The Application of Sonic/Pervasive Integration in Healthcare
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1 Cerner Corporation The Application of Sonic/Pervasive Integration in Healthcare Steven Baranowski Health Information Exchange Development October 22, 2007
2 Cerner At A Glance Largest company focused on clinical information and transformational solutions for healthcare Revenues $1.16 Billion 2006 $1.38 Billion Committed to Innovation: Invested over $1.3 billion in R&D over past 10 years, will invest more than $1 billion over the next 4. Over 7,500 associates, including over 900 clinicians Over 2,000 Member Professional Services Org Over 2,000 Member Intellectual Property (IP) Org Largest client base on modern platform (Cerner Millennium) 6,447 Live Solutions; 377 Clients; ~1,112 Hospitals (as of March 2007)
3 Use Case: Electronic Prescribing eprescribing is process by which prescription information is transferred electronically between prescribers and pharmacies. Reduces errors in the transcription of written prescriptions Reduces the friction between pharmacies and prescribers Cerner s Healthe Hub is a prescriber network gateway to transform and route messages between prescriber systems and an intermediary network connecting pharmacies. Adaptability add prescribers systems that require adapters to conform to NCPDP EDIFACT and XML as supported by Pervasive Scalability add resources to meet volumes and SLAs Availability 24x7 up-time with fail-over capability
4 Electronic Prescribing Overview CERNER PowerWorks (Hosted Physician Office Systems) CERNER HEALTHE HUB CERNER Community Solutions
5 eprescribing Functional View Cerner Clients Solutions (CHR, PowerChart) Cerner Healthe Hub 3 rd Party Solutions Sonic ESB Server Eligibility Check/ Trigger View Medication Claims NEWRX Adapters (Pervasive Transforations) RxHub Message Flow SureScripts CernerWorks Message RxHub Switch Flow HTTPS HTTPS RxHub PBM(s) PBM PBM SureScripts REFREQ HTTPS Retail Pharmacies Pharmacy Directory Query HTTPS Pharmacy Directory
6 eprescribing ESB View NCPDP XML Eligibility Check NCPDP XML Refill Request NCPDP XML New erx Adapter Adapter Adapter Cerner Healthe Hub HTTP HTTP HTTP HTTP SureScripts RxHub
7 The Road to Production 4 th Qtr, nd Qtr, 2006, Cerner implemented eprescribing using SeeBeyond Concerns over high availability, vendor costs, and support initiated a change to Sonic and Pervasive 2 nd Qtr, 2006, A person directory proof of concept utilizing SonicESB and Pervasive Health Level 7 (HL7) transforms Pervasive out-of-the-box did not meet service level agreements (SLA). Pervasive Engineering optimized transforms and Sonic/Pervasive interfaces 1 st Qtr, 2007, Cerner initiated the change to Sonic/Pervasive combination for eprescribing and Lab Results capabilities NCPDP SCRIPT standard was not fully supported Pervasive Engineering extended support for NCPDP SCRIPT EDIFACT and XML 4 th Qtr, 2007, Full production of eprescribing and Lab Result Capabilities on Sonic 7.5 and Pervasive 8.14 releases Next up, the Pervasive 9.0 release Pervasive services move into the Sonic container creating an integrated solution that should provide improvements in deployment and support
8 Additional Use Cases MDBus medical device integration with an EMR system An HL7 adapter using Pervasive protocol and transform support will be used to integrate the MDBus with non-cerner EMR systems Results Delivery similar to the eprescribing deployment except the intermediary may be a regional performing laboratory Adapters leverage Pervasive to transform HL7 v2.x messages to HL7 XML Batch Clinical Activity Uploads ETL support of person and health record activity Adapters implement Pervasive parsing and transformation capabilities
9 CareAware MDBus the USB for Healthcare Keyboard Barcode Scanner Fingerprint Scanner Printer Mouse Medication Dispensing Cabinet
10 Evolution in Healthcare Community Connectivity Mix of paper and electronic Not standardized Incomplete Expensive Unmanageable Portable lifetime health record Improved health system / consumer relationship
11 Lessons Learned Just starting? Get your development staff trained Work with your technology vendor on early prototypes Build a good business relationship with your vendor Communicate your business strategy and requirements Arrange for support Prototype vendor capabilities earlier Ensure the messaging standards that your system are provided Messaging versions may provide gaps Some messaging standards provide broad areas of support Understand your deployment Deployment models may provide input into the design
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