Cerner Corporation: A Case Study

SHC mission was to care, to educate, and to discover for the benefit of patients and larger community. Multiple problems and opportunities were present within the organization’s IT infrastructure that needed to be resolved before implementing an EMR system. The case stated, “In the early 2000s, SHC was in no shape to support an EMR system comparable to other healthcare groups” (Denend & Zenios, 2010). They needed to fix their existing IT infrastructure in order to resolve network, security, and regulatory compliance (HIPPA) issues. After addressing these concerns, they could focus on a solution for an EMR system. The strategic motivation behind implementing an EMR system was to reduce cost, meet competitive (internal and external) pressures, improve

Through interoperability, EHRs have the ability to exchange health information electronically to help providers deliver higher quality and safer care. The ability to share health data is extremely important, both within an organization and across organizational boundaries. EHRs provide real-time health information, which coordinates quick access to patient records for proficient care. In an ideal world, organizations would work together to integrate healthcare delivery systems for

The Medicare and Medicaid EHR Incentive Program will provide incentive payments to eligible professionals and hospitals that exhibit significant use of certified EHR technology. Participation can begin as early as 2011. Eligible professionals and hospitals can receive up to $44,000 over five years under the Medicare EHR Incentive Program. There is an additional incentive for eligible professionals and hospitals that provide services in a Health Professional Shortage Area (HSPA). In order to receive the maximum incentive payment, Medicare eligible professionals must begin participation by 2012. Health care professionals and hospitals that do not meet the requirements by 2015 will be subject to a decrease in reimbursement (CMS, 2011).

Hence, EHR 's are inherently complex amalgamations of diverse subsystems targeted toward varied users. The stakeholders are the users and must have a role in implementing any IT or EHR system into its work flow. An EHR can be customized to accommodate any environment depending on the level of expertise of the vendor and how long they have been in the business of creating an optimum system that 's customized to fit the organizations needs. For the most part, EHR 's must be designed for efficient, error free use. Ideally, an EHR is a system that encompass all the subsystems that make a hospital meet "meaningful use" criteria to acquire incentives for adopting EHR into practice. In the next five years, EHR adoption will no longer be a luxury, it will be a "MUST". EHR 's and other health information technology will be a necessity to practice medicine (econsultant.com, 2010). Rather than purchase several standalone systems, it would behoove one , in my opinion , to purchase an EHR that would satisfy all the needs of the stakeholders, the physician , nurses and other hospital staff and all parties involved in the tertiary practice too. Although LWMS 's budget is not large enough to accommodate the full cost of implementing an EHR,

However, there’s an enormous amount of money involved to acquire these advanced EHR systems. There are fears of losing the capital investment. According to Prasad (2013), “better medicine means stable business.” With EHRs capability to provide efficient healthcare services, it is helping in containing the healthcare cost. However, some CFOs have looked beyond the financial gains of the EHR implementation. “You have to look beyond that to the intangible benefits, the improvements in delivery care and position your organization to be competitive in the future” (“ROI: Look beyond,” n.d.). Indeed, EHR is a long-term investment for HCOs with a great promise for future

Practices using EHR systems accredited by the Office of the National Coordinator for Health IT (ONC) and

In efforts to reform the United States healthcare system and create a nationally unified data exchange system the federal government has established an incentive program to eligible professionals and hospitals. The federal government has turned to certified electronic health record (EHR) technology to help facilitate the process of broadening health IT infrastructures. The federal government views EHR system used in meaningful ways as the key to reforming the healthcare systems. Meaningful use of the EHR systems can also improve the overall quality of healthcare, insure patient safety, as well as reduce the cost of healthcare to individuals (Bigalke & Morris, 2010, p. 116).

According to Athenahealth, they feel as though the EHR program is never complete. “Because they operate by the cloud, they are constantly changing to meet certain standards;

In order to participate in stage 1 of the HITECH/ARRA incentive program, the Ambulatory care practice must choose an EHR that is specially certifies the EHR technology meets 100% of the CMS requirements. A CMS certification ID number must be provided. The factors to consider must include security, functionality and technical capability. CMS has provided a website to verify the certification of EHR products via the ONC website at oncchpl.force.com/ehrcert. Meaningful use is divided into 2 categories. The first is for hospitals and the second is for eligible professional. In order to qualify for incentive payments through Medicare EHR incentive program, Hospitals must meet 8 required core objective which Includes 1 public health objective (CMS.GOV, "2015 Program Requirements").

A wave of medical errors and patient deaths caused by healthcare providers renewed the search for a viable EHR system in 2000. Electronic health records would allow "providers to make better decisions and provide better

Getting successful universal EHR is not just technology selection, implementation question it needs to address many other aspects such as physician’s acceptance, policy/laws, incentives, security, and privacy and training issues before we can concentrate or focus on technology selection and implementations. The ecosystem should be ready with all these critical elements addressed only then successful EHR implementation can sustain in US. First and foremost there is a need to have consistency around the state/federal and HIPPA regulations which defines security and privacy issues in US. Due to conflicting requirements in these regulations mass acceptance of any medical system/technology cannot be effectively done. Second biggest issue for universal EHR adoption is the acceptance of EHR by physician’s communities. The benefits of EHR has been identified and acknowledged by medical communities at large however the rate of adoption and use after implementation is sluggish. The biggest common contributor for implementation, design and use of EHR systems is physician. Physicians should be properly trained and emphasis on continual education should also be placed through continuing education credits. Unless small physician office (stand-alone offices) buy-in the adoption of EHR no matter what technology and processes we have in place, EHR won’t be universally accepted and the entire benefit and value associated with EHR can be realized with universal acceptance of EHR. Thus need for

Cerner Corporation designs, develops, markets, hosts and supports the health care information technology, health care devices, hardware and contents solution for health care organizations. Cerner technologies connects people and system over worldwide and our wide range of services supports the clinical, financial and operational needs of organization.

Care360 EHR was created by Quest Diagnostics, the world’s leading innovator in diagnostic information services. In 2012, Care360 was honored by receiving the top spot in Black Book’s 2012 Rankings of Top EHR software and electronic medical records vendors, for placing in the single physician practicing and e-scribing categories. (www.bizjournals.com) In 2015 Black Book ranked Care360, a top EHR for small group practices. Care 360 was also ranked number one, by physician practices and groups with two to five practicing physicians. “This ranking is based on a poll of 5,700 small and solo medical practices surveyed by Black Book in 2015”. (www.ktvn.com)

The first barrier that small medical practices experience is their lack of technical expertise and knowledge on best practices with the use of EHRs. One reason for this

It is one of the first products of the Centricity software, which initially began as Medicalogic Logician. Centricity EMR runs on oracle. The technical care support is provided through GE Healthcare. The interface abilities of the Centricity EMR are named “LinkLogic” throughout the application and are file or TCP socket based. Specific servers dedicated to interfacing records are known as “Data Transfer Stations” (DTS) and they always monitor directly for inbound small, text files which are then brought into the EMR according to regulations and policies. These particular files conform to the HL7 specification. Centricity enterprise is the main source for clinical, financial, and administrative solutions for hospitals. It was formerly known as IDX Carecast” (Wikipedia, GE Healthcare,