1. Interoperability 1-21-2013 Kevin Schmidt Director, Clinical Network

2. © 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

3. © 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. 3 Goal is to close the Gaps Physician Office

4. © 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. 4 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’s approach to interoperability divides HIE into 3 categories, this presentation will describe each category and how Cerner responds to these categorical needs in Healthcare.

5. © 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. 5 Trust Usually the hardest thing to get past HIE requires collaboration and trust between 2 or more entities and includes Users Technologies Vendors Forms of Trust DURSA – Data Use and Reciprocal Support Agreement MPA – Membership Participation Agreement Electronic Certificates NDA – Non-Disclosure Agreement

6. © 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. 6 HIE Categorically Send Fire and Forget Systematic Push to Notify Regarding Important Information Collaborate Back and forth exchange Ad Hoc Communication Discover Query. Information Pulled from the Community at The Point of Care

7. © 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. 7 Send Systematically Push in Real Time Responds 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 Registry Deliver Notifications of a patient registering in a hospital to PCP ePrescribing

8. © 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. 8 Cerner’s Response Send Cerner 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

9. © 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. 9 Discover On Demand Query Query for CDA from EHR System to Community or State Query for CDA from EHR System to EHR System Query for CDA from Community or State to Community or State Integrated in the clinician’s workflow Content of the CDA will continue to grow as EHR Systems adopt interoperability functionality Leverage Standards NwHIN – eHealth Exchange XCA – Cross Community Access XDS.b – Cross Document Sharing HL7 – Health Level 7

10. © 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. 10 Cerner’s Response Discover Cerner 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

11. © 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. 11 Collaborate Ad Hoc communication Use DIRECT Standards Building a Nationwide Ad Hoc Network connecting trusted HISPs – Health Information Service Provider Able to attach clinical information to the message Requires a relationship between to end points Integrated in the clinician’s workflow Satisfies Meaningful Use Stage 2

12. © 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. 12 Cerner’s Response Collaborate Cerner is a HISP (Health Information Service Provider) for all of Cerner’s clients Cerner Actively participates and sits on the board of DirectTrust.org Enabled Message Center in Cerner’s EHR System to use Cerner’s HISP Cerner Direct Inbox is a stand alone portal offering that leverages Cerner HISP

13. © 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. 13 Summary HIE is placed in 3 different categories Send Discover Collaborate Not one is a replacement for the other It is very important to integrate HIE into the user’s everyday workflow Technology is not the hardest part The exchange of Health Information can only take place at the “speed of trust”

14. © 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. 14 Questions?