 days for the quarter ended December 29, 2007.   Revenues provided under support and maintenance 
agreements represent recurring cash flows.  Support and maintenance revenues increased 19% in 2008 and 17% in 2007, and 
the Company expects these revenues to continue to grow as the base of installed Cerner Millennium systems grows. 

Cash Flows from Investing Activities 
Cash  used  in  investing  activities  in  2008  consisted  primarily  of  capital  purchases  of  $108,099,000,  which  includes 
$89,904,000 of capital equipment and $18,195,000 of land, buildings and improvements.   Capitalized software development 
costs were $70,098,000 in 2008.  Payments aggregating $5,719,000 were made during 2008 for an acquisition of a business 
and  an  earnout  payment  related  to  a  2005  acquisition.    Cash  received  from  short-term  investments,  net  of  purchases  was 
$17,510,000  in  2008.    Cash  used  in  investing  activities  in  2007  consisted  primarily  of  capital  purchases  of  $180,723,000, 
which  includes  $105,678,000  of  capital  equipment  and  $75,045,000  of  land,  buildings  and  improvements.    Capitalized 

45 

 
 
 
 
 
 
 
 
 
software development costs were $66,063,000 and the acquisition of businesses totaled $24,061,000.  Cash paid for short-
term investments, net of sales and maturities, was $13,277,000 in 2007. 

In  the  second  quarter  of  2007,  the  Company  completed  the  construction  of  a  new  data  center  on  its  World  Headquarters 
campus in North Kansas City, Missouri.  The Company spent approximately $61,203,000 on this construction project.  Of this 
amount, approximately $26,858,000 was spent in 2007, with the remainder being spent in prior years.  

Cash Flows from Financing Activities 
The  Company’s  2008  financing  activities  consisted  of  proceeds  from  the  exercise of  options  of  $15,364,000,  the  excess  tax 
benefit  from  share-based  compensation  of  $9,166,000,  net  repayment  of  long-term  debt  of  $15,317,000,  sales  of  future 
receivables  of  $7,135,000,  and  purchases  of  treasury  stock  of  $28,002,000.    In  2007,  the  Company’s  financing  activities 
consisted  primarily  of  proceeds  from  the  exercise  of  options  of  $29,085,000,  the  excess  tax  benefit  from  share-based 
compensation of $30,357,000 and repayment of long-term debt of $22,359,000. 

In December 2008, the Company had a same-day borrowing of $44,500,000 from its line of credit which was repaid that same 
day.  This was in connection with tax incentives related to the World Headquarters data center and the Innovation Campus.  In 
December  2007,  the  Company  had  a  one-day  borrowing  of  $40,000,000  from  its  line  of  credit  which  was  repaid  on  the 
following day.  This was in connection with tax incentives related to the World Headquarters data center.   

In November 2005, the Company completed a £65,000,000 ($94,556,000 at January 3, 2009) private placement of debt at 
5.54%  pursuant  to  a  Note  Agreement.    The  Note  Agreement  is  payable  in  seven  equal  annual  installments  beginning  in 
November 2009. The proceeds were used to repay the outstanding amount under the Company’s credit facility and for general 
corporate purposes.  The Note Agreement contains certain net worth and fixed charge coverage covenants and provides certain 
restrictions on the Company’s ability to borrow, incur liens, sell assets and pay dividends.  The Company was in compliance with 
all covenants at January 3, 2009. 

In  December  2002,  the  Company  completed  a  $60,000,000  private  placement  of  debt  pursuant  to  a  Note  Agreement.    The 
Series A Senior Notes, with a $21,000,000 principal amount at 5.57% were paid in full by the end of 2008.  The Series B Senior 
notes,  with  a  $39,000,000  principal  amount  at  6.42%,  are  payable  in  four  equal  annual  installments  beginning  December 
2009.  The proceeds were used to repay the outstanding amount under the Company’s credit facility and for general corporate 
purposes.    The  Note  Agreement  contains  certain  net  worth  and  fixed  charge  coverage  covenants  and  provides  certain 
restrictions on the Company’s ability to borrow, incur liens, sell assets and pay dividends.  The Company was in compliance with 
all covenants at January 3, 2009.   

In May 2002, the Company expanded its credit facility by entering into an unsecured credit agreement with a group of banks led 
by US Bank.  This agreement was amended and restated on November 30, 2006, and provides for a current revolving line of 
credit for working capital purposes.  The current revolving line of credit is unsecured and requires monthly payments of interest 
only.    Interest  is  payable  at  the  Company’s  option  at  a  rate  based  on  prime  (3.25%  at  January  3,  2009)  or  LIBOR  (1.41%  at 
January 3, 2009) plus 1.55%.  The interest rate may be reduced by up to 1.15% if certain net worth ratios are maintained.  The 
agreement contains certain net worth, current ratio, and fixed charge coverage covenants and provides certain restrictions on 
the Company’s ability to borrow, incur liens, sell assets and pay dividends.  A commitment fee of .2% is payable quarterly based 
on  the  usage  of  the  revolving  line  of  credit.    The  revolving  line  of  credit  matures  on  May  31,  2010.    At  January  3,  2009,  the 
Company had no outstanding borrowings under this agreement and had $90,000,000 available for working capital purposes.  
The Company was in compliance with all covenants at January 3, 2009.   

In April 1999, the Company completed a $100,000,000 private placement of debt pursuant to a Note Agreement.  The Series A 
Senior Notes, with a $60,000,000 principal amount at 7.14%, were paid in full by the end of 2006.  The Series B Senior Notes, 
with a $40,000,000 principal amount at 7.66%, are payable in six equal annual installments which commenced in April 2004.  
The  proceeds  were  used  to  retire  the  Company’s  then-existing  $30,000,000  of  debt,  and  the  remaining  funds  were  used  for 
capital improvements and to strengthen the Company’s cash position.  The Note Agreement contains certain net worth, current 
ratio, and fixed charge coverage covenants and provides certain restrictions on the Company’s ability to borrow, incur liens, sell 
assets and pay dividends.  The Company was in compliance with all covenants at January 3, 2009.   

The  Company  believes  that  its  present  cash  position,  together  with  cash  generated  from  operations,  short-term  investments 
and, if necessary, its lines of credit, will be sufficient to meet anticipated cash requirements during 2009. 

The following table represents a summary of the Company’s  contractual obligations and commercial commitments, excluding 
interest, as of January 3, 2009, except short-term purchase order commitments arising in the ordinary course of business. 

46 

 
 
 
 
 
 
   
 
 
   
 
 
 
The effects of inflation on the Company's business during 2008, 2007 and 2006 were not significant. 

Recent Accounting Pronouncements 
In September 2006, the Financial Accounting Standards Board (FASB) issued Statement of Financial Accounting Standards No. 
157  (SFAS  157),  "Fair  Value  Measurements."    This  statement  establishes  a  single  authoritative  definition  of  fair  value  when 
accounting rules require the use of fair value, sets out a framework for measuring fair value and requires additional disclosures 
about fair value measurements.  On February 12, 2008, the FASB issued FASB Staff Position (FSP) No. FAS 157-2.  This FSP 
defers the effective date of SFAS 157 to fiscal years beginning after November 15, 2008 for nonfinancial assets and liabilities 
within the scope of the FSP.  The Company adopted SFAS 157 for fair value measurement outside of the scope of FSP No. 157-
2 on December 30, 2007.  On October 10, 2008, the FASB issued FSP No. FAS 157-3 that clarifies the application of SFAS 157 
in  a  market  that  is  not  active.    FSP  No.  157-3  is  effective  for  all  periods  presented  in  accordance  with  SFAS  157  and  the 
Company has considered the guidance with respect to the valuation of its financial assets and their designation within the fair 
value hierarchy.  The Company was required to fully adopt SFAS 157 as of the first day of the 2009 fiscal year and does not 
expect its adoption to have a material impact on the Company’s consolidated financial statements. 

In  December  2007,  the  FASB  issued  Statement  of  Financial  Accounting  Standards  No.  141  (revised  2007),  “Business 
Combinations”  (SFAS  141(R))  which  replaces  SFAS  141  and  supersedes  FIN  4,  “Applicability  of  FASB  Statement  No.  2  to 
Business  Combinations  Accounted  for  by  the  Purchase  Method.”    SFAS  141(R)  establishes  guidelines  for  how  an  acquirer 
measures  and  recognizes  the  identifiable  assets,  goodwill,  noncontrolling  interest,  and  liabilities  assumed  in  a  business 
combination.    Additionally,  SFAS  141(R)  outlines  the  disclosures  necessary  to  allow  financial  statement  users  to  assess  the 
impact  of  the  acquisition.    The  Company  is  currently  assessing  the  impact  of  adoption  of  SFAS  141(R),  which  will  depend  on 
future acquisition activity, and will be required to adopt SFAS 141(R) prospectively for business combinations occurring on or 
after the first day of the 2009 fiscal year.  

Also  in  December  2007,  the  FASB  issued  Statement  of  Financial  Accounting  Standards  No. 160  (SFAS  160),  “Noncontrolling 
Interests in Consolidated Financial Statements,” which amends ARB No. 51.  SFAS 160 guides that a noncontrolling interest in 
a subsidiary should be reported as equity in the consolidated financial statements, and that net income should be reported at 
amounts  that  include  the  amounts  attributable  to  both  the  parent  and  the  noncontrolling  interest.    The  Company  is  currently 
assessing the impact of adoption of SFAS 160 on its results of operations, which is expected to be immaterial, and its financial 
position and was required to adopt SFAS 160 as of the first day of the 2009 fiscal year. 

In  March  2008,  the  FASB  issued  Statement  of  Accounting  Standards  No.  161  (SFAS  161),  “Disclosures  about  Derivative 
Instruments and Hedging Activities – an amendment of FASB Statement No. 133.”  SFAS 161 requires enhanced disclosures 
about  the  uses  of  derivative  instruments  and  hedging  activities,  how  these  activities  are  accounted  for,  and  their  respective 
impact on an entity’s financial position, financial performance, and cash flows.  The Company is currently assessing the impact 
of  adoption  of  SFAS  161  on  its  results  of  operations  and  its  financial  position,  which  is  expected  to  be  immaterial,  and  was 
required to adopt SFAS 161 as of the first day of the 2009 fiscal year. 

Critical Accounting Policies 
The Company believes that there are several accounting policies that are critical to understanding the Company’s historical and 
future  performance,  as  these  policies  affect  the  reported  amount  of  revenue  and  other  significant  areas  involving 
management’s  judgments  and  estimates.    These  significant  accounting  policies  relate  to  revenue  recognition,  software 
development,  potential  impairments  of  goodwill  and  income  taxes.    These  policies  and  the  Company’s  procedures  related  to 
these  policies  are  described  in  detail  below  and  under  specific  areas  within  this  “Management  Discussion  and  Analysis  of 
Financial  Condition  and  Results  of  Operations.”    In  addition,  Note  1  to  the  consolidated  financial  statements  expands  upon 
discussion of the Company’s accounting policies. 

47 

 
 
 
 
 
 
  
 
 
 
 
Revenue Recognition 
The  Company  recognizes  its  multiple  element  arrangements,  including  software  and  software-related  services,  using  the 
residual  method  under  SOP  97-2,  “Software Revenue  Recognition,”  as  amended  by  SOP  No.  98-4,  SOP  98-9  and  clarified  by 
Staff Accounting Bulletin’s (SAB) 104 “Revenue Recognition” and Emerging Issues Task Force 00-21 “Accounting for Revenue 
Arrangements  with  Multiple  Deliverables”  (“EITF  00-21”).    Key  factors  in  the  Company’s  revenue  recognition  model  are 
management’s  assessments  that  installation  services  are  essential  to  the  functionality  of  the  Company’s  software  whereas 
implementation  services  are  not;  and  the  length  of  time  it  takes  for  the  Company  to  achieve  its  delivery  and  installation 
milestones for its licensed software.  If the Company’s business model were to change such that implementation services are 
deemed to be essential to the functionality of the Company’s software, the period of time over which the Company’s licensed 
software revenue would be recognized would lengthen.  The Company generally recognizes combined revenue from the sale of 
its licensed software and related installation services over two key milestones, delivery and installation, based on percentages 
that  reflect  the  underlying  effort  from  planning  to  installation.    Generally,  both  milestones  are  achieved  in  the  quarter  the 
contracts  are  executed.    If  the  period  of  time  to  achieve  the  Company’s  delivery  and  installation  milestones  for  its  licensed 
software  were  to  lengthen,  its  milestones  would  be  adjusted  and  the  timing  of  revenue  recognition  for  its  licensed  software 
could materially change. 

The Company also recognizes revenue for certain projects using the percentage of completion method pursuant to Statement of 
Position  81-1  (SOP  81-1),  “Accounting  for  Performance  of  Construction-Type  and  Certain  Production-Type  Contracts,”  as 
prescribed by SOP 97-2.  The Company’s revenue recognition is dependent upon the Company’s ability to reliably estimate the 
direct labor hours to complete a project which in some cases can span several years.  The Company utilizes its historical project 
experience and detailed planning process as a basis for its future estimates to complete current projects. Significant delays in 
completion of the projects, unforeseen cost increases or penalties could result in significant reductions to revenue and margins 
on these contracts. 

Software Development Costs 
Costs  incurred  internally  in  creating  computer  software  solutions  and  enhancements  to  those  solutions  are  expensed  until 
completion  of  a  detailed  program  design,  which  is  when  the  Company  determines  that  technological  feasibility  has  been 
established.  Thereafter,  all  software  development  costs  are  capitalized  until  such  time  as  the  software  solutions  and 
enhancements are available for general release, and the capitalized costs subsequently are reported at the lower of amortized 
cost  or  net  realizable  value.    Net  realizable  value  is  computed  as  the  estimated  gross  future  revenues  from  each  software 
solution less the amount of estimated future costs of completing and disposing of that product.  Because the development of 
projected  net  future  revenues  related  to  our  software  solutions  used  in  our  net  realizable  value  computation  is  based  on 
estimates,  a  significant  reduction  in  our  future  revenues  could  impact  the  recovery  of  our  capitalized  software  development 
costs.    We  historically  have  not  experienced  significant  inaccuracies  in  computing  the  net  realizable  value  of  our  software 
solutions and the difference between the net realizable value and the unamortized cost has grown over the past three years.  
We expect that trend to continue in the future.  If we missed our estimates of net future revenues by up to 10%, the amount of 
our  capitalized  software  development  costs  would  not  be  impaired.    Capitalized  costs  are  amortized  based  on  current  and 
expected  net  future  revenue  for  each  software  solution  with  minimum  annual  amortization  equal  to  the  straight-line 
amortization over the estimated economic life of the software solution.  The Company is amortizing capitalized costs over five 
years.    The  five-year  period  over  which  capitalized  software  development  costs  are  amortized  is  an  estimate  based  upon  the 
Company’s forecast of a reasonable useful life for the capitalized costs.  Historically, use of the Company’s software programs 
by its clients has exceeded five years and is capable of being used a decade or more.   

The  Company  expects  that  major  software  information  systems  companies,  large  information  technology  consulting  service 
providers and systems integrators and others specializing in the healthcare industry may offer competitive products or services.  
The pace of change in the HIT market is rapid and there are frequent new product introductions, product enhancements and 
evolving  industry  standards  and  requirements.    As  a  result,  the  capitalized  software  solutions  may  become  less  valuable  or 
obsolete and could be subject to impairment. 

Fair Value Measurements 
On  December  30,  2007,  the  Company  adopted  the  provisions  of  SFAS  157,  “Fair  Value  Measurements”  except  for  portions 
related  to  the  non-financial  assets  and  liabilities  within  the scope  of  the  deferral  provided  by  FSP  No.  FAS  157-2.    The  three 
levels of the fair value hierarchy defined by SFAS No. 157 are as follows: 

(cid:131) 

(cid:131) 

(cid:131) 

Level 1 – Valuations based on quoted prices in active markets for identical assets or liabilities that the entity has the 
ability to access. 

Level  2  –  Valuations  based  on  quoted  prices  for  similar  assets  or  liabilities,  quoted  prices  in  markets  that  are  not 
active, or other inputs that are observable or can be corroborated by observable data for substantially the full term of 
the assets or liabilities. 

Level 3 – Valuations based on inputs that are supported by little or no market activity and that are significant to the 
fair value of the assets or liabilities. 

At January 3, 2009, the Company held investments in commercial paper along with auction rate securities.  Commercial paper 
consists of short-term corporate debt with maturities of less than three months.  All of the commercial paper held at January 3, 
2009 was rated P1/A1 or higher.  Auction rate securities are debt instruments with long-term nominal maturities, for which the 

48 

 
 
 
 
 
 
 
interest  rates  regularly  reset  every  7-35  days  under  an  auction  system.    Due  to  the  lack  of  availability  of  observable  market 
quotes on the Company’s investment portfolio of auction rate securities, the Company utilizes valuation models including those 
that are based on discounted cash flow streams, including assessments of counterparty credit quality, default risk underlying 
the  security,  discount  rates  and  overall  capital  market  liquidity.  The  valuation  is  subject  to  uncertainties  that  are  difficult  to 
predict.  

A  considerable  amount  of  judgment  and  estimation  is  applied  in  the  valuation  of  auction  rate  securities.  In  addition,  the 
Company  also  applies  judgment  in  determining  whether  the  marketable  securities  are  other-than-temporarily  impaired.  The 
Company typically considers the severity and duration of the decline, future prospects of the issuer and the Company’s ability 
and intent to hold the security to recovery. 

Goodwill 
The Company accounts for its  goodwill under  the provisions  of Statement of Financial  Accounting  Standards (SFAS) No.  142, 
“Goodwill and Other Intangible Assets.”  As a result, goodwill and intangible assets with indefinite lives are not amortized but are 
evaluated for  impairment  annually or whenever there  is an impairment  indicator.  All goodwill  is assigned to a reporting  unit, 
where  it  is  subject  to  an  annual  impairment  test  based on  fair  value.    The Company  assesses  goodwill  for  impairment  in  the 
second  quarter  of  each  fiscal  year  and  evaluates  impairment  indicators  at  each  quarter  end.    The  Company  assessed  its 
goodwill for impairment in the second quarters of 2008 and 2007 and concluded that no goodwill was impaired.  The Company 
used  a  discounted  cash  flow  analysis  to determine  the  fair  value  of  the  reporting  units  for  all  periods.  Goodwill  amounted  to 
$146,666,000 and $143,924,000 at January 3, 2009 and December 29, 2007, respectively.  If future, anticipated cash flows 
from the Company’s reporting units that recognized goodwill do not materialize as expected the Company’s goodwill could be 
impaired, which could result in significant write-offs.     

Income Taxes 
In  2006,  the  FASB  issued  Interpretation  No.  48  (FIN  48),  “Accounting  for  Uncertainty  in  Income  Taxes  –  an  Interpretation  of 
SFAS  No.  109.”  FIN  48  clarifies  the  accounting  for  uncertainty  in  income  taxes  recognized  in  an  enterprise’s  financial 
statements in accordance with SFAS No. 109, “Accounting for Income Taxes.” FIN 48 also prescribes a recognition threshold 
and measurement of a tax position taken or expected to be taken in an enterprise’s tax return. Management makes a number 
of  assumptions  and  estimates  in  determining  the  appropriate  amount  of  expense  to  record  for  income  taxes.    These 
assumptions and estimates consider the taxing jurisdiction in which the Company operates as well as current tax regulations.  
Accruals  are  established  for  estimates  of  tax  effects  for  certain  transactions,  business  structures  and  future  projected 
profitability of the Company’s businesses based on management’s interpretation of existing facts and circumstances.  If these 
assumptions and estimates were to change as a result of new evidence or changes in circumstances the change in estimate 
could result in a material adjustment to the consolidated financial statements.   The Company adopted FIN 48 effective at the 
beginning of 2007. The adoption of FIN 48 did not have a material impact on Cerner’s consolidated financial position.  See Note 
11 to the consolidated financial statements for additional disclosures related to FIN 48. 

Our management has discussed the development and selection of these critical accounting estimates with the Audit Committee 
of our Board of Directors and the Audit Committee has reviewed the Company's disclosure contained herein. 

Item 7A.  Quantitative and Qualitative Disclosures about Market Risk 
At January 3, 2009, the Company had a £65,000,000 ($94,556,000 at January 3, 2009) note payable outstanding through a 
private placement with an interest rate of 5.54%.  The note is payable in seven equal installments beginning in November 2009.  
Because the borrowing is denominated in pounds, the Company is exposed to movements in the foreign currency exchange rate 
between the U.S. dollar and the Great Britain pound.  The note was entered into for other than trading purposes.  Beginning in 
2006, at the beginning of each quarterly period, the Company designated a portion (between £60 million and £63 million during 
the year) of its debt (£65 million) that is denominated in Great Britain Pounds, to hedge its net investment in a subsidiary  in 
England.    During  2007  and  2008  the  Company  designated  all  £65  million  of  its  debt  that  is  denominated  in  Great  Britain 
Pounds.   

Item 8.  Financial Statements and Supplementary Data 
The Financial Statements and Notes required by this Item are submitted as a separate part of this report. 

Item 9.  Changes in and Disagreements with Accountants on Accounting and 
Financial Disclosure 
N/A 

49 

 
 
 
 
 
 
 
 
 
 
Item 9A. Controls and Procedures 

a)  Evaluation  of  disclosure  controls  and  procedures.    The Company’s  Chief  Executive  Officer  (CEO)  and  Chief  Financial 
Officer (CFO) have evaluated the effectiveness of the Company’s disclosure controls and procedures (as defined in the 
Exchange  Act  Rules  13a-15(e)  and  15d-15(e))  as  of  the  end  of  the  period  covered  by  the  Annual  Report  (the 
“Evaluation Date”).  They have concluded that, as of the Evaluation Date, these disclosure  controls and procedures 
were effective to ensure that material information relating to the Company and its consolidated subsidiaries would be 
made known to them by others within those entities and would be disclosed on a timely basis.  The CEO and CFO have 
concluded that the Company’s disclosure controls and procedures are designed, and are effective, to give reasonable 
assurance that the information required to be disclosed by the Company in reports that it files under the Exchange Act 
is recorded, processed, summarized and reported within the time period specified in the rules and forms of the SEC.  
They  have  also  concluded  that  the  Company’s  disclosure  controls  and  procedures  are  effective  to  ensure  that 
information  required  to  be  disclosed  in  the  reports  that  are  filed  or  submitted  under  the  Exchange  Act  are 
accumulated and communicated to the Company’s management, including the CEO and CFO, to allow timely decisions 
regarding required disclosure.  

b) 

c) 

There  were  no  changes  in  the  Company’s  internal  controls  over  financial  reporting  during  the  three  months  ended 
January 3, 2009, that have materially affected, or are reasonably likely to materially affect, its internal controls over 
financial reporting. 

The Company’s management, including its Chief Executive Officer and Chief Financial Officer, have concluded that our 
disclosure  controls  and  procedures  and  internal  control  over  financial  reporting  are  designed  to  provide  reasonable 
assurance of achieving their objectives and are effective at that reasonable assurance level.  However, the Company’s 
management  can  provide  no  assurance  that  our  disclosure  controls  and  procedures  or  our  internal  control  over 
financial reporting can prevent all errors and all fraud under all circumstances.  A control system, no matter how well 
conceived  and  operated,  can  provide  only  reasonable,  not  absolute,  assurance  that  the  objectives  of  the  control 
system are met. Further, the design of a control system must reflect the fact that there are resource constraints, and 
the  benefits  of  controls  must  be  considered  relative  to  their  costs.  Because  of  the  inherent  limitations  in  all  control 
systems,  no  evaluation  of  controls  can  provide  absolute  assurance  that  all  control  issues  and  instances  of  fraud,  if 
any,  within  the  Company  have  been  or  will  be  detected.    The design  of  any  system  of  controls  also  is  based  in  part 
upon certain assumptions about the likelihood of future events, and there can be no assurance that any design will 
succeed in achieving its stated goals under all potential future conditions; over time, controls may become inadequate 
because of changes in conditions, or the degree of compliance with policies or procedures may deteriorate. Because 
of the inherent limitations in a cost-effective control system, misstatements due to error or fraud may occur and not be 
detected. 

Management’s Report on Internal Control over Financial Reporting 
The Company’s management is responsible for establishing and maintaining adequate internal control over financial reporting 
(as defined in Rule 13a-15(f) under the Securities Exchange Act of 1934, as amended).  The Company’s management assessed 
the effectiveness of the Company’s internal control over financial reporting as of January 3, 2009.  In making this assessment, 
the  Company’s  management  used  the  criteria  set  forth  by  the  Committee  of  Sponsoring  Organizations  of  the  Treadway 
Commission  (“COSO”)  in  its  Internal  Control-Integrated  Framework.    The  Company’s  management  has  concluded  that,  as  of 
January 3, 2009, the Company’s internal control over financial reporting is effective based on these criteria.  The Company’s 
independent registered public accounting firm that audited the consolidated financial statements included in the annual report 
has  issued  an  audit  report  on  the  effectiveness  of  the  Company’s  internal  control  over  financial  reporting,  which  is  included 
herein under “Report of Independent Registered Public Accounting Firm”. 

Item 9B. Other Information 
N/A 

50 

 
 
 
 
 
 
 
 
PART III 
Item 10.  Directors, Executive Officers and Corporate Governance 
The information required by this Item 10 regarding our Directors will be set forth under the caption “Election of Directors” in our 
Proxy  Statement  in  connection  with  the  2009  Annual  Shareholders’  Meeting  scheduled  to  be  held  May  22,  2009,  and  is 
incorporated in this Item 10 by reference.  The information required by this Item 10 concerning compliance with Section 16(a) 
of  the  Securities  Exchange  Act  of  1934  will  be  set  forth  under  the  caption  “Section  16(a)  Beneficial  Ownership  Reporting 
Compliance” in our Proxy Statement in connection with the 2009 Annual Shareholders’ Meeting scheduled to be held May 22, 
2009, and is incorporated in this Item 10 by reference.  

The information required by this Item 10 concerning our Code of Business Conduct and Ethics will be set forth under the caption 
“Code  of  Business  Conduct  and  Ethics”  in  our  Proxy  Statement  in  connection  with  the  2009  Annual  Shareholders’  Meeting 
scheduled to be held May 22, 2009, and is incorporated in this Item 10 by reference.  The information required by this Item 10 
concerning our Audit Committee and our Audit Committee financial expert will be set forth under the caption “Audit Committee” 
in our Proxy Statement in connection with the 2009 Annual Shareholders’ Meeting scheduled to be held May 22, 2009, and is 
incorporated in this Item 10 by reference. 

There have been no material changes to the procedures by which security holders may recommend nominees to our Board of 
Directors since our last disclosure thereof. 

The  following  table  sets  forth  the  names,  ages,  positions  and  certain  other  information  regarding  the  Company’s  executive 
officers as of February 27, 2009.  Officers are elected annually and serve at the discretion of the Board of Directors.   

Name   

     Age              Positions 

Neal L. Patterson   

Clifford W. Illig 

Earl H. Devanny, III  

Marc G. Naughton  

Michael R. Nill 

Randy D. Sims 

Jeffrey A. Townsend  

Mike Valentine 

Julia M. Wilson 

59 

58 

57 

53 

44 

48 

45 

40    

46 

Chairman of the Board of Directors and Chief Executive Officer  

Vice Chairman of the Board of Directors 

President 

Senior Vice President and Chief Financial Officer 

Executive Vice President and Chief Engineering Officer 

Vice President, Chief Legal Officer and Secretary 

Executive Vice President 

Executive Vice President and General Manager, U.S. 

Senior Vice President and Chief People Officer 

Neal L. Patterson has been Chairman of the Board of Directors and Chief Executive Officer of the Company for more than five 
years.  Mr. Patterson also served as President of the Company from March of 1999 until August of 1999. 

Clifford W. Illig has been a Director of the Company for more than five years.  He also served as Chief Operating Officer of the 
Company for more than five years until October 1998 and as President of the Company for more than five years until March of 
1999.  Mr. Illig was appointed Vice Chairman of the Board of Directors in March of 1999. 

Earl H. Devanny, III joined the Company in August of 1999 as President.  Mr. Devanny also served as interim President of Cerner 
Southeast  from  January  2003  through  July  2003.    Prior  to  joining  the  Company,  Mr.  Devanny  served  as  president  of  ADAC 
Healthcare Information Systems, Inc.  Prior to joining ADAC, Mr. Devanny served as a Vice President of the Company from 1994 
to 1997.  Prior to that he spent 17 years with IBM Corporation.  

Marc  G.  Naughton  joined  the  Company  in  November  1992  as  Manager  of  Taxes.    In  November  1995  he  was  named  Chief 
Financial Officer and in February 1996 he was promoted to Vice President.  He was promoted to Senior Vice President in March 
2002.   

Michael  R.  Nill  joined  the  Company  in  November,  1996.    Since  that  time  he  has  held  several  positions  in  the  Technology, 
Intellectual  Property  and  CernerWorks  client  hosting  organizations.    He  was  promoted  to  Vice  President  in  January  2000, 
promoted to Senior Vice President in April 2006 and promoted to Executive Vice President and named Chief Engineering Officer 
in February 2009.  

51 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Randy D. Sims joined the Company in March 1997 as Vice President and Chief Legal Officer.  Prior to joining the Company, Mr. 
Sims worked at Farmland Industries, Inc. for three years where he served most recently as Associate General Counsel.  Prior to 
Farmland,  Mr.  Sims  was  in-house  legal  counsel  at  The  Marley  Company  for  seven  years,  holding  the  position  of  Assistant 
General Counsel when he left to join Farmland. 

Jeffrey A. Townsend joined the Company in June 1985.  Since that time he has held several positions in the Intellectual Property 
Organization  and  was  promoted  to  Vice  President  in  February  1997.    He  was  appointed  Chief  Engineering  Officer  in  March 
1998, promoted to Senior Vice President in March 2001 and promoted to Executive Vice President in March 2005.  

Mike Valentine joined the Company in December 1998 as Director of Technology.  He was promoted to Vice President in 2000 
and  to  President  of  Cerner  Mid  America  in  January  of  2003.    In  February  2005,  he  was  named  General  Manager  of  the  U.S. 
Client Organization and was promoted to Senior Vice President in March 2005.  He was promoted to Executive Vice President in 
March 2007.  Prior to joining the Company, Mr. Valentine was with Accenture Consulting. 

Julia M. Wilson joined the Company in November 1995.  Since that time, she has held several positions in the Functional Group 
Organization.    She  was  promoted  to  Vice  President  and  Chief  People  Officer  in  August  2003  and  to  Senior  Vice  President  in 
March 2007. 

Item 11.  Executive Compensation 
The  information  required  by  this  Item  11  concerning  our  executive  compensation  will  be  set  forth  under  the  caption 
“Compensation  Discussion  and  Analysis”  in  our  Proxy  Statement  in  connection  with  the  2009  Annual  Shareholders’  Meeting 
scheduled to be held May 22, 2009, and is incorporated in this Item 11 by reference.  The information required by this Item 11 
concerning  Compensation  Committee  interlocks  and  insider  participation  will  be  set  forth  under  the  caption  “Compensation 
Committee  Interlocks  and  Insider  Participation”  in  our  Proxy  Statement  in  connection  with  the  2009  Annual  Shareholders’ 
Meeting scheduled to be held May 22, 2009, and is incorporated in this Item 11 by reference.  The information required by this 
Item 11 concerning Compensation Committee report will be set forth under the caption “Compensation Committee Report” in 
our  Proxy  Statement  in  connection  with  the  2009  Annual  Shareholders’  Meeting  scheduled  to  be  held  May  22,  2009,  and  is 
incorporated in this Item 11 by reference.   

Item 12.  Security Ownership of Certain Beneficial Owners and Management and 
Related Stockholder Matters 
The information required by this Item 12 will be set forth under the caption "Voting Securities and Principal Holders Thereof" in 
our  Proxy  Statement  in  connection  with  the  2009  Annual  Shareholders’  Meeting  scheduled  to  be  held  May  22,  2009,  and  is 
incorporated in this Item 12 by reference. 

Item 13.  Certain Relationships and Related Transactions, and Director 
Independence 
The  information  required  by  this  Item  13  concerning  our  transactions  with  related  parties  will  be  set  forth  under  the  caption 
“Certain Transactions” in our Proxy Statement in connection with the 2009 Annual Shareholders’ Meeting scheduled to be held 
May 22, 2009, and is incorporated in this Item 13 by reference.  The information required by this Item 13 concerning director 
independence will be set forth under the caption “Director Independence” in our Proxy Statement in connection with the 2009 
Annual Shareholders’ Meeting scheduled to be held May 22, 2009, and is incorporated in this Item 13 by reference. 

Item 14.  Principal Accountant Fees and Services    
The information required by this Item 14 will be set forth under the caption “Relationship with Independent Registered Public 
Accounting Firm” in our Proxy Statement in connection with the 2009 Annual Shareholders’ Meeting scheduled to be held May 
22, 2009, and is incorporated in this Item 14 by reference. 

52 

 
 
 
 
 
 
 
 
 
 
 
PART IV 
Item 15.  Exhibits and Financial Statement Schedules 

(a) 

Financial Statements and Exhibits.  

(1) 

Consolidated Financial Statements: 

Reports of Independent Registered Public Accounting Firm 

Consolidated Balance Sheets - 
January 3, 2009 and December 29, 2007  

Consolidated Statements of Operations - 
Years Ended January 3, 2009, December 29, 2007, and December 30, 2006 

Consolidated Statements of Changes in Equity 
Years Ended January 3, 2009, December 29, 2007, and December 30, 2006 

Consolidated Statements of Cash Flows 
Years Ended January 3, 2009, December 29, 2007, and December 30, 2006 

Notes to Consolidated Financial Statements 

(2) 

The following financial statement schedule and Report 
of Independent Registered Public Accounting Firm of the 
Registrant for the three-year period ended 
January 3, 2009 are included herein: 

Schedule II - Valuation and Qualifying Accounts, 

Report of Independent Registered Public Accounting Firm 

All  other  schedules  are  omitted,  as  the  required  information  is  inapplicable  or  the  information  is 
presented in the consolidated financial statements or related notes. 

(3) 

The exhibits required to be filed by this item are set forth below: 

Number   

Description 

3(a) 

3(b) 

4(a) 

4(b) 

4(c) 

4(d) 

Second Restated Certificate of Incorporation of the Registrant, dated December 5, 2003 (filed as exhibit 3(a) 
to Registrant’s Annual Report on Form 10-K for the year ended January 3, 2004 and incorporated herein by 
reference). 

Amended and Restated Bylaws, dated September 16, 2008 (filed as Exhibit 3.1 to Registrant’s Form 8-K 
filed on September 22, 2008 and incorporated herein by reference). 

Specimen stock certificate (filed as Exhibit 4(a) to Registrant’s Annual Report on Form 10-K for the year 
ended December 30, 2006 and incorporated herein by reference).   

Amended and Restated Credit Agreement between Cerner Corporation and U.S. Bank N.A., LaSalle Bank 
National Association, Commerce Bank, N.A. and UMB Bank, N.A., dated November 30, 2006 (filed as Exhibit 
99.1 to Registrant’s Form 8-K filed on December 6, 2006, and incorporated herein by reference). 

Cerner Corporation Note Agreement dated April 1, 1999 among Cerner Corporation, Principal Life Insurance 
Company, Principal Life Insurance Company, on behalf of one or more separate accounts, Commercial Union 
Life Insurance Company of America, Nippon Life Insurance Company of America, John Hancock Mutual Life 
Insurance Company, John Hancock Variable Life Insurance Company, and Investors Partner Life Insurance 
Company (filed as Exhibit 4(e) to Registrant’s Form 8-K dated April 23, 1999 and incorporated herein by 
reference). 

Note Purchase Agreement between Cerner Corporation and the purchasers therein, dated December 15, 
2002 (filed as Exhibit 10(x) to Registrant’s Annual Report on Form 10-K for the year ended December 28, 
2002 and incorporated herein by reference). 

53 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4(e) 

10(a) 

10(b) 

10(c) 

10(d) 

10(e) 

10(f) 

10(g) 

10(h) 

10(i) 

10(j) 

10(k) 

10(l) 

10(m) 

10(n) 

10(o) 

10(p) 

10(q) 

Cerner Corporation Note Purchase Agreement dated November 1, 2005 among Cerner Corporation, as 
issuer, and AIG Annuity Insurance Company, American General Life Insurance Company and Principal Life 
Insurance Company, as purchasers, (filed as Exhibit 99.1 to Registrant’s Form 8-K filed on November 7, 
2005 and incorporated herein by reference).   

Indemnification Agreement Form for use between the Registrant and its Directors (filed as Exhibit 10(a) to 
Registrant’s Annual Report on Form 10-K for the year ended December 30, 2006 and incorporated herein by 
reference).* 

Employment Agreement of Earl H. Devanny, III dated August 13, 1999 (filed as Exhibit 10(q) to Registrant's 
Annual Report on Form 10-K for the year ended January 1, 2000 and incorporated herein by reference).* 

Amendment Number One to Cerner Associate Employment Agreement between Cerner Corporation and E. H. 
Devanny, III, dated November 1, 2008.* 

Amended & Restated Executive Employment Agreement of Neal L. Patterson dated January 1, 2008.  (filed 
as Exhibit 10(c) to Registrant’s Annual Report on Form 10-K for the year ended December 29, 2007 and 
incorporated herein by reference).* 

Amended Stock Option Plan D of Registrant dated December 8, 2000 (filed as Exhibit 10(f) to Registrant’s 
Annual Report on Form 10-K for the year ended December 30, 2000 and incorporated herein by reference).*  

Amended Stock Option Plan E of Registrant dated December 8, 2000 (filed as Exhibit 10(g) to Registrant’s 
Annual Report on Form 10-K for the year ended December 30, 2000 and incorporated herein by reference).*  

Cerner Corporation 2001 Long-Term Incentive Plan F (filed as Annex I to Registrant's 2001 Proxy Statement 
and incorporated herein by reference).* 

Cerner Corporation 2004 Long-Term Incentive Plan G Amended & Restated dated October 1, 2007 (filed as 
Exhibit 10(g) to Registrant’s Annual Report on Form 10-K for the year ended December 29, 2007 and 
incorporated herein by reference).* 

Cerner Corporation 2001 Associate Stock Purchase Plan (filed as Annex II to Registrant's 2001 Proxy 
Statement and incorporated herein by reference).* 

Qualified Performance-Based Compensation Plan dated December 3, 2007 (filed as Exhibit 10(i) to the 
Registrant’s Annual Report on Form 10-K for the year ended December 29, 2007 and incorporated herein by 
reference).* 

Form of 2008 Executive Performance Agreement (filed as Exhibit 99.1 to Registrant’s Form 8-K on April 3, 
2008 and incorporated herein by reference).* 

Cerner Corporation Executive Deferred Compensation Plan as Amended & Restated dated January 1, 2008 
(filed as Exhibit 10(k) to Registrant’s Annual Report on Form 10-K for the year ended December 29, 2007 
and incorporated herein by reference).* 

Cerner Corporation 2005 Enhanced Severance Pay Plan as Amended and Restated dated January 1, 2008 
(filed as Exhibit 10(l) to Registrant’s Annual Report on Form 10-K for the year ended December 29, 2007 
and incorporated herein by reference).* 

Cerner Corporation 2001 Long-Term Incentive Plan F Nonqualified Stock Option Agreement (filed as Exhibit 
10(v) to Registrant’s Annual Report on Form 10-K for the year ended January 1, 2005 and incorporated 
herein by reference).* 

Cerner Corporation 2001 Long-Term Incentive Plan F Nonqualified Stock Option Grant Certificate (filed as 
Exhibit 10(a) to Registrant’s Quarterly Report on Form 10-Q for the quarter ended October 1, 2005 and 
incorporated herein by reference).* 

Cerner Corporation 2001 Long-Term Incentive Plan F Nonqualified Stock Option Director Agreement (filed as 
Exhibit 10(x) to Registrant’s Annual Report on Form 10-K for the year ended January 1, 2005 and 
incorporated herein by reference).* 

Cerner Corporation 2001 Long-Term Incentive Plan F Director Restricted Stock Agreement (filed as Exhibit 
10(w) to Registrant’s Annual Report on Form 10-K for the year ended January 1, 2005 and incorporated 
herein by reference).* 

54 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
10(r) 

10(s) 

10(t) 

10(u) 

11 

21 

23 

31.1 

31.2 

32.1  

32.2  

Cerner Corporation 2004 Long-Term Incentive Plan G Nonqualified Stock Option Grant Certificate. (filed as 
Exhibit 10(q) to Registrant’s Annual Report on Form 10-K for the year ended December 29, 2007 and 
incorporated herein by reference).* 

Time Sharing Agreements between the Registrant and Neal L. Patterson and Clifford W. Illig, both dated 
February 7, 2007 (filed as Exhibits 10.2 and 10.3, respectively, to Registrant’s Form 8-K filed on February 9, 
2007 and incorporated herein by reference).* 

Notice of Change of Aircraft Provided Under Time Sharing Agreements from Registrant to Neal L. Patterson 
and Clifford W. Illig, both notices dated December 23, 2008.* 

Aircraft Services Agreement between the Registrant’s wholly owned subsidiary, Rockcreek Aviation, Inc., and 
PANDI, Inc., dated February 6, 2007 (filed as Exhibit 10.1 to Registrant’s Form 8-K filed on February 9, 2007 
and incorporated herein by reference).* 

*Management contracts or compensatory plans or arrangements required to be identified by Item 15(a)(3) 

Computation of Registrant's Earnings Per Share. (Exhibit omitted.  Information contained in notes to 
consolidated financial statements.) 

Subsidiaries of Registrant. 

Consent of Independent Registered Public Accounting Firm. 

Certification of Neal L. Patterson pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. 

Certification of Marc G. Naughton pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. 

Certification pursuant to 18 U.S.C. Section. 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley 
Act of 2002. 

Certification pursuant to 18 U.S.C. Section. 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley 
Act of 2002. 

(b) 

Exhibits. 

The response to this portion of Item 15 is submitted as a separate section of this report. 

(c) 

Financial Statement Schedules. 

The response to this portion of Item 15 is submitted as a separate section of this report. 

55 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
Signatures 
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this 
report to be signed on its behalf by the undersigned, thereunto duly authorized. 

Dated: March 2, 2009 

CERNER CORPORATION 

By:/s/Neal L. Patterson 

Neal L. Patterson 
Chairman of the Board and 
Chief Executive Officer  

Pursuant  to  the  requirements  of  the  Securities  Exchange  Act  of  1934,  this  report  has  been  signed  below  by  the  following 
persons on behalf of the registrant and in the capacities and on the dates indicated: 

Signature and Title 

Date 

/s/Neal L. Patterson 
Neal L. Patterson, Chairman of the Board and 
 Chief Executive Officer (Principal Executive Officer)  

/s/Clifford W. Illig   
Clifford W. Illig, Vice Chairman and Director 

/s/Marc G. Naughton 
Marc G. Naughton, Senior Vice President and 
 Chief Financial Officer (Principal Financial and Accounting Officer) 

/s/Gerald E. Bisbee, Jr. 
Gerald E. Bisbee, Jr., Ph.D., Director 

/s/John C. Danforth 
John C. Danforth, Director 

/s/Nancy-Ann DeParle 
Nancy-Ann DeParle, Director  

/s/Michael E. Herman 
Michael E. Herman, Director 

/s/William B. Neaves 
William B. Neaves, Ph.D., Director 

/s/William D. Zollars 
William D. Zollars, Director 

March 2, 2009 

March 2, 2009 

March 2, 2009 

March 2, 2009 

March 2, 2009 

March 2, 2009 

March 2, 2009 

March 2, 2009 

March 2, 2009 

56 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
       
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Report of Independent Registered Public Accounting Firm 

The Board of Directors and Stockholders 

Cerner Corporation: 

We  have  audited  the  internal  control  over  financial  reporting  of  Cerner  Corporation  as  of  January  3,  2009,  based  on  criteria 
established in Internal Control – Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway 
Commission (COSO).  Cerner Corporation’s management is responsible for maintaining effective internal control over financial 
reporting and for its assessment of the effectiveness of internal control over financial reporting, included in the accompanying 
Management’s  Report  on  Internal  Control  over  Financial  Reporting,  appearing  in  Item  9.A.  Controls  and  Procedures.  Our 
responsibility is to express an opinion on the Corporation’s internal control over financial reporting based on our audit. 

We conducted our audit in accordance with the standards of the Public Company Accounting Oversight Board (United States). 
Those standards require that we plan and perform the audit to obtain reasonable assurance about whether effective internal 
control  over  financial  reporting  was  maintained  in  all  material  respects.  Our  audit  included  obtaining  an  understanding  of 
internal  control  over  financial  reporting,  assessing  the  risk  that  a  material  weakness  exists,  and  testing  and  evaluating  the 
design  and  operating  effectiveness  of  internal  control  based  on  the  assessed  risk.  Our  audit  also  included  performing  such 
other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for 
our opinion. 

A  company’s  internal  control  over  financial  reporting  is  a  process  designed  to  provide  reasonable  assurance  regarding  the 
reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally 
accepted  accounting  principles.  A  company’s  internal  control  over  financial  reporting  includes  those  policies  and  procedures 
that  (1)  pertain  to  the  maintenance  of  records  that,  in  reasonable  detail,  accurately  and  fairly  reflect  the  transactions  and 
dispositions  of  the  assets  of  the  company;  (2)  provide  reasonable  assurance  that  transactions  are  recorded  as  necessary  to 
permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and 
expenditures  of  the  company  are  being  made  only  in  accordance  with  authorizations  of  management  and  directors  of  the 
company;  and  (3)  provide  reasonable  assurance  regarding  prevention  or  timely  detection  of  unauthorized  acquisition,  use, or 
disposition of the company’s assets that could have a material effect on the financial statements. 

Because  of  its  inherent  limitations,  internal  control  over  financial  reporting  may  not  prevent  or  detect  misstatements.  Also, 
projections  of  any  evaluation  of  effectiveness  to  future  periods  are  subject  to  the  risk  that  controls  may  become  inadequate 
because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. 

In our opinion, Cerner Corporation maintained, in all material respects, effective internal control over financial reporting as of 
January  3,  2009,  based  on  criteria  established  in  Internal  Control–Integrated  Framework  issued  by  the  Committee  of 
Sponsoring Organizations of the Treadway Commission (COSO). 

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), the 
consolidated balance sheets of Cerner Corporation and subsidiaries as of January 3, 2009 and December 29, 2007, and the 
related consolidated statements of operating earnings, changes in equity, and cash flows for each of the years in the three-year 
period ended January 3, 2009, and our report dated March 2, 2009 expressed an unqualified opinion on those consolidated 
financial statements. 

/s/KPMG LLP 

Kansas City, Missouri 

March 2, 2009 

57 

 
 
 
 
 
 
 
 
 
 
 
 
Report of Independent Registered Public Accounting Firm 

The Board of Directors and Stockholders 

Cerner Corporation: 

We have audited the accompanying consolidated balance sheets of Cerner Corporation and subsidiaries (the Corporation) as of 
January 3, 2009 and December 29, 2007, and the related consolidated statements of operating earnings, changes in equity, 
and cash flows for each of the years in the three-year period ended January 3, 2009. These consolidated financial statements 
are  the  responsibility  of  the  Corporation’s  management.  Our  responsibility  is  to  express  an  opinion  on  these  consolidated 
financial statements based on our audits. 

We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States). 
Those  standards  require  that  we  plan  and  perform  the  audit  to  obtain  reasonable  assurance  about  whether  the  financial 
statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts 
and  disclosures  in  the  financial  statements.  An  audit  also  includes  assessing  the  accounting  principles  used  and  significant 
estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits 
provide a reasonable basis for our opinion. 

In  our  opinion,  the  consolidated  financial  statements  referred  to  above  present  fairly,  in  all  material  respects,  the  financial 
position of the Corporation as of January 3, 2009 and December 29, 2007, and the results of its operations and its cash flows 
for  each  of  the  years  in  the  three-year  period  ended  January  3,  2009,  in  conformity  with  U.S.  generally  accepted  accounting 
principles. 

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), the 
Corporation’s internal control over financial reporting as of January 3, 2009, based on criteria established in Internal Control – 
Integrated  Framework  issued  by  the  Committee  of  Sponsoring  Organizations  of  the  Treadway  Commission  (COSO),  and  our 
report  dated  March  2,  2009  expressed  an  unqualified  opinion  on  the  effectiveness  of  the  Corporation’s  internal  control  over 
financial reporting. 

/s/KPMG LLP 

Kansas City, Missouri 

March 2, 2009 

Management's Report 
The  management  of  Cerner  Corporation  is  responsible  for  the  consolidated  financial  statements  and  all  other  information 
presented in this report.  The financial statements have been prepared in conformity with U.S. generally accepted accounting 
principles appropriate to the circumstances, and, therefore, included in the financial statements are certain amounts based on 
management's  informed  estimates  and  judgments.    Other  financial  information  in  this  report  is  consistent  with  that  in  the 
consolidated  financial  statements.    The  consolidated  financial  statements  have  been  audited  by  Cerner  Corporation's 
independent registered public accountants and have been reviewed by the Audit Committee of the Board of Directors. 

58 

 
 
 
 
 
 
 
 
 
 
59 

 
 
 
60 

 
 
61 

 
 
62 

 
 
 
(1)  Summary of Significant Accounting Policies 

(a)  Principles of Consolidation 
The  consolidated  financial  statements  include  the  accounts  of  Cerner  Corporation  and  its  wholly-owned  subsidiaries  (the 
“Company”).  All significant intercompany transactions and balances have been eliminated in consolidation. 

(b)  Nature of Operations 
The Company designs, develops, markets, installs, hosts and supports software information technology, healthcare devices and 
content  solutions  for  healthcare  organizations  and  consumers.    The  Company  also  provides  a  wide  range  of  value-added 
services,  including  implementing  solutions  as  individual,  combined  or  enterprise-wide  systems;  hosting  solutions  in  its  data 
center; and clinical process optimization services. Furthermore, the Company provides fully–automated on-site employer health 
clinics and third party administrator health plan services for employers.   

(c)  Revenue Recognition 
Revenues  are  derived  primarily  from  the  licensing  of  clinical,  financial  and  administrative  information  systems  and  solutions.  
The components of the system sales revenues are the licensing of computer software, deployment period upgrades, installation, 
content subscriptions, transaction processing and the sale of computer hardware and sublicensed software.  The components 
of support, maintenance and service revenues are software support and hardware maintenance, remote hosting and managed 
services, training, consulting and implementation services.  For arrangements that include both product and services which are 
accounted for under SOP 81-1 and also include support services (PCS) for which vendor-specific objective evidence of fair value 
(VSOE) of PCS does not exist such that a zero margin approach is used to recognize revenue, the Company classifies revenue 
under such arrangements as either systems sales or support, maintenance and services based on the nature of costs incurred. 
For similar arrangements for which VSOE of PCS exists, PCS is separated from the arrangement based on VSOE and the residual 
amount is allocated to the software and services accounted for on a combined basis under SOP 81-1.  For these arrangements, 
the  service  component  of  the  SOP  81-1  deliverable  is  classified  as  service  revenue  based  on  the  VSOE  of  the  services  as  if 
provided on a stand-alone basis and the residual is classified as systems sales revenue.  For the years ended January 3, 2009, 
December 29, 2007 and December 30, 2006, approximately $26,700,000, $20,000,000 and $16,000,000, respectively, of 
revenue  were  included  in  system  sales  and  approximately  $86,600,000,  $95,000,000  and  $55,000,000,  respectively,  of 
revenue were included in support, maintenance, and services for such arrangements.  The Company provides several models 
for the procurement of its clinical, financial and administrative information systems.  The predominant method is a perpetual 
software license agreement, project-related installation services, implementation and consulting services, software support and 
either remote hosting services or computer hardware and sublicensed software. 

The  Company  recognizes  revenue  in  accordance  with  the  provisions  of  Statement  of  Position  (SOP)  97-2, “Software  Revenue 
Recognition,”  as  amended  by  SOP  98-4,  SOP  98-9  and  clarified  by  Staff  Accounting  Bulletin’s  (SAB)  No.  104  “Revenue 
Recognition”  and  Emerging  Issues  Task  Force  Issue  No.  00-21  “Accounting  for  Revenue  Arrangements  with  Multiple 
Deliverables” (“EITF 00-21”).  SOP 97-2, as amended, generally requires revenue earned on software arrangements involving 
multiple-elements to be allocated to each element based on the relative fair values of those elements if fair values exist for all 
elements  of  the  arrangement.    Pursuant  to  SOP  98-9,  the  Company  recognizes  revenue  from  multiple-element  software 
arrangements using the residual method.  Under the residual method, revenue is recognized in a multiple-element arrangement 
when  Company-specific  objective  evidence  of  fair  value  exists  for  all  of  the  undelivered  elements  in  the  arrangement  (i.e. 
professional services, software support, hardware maintenance, remote hosting services, hardware and sublicensed software), 
but does not exist for one or more of the delivered elements in the arrangement (i.e. software solutions including project-related 
installation services).  The Company allocates revenue to each undelivered element in a multiple-element arrangement based 
on the element’s respective fair value, with the fair value determined by the price charged when that element is sold separately.  
Specifically,  the  Company  determines  the  fair  value  of  the  software  support  and  maintenance,  hardware  and  sublicensed 
software  support,  remote  hosting  and  subscriptions  portions  of  the  arrangement  based  on  the  substantive  renewal  price  for 
these  services  charged  to  clients;  professional  services  (including  training  and  consulting)  portion  of  the  arrangement,  other 
than installation services, based on hourly rates which the Company charges for these services when sold apart from a software 
license;  and,  the  hardware  and  sublicensed  software,  based  on  the  prices  for  these elements  when  they  are  sold  separately 
from  the  software.    The  residual  amount  of  the  fee  after  allocating  revenue  to  the  fair  value  of  the  undelivered  elements  is 
attributed  to  the  software  solution,  including  project-related  installation  services.    If  evidence  of  the  fair  value  cannot  be 
established  for  the  undelivered  elements  of  a  license  agreement,  the  entire  amount  of  revenue  under  the  arrangement  is 
deferred until these elements have been delivered or objective evidence can be established.   

The  Company  provides  project-related  installation  services,  which  include  project-scoping  services,  conducting  pre-installation 
audits and creating initial environments.  Because installation services are deemed to be essential to the functionality of the 
software, the Company recognizes the software license and installation services fees over the software installation period using 
the  percentage  of  completion  method  pursuant  to  Statement  of  Position  81-1  (SOP  81-1),  Accounting  for  Performance  of 
Construction-Type and Certain Production-Type Contracts, as prescribed by SOP 97-2.  The Company measures the percentage 
of  completion  based  on  output  measures  which  reflect  direct  labor  hours  incurred,  beginning  at  software  delivery  and 
culminating at completion of installation.  The installation services process length is dependent upon client specific factors and 
generally occurs in the same period the contracts are executed but can extend up to one year. 

63 

 
 
 
 
 
 
The Company also provides implementation and consulting services, which include consulting activities that fall outside of the 
scope of the standard installation services.  These services vary depending on the scope and complexity requested by the client.  
Examples  of  such  services  may  include  additional  database  consulting,  system  configuration,  project  management,  testing 
assistance, network consulting, post conversion review and application management services.  Implementation and consulting 
services generally are not deemed to be essential to the functionality of the software, and thus do not impact the timing of the 
software  license  recognition,  unless  software  license  fees  are  tied  to  implementation  milestones.    In  those  instances,  the 
portion  of  the  software  license  fee  tied  to  implementation  milestones  is  deferred  until  the  related  milestone  is  accomplished 
and related fees become billable and non-forfeitable.  Implementation fees are recognized over the service period, which may 
extend from nine months to three years for multi-phased projects. 

Remote hosting and managed services are marketed under long-term arrangements generally over periods of five to 10 years.  
These services are typically provided to clients that have acquired a perpetual license for licensed software and have contracted 
with the Company to host the software in its data center.  Under these arrangements, the client generally has the contractual 
right  to  take  possession  of  the  licensed  software  at  any  time  during  the  hosting  period  without  significant  penalty  and  it  is 
feasible for the client to either run the software on its own equipment or contract with another party unrelated to the Company 
to  host  the  software.    These  services  are  not  deemed  to  be  essential  to  the  functionality  of  the  licensed  software  or  other 
elements of the arrangement and as such, the Company accounts for these arrangements under SOP 97-2, as prescribed by 
EITF Issue No. 00-3, “Application of AICPA Statement of Position 97-2 to Arrangements That Include the Right to Use Software 
Stored  on  Another  Entity’s  Hardware”.    For  those  arrangements  where  the  client  does  not  have  the  contractual  right  or  the 
ability  to  take  possession  of  the  software  at  any  time,  the  Company  accounts  for  the  arrangement  as  a  service  contract  and 
thereby  recognizes  revenues  for  the  arrangement  over  the  hosting  service  period.    The  hosting  and  managed  services  are 
recognized as the services are performed.       

The Company also offers its solutions on an application service provider (“ASP”) model, making available time based licenses 
for the Company’s software functionality and providing the software solutions on a remote processing basis from the Company’s 
data centers.  The data centers provide system and administrative support as well as processing services.  Revenue on software 
and  services  provided  on  an  ASP  or  term  license  basis  is  combined  and  recognized  on  a  monthly  basis  over  the  term  of  the 
contract.    The  Company  capitalizes  related  direct  costs  consisting  of  third  party  costs  and  direct  software  installation  and 
implementation  costs  associated  with  the  initial  set  up  of  the  client  on  the  ASP  service.    These  costs  are  amortized  over  the 
term of the arrangement. 

Software support fees are marketed under annual and multi-year arrangements and are recognized as revenue ratably over the 
contracted  support  term.    Hardware  and  sublicensed  software  maintenance  revenues  are  recognized  ratably  over  the 
contracted maintenance term. 

Subscription and content fees are generally marketed under annual and multi-year agreements and are recognized ratably over 
the contracted terms. 

Hardware and sublicensed software sales are generally recognized when delivered to the client, assuming title and risk of loss 
have transferred to the client. 

Where  the  Company  has  contractually  agreed  to  develop  new  or  customized  software  code  for  a  client  as  a  single  element 
arrangement, the Company utilizes percentage of completion accounting, labor-hours method, in accordance with SOP 81-1.   

In  England,  the  Company  has  contracted  with  third  parties  to  customize  software  and  provide  implementation  and  support 
services  under  long  term  arrangements  (nine  years).    Prior  to  2008  the  Company  accounted  for  the  arrangements  as  single 
units  of  accounting  under  SOP  81-1  because the  arrangements  require  customization  and  development  of  software,  and  fair 
value for the support services had not been established.  Also prior to 2008 the Company believed it was reasonably assured 
that  no  loss  would  be  incurred  under  these  arrangements  and  therefore  it  utilized  the  zero  margin  approach  of  applying 
percentage-of-completion  accounting.    During  2008  the  Company  established  fair  value  of  the  undelivered  elements  of  the 
arrangement that are not subject to percentage of completion accounting.  Also, during the fourth quarter of 2008 the Company 
realized a significant milestone in London which significantly enhances the Company’s ability to reliably estimate work effort for 
the remainder  of the contract  and estimate a minimum level of profit on the arrangement.  These events, combined with the 
Company’s  experience  since  the  contract  signed  in  2006  and  the  experience  gained  in  the  South,  allowed  the  Company  to 
conclude that reasonably dependable work effort estimates could be produced and allow for margin recognition.  As a result, 
the Company’s fourth quarter 2008 revenues included a cumulative catch-up adjustment, resulting from the significant change 
in accounting estimate, in the amount of $28,640,000 which represents the margin on the contract which had been previously 
deferred as a result of the zero margin approach of applying percentage of completion accounting.  Greater than a majority of 
the catch-up adjustment revenue was included in support, maintenance and services.  The remaining margin attributed to the 
services subject to SOP 81-1 will be recognized over the remaining service period until the services are complete and amounts 
allocated to the other support services subject to SOP 97-2 will be recognized over the relevant support periods.  The contract 
expires in 2014. 

64 

 
 
 
 
 
 
 
 
 
 
Deferred  revenue is comprised of deferrals for license fees, support, maintenance  and other services for  which payment  has 
been received and for which the service has not yet been performed and revenue has not been recognized.  Long-term deferred 
revenue  at  January  3,  2009,  represents  amounts  received  from  software  support  and  maintenance  services  to  be  earned  or 
provided beginning in periods on or after January 4, 2009.   

The Company incurs out-of-pocket expenses in connection with its client service activities, primarily travel, which are reimbursed 
by  its  clients.    The  amounts  of  ”out-of-pocket”  expenses  and  equal  amounts  of  related  reimbursements  were  $37,759,000, 
$36,778,000  and  $39,051,000  for  the  years  ended  January  3,  2009,  December  29,  2007  and  December  30,  2006, 
respectively.   

The  Company’s  arrangements  with  clients  typically  include  an  initial  payment  due  upon  contract  signing  and  date-based 
licensed  software  payment  terms  and  payments  based  upon  delivery  for  services,  hardware  and  sublicensed  software.    The 
Company has periodically provided long-term financing options to creditworthy clients through third party financing institutions 
and has directly provided extended payment terms to clients from contract date.  These extended payment term arrangements 
typically  provide  for  date  based  payments  over  periods  ranging  from  12  months  up  to  seven  years.    Pursuant  to  SOP  97-2, 
because  a  significant  portion  of  the  fee  is  due  beyond  one  year,  the  Company  has  analyzed  its  history  with  these  types  of 
arrangements and has concluded that it has a standard business practice of using extended payment term arrangements and a 
long history of successfully collecting under the original payment terms for arrangements with similar clients, product offerings, 
and  economics  without  granting  concessions.    Accordingly,  the  Company  considers  the  fee  to  be  fixed  and  determinable  in 
these  extended  payment  term  arrangements  and,  thus,  the  timing  of  revenue  is  not  impacted  by  the  existence  of  extended 
payments.  Some of these payment streams have been assigned on a non-recourse basis to third party financing institutions.  
The  Company  accounts  for  the  assignment  of  these  receivables  as  “true  sales”  as  defined  in  FASB  Statement  No.  140, 
“Accounting  for  Transfers  and  Servicing  of  Financial  Assets  and  Extinguishments  of  Liabilities.”    Provided  all  revenue 
recognition  criteria  have  been  met,  the  Company  recognizes  revenue  for  these  arrangements  under  its  normal  revenue 
recognition criteria, and if appropriate, net of any payment discounts from financing transactions.   

The terms of the Company’s software license agreements with its clients generally provide for a limited indemnification of such 
intellectual property against losses, expenses and liabilities arising from third party claims based on alleged infringement by the 
Company’s solutions of an intellectual property right of such third party. The terms of such indemnification often limit the scope 
of and remedies for such indemnification obligations and generally include a right to replace or modify an infringing solution. To 
date,  the  Company  has  not  had  to  reimburse  any  of  its  clients  for  any  losses  related  to  these  indemnification  provisions 
pertaining to third party intellectual property infringement claims. For several reasons, including the lack of prior indemnification 
claims and the lack of a monetary liability limit for certain infringement cases under the terms of the corresponding agreements 
with  its  clients,  the  Company  cannot  determine  the  maximum  amount  of  potential  future  payments,  if  any,  related  to  such 
indemnification provisions. 

(d)  Fiscal Year 
The Company’s fiscal year ends on the Saturday closest to December 31.  Fiscal year 2008 consisted of 53 weeks and fiscal 
years 2007 and 2006 consisted of 52 weeks each.  All references to years in these notes to consolidated financial statements 
represent fiscal years unless otherwise noted. 

(e)  Software Development Costs 
Costs  incurred  internally  in  creating  computer  software  products  are  expensed  until  technological  feasibility  has  been 
established  upon  completion  of  a  detailed  program  design.    Thereafter,  all  software  development  costs  are  capitalized  and 
subsequently reported at the lower of amortized cost or net realizable value.  Capitalized costs are amortized based on current 
and  expected  future  revenue  for  each  software  solution  with  minimum  annual  amortization  equal  to  the  straight-line 
amortization  over  the  estimated  economic  life  of  the  solution.    The  Company  is  amortizing  capitalized  costs  over  five  years.  
During 2008, 2007 and 2006, the Company capitalized $69,981,000, $65,985,000 and $60,943,000, respectively, of total 
software  development  costs  of  $291,368,000,  $283,086,000  and  $262,163,000,  respectively.    Amortization  expense  of 
capitalized  software  development  costs  in  2008,  2007  and  2006  was  $51,132,000,  $53,475,000  and  $45,750,000, 
respectively, and accumulated amortization was $410,407,000, $356,485,000 and $303,010,000, respectively.  Included in 
2007  total  software  development  costs  is  $8.6  million  of  research  and  development  activities  for  the  RxStation  medical 
dispensing devices.  $3.4 million of this amount recorded in 2007 is related to periods prior to 2007 and is immaterial to both 
2007 and the prior periods to which it relates. 

(f)  Cash Equivalents 
Cash equivalents consist of short-term marketable securities with original maturities less than 90 days. 

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(g)  Short-term Investments 
The  Company’s  short-term  investments  are  primarily  invested  in  commercial  paper.    Refer  to  Note  (6)  and  Note  (7)  for  a 
comprehensive description of these assets and their value. 

(h)  Long-term Investments 
The  Company’s  long-term  investments  are  primarily  invested  in  auction  rate  securities.    Refer  to  Note  (6)  and  Note  (7)  for  a 
comprehensive description of these assets and their value. 

(i)  Inventory 
Inventory consists primarily of computer hardware, sublicensed software held for resale and RxStation medication dispensing 
units.  Inventory is recorded at the lower of cost (first-in, first-out) or market. 

(j)  Property and Equipment 
Property,  equipment  and  leasehold  improvements  are  stated  at  cost.    Depreciation  of  property  and  equipment  is  computed 
using the straight-line method over periods of two to 50 years.  Amortization of leasehold improvements is computed using a 
straight-line method over the shorter of the lease terms or the useful lives, which range from periods of two to 15 years. 

(k)  Earnings per Common Share 
Basic earnings per share (EPS) excludes dilution and is computed by dividing income available to common shareholders by the 
weighted-average number of common shares outstanding for the period.  Diluted EPS reflects the potential dilution that could 
occur if securities or other contracts to issue stock were exercised or converted into common stock or resulted in the issuance 
of common stock that then shared in the earnings of the Company.  A reconciliation of the numerators and the denominators of 
the basic and diluted per-share computations are as follows: 

Options to purchase 2,336,000, 1,081,000 and 1,121,000 shares of common stock at per share prices ranging from $33.63 
to $136.86, $40.84 to $136.86 and $33.86 to $136.86, were outstanding at the end of 2008, 2007 and 2006, respectively, 
but were not included in the computation of diluted earnings per share because they were antidilutive.   

(l)  Foreign Currency 
Assets and liabilities of non-U.S. subsidiaries whose functional currency is the local currency are translated into U.S. dollars at 
exchange rates prevailing at the balance sheet date.  Revenues and expenses are translated at average exchange rates during 
the  year.    The  net  exchange  differences  resulting  from  these  translations  are  reported  in  accumulated  other  comprehensive 
income.    Gains  and  losses  resulting  from  foreign  currency  transactions  are  included  in  the  consolidated  statements  of 
operations.  The net gain resulting from foreign currency transactions is included in general and administrative expenses in the 
consolidated statements of operations and amounted to $9,858,000, $3,691,000 and $3,764,000 in 2008, 2007 and 2006, 
respectively. 

(m)  Income Taxes 
Deferred  tax  assets  and  liabilities  are  recognized  for  the  future  tax  consequences  attributable  to  differences  between  the 
financial statement carrying amounts of existing assets and liabilities and their respective tax bases.  Deferred tax assets and 
liabilities  are  measured  using  enacted  tax  rates  expected  to  apply  to  taxable  income  in  the  years  in  which  those  temporary 
differences are expected to be recovered or settled. 

66 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
(n)  Goodwill and Other Intangible Assets 
The  Company  accounts  for  goodwill  under  the  provisions  of  Statement  of  Financial  Accounting  Standards  (SFAS)  No.  142, 
“Goodwill and Other Intangible Assets.”  As a result, goodwill and intangible assets with indefinite lives are not amortized but are 
evaluated for  impairment  annually or whenever there  is an impairment  indicator.  All goodwill  is assigned to a reporting  unit, 
which  are  the  same  as  our  operating  segments  (Domestic  &  Global),  where  it  is  subject  to  an  impairment  test  based  on  fair 
value.  The Company assesses its goodwill for impairment in the second quarter of its fiscal year.  There was no impairment of 
goodwill in 2008 and 2007.  The Company used a discounted cash flow analysis to determine the fair value of the reporting 
units for all periods tested.  The Company evaluated for potential interim impairment indicators in 2007 and 2008, and there 
were  no  indicators  that  suggested  goodwill  was  impaired  on  an  interim  basis.    The  Company’s  intangible  assets,  other  than 
goodwill or intangible assets with indefinite lives, are all subject to amortization, are amortized on a straight-line basis, and are 
summarized as follows: 

Amortization  expense  was  $19,966,000,  $19,674,000  and  $16,842,000  for  the  years  ended  2008,  2007,  and  2006, 
respectively. 

Estimated aggregate amortization expense for each of the next five years is as follows: 

The changes in the carrying amount of goodwill for the 12 months ended January 3, 2009 are as follows: 

At  January  3,  2009  and  December  29,  2007,  goodwill  of  $126,933,000  and  $125,516,000  has  been  allocated  to  the 
Domestic segment respectively.  The 2008 and 2007 amounts of goodwill allocated to the global segment were $19,733,000 
and $18,408,000, respectively. 

(o)  Use of Estimates 
The  preparation  of  financial  statements  in  conformity  with  accounting  principles  generally  accepted  in  the  United  States  of 
America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities 
and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues 
and expenses during the reporting period.  Actual results could differ from those estimates. 

(p)  Concentrations 
Substantially all of the Company’s cash and cash equivalents and short-term investments are held at three major U.S. financial 
institutions.  The majority of the Company’s cash equivalents consist of money market funds.  Deposits held with banks may 
exceed  the  amount  of  insurance  provided  on  such  deposits.  Generally  these  deposits  may  be  redeemed  upon  demand  and, 
therefore, bear minimal risk.   

67 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Substantially all of the Company’s clients are integrated delivery networks, physicians, hospitals and other healthcare related 
organizations.   If  significant  adverse  macro-economic  factors  were  to  impact  these  organizations  it  could  materially  adversely 
affect the Company. The Company’s access to certain software and hardware components is dependent upon single and sole 
source suppliers.  The inability of any supplier to fulfill supply requirements of the Company could affect future results. 

During  the  second  quarter,  Fujitsu  Services  Limited’s  contract  as  the  prime  contractor  in  the  National  Health  Service  (NHS) 
initiative to automate clinical  processes and digitize medical records in the Southern  region of England was terminated.  This 
had  the  effect  of  automatically  terminating  the  Company’s  subcontract  for  the  project.   At  January  3,  2009,  more  than  ten 
percent  of  total  net  receivables  represent  accounts  receivable  and  contracts  receivable  related  to  that  subcontract.   The 
Company  and  Fujitsu  are  in  dispute  regarding  the  receivables  and  are  working  to  resolve  these  issues  based  on  processes 
provided  for  in  the  contract.   While  uncertainties  exist  related  to  the  ultimate  collectability  of  the  receivables,  management 
believes  that  it  has  valid  and  equitable  grounds  for  recovery  of  such  amounts  and  that  collection  of  recorded  amounts  are 
probable. 

(q)  Accounting for Share-based payments 
The  Company  follows  SFAS  No.  123(R),  “Share-Based  Payments”  to  account  for  share-based  awards.    SFAS  No.  123R 
addresses the accounting for share-based payment transactions with employees and other third parties and requires that the 
compensation costs relating to such transactions be recognized in the consolidated statement of earnings.  Refer to Note (9) for 
a detailed discussion of share-based payments. 

(r)  Reclassifications 
Certain  prior  year  amounts  in  our  consolidated  financial  statements  have  been  reclassified  to  conform  to  the  current  year 
presentation. 

(s)  Derivative Instruments and Hedging Activities 
The Company follows Statement of Financial Accounting Standards No. 133 (SFAS 133), “Accounting for Derivative Investments 
and Hedging Activities,” as amended, to account for its derivative and hedging activities.   

The Company has issued foreign-denominated debt to manage its foreign currency exposure related to its net investment in its 
subsidiary  in  England.    Beginning  in  2006,  at  the  beginning  of  each  quarterly  period,  the  Company  designated  a  portion 
(between £60 million and £63 million during the year) of its debt (£65 million), which is denominated in Great Britain Pounds, to 
hedge its net investment in a subsidiary in England.  During 2007 and 2008 the Company designated all £65 million of its debt 
that  is  denominated  in  Great  Britain  Pounds.    For  the  year  ended  January  3,  2009,  approximately  $22  million,  net  of 
approximately  $13  million  of  tax,  of  decreases  in  the  debt  related  to  changes  in  the  foreign  currency  exchange  rate  were 
included in accumulated other comprehensive income.  For the year ended December 29, 2007 approximately $1.5 million, net 
of  approximately  $1  million  of  tax,  of  increases  in  the  debt  related  to  changes  in  the  foreign  currency  exchange  rate  were 
included in accumulated other comprehensive income.   

(t)  Recent Accounting Pronouncements 
In September 2006, the Financial Accounting Standards Board (FASB) issued Statement of Financial Accounting Standards No. 
157  (SFAS  157),    "Fair  Value  Measurements."    This  statement  establishes  a  single  authoritative  definition  of  fair  value  when 
accounting rules require the use of fair value, sets out a framework for measuring fair value and requires additional disclosures 
about fair value measurements.  On February 12, 2008, the FASB issued FASB Staff Position (FSP) No. FAS 157-2.  This FSP 
defers the effective date of SFAS 157 to fiscal years beginning after November 15, 2008 for nonfinancial assets and liabilities 
within the scope of the FSP.  The Company adopted SFAS 157 for fair value measurement outside of the scope of FSP No. FAS 
157-2 on December 30, 2007.  On October 10, 2008, the FASB issued FSP No. FAS 157-3 that clarifies the application of SFAS 
157 in a market that is not active.  FSP No. FAS 157-3 is effective for all periods presented in accordance with SFAS 157 and 
the Company has considered the guidance with respect to the valuation of its financial assets and their designation within the 
fair value hierarchy.  The Company was required to fully adopt SFAS 157 as of the first day of the 2009 fiscal year and does not 
expect its adoption to have a material impact on the Company’s consolidated financial statements. 

In  December  2007,  the  FASB  issued  Statement  of  Financial  Accounting  Standards  No.  141  (revised  2007),  Business 
Combinations  (SFAS  141(R))  which  replaces  SFAS  141  and  supersedes  FIN  4,  “Applicability  of  FASB  Statement  No.  2  to 
Business  Combinations  Accounted  for  by  the  Purchase  Method”.    SFAS  141(R)  establishes  guidelines  for  how  an  acquirer 
measures  and  recognizes  the  identifiable  assets,  goodwill,  noncontrolling  interest,  and  liabilities  assumed  in  a  business 
combination.    Additionally,  SFAS  141(R)  outlines  the  disclosures  necessary  to  allow  financial  statement  users  to  assess  the 
impact  of  the  acquisition.    The  Company  is  currently  assessing  the  impact  of  adoption  of  SFAS  141(R),  which  will  depend  on 
future acquisition activity, and will be required to adopt SFAS 141(R) prospectively for business combinations occurring on or 
after the first day of the 2009 fiscal year.  

Also  in  December  2007,  the  FASB  issued  Statement  of  Financial  Accounting  Standards  No. 160  (SFAS  160),  “Noncontrolling 
Interests in Consolidated Financial Statements”, which amends ARB No. 51.  SFAS 160 guides that a noncontrolling interest in 
a subsidiary should be reported as equity in the consolidated financial statements, and that net income should be reported at 

68 

 
 
 
 
 
 
 
  
 
 
amounts  that  include  the  amounts  attributable  to  both  the  parent  and  the  noncontrolling  interest.    The  Company  is  currently 
assessing the impact of adoption of SFAS 160 on its results of operations and its financial position, both of which are expected 
to be immaterial, and was required to adopt SFAS 160 as of the first day of the 2009 fiscal year. 

In March 2008, the FASB issued Statement of Accounting Standards No. 161, “Disclosures about Derivative Instruments and 
Hedging Activities – an amendment of FASB Statement No. 133.”  SFAS 161 requires enhanced disclosures about the uses of 
derivative instruments and hedging activities, how these activities are accounted for, and their respective impact on an entity’s 
financial position, financial performance, and cash flows.  The Company is currently assessing the impact of adoption of SFAS 
161 on its results of operations and its financial position, which is expected to be immaterial, and was required to adopt SFAS 
161 as of the first day of the 2009 fiscal year. 

(2)  Business Acquisitions  
During the three years ended January 3, 2009, the Company completed three acquisitions, which were accounted for under the 
purchase  method  of  accounting.    The  results  of  each  acquisition  are  included  in  the  Company’s  consolidated  statements  of 
operations from the date of each acquisition. Below is a description of the acquisitions. 

On August 1, 2008, the Company completed the purchase of LingoLogix, Inc. (“LingoLogix”), for $4,000,000.  LingoLogix was a 
provider  of  software  used  for  computer  automated  coding  technology.    The  acquisition  of  LingoLogix  has  enhanced  the 
Company’s  revenue  cycling  offerings  as  the  solutions  can  be  used  in  both  inpatient  and  outpatient  environments  to  improve 
physician workflow and drive more accurate and efficient reimbursement through automated coding.  The operating results of 
LingoLogix were combined with those of the Company subsequent to the purchase date of August 1, 2008.  The allocation of 
the purchase price to the estimated fair values of the identified tangible and intangible assets acquired and liabilities assumed 
resulted  in  goodwill  of  $1,253,000  and  $4,053,000  in  intangible  assets.    The  intangible  assets  are  being  amortized  over  5 
years.  The goodwill was allocated to the reporting unit.  Pro-forma results of operations have not been presented because the 
effect of this acquisition was not material to the Company. 

On  February  22,  2007,  the  Company  completed  the  purchase  of  assets  of  Etreby  Computer  Company,  Inc.  (“Etreby”),  for 
$25,120,000, which was reduced by $1,588,000 for a working capital adjustment in the second quarter of 2007.  Etreby was a 
software  provider  of  retail  pharmacy  management  systems.    The  acquisition  of  Etreby’s  assets  has  expanded  the  Company’s 
pharmacy  systems  portfolio.  The  operating  results  of  Etreby  were  combined  with  those  of  the  Company  subsequent  to  the 
purchase date of February 22, 2007.  The allocation of the purchase price to the estimated fair values of the identified tangible 
and  intangible  assets  acquired  and  liabilities  assumed  resulted  in  goodwill  of  $12,676,000  and  $10,181,000  in  intangible 
assets.    The  intangible  assets  are  being  amortized  over  five  years.    The  goodwill  was  allocated  to  the  reporting  unit  and  is 
expected to be deductible for tax purposes.  Pro-forma results of operations have not been presented because the effect of this 
acquisition was not material to the Company. 

On  July  5,  2006,  the  Company  completed  the  purchase  of  Galt  Associates,  Inc.,  now  known  as  Cerner  Galt,  Inc.  (“Galt”)  for 
$13,766,000, net of cash acquired.  Galt is a provider of safety and risk management solutions for pharmaceutical, medical 
device  and  biotechnology  companies.    The  acquisition  of  Galt  has  enhanced  the  Company’s  LifeSciences  portfolio  by  adding 
solutions and services that use medical event data to monitor and manage the safety and effectiveness of various therapies.  
The allocation of the purchase price to the estimated fair values of the identified tangible and intangible assets acquired and 
liabilities assumed, resulted in goodwill of $9,298,000 and $4,266,000 in intangible assets.  The intangible assets are being 
amortized over periods between two and five years.  The goodwill was allocated to the reporting unit. 

All of the goodwill for the above acquisitions has been allocated to the Company’s Domestic operating segment.   

69 

 
 
 
 
 
 
 
 
 
A  summary  of  the  Company's  purchase  acquisitions  for  the  three  years  ended  January  3,  2009,  is  included  in  the  following 
table: 

Amounts allocated to intangibles are amortized on a straight-line basis over three to 17 years.  Amounts allocated to software 
are amortized based on current and expected future revenues for each solution with minimum annual amortization equal to the 
straight-line amortization over the estimated economic life of the solution.   

(a)  The assets and liabilities of the acquired companies at the date of acquisition are as follows:       

(3)   Receivables 
Receivables  consist  of  accounts  receivable  and  contracts  receivable.    Accounts  receivable  represent  recorded  revenues  that 
have been billed.  Contracts receivable represent recorded revenues that are billable by the Company at future dates under the 
terms  of  a  contract  with  a  client.    Billings  and  other  consideration  received  on  contracts  in  excess  of  related  revenues 
recognized  are  recorded  as  deferred  revenue.      Substantially  all  receivables  are  derived  from  sales  and  related  support  and 
maintenance  and  professional  services  of  the  Company's  clinical,  administrative  and  financial  information  systems  and 
solutions  to  healthcare  providers  located  throughout  the  United  States  and  in  certain  non-U.S.  countries.    A  summary  of 
receivables is as follows: 

70 

 
 
 
 
 
 
 
 
 
 
The Company performs ongoing credit evaluations of its clients and generally does not require collateral from its clients.  The 
Company provides an allowance for estimated uncollectible accounts based on specific identification, historical experience and 
management's judgment.  At the end of 2008 and 2007 the allowance for estimated uncollectible accounts was $18,149,000 
and $15,469,000, respectively.   

During  the  second  quarter,  Fujitsu  Services  Limited’s  contract  as  the  prime  contractor  in  the  National  Health  Service  (NHS) 
initiative to automate clinical  processes and digitize medical records in the Southern  region of England was terminated.  This 
had  the  effect  of  automatically  terminating  the  Company’s  subcontract  for  the  project.   At  January  3,  2009,  more  than  ten 
percent  of  total  net  receivables  represent  accounts  receivable  and  contracts  receivable  related  to  that  subcontract.   The 
Company  and  Fujitsu  are  in  dispute  regarding  the  receivables  and  are  working  to  resolve  these  issues  based  on  processes 
provided  for  in  the  contract.   While  uncertainties  exist  related  to  the  ultimate  collectability  of  the  receivables,  management 
believes  that  it  has  valid  and  equitable  grounds  for  recovery  of  such  amounts  and  that  collection  of  recorded  amounts  are 
probable. 

During  2008  and  2007,  the  Company  received  total  client  cash  collections  of  $1,729,526,000  and  $1,646,584,000, 
respectively, of which $89,881,000 and $88,286,000 were received from third party arrangements with non-recourse payment 
assignments. 

(4)   Property and Equipment 
A  summary  of  property,  equipment,  and  leasehold  improvements  stated  at  cost,  less  accumulated  depreciation  and 
amortization, is as follows: 

Depreciation expense for the years ended January 3, 2009, December 29, 2007, and December 30, 2006 was $96,739,000, 
$80,020,000, and $61,380,000, respectively. 

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(5)   Indebtedness 
The following is a summary of indebtedness outstanding: 

In November 2005, the Company completed a £65,000,000 ($94,556,000 at January 3, 2009) private placement of debt at 
5.54%  pursuant  to  a  Note  Agreement.    The  Note  Agreement  is  payable  in  seven  equal  annual  installments  beginning  in 
November 2009. The proceeds were used to repay the outstanding amount under the Company’s credit facility and for general 
corporate purposes.  The Note Agreement contains certain net worth and fixed charge coverage covenants and provides certain 
restrictions on the Company’s ability to borrow, incur liens, sell assets and pay dividends.  The Company was in compliance with 
all covenants at January 3, 2009. 

In  December  2002,  the  Company  completed  a  $60,000,000  private  placement  of  debt  pursuant  to  a  Note  Agreement.    The 
Series A Senior Notes, with a $21,000,000 principal amount at 5.57% were paid in full in 2008.  The Series B Senior notes, with 
a  $39,000,000  principal  amount  at  6.42%,  are  payable  in  four  equal  annual  installments  beginning  December  2009.    The 
proceeds were used to repay the outstanding amount under the Company’s credit facility and for general corporate purposes.  
The Note Agreement contains certain net worth and fixed charge coverage covenants and provides certain restrictions on the 
Company’s ability to borrow, incur liens, sell assets and pay dividends.  The Company was in compliance with all covenants at 
January 3, 2009.   

In May 2002, the Company expanded its credit facility by entering into an unsecured credit agreement with a group of banks led 
by US Bank.  This agreement was amended and restated on November 30, 2006 and provides for a current revolving line of 
credit for working capital purposes.  The current revolving line of credit is unsecured and requires monthly payments of interest 
only.    Interest  is  payable  at  the  Company’s  option  at  a  rate  based  on  prime  (3.25%  at  January  3,  2009)  or  LIBOR  (1.41%  at 
January 3, 2009) plus 1.55%.  The interest rate may be reduced by up to 1.15% if certain net worth ratios are maintained. The 
agreement contains certain net worth, current ratio, and fixed charge coverage covenants and provides certain restrictions on 
the Company’s ability to borrow, incur liens, sell assets, and pay dividends.  A commitment fee of .2% is payable quarterly based 
on the usage of the revolving line of credit.  The revolving line of credit matures on May 31, 2010.    As of January 3, 2009, the 
Company had no outstanding borrowings under this agreement and had $90,000,000 available for working capital purposes.  
The Company was in compliance with all covenants at January 3, 2009.   

In April 1999, the Company completed a $100,000,000 private placement of debt pursuant to a Note Agreement.  The Series A 
Senior  Notes,  with  a  $60,000,000  principal  amount  at  7.14%  were  paid  in  full  in  2006.    The  Series  B  Senior  Notes,  with  a 
$40,000,000 principal amount at 7.66%, are payable in six equal annual installments which commenced in April 2004.  The 
proceeds  were  used  to  retire  the  Company’s  existing  $30,000,000  of  debt,  and  the  remaining  funds  were  used  for  capital 
improvements and to strengthen the Company’s cash position.  The Note Agreement contains certain net worth, current ratio, 
and  fixed  charge  coverage  covenants  and  provides  certain  restrictions  on  the  Company’s  ability  to  borrow,  incur  liens,  sell 
assets and pay dividends.  The Company was in compliance with all covenants at January 3, 2009.  

In March 2004, the Company issued a $7,500,000 promissory note to Cedars-Sinai Medical Center of which $2,500,000 was 
repaid in October 2004.  The balance of the note was paid on April 30, 2007. 

The Company also has capital lease obligations amounting to $191,000, payable over the next two years. 

72 

 
 
 
 
 
 
 
   
 
 
 
The aggregate maturities for the Company’s long-term debt, including capital lease obligations, are as follows: 

The  Company  estimates  the  fair  value  of  its  long-term,  fixed-rate  debt  using  a  discounted  cash  flow  analysis  based  on  the 
Company's  current  borrowing  rates  for  debt  with  similar  maturities.    The  fair  value  of  the  Company’s  long-term  debt  was 
approximately $159,349,000 and $173,675,000 at January 3, 2009 and December 29, 2007, respectively. 

73 

 
 
 
 
 
(6)  Fair Value Measurements 
In September 2006, the Financial Accounting Standards Board (FASB) issued Statement of Financial Accounting Standards No. 
157  (SFAS  157),  “Fair  Value  Measurements.”    This  statement  establishes  a  single  authoritative  definition  of  fair  value  to  be 
used when accounting rules require the use of fair value, sets out a framework for measuring fair value and requires additional 
disclosures about fair value measurement.  On February 12, 2008, the FASB issued FASB Staff Position (FSP) No. FAS 157-2.  
This FSP defers the effective date of SFAS 157 to fiscal years beginning after November 15, 2008 for items within the scope of 
the FSP.  On October 10, 2008, the FASB issued FSP No. FAS 157-3 that clarifies the application of SFAS 157 in a market that 
is  not  active.    FSP  No.  FAS  157-3  is  effective  for  all  periods  presented  in  accordance  with  SFAS  157  and  the  Company  has 
considered the guidance with respect to the valuation of its financial assets and their designation within the fair value hierarchy.   

On  December  30,  2007,  the  Company  adopted  the  provisions  of  SFAS  157,  “Fair  Value  Measurements”  except  for  portions 
related  to  the  non-financial  assets  and  liabilities  within  the scope  of  the  deferral  provided  by  FSP  No.  FAS  157-2.    The  three 
levels of the fair value hierarchy defined by SFAS No. 157 are as follows: 

(cid:131) 

(cid:131) 

(cid:131) 

Level 1 – Valuations based on quoted prices in active markets for identical assets or liabilities that the entity has the 
ability to access. 

Level  2  –  Valuations  based  on  quoted  prices  for  similar  assets  or  liabilities,  quoted  prices  in  markets  that  are  not 
active, or other inputs that are observable or can be corroborated by observable data for substantially the full term of 
the assets or liabilities. 

Level 3 – Valuations based on inputs that are supported by little or no market activity and that are significant to the 
fair value of the assets or liabilities. 

The following table details the fair value measurements within the fair value hierarchy of our financial assets: 

Short  term  available-for-sale  securities  consist  of  commercial  paper  on  the  consolidated  balance  sheet,  whereas  long  term 
trading securities represent the value of the Company’s investment in auction rate securities.  The Company utilizes valuation 
models  with  observable  market  data  inputs  to  estimate  the  fair  value  of  its  commercial  paper.    Refer  to  Note  (7)  for  a 
comprehensive description of these assets. 

In February and March 2008, liquidity issues in the global credit markets resulted in the failure of auctions representing all the 
auction  rate  securities  held  by  the  Company.    As  a  result, at  the  end  of  the first  quarter  of  2008  the  Company  assessed the 
decline in fair value of the securities as a temporary impairment. 

Based upon the change in the market and unavailability of observable inputs for auction rate securities during the first quarter, 
the Company changed its valuation methodology to a discounted cash flow model based on various estimates, which changed 
the input category from level 1 to level 3 (significant unobservable inputs) within the SFAS 157 hierarchy.  Included in the inputs 
are the current coupon rates, the interest rate environment, the credit rating of the issuers, the Federal Family Education Loan 
Program (FFELP) guarantee, and the insurance issued by monoline insurance companies. 

Since  the  first  quarter,  overall  market  conditions  have  not  improved  and  auctions  continue  to  fail.    At  January  3,  2009,  the 
Company held auction rate securities with a par value of $105,300,000.  The Company’s updated valuation model resulted in 
an estimated fair value of $85,440,000.   

In November 2008, the Company entered into an agreement (the “Settlement Agreement”) with the investment firm that sold 
the  Company  its  auction  rate  securities.    Under  the  terms  of  the  Settlement  Agreement,  the  Company  received  the  right  to 
redeem the securities at par value during a period from June 2010 through June 2012.  The right to redeem the securities is 
being treated similar to a put option, which the Company has elected to measure under the fair value option of Statement of 
Financial Accounting Standards No. 159 (SFAS 159), “The Fair Value Option for Financial Assets and Financial Liabilities.”  The 
Company’s valuation model resulted in an estimated fair value of $19,860,000 for the value of the put-like feature, which was 
recognized in other income.  Consequently, changes in the fair value of the Settlement Agreement will continue to be recorded 
in income.   

74 

 
 
 
 
 
 
 
 
 
 
 
 
Concurrently with the recognition of the put-like feature, the Company transferred the auction rate securities from available-for-
sale to trading securities.  As a result of the transfer, the Company recognized a pre-tax, other-than-temporary impairment loss 
of approximately $19,860,000 in other income.  As trading securities, changes in the fair value of the investments will continue 
to be recorded in income.  The recording of both the put-like feature and the recognition of the other-than-temporary impairment 
loss resulted in no impact to the Consolidated Statements of Operating Earnings for the year ended January 3, 2009. 

The  table  below  presents  the  Company’s  assets  measured  at  fair  value  on  a  recurring  basis  using  significant  unobservable 
inputs (level 3) as defined in SFAS 157 at January 3, 2009. 

The  effect  of  adopting  the  required  portions  of  SFAS  157  did  not  have  a  material  impact  on  the  Company’s  consolidated 
financial statements.  The Company was required to fully adopt SFAS 157 as of the first day of the 2009 fiscal year and does 
not expect its adoption to have a material impact on the Company’s consolidated financial statements.  At the end of the 2008 
fiscal year, categories where SFAS 157 had not been applied consisted of goodwill and intangible assets. 

(7)  Marketable Securities 
As  of  January  3,  2009,  the  Company  held  investments  in  commercial  paper  along  with  auction  rate  securities.    Commercial 
paper  consists  of  short-term  corporate  debt  with  maturities  of  less  than  three  months.    All  of  the  commercial  paper  held  at 
January 3, 2009 was rated P1/A1 or higher. 

Auction rate securities are debt instruments with long-term nominal maturities, for which the interest rates regularly reset every 
7-35 days under an auction system.  Because auction rate securities historically re-priced frequently, they traded in the market 
on  par-in,  par-out  basis.    In  prior  periods,  the  Company  regularly  liquidated  its  investments  in  these  securities  for  reasons 
including,  among  others,  changes  in  the  market  interest  rates  and  changes  in  the  availability  of  and  the  yield  on  alternative 
investments.    Beginning  in  February  2008,  liquidity  issues  in  the  global  credit  markets  resulted  in  the  progressive  failure  of 
auctions representing all of the auction rate securities held by the Company, because the amount of securities submitted for 
sale in those auctions exceeded the amount of bids. To date the Company has collected all interest receivable on our auction 
rate securities when due and expect to continue to do so in the future; however, the principal associated with failed auctions will 
not  be  accessible  until  successful  auctions  occur,  a  buyer  is  found  outside  of  the  auction  process,  the  issuers  establish  a 
different form of financing to replace these securities, or final payments come due according to contractual maturities ranging 
from 13 to 30 years.  

In August 2008, the Company’s broker agreed to a settlement in principle with the Securities and Exchange Commission, the 
New  York  Attorney  General  and  other  regulatory  agencies  to  restore  liquidity  to  clients  who  hold  auction  rate  securities.    In 
November  2008,  the  Company  entered  into  a  Settlement  Agreement  with  its  broker.    Under  the  terms  of  the  Settlement 
Agreement, the Company will have the ability to redeem the securities at par during a period from mid-2010 through mid-2012.  
Additionally, the Company has the option to obtain a  loan, secured by such securities, at no net cost prior to the redemption 
period. 

During the fourth quarter of 2008 and in conjunction with the execution of the Settlement Agreement, the Company transferred 
the auction rate securities from available-for-sale to trading securities.  As trading securities, these investments are carried at 
fair value with changes recorded through earnings.  At January 3, 2009, the Company held auction rate  securities with a par 
value of $105,300,000.  In the fourth quarter of 2008 the Company recognized a pre-tax, other-than-temporary impairment loss 
of $19,860,000 through earnings.   

The Settlement Agreement is being accounted for as a put-like feature under the fair value option of SFAS 159.  Accordingly, the 
feature is carried at fair value with changes recorded through earnings.  The Company has valued the put-like feature as the 
difference between the par value of the auction rate securities and the fair value of the securities, discounted by the credit risk 
of  the  broker.    The  loan  option  was  also  valued  taking  into  account  the  settlement  discount  and  credit  risk  during  the  time 
necessary  to  administer  the  loan.    At  January  3,  2009,  the  Company  valued  the  put-like  feature  at  $19,860,000  which  was 
recognized through earnings.  The Company anticipates that any future changes in the fair value of the put-like feature will be 
substantially  offset  by  changes  in  the  fair  value  of  the  related  auction  rate  securities  with  no  material  net  impact  to  the 
Consolidated Statements of Earnings. 

75 

 
 
 
 
 
 
 
 
 
 
 
All of the auction rate securities that the Company currently holds are A rated or higher and are collateralized by student loan 
portfolios, the majority of which are backed by the U.S. government through its Federal Family Education Loan Program. 

Management  regularly  reviews  investment  securities  for  impairment  based  on  both  quantitative  and  qualitative  criteria  that 
include the extent to which cost exceeds fair value, the duration of the market decline, our intent and ability to hold to maturity 
or until forecasted recovery, and the financial health of and specific prospects for the issuer.  Unrealized losses that are other 
than temporary are recognized in earnings. We do not believe the auction failures will materially impact our ability to fund our 
working capital needs, capital expenditures or other business requirements. 

(8)  Interest Income (Expense) 
A summary of interest income and expense is as follows: 

(9)  Stock Options and Equity 
At the end of 2008 and 2007, the Company had 1,000,000 shares of authorized but unissued preferred stock, $.01 par value.   

As of January 3, 2009, the Company had four fixed stock option and equity plans in effect for associates.  The awards granted 
under  these  plans  qualify  for  equity  classification  pursuant  to  SFAS  123R.    Amounts recognized  in  the  consolidated  financial 
statements with respect to these plans are as follows: 

During 2008, the Company had two shareholder approved long-term incentive plans from which it could issue grants. 

Under  the  2001  Long-Term  Incentive  Plan  F,  the  Company  is  authorized  to  grant  to  associates,  directors  and  consultants 
4,000,000 shares of common stock awards taking into account the stock-split effective January 10, 2006.  Awards under this 
plan may consist of stock options, restricted stock and performance shares, as well as other awards such as stock appreciation 
rights,  phantom  stock  and  performance  unit  awards  which  may  be  payable  in  the  form  of  common  stock  or  cash  at  the 
Company’s discretion.  However, not more than 1,000,000 of such shares will be available for granting any types of grants other 
than options or stock appreciation rights. Options under Plan F are exercisable at a price not less than fair market value on the 
date of grant as determined by the Stock Option Committee.  Options under this plan typically vest over a period of five years as 
determined by the Stock Option Committee and are exercisable for periods of up to 25 years. 

Under the 2004 Long-Term Incentive Plan G, the Company is authorized to grant to associates and directors 4,000,000 shares 
of common stock awards taking into account the stock-split effective January 10, 2006.  Awards under this plan may consist of 
stock  options,  restricted  stock  and  performance  shares,  as  well as  other  awards  such  as  stock  appreciation  rights,  phantom 
stock and performance unit awards which may be payable in the form of common stock or cash at the Company’s discretion.  
Options under Plan G are exercisable at a price not less than fair market value on the date of grant as determined by the Stock 
Option  Committee.    Options  under  this  plan  typically  vest  over  a  period  of  five  years  as  determined  by  the  Stock  Option 
Committee and are exercisable for periods of up to 12 years.  In 2007, Long-Term Incentive Plan G was amended to provide the 
Company the ability to recover fringe benefit tax payments made by the Company on behalf of its associates in India.  

The fair market value of each stock option award is estimated on the date of grant using a lattice option-pricing model.  In 2006, 
the Company changed its valuation model from the Black-Scholes option-pricing model to the lattice pricing model because it is 
believed  to  provide  greater  flexibility  for  valuing  the  substantive  characteristics  of  employee  share  instruments,  resulting  in  a 
more accurate estimate of fair market value.  The pricing model requires the use of the following estimates and assumptions: 

(cid:131) 

Expected volatilities under the lattice model are based on an equal weighting of implied volatilities from traded options 
on  the  Company’s  shares  and  historical  volatility.    The  Company  uses  historical  data  to  estimate  the  stock  option 

76 

 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
exercise  and  associate  departure  behavior  used  in  the  lattice  model;  groups  of  associates  (executives  and  non-
executives) that have similar historical behavior are considered separately for valuation purposes.   

(cid:131) 

(cid:131) 

The expected term of stock options granted is derived from the output of the lattice model and represents the period 
of time that stock options granted are expected to be outstanding; the range given below results from certain groups 
of associates exhibiting different post-vesting behaviors.  

The  risk-free  rate  is  based  on  the  zero-coupon  U.S.  Treasury  bond  with  a  term  equal  to  the  contractual  term  of  the 
awards.  

(cid:131) 

The weighted-average assumptions used to estimate the fair market value of stock options are as follows: 

A combined summary of the stock option activity of the Company’s four fixed stock option and equity plans (Non-Qualified Stock 
Option Plans D and E were in effect prior to 2005 and some options remain issued and outstanding; however, no new grants 
were  permitted  to  be  issued  from  Plans  D  and  E  after  January  1,  2005  pursuant  to  the  terms  of  the  Plans)  and  other  stock 
options at the end of 2008, 2007 and 2006 are presented below: 

The following tables summarize information about fixed and other stock options outstanding at January 3, 2009: 

The weighted-average grant date fair market value of stock options granted during 2008, 2007 and 2006 was $22.99, $29.17 
and  $19.68,  respectively.    The  total  intrinsic  value  of  stock  options  exercised  in  2008  and  2007  was  $26,841,000  and 
$67,336,000, respectively.  The Company issues new shares to satisfy option exercises.  

77 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Restricted Stock Grants 
A summary of the Company’s restricted stock grants during 2008, 2007, and 2006 are presented below: 

All grants were valued at the fair market value on the date of grant and vest provided the recipient has continuously served on 
the  Board  of  Directors  through  such  vesting  date  or  in  the  case  of  an  associate  provided  that  performance  measures  are 
attained.  The expense associated with these grants is being recognized over the period from the date of grant to the vesting 
date.  The Company recognized expenses related to the restricted stock of $852,000, $887,000, and $853,000 in 2008, 2007 
and 2006, respectively. 

Nonvested Shares 
A summary of the Company’s nonvested restricted stock compensation arrangements granted under all plans as of January 3, 
2009 is presented below: 

As  of  January  3,  2009,  there  was  $42,984,000  of  total  unrecognized  compensation  cost  related  to  nonvested  share-based 
compensation  arrangements  (including  stock  option  and  nonvested  share  awards)  granted  under  all  plans.    That  cost  is 
expected to be recognized over a weighted-average period of 2.91 years.  The total fair market value of shares vested during 
2008, 2007 and 2006 was $797,000, $1,380,000 and $1,031,000, respectively. 

Associate Stock Purchase Plan  
The Company established an Associate Stock Purchase Plan (ASPP) in 2001, which qualifies under Section 423 of the Internal 
Revenue Code.  Each individual employed by the Company and associates of the Company's United States based subsidiaries, 
except  as  provided  below,  are  eligible  to  participate  in  the  Plan  ("Participants").    The  following  individuals  are  excluded  from 
participation: (a) persons who, as of the beginning of a purchase period under the Plan, have been continuously employed by 
the Company or its domestic subsidiaries for less than two weeks; (b) persons who, as of the beginning of a purchase period, 

78 

 
 
 
 
 
 
 
 
 
 
own directly or indirectly, or hold options or rights to acquire under any agreement or Company plan, an aggregate of 5% or more 
of the total combined voting power or value of all outstanding shares of all classes of Company Common Stock; and, (c) persons 
who are customarily employed by the Company for less than 20 hours per week or for less than five months in any calendar 
year.  Participants may elect to make contributions from 1% to 20% of compensation to the ASPP, subject to annual limitations 
determined by the Internal Revenue Service.   Participants may purchase Company Common Stock at a 15% discount on the 
last  business  day  of  the  purchase  period.    The  purchase  of  the  Company’s Common Stock is made through the ASPP on the 
open market and subsequently reissued to the associates.  Under FAS123R, the difference of the open market purchase and 
the participant’s purchase price is being recognized as compensation expense. 

Treasury Stock 
In March 2008, our Board of Directors authorized a stock repurchase program of up to $45 million of our Common Stock on the 
open market and/or in privately-negotiated purchase.  The stock repurchase activity as of January 3, 2009 is as follows: 

These  repurchased  shares  are  recorded  as  treasury  stock  and  are  accounted  for  under  the  cost  method.    No  repurchased 
shares have been retired. 

(10)   Foundations Retirement Plan 
The  Cerner  Corporation  Foundations  Retirement  Plan  (the  Plan)  is  established  under  Section  401(k)  of  the  Internal  Revenue 
Code.  All associates over age 18 and not a member of an excluded class are eligible to participate.  Participants may elect to 
make pretax contributions from 1% to 80% of eligible compensation to the Plan, subject to annual limitations determined by the 
Internal Revenue Service.  Participants may direct contributions into mutual funds, a stable value fund, a Company stock fund, 
or a self-directed brokerage account.  The Company makes matching contributions to the Plan, on behalf of participants, in an 
amount equal to 33% of the first 6% of the participant's salary contribution.  The Company's expenses for the Plan amounted to 
$8,669,000, $8,280,000 and $7,791,000 for 2008, 2007 and 2006, respectively. 

The  Company  added  a  second  tier  discretionary  match  to  the  Plan  in  2000.    Contributions  are  based  on  attainment  of 
established earnings per share goals for the year or the established financial metric for the Plan.  Only participants who defer 
2% of their base salary, are actively employed as of the last day of the Plan year and are employed before October 1st of the 
Plan year are eligible to receive the discretionary match contribution.  For the years ended 2008, 2007 and 2006 the Company 
expensed $2,228,000, $6,019,000 and $6,638,000 for discretionary distributions, respectively.   

79 

 
 
 
 
 
 
 
 
   
(11)   Income Taxes 
Income tax expense (benefit) for the years ended 2008, 2007 and 2006 consists of the following: 

Temporary differences between the financial statement carrying amounts and tax basis of assets and liabilities that give rise to 
significant portions of deferred income taxes at the end of 2008 and 2007 relate to the following: 

During  2007,  the  Company  determined  that  due  to  a  change  in  circumstances,  it  is  more  likely  than  not  that  certain  tax 
operating loss carry-forwards in a non-U.S. jurisdiction would not be realized resulting in the recognition of a valuation allowance 
totaling  approximately  $7,982,000.    During  2008,  this  non-U.S.  jurisdiction  audited  the  Company.    As  a  result  of  the  audit, 
certain tax positions previously taken were disallowed by the foreign jurisdiction, which reduced the deferred tax asset relating 
to the net operating loss carryforward in that jurisdiction.  The valuation allowance related to the net operating loss carryforward 
was  released  because  management  believes  it  is  more  likely than  not  the  Company  will  realize  the  remaining  operating  loss 
carry-forward  amount.    Based  upon  the  level  of  historical  taxable  income  and  projections  for  future  taxable  income  over  the 
periods which the remaining deferred tax assets are expected to be deductible, as well as the scheduled reversal of deferred tax 
liabilities,  management  believes  it  is  more  likely  than  not  the  Company  will  realize  the  remaining  deferred  tax  assets  and  no 
valuation allowance is required.  At January 3, 2009, the Company had net operating loss carry-forwards subject to Section 382 
of  the  Internal  Revenue  Code  for  Federal  income  tax  purposes  of  $14.9  million  which  are  available  to  offset  future  Federal 
taxable income, if any, through 2020.  

80 

 
 
 
 
 
 
 
 
 
The effective income tax rates for 2008, 2007 and 2006 were 33%, 38% and 34%, respectively.  These effective rates differ 
from the Federal statutory rate of 35% as follows: 

The  2008,  2007  and  2006  tax  expense  amounts  include  the  recognition  of  approximately  $2,879,000,  $3,125,000  and 
$1,994,000 respectively of tax benefits for items related to prior periods.  The 2008 amount was related to an adjustment of a 
foreign tax credit claimed.  The adjustments in 2007 were recorded primarily to correct an error in the Company’s 2006 state 
income tax rate.  These differences have accumulated over several years and the impact to any one of these prior periods is not 
material.    The  2006  amounts  relate  to  tax  credits  taken  on  prior  income  tax  returns  and  to  correct  an  error  in  prior  years’ 
effective foreign tax rate, which had accumulated over several years.  

On December 31, 2006, the Company adopted the Financial Accounting Standards Board (FASB) Interpretation No. 48 (FIN 48), 
“Accounting for Uncertainty in Income Taxes,” an interpretation of the Statement of Financial Accounting Standards (SFAS) No. 
109, “Accounting for Income Taxes.”  This interpretation clarifies how companies calculate and disclose uncertain tax positions.  
The effect of adopting this interpretation did not impact any previously recorded amounts for unrecognized tax benefits. 

The  2008  beginning  and  ending  amounts  of  accrued  interest  related  to  the  underpayment  of  taxes  was  $202,000  and 
$925,000, respectively.  The Company classifies interest and penalties as income tax expense in its consolidated statement of 
earnings, which is consistent with how the Company previously classified interest and penalties related to the underpayment of 
income taxes.  No accrual for tax penalties was recorded upon adoption of FIN 48 or at the end of the year. 

The total amount of unrecognized tax benefits including interest was $8,069,000 as of December 29, 2007.  During 2008, the 
Company settled IRS examinations for the 2005 to 2006 periods and as a result reversed previously recorded reserves for tax 
uncertainties by $1,319,000.  The years after 2006 remain open.  As of January 3, 2009, the total amount of unrecognized tax 
benefits,  including  interest,  was  $12,440,000.    It  is  reasonably  possible  that  within  the  next  12  months  the  Company  will 
resolve  some  of  the  matters  which  may  decrease  unrecognized  tax  benefits  for  these  open  tax  years  by  $1,000,000.    Any 
settlement of those unrecognized tax benefits will affect the effective tax rate of the Company.    

A reconciliation of unrecognized tax benefit as of January 3, 2009, is presented below: 

(12)   Related Party Transactions 
For the first half of 2008 and prior years, the Company leased an airplane from PANDI, Inc. (PANDI), a company owned by Mr. 
Neal  L.  Patterson  and  Mr.  Clifford  W.  Illig,  the  Company’s  Chairman/CEO  and  Vice  Chairman  of  the  Board,  respectively.    The 
airplane was leased on a per mile basis with no minimum usage guarantee.  The lease rate was believed to approximate fair 
market value for this type of aircraft.  During 2008, 2007 and 2006 the Company paid an aggregate of $423,000, $661,000, 
and $670,000 for the rental of the airplane, respectively.  The airplane was used principally by Mr. Trace Devanny, President, 
and  Mr. Mike  Valentine,  Executive  Vice  President,  to  make  client  visits.   On August  14,  2008,  the  PANDI  aircraft  was  sold by 
PANDI to a third party, which had the effect of terminating the lease agreement with the Company. 

On February 6, 2007, the Company entered into an Aircraft Service Agreement between Rockcreek Aviation, Inc. (the Company’s 
wholly-owned  flight  operations  subsidiary)  and  PANDI.  Under  this  agreement  Rockcreek  Aviation  provided  flight  operations 
services to PANDI with respect to PANDI’s aircraft.  PANDI owned and operated a Beechcraft, BeechJet 400 for the first half of 
2008.  During 2008, the aircraft services fees paid by PANDI to the Company were $297,000.  On August 14, 2008, the PANDI 
aircraft  was  sold  by  PANDI  to  a  third  party,  which  had  the  effect  of  terminating  the  Aircraft  Service  Agreement  between 
Rockcreek Aviation and PANDI.     

81 

 
 
 
 
 
 
 
 
 
 
 
 
 
(13)   Commitments 
In  prior  years,  the  Company  leased  space  to  unrelated  parties  in  its  North  Kansas  City  headquarters  complex  and  in  other 
business locations under noncancelable operating leases.  Included in other revenues is rental income of $305,000 in 2006.  
The Company did not receive rental income in 2007 or 2008. 

The  Company  is  committed  under  operating  leases  for  office  space  and  computer  equipment  through  October  2027.    Rent 
expense  for  office  and  warehouse  space  for  the  Company’s  regional  and  global  offices  for  2008,  2007,  and  2006  was 
$16,091,000, $12,436,000 and $11,391,000, respectively.  Aggregate minimum future payments under these noncancelable 
operating leases are as follows: 

(14)   Segment Reporting 
The  Company  has  two  operating  segments,  Domestic  and  Global.    Revenues  are  derived  primarily  from  the  sale  of  clinical, 
financial and administrative information systems and solutions.  The cost of revenues includes the cost of third party consulting 
services, computer hardware  and sublicensed software purchased from computer  and software manufacturers for delivery to 
clients.    It  also  includes  the  cost  of  hardware  maintenance  and  sublicensed  software  support  subcontracted  to  the 
manufacturers.  Operating expenses incurred by the geographic business segments consist of sales and client service expenses 
including  salaries  of  sales  and  client  service  personnel,  communications  expenses  and  unreimbursed  travel  expenses.  
Performance  of  the  segments  is  assessed  at  the  operating  earnings  level  and,  therefore,  the  segment  operations  have  been 
presented  as  such.    “Other”  includes  revenues  not  generated  by  the  operating  segments  and  expenses  such  as  software 
development, marketing, general and administrative, share-based compensation expense and depreciation that have not been 
allocated to the operating segments.  It is impractical for the Company to track assets by geographical business segment. 

82 

 
 
 
 
 
 
 
 
Accounting  policies  for  each  of  the  reportable  segments  are  the  same  as  those  used on  a  consolidated  basis.    The  following 
table  presents  a  summary  of  the  operating  information  for  the  years  ended  January  3,  2009,  December  29,  2007  and 
December 30, 2006. 

83 

 
 
 
(15)   Quarterly Results (unaudited) 

Selected quarterly financial data for 2008 and 2007 is set forth below: 

(1)  Includes margin of $28.6 million related to the Company’s contract in London as part of the National Health Service (NHS) 
initiative to automate clinical processes and digitize medical records in England.  This represents a one-time catch-up resulting 
from a change in accounting estimate and the ability to separate the support services element of the contract.  The after tax 
effect  of  this  item  increased  fourth  quarter  2008  net  earnings  and  diluted  earnings  per  share  by  $20.6  million  and  $0.24, 
respectively. 

84 

 
 
 
 
 
 
 
Stock Price Performance 
The  following  graph  presents  a  comparison  for  the  five-year  period  ended  December  31,  2008  of  the  performance  of  the 
Common Stock of the Company with the NASDAQ Composite Index (US Companies) (as calculated by The Center for Research in 
Security  Prices)  and  the  NASDAQ  Computer/Data  Processing  Group  (as  calculated  by  The  Center  for  Research  in  Security 
Prices): 

The above comparison assumes $100 was invested on December 31, 2003 in Common Stock of the Company and in each of 
the  foregoing  indices  and  assumes  reinvestment  of  dividends.    The  results  of  each  component  issuer  of  each  group  are 
weighted according to such issuer’s stock market capitalization at the beginning of the year. 

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Annual Shareholders’ Meeting 
The Annual Shareholders’ Meeting will be held at 10:00 a.m. on May 22, 2009, at The Cerner Round auditorium in the Cerner 
Vision Center, located on the Cerner campus at 2850 Rockcreek Parkway, North Kansas City, Missouri.  A formal notice of the 
Meeting, with a Proxy Statement and Proxy Card, will be available, to each shareholder of record, in April 2009. 

Annual Report/10-K Report 
Publications of interest to current and potential Cerner investors are available upon written request or via Cerner’s Web site at 
www.cerner.com.  These  include  annual  and  quarterly  reports  and  the  Form  10-K  filed  with  the  Securities  and  Exchange 
Commission. 

Written requests should be made to: 

Cerner Corporation 
Investor Relations 
2800 Rockcreek Parkway 
North Kansas City, MO 64117-2551 

Inquiries  of  an  administrative  nature  relating  to  shareholder  accounting  records,  stock  transfer,  change  of  address  and 
miscellaneous shareholder requests should be directed to the transfer agent and registrar, Computershare Trust Company, at 1-
800-884-4225. 

Transfer Agent and Registrar 
Computershare Trust Company, N.A. 
P.O. Box 43078 
Providence, RI 02940-3078 
1-800-884-4225 

Stock Listings 
Cerner Corporation’s common stock trades on The NASDAQ Stock Market LLC under the symbol CERN. 

Independent Accountants 
KPMG LLP 
Kansas City, MO 

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World Headquarters
Cerner Worldwide
2800 Rockcreek Parkway
North Kansas City, MO USA
64116-2551
816.221.1024
www.cerner.com

Worldwide
Australia
Canada
France
Germany
Hong Kong
India
Ireland
Malaysia
Singapore
Spain
United Arab Emirates
United Kingdom