HISI June 19th

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HISI June 19th

• Amanda Green M.D Cerner Ireland
• Martin Buckley ICT Director, St James
• Developing and implementing the optimum
  healthcare information and systems environment

SEE DETAIL IN NOTES SECTION ON HOW THE 160K
PHYSICIAN USERS FIGURE WAS CALCULATED
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Cerner Vital Statistics

• Healthcare IT focus
• Consistent leadership of three founders for over
  25 years
• 7,300 associates, including 900 clinicians
• End-to-end portfolio
• Cumulative RD investment to exceed 2Bby 2010
• Wide range of solutions on a unified architecture
  addressing nearly every technology need within a
  healthcare community
• Proven
• Over 6,000 Cerner Millennium solutions liveat
  more than 1,000 facilities
• 160,000 total physician users

SEE DETAIL IN NOTES SECTION ON HOW THE 160K
PHYSICIAN USERS FIGURE WAS CALCULATED
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Global reach

• Cerner has a presence in 70 percent of global
  clinical HIT markets.
• Australia, Austria, Canada, Chile, Cayman
  Islands, Egypt, France, Germany, Hong Kong,
  India, Ireland, Malaysia, Puerto Rico, Saudi
  Arabia, Singapore, Spain, Sweden, Switzerland,
  UAE, United Kingdom and United States
• Live solutions in 17 countries, 5 continents
• St James, Dublin, client since 2006
• Dublin office opened December 2007

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Journey to HIT transformation
Cumulative Capabilities
Stage
of Hospitals
Personalized medicine
11
Clinical process optimization
10
Outcomes-based condition management (all venues)
9
Complete device integration
8
7
0.0
Medical record fully electronic care delivery
organization able to contribute to electronic
health record as byproduct of electronic medical
record
6
0.1
Physician documentation, full clinical decision
support system (variance and compliance), full
PACS
Closed-loop medication administration
5
0.5
CPOE, clinical decision support system (clinical
protocols)
4
2.7
Clinical documentation (flow sheets), eMAR,
clinical decision support system (error
checking), PACS available outside radiology
3
14.2
2
42.9
Clinical data repository, controlled medical
vocabulary, clinical decision support inference
engine, document imaging
Ancillaries laboratory, radiology, pharmacy
1
21.8
All three ancillaries not installed
0
17.9
Source HIMSS Analytics EMR Adoption Model
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Systems view Integrated clinical systems

• Historic focus on core clinical automation
• In 1979, 90 of healthcare computer systems were
  financial administrative Cerners focus was
  and is clinical
• Launched with an integrated approach at a time of
  best of breed
• Unified clinical suite

(Cerner Systems View 1980s)
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Millennium Vital Statistics

• Distributed 3 tier architecture providing
  flexibility and scalability for small to
  extremely large organisations/countries
• Tested and proven to perform and scale
• Full redundancy and failover capabilities deliver
  high availability
• Over 4000 foreign system interfaces to ensure
  clients can leverage their investment in Cerner
  in combination with other systems in their
  organisation
• Patient centre data model and Oracle RDBMS

SEE DETAIL IN NOTES SECTION ON HOW THE 160K
PHYSICIAN USERS FIGURE WAS CALCULATED
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Millennium Vital Statistics

• Evidence based content delivered real time at the
  point of care (published literature, empirical
  data, scientific methodology, best practice)
• Drug database offering patient specific drug
  information, disease specific therapeutic
  pathways, expert dosing support and patient
  education materials
• Controlled medical terminology, including SNOMED
• Data extraction from multiple sources, clinical,
  operational and financial systems enterprise
  view of performance indicators
• Web based enterprise dashboard of 600
  performance indicators, measures and analytics

SEE DETAIL IN NOTES SECTION ON HOW THE 160K
PHYSICIAN USERS FIGURE WAS CALCULATED
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End-to-end solutions
9
Clinical solutions
Supporting clinician workflow
10
Knowledge solutions
Leveraging clinical knowledge to drive outcomes
improvements
11
Community and personal health solutions
Connecting the community and person
12
Systems view Why does it matter?
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Clinical orientation Millennium 2007

• Objective Universal Design Framework
• Leverage Cerner Millennium architecture in 15th
  release
• Enable clinician workflow to seamlessly span role
  and venue
• Elevate usability
• Approach Clinical Validation
• Process modeling
• 1,075 process models for 107 roles
• Extensive client feedback
• Cerner Physician Community, Patient Care
  Executive Council
• Vigorous testing
• Client site alpha beta testing
• Result 2007 Release
• 8,000 new functionality features

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Standards and interoperability

• Structured, person-centric contextual health
  information enables the healthcare organizations
  to
• Reduce costs
• Improve coordination of care
• Generate knowledge across communities, regions
  and countries

The lack of operability is the single greatest
barrier to realizing our IT vision and to
achieving an ROI in IT. KLAS Interoperability
Plug and Play Report October 2006
Graphic Source HHS http//xreg2.nist.gov/hit-tes
ting/
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Industry involvement Inspiring change
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Systems view Community Health Model
(Cerner Systems View 1990s)
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Community services

• Condition management programs
• National Juvenile Diabetes Programme
• Haemophiliac Network, Utah
• Electronic health records

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Connecting the community

• Jacksonville Health Information Network
• Virtual medical home for approximately 100K
  patients
• Aggregates data from five area hospitals, a FQHC
  and the JaxCare health plan
• Kansas City Metropolitan
• 100K patients
• Clinical and consumer EHR

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VA-DoD Universal Record Demonstration in
Jacksonville
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Cerner Connection Utility in Jacksonville
PowerWorks (Physicians)
Healthe (Employers/Government)
Patient/ Member
Provider

• 3,000 physicians
• gt50 group practice

(19,500)
- Patient Services
- Member Services
Cerner Network
Radiology
(15,300)
Medical Claims
Network Framework
Labs
Pharmacy Claims
Clinical Hub
Home Health
Home Devices
(15,000)
Financial Hub
Employer Clinics
Physicians
Financial Hub
Web Connect
HR - Demographics
Hospitals
(7,200)
(7,000)
Millennium (Acute Care)
Other (Ancillary)
(6,600)
(5,600)
- Patient Services
- Patient Services
Google
IHRTs
Health Vault
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JHIN Participants
JHIN Community Milestones
Baptist Health System
SMS
Cerner
Brooks Rehabilitation Hospital
MediTech

• Clinical and claims data for the under- and
  uninsured and
• Medicaid member population shared across 7
  organizations
• Governance JaxCare BOD and JHIN Committee
• Legal infrastructure in place through Master
• Participation Agreement (MPA) and
  Individual User
• Agreements

HMS
Duval County Health Department
Med Claims
I.M. Sulzbacher Center the Homeless (FQHC)
Medical Mgr
Claims
JaxCare Health Flex Plan
Mayo Clinic Jacksonville
Cerner
Community Electronic Health Record
Memorial Hospital (HCA)
HL7 Interfaces, Data Extracts
MediTech
Shands Jacksonville
McKesson
St. Vincents Medical Center
IDX
Cerner
Network powered by Centralized data repository
accessible via a secure internet site
University of Florida Jacksonville Physicians
IDX
AllScripts
Participating in a later phase
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Continuing Innovation

• Creates a single source of truth
• Enables plug-and-play device connectivity to EHR
• Establishes a dynamic, comprehensive inventory of
  critical device asset information

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Continuing innovation
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Continuing Innovation New discoveries

• Harnessing the power of EHR
• Resolves pharmaceutical and biotech challenges
  with unrivaled clinical data, scientific
  expertise and technical rigor
• Develops new therapies through a thorough
  analysis of EHR data
• Improving drug safety
• Uses aggregated data to monitor drug safety
• Streamlining clinical trials
• Identifies subjects through EHR rules engine
• Leverages patient data from the EHR in a single
  workflow
• Leveraging clinical data warehouse
• Captures and stores Cerner solution data
• Robust reporting
• Enables hospitals to intervene, improve and
  benchmark progress against regional and national
  data

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Building value through collaboration
Cerner matched our vision. Cerner Millennium
is an integrated architecture, and Cerner offered
solutions across the care continuum that were
important to us through the long term. Lee
Sacks, CMO Advocate HealthCare I dont
think there could be a better partner than
Cerner. Our success has indicated that we were in
the cockpit with the right copilot. A. Hugh
Greene, President and CEO Baptist Health
CUSTOMIZE FOR YOUR AUDIENCE SELECT FROM IDN
HOSPITAL VALUE STATEMENTS IN NOTES SECTION BELOW
SLIDE.
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Cerner Delivery Model

• Cerner believes in
• An Outcomes-Based Approach
• Aligned with clients organizational imperatives
  
• A Disciplined and Predictable Approach
• Rapidly achieves intended outcomes
• Leveraging the Experiences of other clients
• Our beliefs come from experience
• 5877 Millennium Conversions
• 1,328 Sites Using Millennium in Production
• Enablers of our approach
• Our Associates
• MethodM
• Implementation Methodology Framework, Content and
  Online Portal
• The Bedrock System
• Design, Build and Maintenance wizards

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MethodM and the Bedrock System

• What is MethodM?
• Our approach to working with clients to deliver
  value through Millennium solutions. The
  approach
• Aligns your organizations imperatives with the
  IT Project, through its Outcome Framework
• Leverages our proven experience and associate
  knowledge through recommended practices and
  rigorous review processes
• Defines the steps of the project to task and role
  level detail required to insure a high quality
  outcome
• What is the Bedrock System?
• An innovative system of intuitive wizards--using
  natural language to guide clients through the
  process of designing, building and maintaining a
  unified Cerner Millennium architecture.

Creates efficient use of resources to manage your
total cost of ownership and delivers intended
project outcomes
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MethodM Framework
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Example Using the Task Listto Design Pharmacy
ClinicalDecision Support with theDesign
Decision Matrix Pharmacy strongly benefits from
thestandard approaches and recommend-ations
presented in the PharmacyDesign Decision
Matrix This matrix is presented to the
client Analyst in context of the task(s)
wherethe decision is made, as well as wherethe
decision is consumed.
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Project and Support Investment

• Traditional HCIT implementation models assume
  Clients will spend 3x the effort than a
  supplier/3rd party
• MethodM and the Bedrock System reduce the work
  effort for Client participation by as much as 40
  during a project and the Cerner effort by as much
  as 20
• Client labor for production system support may
  run from 10-25 of client project labor
  investment each year. The Bedrock System reduces
  the maintenance tasks by as much as 40 through
  an intuitive, streamlined user interface
• Cerner continues to evolve our approach and
  enhance our tools to provide a lower cost, more
  predictable outcome