Interoperability

1-21-2013

Kevin Schmidt

Director, Clinical Network

© 2011 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

Gaps Across Care Venues

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Goal is to close the Gaps

Physician Office

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What is HIE?

HIE (Health Information Exchange) is a verb that describes what type of data is exchanged between different parties, known as interoperability. Cerner’sapproach to interoperability divides HIE into 3 categories, this presentation will describe each category and how Cerner responds to these categorical needs in Healthcare.

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Trust

Usually the hardest thing to get pastHIE requires collaboration and trust between 2 or more entities and includes

UsersTechnologiesVendors

Forms of TrustDURSA – Data Use and Reciprocal Support AgreementMPA – Membership Participation AgreementElectronic CertificatesNDA – Non-Disclosure Agreement

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HIE Categorically

SendFire and Forget

Systematic Push to NotifyRegarding Important

Information

CollaborateBack and forth exchangeAd Hoc Communication

DiscoverQuery.

Information Pulled from the Community at The Point of

Care

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Send

Systematically Push in Real TimeResponds from an Electronic Order to Deliver Results from one EHR System to another• CCD• Radiology Results• Lab Results• Documents• Etc.

Deliver Immunizations from EHR System to State Immunization RegistryDeliver Notifications of a patient registering in a hospital to PCPePrescribing

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Cerner’s Response

SendCerner Clinical HUB Connects any Certified EHR System to any other Certified EHR System• Note: Each system will still need an outbound and inbound

interface

Cerner Immunization HUB can connect any Certified EHR System to a Certified Immunization Registry• Note: For Cerner EHR Systems, the user can query the

connected Immunization Registry

Cerner’s RxHub Connects EHR System to SureScripts

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Discover

On Demand QueryQuery for CDA from EHR System to Community or StateQuery for CDA from EHR System to EHR SystemQuery for CDA from Community or State to Community or StateIntegrated in the clinician’s workflowContent of the CDA will continue to grow as EHR Systems adopt interoperability functionalityLeverage Standards• NwHIN – eHealth Exchange• XCA – Cross Community Access• XDS.b – Cross Document Sharing• HL7 – Health Level 7

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Cerner’s Response

DiscoverCerner offers an open network to any community or EHR System that can leverage XCA (Cross Community Access) called Resonance• Incorporates query into the clinician’s workflows• For Cerner EHR Solutions, can import Problems, Allergies,

Medications, and Immunization

Cerner offers an XDS.b Repository with MPI called Clinical Exchange Platform• Also includes XCA, eHealth Exchange, and a HL7v2 to HL7v3

adapter• Incorporates query into the clinician’s workflow• For Cerner EHR Solutions, can import Problems, Allergies,

Medications, and Immunization

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Collaborate

Ad Hoc communicationUse DIRECT StandardsBuilding a Nationwide Ad Hoc Network connecting trusted HISPs – Health Information Service ProviderAble to attach clinical information to the messageRequires a relationship between to end points Integrated in the clinician’s workflowSatisfies Meaningful Use Stage 2

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Cerner’s Response

CollaborateCerner is a HISP (Health Information Service Provider) for all of Cerner’s clientsCerner Actively participates and sits on the board of DirectTrust.orgEnabled Message Center in Cerner’s EHR System to use Cerner’s HISPCerner Direct Inbox is a stand alone portal offering that leverages Cerner HISP

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Summary

HIE is placed in 3 different categoriesSendDiscoverCollaborate

Not one is a replacement for the otherIt is very important to integrate HIE into the user’s everyday workflowTechnology is not the hardest partThe exchange of Health Information can only take place at the “speed of trust”

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Questions?