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How Cerner enables the sharing of data across a Healthcare Community Cerner Network Current State - The Chaotic Middle Interaction Communication Partial Communication Paper Chart Friction Error Superbill Variance EDI Waste Coder Delay EOB Payer edits CPT Clipboard 837/835 ICD-9 Scrubber Modifier Clearinghouse © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 1 The ABCs of Systemic Healthcare Reform (2/26/09) The opportunity for a “New Middle” © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 2 Cerner State - The New Middle © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 3 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 © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 4 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) © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 5 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 © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 6 Provider Connectivity © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 7 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 © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 8 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 EMR’s 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 © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 9 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 physician’s 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 XML Data such as CCDs © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 10 Distributed MPI Matching View © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 11 Audit Trail View – Hospital © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 12 Audit Trail View – Physician Office © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 13 Cerner Hub\HealthDock – Current Connections Allscripts AthenaHealth Amazing Charts SOAPware, Inc. CommChart Encite Misys e-MDs Epic Praxis SRS Soft eClinicalWorks Glostream meridianEMR Ingenix GE Centricity Greenway NextGen Sage iMed Corp Sage Intergy HealthVision Prognosis gMed Atlas InterComponentWare Integritas Ingenious Med © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 14 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. © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 15 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 © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 16 WebConnect- Patient Search © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 17 WebConnect- Order History © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 18 WebConnect- Tests © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 19 WebConnect- New Results © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 20 WebConnect- Results Detail © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 21 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 can’t/won’t incorporate APIs Easy registration and management Supports workflow associated with: Provider to Provider Communications Consultations Referrals © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 22 Community Connectivity © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 23 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 provider’s EMR The HIE acts an aggregator, the EMR should act as the engagement mechanism The HIE is “Plumbing” – Don’t make it more complicated than it should be Focus the HIE on connectivity not re-creating EMR functionality © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 24 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 © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 25 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%) © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 26 “A Success Story” © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 27 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 EMR’s Interfaced Epic Meditech McKesson Cerner CPSI eClinical Greenway © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 28 SMRTNET Community “The Experience” First Visit?? SMRTNET Community Data © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 29 SMRTNET Community “The Experience” No Historical Data in EMR SMRTNET Community SMRTNET Community Data © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 30 SMRTNET Community “The Experience” SMRTNET HIE View Who Prescribed these? What was Observed? SMRTNET Community Data © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 31 SMRTNET Community “The Experience” SMRTNET Community Data © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 32 SMRTNET Community “The Experience” Details from Encounter SMRTNET Community Data © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 33 Future: Pull Data From SMRTNET Into Chart © 2010 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 34 How Cerner enables the sharing of data across a Healthcare Community Grady Cason [email protected] (816) 885-5537