Title in Franklin Gothic Demi 18pt. Cerner Ambulatory. Cloudy Forecast: Predictions for Big Data Large and Small Practices

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1 Cerner Ambulatory Cloudy Forecast: Predictions for Big Data Large and Small Practices in

2 Cloudy Forecast: Predictions for Big Data in Large and Small Medical Practices Whether gathering a patient s history, learning about new medications on the market, or forecasting his or her population s health the information a physician collects can be both life-saving and overwhelming. If used appropriately and innovatively, these numbers and letters can predict a problem before it happens. We cannot predict when a person will have a heart attack, said Dr. Christopher Tashjian, but we can say this person s at a great risk for a stroke. Rather than wait until they get their stroke, we can bring them in, treat their hypertension, treat their diabetes, prevent their blindness, and prevent them from having an amputation. But often, this valuable data often sits in a chart, electronic or paper, and all the useful dots are never connected. Until now, with the use of Big Data. BIG DATA The phrase Big Data is an all-encompassing term for advancing technology which allows a new approach to understanding the world and making decisions. Data is growing every moment, and it comes from a growing stream of sources. The technology research firm IDC estimates data grows at 50 percent a year, or more than double every two years. That assessment accounts for information from various industries, but it includes the medical field. That medical data, when put into digital form, can change lives of provider, of patient, and the lives of those who interact with both. In a physician s practice alone, the data comes from digital stethoscopes, s, social media, patients, and government and medical agencies. Dr. Tashjian is a proponent of using Big Data to connect the dots at his River Falls Medical Clinic. The group of 20 family physicians, general surgeons, and internists sits in a town of 2,000 in western Wisconsin. I am the medical director for public health, the ambulance, practice emergency medicine, do C-sections, and see patients in the clinic, hospital, and nursing home. In short, he s busy. While he sees the benefits of Big Data, he doesn t have a lot of time to crunch it. As you can expect with a small clinic, he added with a wry grin, we don t have a lot of technical expertise. What we found in our small rural family practice is that we ve been able to use the electronic record to help better manage our patients, he said. We take advantage of Cerner s expertise and utilize the Application Service Provider (ASP) model. We have access to a fully state-of-the-art electronic record that we can manage and use to better care for our patients. The Cloudy Forecast

3 APPLICATION SERVICE PROVIDER This remote-hosted model keeps all of River Falls Medical Center s data a secure data warehouse. All Dr. Tashjian s office needs is access to the internet, a T1 line, and his computer system. His important data files are all digital and still easily accessible, thanks to the medical center s use of electronic health records (EHRs) and the Application Service Provider model of remote-hosting. We use Cerner PowerWorks Advanced Reporting, said Dr. Tashjian. My care coordinator manages that data gathering. She brings people to my attention who need help, people who need a lot of help, and people who are doing really well. So we can focus on the patients who need and desire it. Dr. Tashjian s office now can, in essence, forecast which patients will need the most care. We can actually look at our patients, determine who s going to get sick, call them in, treat them and prevent the illness altogether. He can harvest the Big Data collected in the EHR, which is stored off-site through the ASP model. The Cerner ASP is a subscription-based service using cloud technology. Practices do not need their own hardware with the ASP service. Instead, it is sent digitally to the Cerner Technology Center, located at its world headquarters in Kansas City, Missouri. All the Big Data blood pressure readings, allergies, immunizations, medications, etc. - are stored on servers inside a concrete structure built to withstand an EF-5 tornado. Eight emergency generators are onsite to prevent any electrical outage. 24 hour security keeps everything secure. Within the ASP model, we have cutting edge technology from an industry leader, said Alan Velarde, Cerner Solution Architect, of the ASP system. We can harvest the best capabilities from Cerner s Millennium Plus Cloud Platform and all the physician needs is an internet connection to access it. With the cloud, Velarde continued, there is no hardware maintenance for our clients. There are no software maintenance updates. The physician practice has updated functionality, automatic back-ups, and regulatory updates done for them. We use our ASP model to leverage our best practices and ideals across the client base. It was one of the biggest reasons Dr. Tashjian and his group searched for three years for their EHR vendor: remote-hosted capability gave physicians the ability to retrieve the data whenever needed. But many other health systems do not have the luxury of time to decide. Palmetto Health had just nine months to replace its old EHR system at 60 sites across the state of South Carolina. WE EXAMINED OUR POSSIBILITIES Dr. Tripp Jennings, Assistant Vice President, Medical Information Officer explained his large health system chose remote hosting for several reasons. The first: get everyone on the same EHR system. In the summer of 2013, it had 350 physicians and 200 medical residents across dozens of sites, all eager to all work on the The same EHR Cloudy system. Forecast

4 But we realized that it was time for us to transition to as much of an integrated model as we could, said Dr. Jennings. We also realized a critical piece was the future mandates and regulations as well as where we wanted to go with the healthcare delivery system. So we examined our possibilities. Cerner had the company stability and the wise technology investment. Both would allow for a better, more comprehensive information system, giving Palmetto Health its second reason: streamlined data analytics for improved population monitoring. The Palmetto Health System has a population with a lot of disparities. I think we have the largest rate of diabetic amputations in the nation in one of the zip codes in our area. We felt that we needed to make our information system as comprehensive as possible, so we truly could care for this population. We were able to do this on a small scale before, with manual processes and paper tracking. But with the information systems that we have allow us to do that much, much larger scale. The third, and most important reason, Palmetto Health chose the ASP model: the conversion speed. Much of which was the pace in which we wanted to roll it out, Dr. Jennings explained. But when you re rolling out a system, you have to go at a certain scheduled pace. And that pace was fast. And it was rigorous. The health system already had the capabilities and employees to host its own data on-site. Palmetto Health is one of IDG s Computerworld s Best Places to Work in IT since It is also one of the Most Wired organizations in Hospitals and Health Networks Magazine for a sixth year. But to convert all its sites in nine months, Palmetto Health wanted different employees those of its EHR vendor. Jennings said having Cerner employees on-site was critical to Palmetto Health s success. It wasn t even that it was easier. It was that we couldn t have done it without that. He continued, In talking to my colleagues across the country, I believe this is really a preferred model. You still need to have your own staff for support long-term, but to have those resources coming from the vendor partner is priceless. IT S A WIN-WIN FOR EVERYBODY Among those resources: the ability to hold the data of thousands of patients without worrying about software updates, weather patterns, or security breaches. That gives peace of mind to practices large and small, and allows them to focus on what they do best: medicine. It s good for everybody, said Dr. Tashjian of Wisconsin. It s good for doctors because it s just much more fun to practice that way. It s good for the patient because they re healthier and they can lead more meaningful, useful lives. And it s good for the healthcare system, because if we save them from having these procedures and services, we have dramatically cut the cost of healthcare. Dr. Tashjian now has time not only to take care of patients, but to excel at doing it with his Big Data mining. The He is recognized Cloudy as Forecast a Health IT Fellow for the Office of the National Coordinator for Health Information

5 Technology. He was named a Hypertension Control Champion by the Centers for Disease Control and the Million Hearts Title Challenge in Franklin Program. His Gothic River Falls Medical Demi Clinic was 18pt recently designated as one of 30 Robert Woods Johnson Foundation s Exemplar Clinics. Palmetto Health is seen as a leader, not just in the IT world, but also in the medical field with its Patient Centered Medical Home Initiatives. It has multiple accolades for improving its patient outcomes, based on its use of Big Data to help individuals. Dr. Tashjian attributes much of his success to the technology he can use but not worry about in his practice. So in our world, it s a win win-win for everybody, he said. And as a practicing physician, it s just more fun. For more information about Cerner s ASP model: CernerAmbulatory@cerner.com The Cloudy Forecast