Cerner s Approach to Interoperability: Enterprise Device Communication Health Information Exchange Network TM
Introduction The seismic shift taking place in the health care industry has created an environment where using new technologies is at the core of care delivery. New technology innovations and developments provide caregivers with the robust systems required for attaining certain regulation and organizational standards; however, the paradigm of technology for technology s sake is rapidly becoming an afterthought, as health organization stakeholders are in need of systems which make meaningful contributions to patient outcomes while continuously leveraging existing capital investments. Meaningful process change to produce real health outcomes begins with the selection of enabling technology which is truly interoperable. Divisive systems, while potentially effective in solving individual clinical problems, add to the complexity of health care management as key clinical information remains within information silos. To create a single source of truth and continuously drive value from a clinical information system, the correct architecture must first be in place. As many health care organization leaders can attest to, an investment in information technology without the proper end-goal and achievement path in mind is a recipe for disorder, often resulting in challenges with user adoption and real clinical process change. Strategic interoperability using adopted standards contributes to the systemic improvement of health care delivery and the health of communities. By adhering to the standards in place, health care organizations can maximize the use of interoperable technology coupled with meaningful process change to directly impact outcomes, and ultimately make a fundamental shift in population health.
Enterprise Device Communication CareAware ibus: More than 80,000 live hospital beds across the world Over 700 supported devices and more than 170 drivers available Over 50 partners to date Patient Care Device IHE Domain The IHE Patient Care Device (PCD) domain addresses the integration of medical devices into the health care enterprise, from the point-of-care to the EHR, helping to provide significant improvements in clinical workflows, patient safety and quality of care. Medical devices contain life-critical information; thus, it is essential for health care providers to have access to this information in order to make the best care decisions. CareAware ibus To help hospitals address the knowledge gap between medical devices and the EHR, Cerner created the CareAware device interoperability architecture. At the core of the architecture is the CareAware ibus, which facilitates the bidirectional flow of information between medical devices and the EHR. This two-way communication helps health care organizations improve workflow efficiencies and maintain a single source of truth for patient data. The CareAware device interoperability architecture was developed based on a need to go beyond connectivity, giving clinicians the information necessary to make informed decisions at the point-of-care. For this reason, 12 solutions were developed to reside on top of the CareAware architecture, providing a number of integration points for areas like medication administration, resource and capacity management and secondary alerting. Key takeaways about the CareAware ibus include: < More than 80,000 live hospital beds across the world < Over 700 supported devices and more than 170 drivers available < Over 50 partners to date Client Successes BayCare Health System BayCare Health System is a community-based health care provider with 10 not-for-profit hospitals, as well as a number of outpatient facilities and other health service offerings that serve the Tampa Bay, Fla. area. The facilities within BayCare s extensive network are wellrespected and technologically-innovative, winning numerous annual awards, in addition to receiving Magnet designation for four of the hospitals. BayCare needed a way to increase the speed and accuracy of patient data capture and documentation. Already pressed for time, BayCare nurses and other caregivers also felt the constraints of computerized data entry and double-transcription requirements. These inefficiencies were compounded when caregivers were required to manually record patient vital signs and ventilator data several times an hour in critical care areas. To address these issues, BayCare implemented Cerner s CareAware device connectivity architecture within several units across its 10 hospitals. The organization took pre-go-live measurements to evaluate the amount of time spent on manual vital sign assessments and documentation into the EHR. The measurements indicated that it was taking nurses between 0.57 and 0.69 minutes to complete a vital sign assessment for a single patient. In venues like the ICU and PACU where patient statuses can change frequently, nurses must complete vital sign assessments for each patient at least three or four times per hour, if not more. Therefore, these nurses spent a significant amount of time on data transcription and charting throughout a 12-hour shift. After the CareAware ibus go-live, BayCare took follow-up measurements and found that it was now taking nurses an average of only 0.17 minutes to complete a single vital sign assessment, an improvement of between 0.40 and 0.52 minutes when compared to the baseline data. Total time savings for nurses varied across units and hospitals due to a fluctuation of patient beds, nurse-to-patient ratios and frequency of vital sign assessments. Using the averages across all units of the five hospitals, BayCare determined units
Enterprise Device Communication Penn State Hershey needed to bridge the recognized gap which existed between its electronic health record system and medical devices, specifically within the operating room. Anesthesia providers were spending significant amounts of time charting data points throughout surgical procedures. To fix this lack of device connectivity, Penn State Hershey implemented the CareAware architecture to connect its anesthesia devices to the EHR. using the CareAware ibus technology are saving an average of 42 minutes per nurse per shift. With these increased efficiencies, nurses are able to reallocate time back to providing direct patient care, instead of charting clinical data. Penn State Hershey Medical Center Penn State Milton S. Hershey Medical Center in Hershey, PA., is one of the premier medical and academic institutions within the United States. It prides itself on using state-of-the art technology and the most advanced medical techniques, and is renowned for providing the highest level of innovative patient care. Penn State Hershey is consistently recognized in national and regional rankings for its excellence in quality, patient safety and clinician experience, and has recently been re-designated as a Magnet organization for its excellence in nursing. At Penn State Hershey, anesthesia providers now have more time to devote to patient decisionmaking since the medical center implemented CareAware ibus. Benefits include: < Spend 90 percent less time charting data points < Chart 15 fewer data points every 10 minutes, and over 90 fewer data points every hour < Spend less than one minute charting data points during a two-hour surgery, as opposed to nearly 10 minutes prior to implementation < Chart fewer than 20 data points during a twohour surgery, as opposed to nearly 200 prior to implementation NCH Healthcare System NCH Healthcare System is an alliance of more than 500 independent physicians and medical facilities throughout Collier County and southwest Florida. Its two Naples, Fla. hospitals, NCH Downtown Naples Hospital and NCH North Naples Hospital, provide personalized care for over 30,000 patients each year. NCH is consistently ranked as a top organization in many specialties by independent rating organizations, and was recently recognized by U.S. News and World Report as the Best Regional Hospital in four specialties. In April 2012, NCH s North Naples Hospital began using Cerner s CareAware VitalsLink to provide electronic transmission of vital sign data into the EHR from the point-of-care. Residing on the CareAware architecture, the solution enables clinicians to take and chart patient vital signs at
Enterprise Device Communication the bedside using a mobile vitals collection device. Data is sent seamlessly from the device to the EHR via the CareAware ibus, eliminating the need for manual transcription. Clinicians at NCH simply associate the patient to the device via barcode scanning, take the patient s vitals, view the results and electronically sign Since implementation of CareAware VitalsLink, the average time spent documenting patient vital signs for nurses and patient care technicians at NCH has been reduced from an average of 1 minute and 42 seconds to an average of 18 seconds. This equates to a time savings of 1 minute and 24 seconds per vitals session, and represents an 82 percent efficiency gain. Extrapolating for the typical 10-patient vitals round, clinicians are now saving an average of 14 minutes per vitals round. Prior to implementation, there was also a substantial gap in time between the taking and charting of patient vital signs. With CareAware VitalsLink, this data latency has been reduced from an average of 46 minutes and 20 seconds to an average of 27.6 seconds. This change represents a 99% improvement in data latency, ensuring clinicians have the correct patient information at the correct time. The implementation of CareAware VitalsLink was the first phase in multi-solution Cerner Smart Room project at NCH, where the CareAware platform has been leveraged to implement other workflow-enabling solutions native to the architecture, providing true system interoperability and enabling the best possible patient outcomes. them into the EHR via a touch-screen display. This simplified workflow removes the need for manual transcription and also greatly reduces any latency in time between when vitals are taken and when they are documented into the EHR. Cerner Corporation Confidential Information Cerner Corporation. All rights reserved. This document contains confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner.
Health Information Exchange Network Cerner Network: Recognized as the #1 HIE Vendor Black Book 2012 Most Complete Service Offering Chilmark Research Top 3 HIE vendor KLAS HIE Report IT Infrastructure IHE Domain The IHE IT Infrastructure (ITI) domain addresses the implementation of standards-based interoperability solutions to improve information sharing, workflow and patient care. The exchange of health information allows patients and physicians to make sure the right health data is available when and where it is needed most, while under the protection of standard medical privacy and confidentiality procedures. The Cerner Network The Cerner Network encompasses multiple interoperability solutions that cover everything from Send (Cerner HUB), Collaborate (Direct messaging) and Discover (Cerner HIE). The Cerner Network provides immediate value to health care organizations, and continues to grow with over 50,000 Physicians, 102 Provider Networks, 130 Health Systems, 575 hospital clinics and multiple laboratories. Cerner Network Industry Recognition: < Recognized as the #1 HIE Vendor Black Book 2012 < Most Complete Service Offering Chilmark Research < Top 3 HIE vendor KLAS HIE Report Client Successes Secure Medical Records Transport Network (SMRTNet) Oklahoma The SMRTNet HIE is a 7-year old Physician/ Hospital-sustained HIE that has proven integration with all major EHR platforms, including Allscripts, eclinicalworks, Epic, Cerner, CPSI and GE Centricity. The exchange provides Clinical Decision Support for clinicians and provides NwHIN/eHealth Exchange and Direct Project integration. SMRTNet currently acts as a de facto statewide HIE that connects 26 Hospitals and 99 Clinics, and serves up to 2,500 users. To date, the SMRTNet HIE has 3.2 million/4 million+ encounters, and in excess of 100 million clinical data elements. Adventist Health System Adventist Health System is a national health system with 43 hospital campuses in 10 states, serving 4 million patients each year through inpatient, outpatient and emergency room visits. < 39 Acute-care facilities, 10 states < 600 employed physicians (NextGen) < 5000+ affiliated physicians (varied EHRs) Adventist leveraged Cerner s Clinical Exchange Platform to form its enterprise HIE, named inetwork. Adventist Health System has also connected 14 community clinics to exchange real-time data using Cerner s state-of-the-art edge-server, the HealthDock. Cerner Corporation Confidential Information Cerner Corporation. All rights reserved. This document contains confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner.
Health Information Exchange Network Memorial Hermann Community Health Exchange Memorial Hermann has used the Cerner Network to connect numerous primary care and specialty clinics, FQHCs, and other providers within the Houston community since 2011. There have been over 23,397 Memorial Hermann clinical health exchange data queries since inception in August 2011 from a variety of EHRs, including eclinicalworks, Allscripts, Epic and GE Centricity. As a strategic Cerner partner, Memorial Hermann continues to grow by using advanced platforms like Cerner Healthe Intent and Population Health for data analytics and reporting. includes TMC Hospital Hill, TMC Lakewood, TMC Behavioral Health, the Jackson County Health Department and a number of primary care practices throughout Eastern Jackson County. All of the aforementioned locations are electronically managing referrals within the Kansas City metro area using Cerner s Direct HISP and Cerner s Direct enabled tools Cerner Direct Inbox and Cerner Direct Referrals. Truman Medical Center & 9 Safety Net Providers Truman Medical Center (TMC) is a not-for-profit health system based in Kansas City, Mo. with two acute-care hospitals. The TMC Health System Cerner Corporation Confidential Information Cerner Corporation. All rights reserved. This document contains confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. wp12_340_13_v1