How Cerner enables the sharing of data across a Healthcare Community

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Cerner Network

• How Cerner enables the sharing of data across a
  Healthcare Community

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Current State - The Chaotic Middle
FrictionError Variance Waste Delay
Clipboard
Paper Chart
Superbill
837/835
EDI
ICD-9
Coder
Scrubber
EOB
Modifier
Payer edits
CPT
Clearinghouse
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The ABCs of Systemic Healthcare Reform (2/26/09)
The opportunity for a New Middle
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Cerner State - The New Middle
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What is the Cerner Network

• The Cerner Network is a suite of connectivity
  services that makes electronic data exchange
  simple, fast, affordable and meaningful.
• Supports information exchange between providers
• Makes it easier for providers to stay in touch
  with their patients
• Helps providers qualify for meaning use
  incentives
• Improves quality of patient care
• Lays foundation for future (Accountable Care
  Organization)
• The Cerner Network suite includes services for
• Providers with an EHR/Hospitals and Health
  Systems
• Providers without an EHR
• Health Information Exchanges
• Patient Engagement

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What it does

• Cerner Network Key Drivers
• Improve Physician Relationships
• Deliver clinical results in real-time to a
  physician office
• Eliminate unnecessary faxing and mailing
• Streamline communication
• Improve Quality of Care Through Better Care
  Coordination
• Enable delivery of patient discharge summaries to
  Physician Office upon patient discharge Visit
  summaries from Physician Office to Hospital
• Provider to provider secure messaging to address
  referral management needs
• Retain and build key service lines (i.e. Lab
  Outreach, etc)
• Improve patient relationships
• Enable delivery of patient discharge summaries to
  patients upon patient discharge
• Provide convenient patient services online
  (provider to patient secure messaging, etc)

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Support for Existing Emerging Standards

• HITSP IHE Federal Standards Consolidation of
  HL7 v3 CDA and ASTM CCR into the HITSP CCD
• Nomenclature standardization such as LOINC,
  SNOMED , CPT ICD9
• Laboratory result delivery specific messages XD
• Many other specific message formats for specific
  purposes such as Biosurveilance, Consumer
  Empowerment, EMR results delivery, inter-HIE
  patient identifier notifications
• HITSP covers messaging standards based on SOAP
  with x.509
• Authentication and authorization assertions
  through SAML
• Detailed audit requirements through ATNA logging
  and query
• NHIN NHIN is providing a mechanism to translate
  the proposed and ratified standards into
  achievable standards for existing systems
• NHIN-certified HIEs are expected to normalize
  varying existing intra-HIE standards
  communication to the NHIN standard so they can
  provide a standards based facade for inter-HIE
  communication

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Provider Connectivity
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Connectivity Strategy - Friends Family
Non-Cerner EMR Health Dock (AllScripts, eCw,
Centricity, Vista, etc)
PWx Clinic Health Dock not required
Paper-Based Clinic Health Dock Or WebConnect
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Cerner Hub - Provider Connectivity

• Facilitate connectivity with employed and
  affiliated physicians regardless of EMR or lack
  thereof
• Plug/Play connectivity in physician offices
  with HealthDock appliance, providing flexibility
  to
• Seamlessly connect and integrate data into 3rd
  party EMRs
• Print to network printer
• Email
• Ability to facilitate Laboratory and Radiology
  order conversations back into Hospital

• Major components
• Orders and Results transaction routing
• Discharge Summary, Continuity of Care
  Document(CCD),
• Clinical Note Distribution
• Connection to SureScripts/RxHub Services

Cerner Hub

• Key Use Cases
• Laboratory and Radiology Outreach Services
• Referral Management
• Improve Affiliated Physician Satisfaction

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Cerner Hub- HealthDock

• Our Technology
• Push technology, versus look up
• Built from the ground up in Physician office
• The way we deploy
• Smart appliance based solution (HealthDock) in
  the physicians office
• No software to load
• Little to no IT knowledge required
• Distributed MPI (dMPI)
• Full audit trail and data reporting tool
• EMR message normalization and exception handling
• Supports all CCHIT EMRs
• Enterprise class Gateway in hospital datacenter
  or cloud
• Enables rapid deployment to thousands of
  physicians
• with minimal IT effort
• Automatically normalizes and cleanses messages
• Dashboard view of clinics
• Supports the complete set of clinical data
• Discharge Summaries, Results, Orders, Clinical
  Notes

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Distributed MPI Matching View
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Audit Trail View Hospital
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Audit Trail View Physician Office
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Cerner Hub\HealthDock Current Connections
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Provider Office- Cost Analysis

• Physician Office
• Cost involved from their EMR vendor to connect
• Vendor fees range from 5000 15,000
• If Health Dock is in place the physician offices
  would be eligible for negotiated rates- cost
  savings up to 50
• Note One Health Dock is needed for each domain
  connected.

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Cerner WebConnect

• Cerner WebConnectTM
• Is a comprehensive, easy-to-use, Web based
  solution that supports laboratory outreach order
  entry, specimen management and result reporting,
  while connecting to a physician EMR.
• Maintains and improves client satisfaction by
  making it easier for outreach customers to
  request services and receive results
• Service providers can increase collections and
  cash flow by ensuring compliance with regulations
  and common billing practices
• Ideal for physicians looking for a unique,
  easy-to-use solutions for managing orders and
  results

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WebConnect- Patient Search
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WebConnect- Order History
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WebConnect- Tests
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WebConnect- New Results
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WebConnect- Results Detail
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Secure Messaging- NHIN Direct

• National email-like network for secure
  point-to-point messaging
• Platform to provide simple ad-hoc connectivity
  between physicians, organizations, and persons
• Open APIs consumable by any clinical system
• Print Driver tool for systems that cant/wont
  incorporate APIs
• Easy registration and management
• Supports workflow associated with
• Provider to Provider Communications
• Consultations
• Referrals

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Community Connectivity
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Cerner Exchange Platform-Key Principles

• Connectivity must be Vendor Agnostic
• HIE must leverage common standards so as to allow
  any EMR adherent to those standards to connect
• HIE is broader than any one Vendor
• HIE engagement must happen in Provider Workflow
• HIE Access should driven through a providers EMR
• The HIE acts an aggregator, the EMR should act as
  the engagement mechanism
• The HIE is Plumbing Dont make it more
  complicated than it should be
• Focus the HIE on connectivity not re-creating EMR
  functionality

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Cerner Exchange Platform-(HIE)

• Provides data aggregation service across
  Regions(small or large)
• Leveraging IHE profiles and HL7 standards
• Customizable web portal access
• Population analytics/analysis
• Centralized or Federated model
• Core Services
• Master Person Index
• Record Locator Service
• Terminology

• Aggregated Continuity of Care Document (CCD)

• Demographics
• Allergies and Alert Problems
• Conditions or Problems
• Medications
• Advance directives
• Immunizations
• Vital Signs
• Results
• Encounters
• Procedures

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2011 Meaningful Use Cerner Network Alignment

• Cerner HUB Clinical Exchange
• ePrescribing
• Provide Summary of care record for transitions of
  care (referrals)
• Incorporate clinical lab results into HER as
  structured data (50)
• Report Hospital quality measures to CMS or the
  respective state (attestation/electronic)
• Capability to provide electronic submission of
  reportable lab result (1 test)
• Capability to provider electronic syndrome
  surveillance data (1 test)
• Capability to submit electronic data to
  immunization registries (1 test)
• Cerner Health Record and Patient Services
• Provide patients with an electronic copy of their
  discharge instructions (80)
• Provide Patients with an electronic copy of their
  health information (80)

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A Success Story
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Success Story- Oklahoma (SMRTNet)
300SMRTNET Users NE Oklahoma
750 SMRTNET Users OKC MSA

• State Population
• 3.6 Million
• SMRTNet Population
• 4 Million
• SMRTNet Users
• 2750
• SMRTNet EMRs Interfaced
• Epic
• Meditech
• McKesson
• Cerner
• CPSI
• eClinical
• Greenway

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SMRTNET Community The Experience
First Visit??
SMRTNET Community Data
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SMRTNET Community The Experience
No Historical Data in EMR
SMRTNET Community
SMRTNET Community Data
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SMRTNET Community The Experience
SMRTNET HIE View
Who Prescribed these?
What was Observed?
SMRTNET Community Data
SMRTNET Community Data
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SMRTNET Community The Experience
SMRTNET Community Data
SMRTNET Community Data
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SMRTNET Community The Experience
Details from Encounter
SMRTNET Community Data
SMRTNET Community Data
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Future Pull Data From SMRTNET Into Chart
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• How Cerner enables the sharing of data across a
  Healthcare Community
• Grady Cason
• gcason_at_cerner.com
• [phone]