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Health Systems Support Framework

The shift to value-based care and to proactively improving the health outcomes for individual patients as well as entire populations requires new skills and capabilities. The NHS’s digital vision, more recently reiterated through the NHS Long Term Plan, can only be achieved through strong collaboration between all the different parts of the health and care system. It equally requires suppliers to deliver innovative solutions that align to this vision and that can integrate and interoperate with one another.

To support this, a wide range of organisations, including NHS Trusts, local authorities, primary and community providers, and other public sector bodies, can now more easily access and source a range of these innovative services and technologies through the Health Systems Support (HSS) Framework.

The Framework will help these organisations - including integrated care systems (ICSs) and sustainability and transformation partnerships (STPs) - come to better decisions more quickly, as each supplier on the list has been pre-approved by NHS England and NHSX. Cerner has secured places in the eight lots we bid for, covering a range of areas that can help accelerate our partners’ digital transformation, allowing them to realise both their individual organisation’s goals, as well as their wider regional population health management ambitions. When you work with Cerner – through the Framework or not – as well as our expertise, experience and technology, we also have a range of existing valued and proven partners that can help you realise your health and care system’s vision.

Lot summaries

Lot 1: Enterprise-wide electronic patient records system (for acute, community and mental health hospitals)

A powerful, open and interoperable platform trusted across the NHS

Cerner recognises and supports clients through the complex maturation of many capabilities that are required to support a system-wide electronic patient record (EPR). As part of our engagement, dedicated solution leads and healthcare executives will work with you to provide oversight and objective expertise to assist in developing and executing strategy across these competencies. This would include a strategic assessment of maturity on each of the competencies and co-developing a transformation plan to assist your Trust in enhancing your position to ultimately create value and move to value-based care to achieve the Quadruple Aim within the hospital setting.

Vitally, we recognise the importance of working with stakeholders, in order to deliver an optimum outcome for programmes of work we will undertake with Trusts. As part of the first steps of our implementation methodology, we will align all key stakeholders to your vision and define a decision-making structure. The project team will validate the understanding of each set of stakeholders’ vision and priorities.

We will help to establish the joint governance structure to ensure mutual engagement and clear lines of accountability. We will work alongside your teams and support them to step back and consider why things are done the way they are and how that could be improved before establishing services and solutions. Our implementation methodology is a transformation methodology with change management, adoption, performance improvement and benefits management embedded throughout our engagements.

Our client relationships are built on partnership, and our methodology is built on transformation. Engagement starts with understanding your people, as well as your organisational strategic imperatives and business strategy. By knowing and understanding what drives you, we can ensure that we are better equipped to support as a partner – from defining the appropriate service and solution scope through to tailoring a transformation programme; designed to deliver maximum value as we start the journey together. From our experience, this alignment is crucial to maintaining a consistent approach throughout and securing buy-in and engagement from clinical and operational teams.

Our offering is a proven and powerful combination of optimised solutions and workflows that facilitates a rapid deployment, as well as increased adoption. We call it our Model Experience. Beyond just an EPR, it comprises of:

  • A pre-built, clinically rich ‘model’ EPR built on our industry-leading Cerner Millennium® platform
  • Streamlined implementation
  • Pre-built training materials
  • Continuous advancement methodology to deliver additional content and ongoing benefits

We have a proven track record of delivering complex projects utilising our established Consulting Framework, in use in all our projects globally. Driven by a dedicated and experienced workforce, we adapt our solution delivery methodology as needed for each of our thousands of unique clients around the globe. The methodology has evolved and has been designed to reduce variation of project and clinical outcomes, and reduce the total cost of ownership to you.

Our experience

West Suffolk NHS Foundation Trust implemented an enterprise-wide integrated EPR using Cerner Millennium, and subsequently achieved an Outstanding CQC rating.

Using Model Experience, Chase Farm Hospital received HIMSS Stage 6 accreditation, just seven months after going live with the system.

In the UK, our Millennium platform is utilised by 128,000+ health and care professionals across 22 NHS Trusts to manage 1.2 million patients every month.

Proven UK local health and care record solutions for almost 10 million citizens

Cerner provides expertise in consultation, advisory methodologies, strategy, and implementation of local health and care record solutions.

We provide constantly updated design and digital maturity assessments to baseline gap analysis against key requirements from the STP/ICSs and key areas aligned to the NHS target architecture.

Working with your diverse stakeholders, we consider the future need of all strategic programmes, helping you to design an optimal and cost-effective local target architecture, and ensure the design, implementation and management is developed with a robust data and record management approach through data and information flow mapping.

Given our work on the national population health management dashboard, we factor into the design how your needs can leverage and optimise the national data asset and analytics for benchmarking, and support the submission of normalised data against future specifications of the dashboard.

Using a single source of truth for your locality, we work with CSU partners to establish commissioning intelligence on the same architecture, supporting the move to risk-and-outcomes-based contracting.

Our approach is one of partnership for value across local health and care settings. We work with frontline system users through to the senior leaders that set strategic vision for new models of care. Our mature, dedicated 70-person practice implements against a UK-proven transformation methodology, delivering performance improvement to ensure value attainment.

Our experience

Our world-class population health platform, HealtheIntent®, includes local health and care records for 185 million-plus citizens globally.

Almost ten million people across the UK are covered by HealtheIntent for population health management (including Wirral, Oxford, West Suffolk, Lewisham and North Central London CCG), hospital chains and analytics (including Royal Free and West Birmingham). We also provide the national population health dashboard.

Our partners contribute complementary knowledge and experience in areas such as actuarial analysis, financial management, risk stratification, workforce management, and information governance.

We partner with CSUs and have proven joint experience. Named CSUs are material subcontractors to ensure that we utilise the capacity and experience of the NHS, while minimising the support we need to provide.

In the UK, our HIE currently connects 16 million citizens’ records (as of April 2020) across hospitals, GP practices, community services, mental health providers and social care services, with over half-a-million accesses each month (as of June 2020).

Proven, scalable, big data platform for population health management

We enable proactive care by delivering a comprehensive set of population health tools including a normalised data intelligence-ready longitudinal health and care record in a world-leading, UK-proven platform.

We support STPs’ and ICSs’ programmes with a combination of robust interoperability with real-time information exchange and a data intelligence platform that can develop insights from data that can be actioned within workflows by care professionals. Using a local single source of truth, we work with CSU partners to establish commissioning intelligence on the same architecture, supporting the move to risk-and-outcomes-based contracting.

This intelligence supports goals and objectives including a comprehensive longitudinal health and care record, a registry/cohort management solution, scorecards for performance management of outcomes contracts, integrated robust analytics and visualisation tools, person-centric and cross-continuum care management and coordination, and the facilitation of health services.

We help clients leverage existing core infrastructure and data systems building on existing investments. We also establish an open ecosystem for new innovation and support a pluralistic strategy for embedding intelligence from a range of content providers, through leveraging data and benchmark analytics from the national population health dashboard we operate for NHS England.

Our platforms work at a large scale and deal with connectivity and data acquisition, data transformation and normalisation, patient consent management, role-based access controls, and audit controls. They provide standard outputs with data syndication and open APIs, while providing actionable insights back into EMIS, Millennium and other EHRs/EPRs.

We champion and support international open standards such as IHE, FHIR, SMART, SAML, OpenID, OAuth, SCIM and CDS Hooks, and implement them in our infrastructure ensuring compliance to ISO security and NHS information governance, and cloud regulation and guidance.

Compliant to ISO security and NHS information governance and cloud regulation and guidance. We conduct continuous production scanning of our solution stack from the application layer down to the infrastructure layer, as well as monitoring and patching systems to minimise threats and vulnerabilities.

Our experience

More than 159 health and care organisations leverage Cerner solutions to enable their population health management strategies.

Over 800 unique data connections feed Cerner’s big data platform, including 40 different EHRs/EPRs, where we have mapped in excess of 12 million codes and work with more than 575 international terminologies.

Cloud-served applications on a massive data processing architecture that supports over 185 million unique lives.

Clinically focused, fully-integrated ICT managed service

ITWorksSM is Cerner’s strategic healthcare IT outsourcing offering that uniquely meets STPs’ and ICSs’ operating requirements by positioning IT as a strategic part of the care delivery process.

Our market-leading technology suppliers, Insight and BT, along with our local CSU partnerships, allow ITWorks to meet the specific needs of the NHS. It also has the capability to manage everything from full system operations and implementations, right through to clinical adoption and process improvement in a cohesive, non-fragmented fashion. Our methodology is flexible enough to be applied across care settings and to organisations of varying size.

ITWorks creates a clinically focused, fully-integrated managed service under five key leadership areas: applications, technology, PMO, service desk and training, and software development. Our proven transition process has deep NHS experience, while we augment existing NHS services into a fully cohesive managed service model by layering in the ITWorks processes and making use of our partners.

The ITWorks governance model equips client teams to help drive behaviour and business outcomes, as well as facilitate them in the innovation process, strengthening expertise to develop an ‘intelligent client’ function.

We support clients overcoming constraints and funding, invest upfront in cloud infrastructure, deliver software-as-a-service, and enter into risk-sharing models including running large Value Creation Offices for scale impact.

Our experience

Our remote hosting, service desk, application and technology management, as well as upgrade managed services, have been addressing the needs of our NHS clients for nearly 20 years.

Cerner manages the ICT infrastructure for 33 ITWorks sites internationally and are among Cerner’s most successful clients. We manage 2,800+ non-Cerner solutions.

In 2017, 14 ITWorks clients were included in HealthCare’s Most Wired Hospitals survey.

83% of ITWorks’ clients are operating their EHRs/EPRs at either HIMSS EMRAM Stage 6 or 7.

Analytics to support system planning, assurance, evaluation and research

We work with clients to analyse data to identify gaps in care, unwarranted variation, ‘triple fail’ events, health inequalities, etc, and we’ll conduct impact assessments to understand the likely impact of the planned intervention(s) on the Quadruple Aim.

Cerner will deliver a population health platform that provides a comprehensive set of tools to standardise and normalise data that can be used as a single source of truth to support system planning, actuarial analysis, financial management, clinical variance and outcomes, and provide the ability to undertake further research.

With clients, we establish and operate:

  • Disease and wellness registries to identify and measure gaps in care and track scorecard outcomes
  • Algorithms against data to segment and stratify patients in a number of different ways
  • Integrated EDW with analytics tools like Tableau and Business Objects
  • New intelligence to be run on the HealtheIntent platform
  • New predictive algorithms using our scalable and elastic data science environment

The near real-time data in HealtheIntent that feeds our EDW and tools helps clients become a learning system with agile analytics that can be created by non-technical resources and clinicians, with surveillance and predictive algorithms that provide proactive alerting, as well as system integration, to trigger workflow and action.

Our experience

As of 2018, 104 clients around the world use HealtheEDWSM, as of 2018, Cerner’s population health management analytics functionality for normalised system-wide analytics.

Nine UK clients are contracted to use HealtheEDW as of 2018, including the Royal Free with Intermountain partnership, population health clients, and NHS England’s national population health dashboard programme.

We work with partners including 3M, Milliman, Bradford Institute of Health Research, Helicon and others for predictive and risk stratification algorithms, cost and utilisation, and more.

Worldwide, 128 clients use Cerner’s disease and wellness registries, driving out gaps in care and tracking to outcomes-based contracts. There are 57 standard registries based upon 982 metrics and measures. In the UK, registries are live at Wirral, Lewisham and North Central London CCG, with 10 standard registries based on 224 measures.

Analytics to support care coordination, risk and impactability models

We work with clients to analyse data to identify gaps in care, unwarranted variation, ‘triple fail’ events, health inequalities, etc, and we’ll conduct impact assessments to understand the likely impact of the planned intervention(s) on the Quadruple Aim.

Cerner will deliver a population health platform that provides a comprehensive set of tools to standardise and normalise data that can be used as a single source of truth to support system planning, actuarial analysis, financial management, clinical variance and outcomes, and provide the ability to undertake further research.

With clients, we establish and operate:

  • Risk stratification algorithms against data to segment and stratify patients in a number of different ways
  • Disease and wellness registries to identify and measure gaps in care and track scorecard outcomes
  • A partnership with the University of Leicester and other bodies to incorporate open and environmental data
  • Impactability studies to ensure a focus on those amenable to change.

We work with clinical research institutes, universities and clients to support research, evaluate new algorithms and tools, publish in the peer-review literature, and resell or make data available in the market.

Using informatics standards such as FHIR, SMART and CDS Hooks, we enable external clinical decision support to proactively alert care professionals to take action inside EHR workflows.

Solutions will be embedded back into individual workflows supporting care providers to make faster, better informed interventions at the point of care.

Our experience

We work in partnership with UCL, the University of Leicester, Bradford Institute of Health, Oxford University and others.

We enable clients to leverage innovation from the national population health dashboard programme, e.g. Bow Tie analysis, to illustrate multiple components of the Quadruple Aim in a single analytics visualisation.

Supporting leading ICSs, hospital chains, Global Digital Exemplars, regional governments and employers on their journeys towards integrated care and proactive health.

Reducing variance to optimise outcomes, performance and cost

Cerner works collectively with clients to provide a range of expert advice, analysis, transformational and change management capabilities to allow effective functionality for ICSs and STPs.

This begins by using systemwide data and Cerner’s analytics solutions to identify areas for improvement based on unwarranted variation in clinical outcomes, performance, inequity and costs. These are prioritised using agreed criteria and the process of addressing the problem/s can begin by ascertaining metrics for improvement to be measured against, before moving on to standardising the processes.

This involves multi-professional clinical teams using policies, guidelines and published evidence to build patient pathways using evidence-based digital tools, such as registries. These can be developed and honed with the support of our vibrant client community of clinicians, subject matter experts and other specialists.

Once live, analysts consider the data and produce reports to ascertain patient-level adoption, with our optimisation team being able to provide support to suggest new and innovative ways to reduce variance and get teams working in the most effective way possible.

We find that embedding our team very early on in the design process has proven to be the best way of helping clients to meet the vision, and strategic and delivery objectives of their pathway optimisation programmes. Our team is structured to reflect the clinician-focused care pathway development process, covering strategic advisory, clinical advisory, analytics, performance improvement, project management, marketing and communications.

Our experience

Working with Cerner and Intermountain Healthcare, Royal Free London (RFL) developed clinical practice groups (CPGs) to reduce variance, save money, improve efficiency and provide a better patient experience.

Pathways developed with RFL include Keeping Mothers and Babies Together, which reduced the admissions of term babies to the neonatal unit from 13% to 6%, and one that reduced the average length of stay for knee replacement patients from 4.9 days to 3.9 days, against a median average of 4.7.

Using Cerner’s intelligence platform, Advocate Physician Partners improved proactive care planning and care management, resulting in an asthma control rate 26% above the national average, and a reduction in high-risk medication usage by one third.

By using HealtheCare℠, Inspira Health Network were able to improve efficiency, helping to save 50 staff hours a week and an estimated $1.3m in costs through reducing unnecessary admissions.

Proven care provider and citizen applications and services

Cerner believes the citizen should be an equal member of a connected team of health and care providers with an active role and responsibilities. We provide a number of technologies and services to enable this connection.

We aggregate health utilisation data (where available), personal health assessment results from a wellness or patient portal and baseline clinical information. Using this data, we segment populations based on health risk.

Patient portal and app integration allows for web-based, mobile, video-enabled telehealth support, embedded within population health tools.

Personal health monitoring enables the collection of data from a number of personal health devices and web apps, where population health management platform intelligence can be applied to support proactive interventions.

Registries manage gaps in chronic disease care and wellness.

Health performance management allows a strategic plan to be formed, with goals that cross multiple categories and organisations.

Care coordination and programme risk management lets the health and care team use applications for risk segmentation (health/engagement/impactability), workflow tools, care plans and services such as health coaching and navigation.

Analytics support the monitoring of outcomes, as well as identification of future opportunities for improvement/focus, including the use of tools such as PAM, PCAM, and PRAPARE.

Our experience

We will work with NHS organisations, such as SCW CSU, that have capabilities for health coaching professional services so as not to recreate the workforce but provide tools and knowhow. We will work with existing or preferred citizen health evaluation methods and share our tools and experience.

Cerner partners with 200+ employers, health plans, health organisations and governments to advance experiential, clinical and financial results for their populations.

Over 16 million unique lives use Cerner wellbeing technology and services.

Cerner clients use activation and empowerment capabilities, from early prevention to advanced accountable care needs.

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