Cerner

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Cerner’s mission: to contribute to the systemic improvement of health care delivery and the health of communities. [1]

Cerner Corporation is a supplier of healthcare information technology (HCIT) solutions, services, devices and hardware. Cerner solutions optimize processes for healthcare organizations. [2] Cerner solutions are licensed by approximately 14,000 facilities around the world, including more than 3,000 hospitals; 4,900 physician practices; 60,000 physicians; 590 ambulatory facilities, such as laboratories, ambulatory centers, behavioral health centers, cardiac facilities, radiology clinics and surgery centers; 3,500 extended care facilities; 150 employer sites and 1,790 retail pharmacies. [1]

Introduction

In1979, inspired by a short consulting project for a medical lab, former Arthur Andersen information systems consultants Neal Patterson, Clifford Illig, and Paul Gorup broke away from Arthur Andersen to form Cerner. Cerner’s name stems from the Latin word cernere, translated as “to sift or understand.” [3]

Cerner is one of the leading global suppliers of healthcare information technology solutions. Around the world, health organizations ranging from single-doctor practices to entire countries turn to Cerner for our powerful yet intuitive solutions. Cerner offers clients a dedicated focus on healthcare, an end-to-end solution and service portfolio, and proven market leadership. [4]


Locations

Cerner is headquartered in Kansas City, Mo., neighbor of North Kansas City Hospital, Cerner's second hospital client. [5]

  • 2005: Cerner acquired the Riverport Campus complex on the site of what was formerly the Sam's Town Casino above the Missouri River in North Kansas City, Missouri. [6]
  • 2006: it also acquired the former Marion Laboratories complex in southeast Kansas City, Missouri, renaming the campus the Innovation Campus. [7]
  • 2013: the company opened the first building in a new campus development located in Kansas City, Kan. The company calls this the Continuous Campus. [8]
  • 2014: the company announced that it had begun a $4.45 billion campus construction project on the site of the former Bannister Mall in South Kansas City near the Innovation Campus. [9]The Kansas City Star reports, that the campus will have enough room to house up to 16,000 employees. [10]

Cerner maintains a handful of additional offices in the United States, as well as offices in the UK, Australia, UAE, Saudi Arabia, Egypt, Germany, France and several other countries outside the United States.

Mission statement

Cerner's Vision has 4 pillars:

  1. Automate the Care Process to Eliminate Paper
  2. Connect the Person by Providing Virtual Personal Health Systems
  3. Structure, Store and Study the Evidence to Create New Knowledge
  4. Close the Loop by Implementing Evidence-Based Care" [11]

From 1980s into the 90s

By 1984, Cerner was ready to roll out its first application, the PathNet laboratory information system. PathNet provided a comprehensive information system for laboratory clinicians, allowing laboratories to automate their processes. PathNet, which grew to combine applications for general laboratory information, microbiology, blood bank transfusion and blood bank donation, and anatomic pathology, broke away not only from the traditional paper-based sharing of information, but also from the prevailing financial focus of data gathering systems. [12]

In 1988, Cerner added the next component of its clinical management systems, RadNet, which focused on automating radiology department functions. The following year, pharmacy support was added with the PharmNet application. As with PathNet, each new component was based on the same application architecture, allowing applications to be seamlessly combined to share information across applications. [12]

By 1990, more than 200 PathNet sites had been installed, solidifying Cerner's position as the leading maker of laboratory information systems. Cerner next moved to expand its product family beyond clinical management systems and into care management systems, with the introduction of its ProNet and CareNet products. ProNet provided automated support for patient management and registration, ordering, scheduling, and tracking processes. CareNet gave patient care planning, management, and measurement tools to nurses and other direct care providers. Care management was meant to play a central role in gathering information needed for the care process. With Cerner's care management tools, providers could more easily manage the many pieces of patient information, including demographic and financial data, health status, operations data such as treatment procedures and protocols, while linking this information to ordering, tracking, scheduling, and patient, case, and health records management. [12]

By the end of 1993, Cerner had completed the largest part of its product family, with the 1992 introduction of its SurgiNet and Open Management Foundation (OMF) products, and the 1993 introduction of its MRNet product. SurgiNet, part of Cerner's clinical management product line, offered information management support for operating room teams. OMF extended Cerner's repository line with tools for supporting management analysis and decision-making based on process-related information. MRNet functioned to link the OCF and OMF products in automating the chart management process for the medical records department. [12]

Cerner EHR

The founders created Cerner Millennium, the industry's first person-centric integrated architecture. [13] Cerner Millennium is a partnership of Cerner and HP. The architecture of Millennium allows caregivers and supporting providers the ability to view results, problems, diagnosis, medications, and other pertinent information in real-time as well as share clinical and management data across multiple disciplines and facilities. This architecture has been referred to as Health Network Architecture (HNA), providing 12 major system applications operating by this means, fitting into 4 interrelated groups [12].

In a continued effort to reduce waste and friction in healthcare, Cerner has developed many solutions including employee health, life sciences, medical devices, clinical trial management, and biosurveillance. In 2012, Cerner announced its acquisition of Anasazi Software Inc. to support continuity of mental health care through the combination of Anasazi’s established community behavioral health functionality with the in-patient behavioral health capabilities of Cerner Millennium. [14] Also in 2012, Cerner announced the launch of Millennium + which combines the enterprise platform with the secure Cerner Cloud. [15]

Millenium+

In 2012, Cerner launched Millennium+, which uses the Cerner Cloud to provide a user experience that is “fast, smart and easy”, enabling caregivers to have personalized, intuitive and moment relevant clinical work flows via desktop, tablet or smartphone with minimal orientation to begin usage. [15]

One of the solutions that was launched as part of the Millennium+ platform was PowerChart+Touch™. PowerChart+Touch as a mobile solution allows physicians to complete workflows directly from their mobile devices and was created specifically for the iPad. [16]

PowerChart

Built upon the scalable, unified, person-centric Cerner Millennium® architecture, PowerChart® delivers the benefits of a clinical database, with functionality allowing you to view clinical data, complete orders and optimise clinician documentation in one powerful solution.

The universal PowerChart framework can be leveraged across multiple roles, venues and disciplines, thereby driving efficiencies and user adoption. The solution provides a foundation for a multitude of Cerner point-of-care solutions, including those for home care, physician offices, clinics, acute patient care, critical care, and long-term and rehabilitation services.

Key Benefits

* Improve coordination and identification of patients
* Positively impact cash flow
* Access records at any time from any location
* Optimize workflow efficiency and performance

[17]

Cerner Pharmacy Solutions

The Cerner Millennium’s pharmacy solutions package and services allow pharmacists to share information electronically with other clinicians, caregivers and providers with regard to the medication process. The system links pharmacists, nurses and physicians from the time the medication is ordered through administration to the patient. With the addition of computerized physician order entry (CPOE) to the Cerner pharmacy solutions, efficiency, continuity and patient safety are ensured at all levels of the medication process.

The Cerner pharmacy solutions have the benefits of improving the quality of patient care, safety and productivity. PharmNet and PowerChart are powerful components of the Cerner pharmacy solutions that provide the tools for pharmacists to manage inpatient information, including patient location, laboratory, radiology and clinical notes across a multi-hospital system. The Cerner Millennium system conforms to national interoperability standards. This enables physician order verification and processing across multiple locations of the same healthcare system.

FirstNet

FirstNet is Cerners emergency department documentation system. FirstNet tracking board allows physicians and staff to see their patient population and their location. The FirstNet tracking board is also customizable so you can see the information you need. FirstNet has a coding functionality that allows ERs to capturing all their physician charges correctly and for reimbursement. Patient education is also part of the FirstNet application so when a patient is discharge they can also receive education material related to their diagnosis or issue. [18]

RadNet

The RadNet® Radiology Information System (RIS) enables radiology practitioners to work more efficiently and provide patients with a positive experience and superior care.

Advanced technology and access to vital clinical information enables you to do more than automate basic radiology processes. You can deliver more effective, more personal care while expanding and optimizing performance.

RadNet RIS helps you streamline departmental operations, from registration and order entry, to worklist management and image interpretation, to image and result distribution, to business analysis. When you need critical allergy data, lab values or current medications, you can access them quickly. RadNet also allows your department to efficiently perform exam coding and procedural documentation, as well as streamline documentation. With only a few key strokes, you can optimize revenue and profitability.

Key Benefits:

Streamline and automate workflow processes Collect, display, manage and instantly deliver vital patient information Increase clinical and operational performance Improve patient safety and reduce error

[19]

Finances

With a total revenue $2.8B including $391M globally (Cerner Corporation 2013 Annual Report), organizations ranging from single-doctor practices to hospitals to corporations to local, regional, national and global government agencies and organizations use Cerner solutions. As of 2012, Cerner works with more than 9,300 facilities worldwide, including 2,650 hospitals, 3,750 physician practices and 500 ambulatory clinics [20]. Associates span 7,300 worldwide with business in Argentina, Aruba, Canada, Cayman Islands, Chile, Puerto Rico, Saudi Arabia, Singapore, Spain and the United Arab Emirates. [21]

Siemens acquisition

In a press release on August 5, 2014, Cerner Corporation announced that they would be acquiring Siemens Health Services for $1.3 billion. This acquisition will allow Cerner to provide health IT to 20,000 associates in more than 30 countries and 18,000 client facilities, greatly expanding their global presence. [22] This deal will increase Cerner's annual revenue form about 3 billion last year to more than 4.5 billion on annual revenue in 2014.

Based on 2014 estimates, Cerner and Siemens Health Services have combined totals of more than: [23]

  • 20,000 associates in more than 30 countries
  • 18,000 client facilities, including some of the largest health care organizations in their respective countries
  • $4.5 billion of annual revenue
  • $650 million of annual R&D investment

Powerchart ECG

The Cerner PowerChart ECG™ solution powered by Mortara provides cardiologists a comprehensive ability to capture, manage, display, interpret and report on ECGs anywhere from within Cerner’s electronic health record (PowerChart®) and other affiliated Cerner solutions, such as PathNet® (pathology) and RadNet® (radiology).

Cerner is the first company to provide full capabilities for the ECG from within an electronic health record (EHR). The PowerChart ECG solution includes communication integration and clinical worklist functionality. The solution presents a consolidated view of ECG information, visually incorporating prior encounters, critical results and observations.

Key Benefits

ECG viewing of full fidelity (DICOM) ECG data Ability to analyze, measure, and manipulate presentation of ECG anywhere and anytime in PowerChart Enterprise distribution of ECG images with automated interpretation for attending and primary doctors, ED staff and cardiologists Access to ECGs at any workstation with PowerChart

[24]

Oracle

The partnership between Cerner and Oracle helps to provide a number benefits to Cerner customers such as: [25]

  • industry-leading scalability and reliability in both clustered and single system configurations
  • high performance
  • fault tolerance
  • heavy online processing loads
  • the ability to handle a large number of users

Cerner Millennium applications use an Oracle database and provide a common data model to enable data sharing between applications and to eliminate redundant data, while maximizing reliability and performance. This implementation runs on a variety of networks, processors and operating systems, including Windows XP Professional and any Internet browser.[8] All Millennium installs take advantage of the full Oracle database stack (9iEE, RAC, and the Management Packs). Oracle’s Real Application Clustering (RAC) enables both reliability and scalability by allowing the addition of servers to the host cluster.

Cerner also uses Oracle’s Tuning Pack, Diagnostic Pack, and Change Management Pack to help protect the integrity, confidentiality, and availability of its Millennium healthcare data. Oracle’s EAL 4 (Evaluation Assurance Level 4) rating also attests to its robust security. Additionally, Cerner's Remote Hosting Facility uses the full Oracle database stack (9iEE, RAC, and the Management Packs) as well and in an exclusive manner [25]

Certification Commission for Health Information Technology (CCHIT) performs rigorous inspection of EHR's integrated functionality, interoperability, security and is intended to serve health care providers looking for maximum assurance that a product will meet their complex needs. These listed products have CCHIT Certification but have not been tested against the applicable proposed Federal standards in existence on the date of certification for certified EHR technology of its type under the American Recovery and Reinvestment Act of 2009 (ARRA):

  1. Cerner Millennium FirstNet 2007.19 (Expired April 22, 2011)
  2. Cerner Millennium PowerChart 2007 (Expired January 22, 2011)
  3. Cerner Millennium FirstNet 2007.19 (Expired April 22, 2011)
  4. Cerner Millennium PowerChart/PowerWorks EMR 2007.19 (Expired April 22, 2011). [12]

Millennium Objects

Clients can create custom applications on the Cerner Millennium architecture with MillenniumObjects. [26] MillenniumObjects utilizes Java and XML services for Application Programming Interfaces (API) development by client developers. MillenniumObjects can be used to create custom applications and additional features on existing processes. This allows the user to create a unique application tailored to their specific needs using data already present within Cerner Millennium. Third-party extensions are available to create new workflows.

Benefits of Millennium Objects include:

  • Quickly create custom applications for your organization
  • Build upon the processes already in place for the maintenance of users, passwords, administration, etc. of the new application
  • Leverage the capabilities of third-party built extensions to create new workflows across applications

[27]

Discern Explorer

Discern Explorer is a proprietary Cerner programming language[28] (formerly known as Cerner Command Language CCL) which is used in a variety of Cerner Millenium solutions to query databases. Discern Explorer was modeled after the Structured Query Language (SQL) database querying language with additional functionality added to facilitate organizing information retrieved into properly formatted reports. Discern Explorer can insert, delete, select, and update data from a variety of databases such as: Oracle, RMS, C-ISAM, and SQL Server.

Cerner provides three different tools to allow users to create programs using Discern Explorer:

  • Visual Explorer[29] - Facilitates in creating a query and/or report by focusing on the data fields they require and allowing Visual Explorer generate the code.
  • Discern Visual Developer[30]- is Cerner’s integrated development environment which allows the users to create and edit queries, programs and templates; as well as providing the functionality to analyze their efficiency.
  • Command-line Discern Explorer[31] - allows the users to manually create and compile their own queries and programs.

Command-line provides a greater variety of functionality which allows the user to generate more advanced programs, but does not provide the more ‘user friendly’ environment of Visual Explorer and Discern Visual Developer. For this reason it is generally recommended to use Visual Explorer and/or Discern Visual Developer to create more basic programs, as well as to build the basic outline of the program and then using Command-line to generate the additional specifications.


St. John Sepsis Agent

Sepsis affects 750,000 patients per year in the United States alone. [32] It also states, nearly $17 billion annual healthcare expenditures in the U.S. goes to health problems associated with sepsis.

However, studies show sepsis can be handled better if it is diagnosed in the first six hours after contracting germs. In order to make this detection as early as possible, Cerner now has come with a solution. St. John Sepsis Agent, created in co-operation with Methodist health care in Memphis, Tennessee speeds up early detection and diagnosis of sepsis. How the system works?

It gathers information from different sources such as: physician practices, ambulances, emergency department ,lab results and patient electronic health record’s vital signs.The integrated system analyzes all the information gathered from the above sources which includes Glucose level, Respiratory rate, Temperature, Heat rate, and Lab results. An alert fires when the system finds three out of range criteria. Then the agent sends a message to the hospital’s clinical team which reviews the data and begins the appropriate treatment.

In addition to the alert, there are enhancements that complement St John’s Sepsis Agent. One of such is The Millennium Light house. This program includes sepsis management power plan with orders for intravenous fluid, diagnostic tests and an empiric therapy adviser. This adviser guide clinicians to a variety of treatment option based on the source of infection.The agent offering also includes Significant Events mpage component which provides up front view of the patient’s most recent lab results, vital signs and significant treatment event. [33]

Finally, to follow up cases of sepsis, Cerner offers the Sepsis Confirmation Power form which is designed to use by organization’s quality officers during case review and quality reporting. [32] Reports show using the St. John Sepsis Agent can improve healthcare organizations in the following ways:

  • 24 percent reduction in in-hospital patient mortality rate.
  • 21 percent reduction in length of stay.
  • $5,882 medical savings per treated patient.

Acute care Electronic Medical Record

The Cerner electronic medical record (EMR) is an integrated database that provides a comprehensive set of capabilities with the following key benefits: 1.Improve patient care as clinicians can focus on the patient’s overall health and not just the encounter 2. Increase efficiency by placing real-time, updated information with the care team in time to make fast and effective decisions 3. Increase access to information from multiple venues in the health system. [34]

The EMR was created to allow healthcare professionals to electronically store, capture and access patient health information in both the acute and ambulatory care setting. It allows the users to provide real-time access to patient results and clinical information across care disciplines, enable that healthcare organizations meet The Joint Commission requirements for patient confidentiality, access patient information securely from wherever and whenever it is most convenient for the care team. [34]


Cerner Laboratory solution

The PathNet laboratory information system delivers to clinicians a comprehensive and fully integrated technology that covers both the managerial and the operational sides of the laboratory. [35] The system operates on the unified Cerner Millennium architecture. As a result, information links seamlessly with the patient's electronic medical record. PathNet serves the needs of different sections under pathology departments umbrella such as Blood Science, Microbiology, Cellular Pathology and Blood Transfusion functions. The technology has a capability to store, retrieved and disseminated patient specific information to and from health care system. Aside from that, the system is continually updated based on national standards and guidelines. Reports enumerates the different kinds of benefits PathNet® laboratory information system provides. Some are: it has a capability to process large quantities of specimens efficiently with minimal error possible. It integrates lab results with patent's EMR which allows the availability of full patient records on the EMR. Finally it ensures the rapid availability of patent results to care providers.

Device Connectivity

Medical devices contain critical health information reports a Cerner’s website, However, it can be a challenge to get that information into the care giver’s hand. As a result Cerner come up with medical device connectivity solution which alleviate this challenge. The company implemented the CareAware iBus, a core component of the CareAware connectivity architecture which acts as a USB for health care devices. In doing so, the solution connects medical devices with EMR enabling two-way communication between the two systems. This solution improves care by allowing care providers to focus on patients rather than paper work and data entry associated with it. [36]

Integrating medical calculators into the EHR

Medical calculators integrated in EHR are invaluable assists for care providers, reports a Cerner website. In order to address this need, a group of physicians at Cerner started to work on integrated medical calculator solutions. In order, to accomplish that they partnered with MedCalc300. As a result, this new solution provides all Cerner clients access to more than 600 calculators, clinical criteria and decision trees. To name one example of such clinical calculator is Apgar score for determining the well being of a new born. [37]

HealthLife

Cerners patient portal was designed to help patients become more actively involved in their healthcare. Individuals will have greater access to their health information than ever before using a variety of access tools including laptops, tablets and other mobile devices. This new design will enable patients to: [38]

* Schedule or reschedule or cancel appointments
* Make payments or view their medical fees
* View their health information and download their data
* Send information to their healthcare team thru secure messaging
* Fill prescriptions

Providers will be able to:

* send their patients reminders
* share the patients lab or diagnostic results
* attach documents concerning education or patient care
* send registration forms for patient to complete

LearningLive

LearningLIVE is a new eLearning solution designed to deliver training closer to the point-of-care and support continuous learning in the healthcare environment. Available within PowerChart, FirstNet, and INet, LearningLIVE offers clinicians relevant learning resources in the context of their workflow.

The simple and flexible design facilitates dynamic delivery and real-time updates. A reporting dashboard allows your organization to track learning activity and user performance, and leverage the data to target training and drive user adoption.

In addition to the creation of customized learning assets, LearningLIVE comes with twenty two standard assets that support Meaningful Use requirements. The pre-built assets are categorized according to the requirement they support and facilitate training for Meaningful Use.

Client Benefits:

Allows clinicians to access learning resources and apply knowledge at the point-of-need. Enables educators to deliver dynamic learning content and communications. Provides hospital administrators key learning and performance metrics. Key Features

The LearningLIVE solution offers:

Relevant, on-demand learning resources in the context of clinical workflow. Reporting dashboard with a comprehensive view of learning activity and user performance. Simple and flexible design to facilitate dynamic delivery and real-time updates. Pre-built assets targeted towards meeting Meaningful Use objectives

[39]

HealtheIntent

This is one of Cerners newest cloud based platforms to address the needs of population health while looking at the health outcomes of an individual. This cloud-based platform enables health care systems to aggregate, transform and reconcile data across the continuum of care. A longitudinal record is established, through that process, for individual members of the population that the organization is held accountable for; helping to improve outcomes and lower costs for health and care. [40]

Population Health Management solution is enabled with the HealtheIntent platform. Physicians will be able to use the tools and programs to address individual patients or a group. This solution will allow physicians to know their population, engage their patients and evaluate patient and population outcomes.

Cerner Wellness solution is designed to assist patients through their continuity of care with resources and tools to engage and motivate them towards healthy lifestyle improvements, managing their medical conditions and enhance their knowledge base. [40]

CareAware AlertLink

In today's health care environment, devices sound many alarms, some of which are informational, some of which are life critical. Nurses often have to rely on proximity to a nurse's station or a patient’s room to ensure an alarm is heard. This can result in delays in responding to life-critical alerts. The problem is amplified when there are high volumes of alarms and only a small number of them requiring life-critical immediate response.

AlertLink provides an alternative. Patient monitors are connected to a network and every alarm they produce is captured by AlertLink. A small percentage of those alarms are considered life critical and can be forwarded to a caregiver’s mobile device, such as a phone.

At the beginning of a shift, a nurse uses the solution to create a connection with his or her phone by scanning an ID badge and phone. Once the nurse connects the phone to the network, he or she can receive alerts, accept notifications and take action. If the nurse is unable to respond to the event, he or she can press “decline” on the phone to immediately forward the alert to the next caregiver, a feature that ultimately improves response times for patients.

CareAware AlertLink system saves time for nurses through improved alert escalation. It also gives administrators better insight into nurse workload by capturing the acceptance and rejection of alerts. The improved ability to monitor facilities and staff gives your organization the opportunity to lower costs.

[41]

Partnerships

Every potential partnership is evaluated for the opportunity for collaboration and innovation in order to serve clients’ health care needs. Cerner has partners in the following areas:

* Medical Device Integration and Connectivity
* Business Continuity
* Caregiver Experience
* Document Management and Imaging
* HotSpot Dictation
* Operational and System Management
* Preferred Suppliers
* Security and Administration

[42]

Cerner has also partnered with CommonWell and will provide it to their clients for free until January 1, 2018. CommonWell will work with Cerner to exchange patient records safely and securely at the right time with any of the CommonWell parnters.

[43]

Virtual Community

Cerner and Second Life

Cerner has established a virtual healthcare environment to represent its 25-year vision. The environment includes numerous venues, such as a hospital, clinic, pharmacy, and more. Within the venues are areas where individuals can interact to learn about Cerner’s solutions. The virtual environment acknowledges education and affiliation among clients and supports Cerner’s vision for the future of healthcare. Virtual characters, known as avatars, will guide you through the environment where you can participate in the following:

  • View and interact with Smart Room technologies such as myStation and iAware, to learn about them in real life
  • Experience how clinicians view real-time data from the care team and medical devices in the medical intensive care unit
  • Witness how Cerner’s solutions enable patients to connect with the care team
  • Collaborate and share knowledge with other individuals in Second Life

What is Second Life?

Launched in 2003, Second Life is a virtual world that creates a user-defined environment where people can interact, conduct business and exchange ideas. Second Life is used in many large corporations such as IBM, Intel and Microsoft to collaborate, share product knowledge and network. Additionally, many leading universities and school systems use Second Life in their educational programs to familiarize students with benefits of virtual worlds, connect them with others and provide instructional simulations. [44]

Awards

• UX Award, 2013, Best Clinical Health Care Experience, Powerchart Touch [45]

• Information Week Elite100, 2014, [46]

• Most Innovative Companies, 2014 [47]

• Best in KLAS award for Application Hosting (CIS/ERP/HIS) 2013 [48]

• One of The 10 Most Competitive Technology Companies of 2013 [49]

• Healthcare Informatics 100 Ranking [50]

References

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  23. Cerner To Buy Siemens Health IT Business For $1.3 Billion http://www.forbes.com/sites/matthewherper/2014/08/05/cerner-to-buy-siemens-health-it-business-for-1-3-billion/
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  25. 25.0 25.1 http://www.cerner.com/About_Cerner/Partnerships/Oracle/, 2014)
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  33. Youtube: Cerner Sepsis Program https://www.youtube.com/watch?v=_-P6DZos9UU
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  35. Laboratory http://www.cerner.com/solutions/Hospitals_and_Health_Systems/Laboratory/
  36. Healthcare Devices http://www.cerner.com/solutions/Healthcare_Devices/?langtype=3081&WT.mc_id=audevice
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  40. 40.0 40.1 Cerner HealtheIntent. http://www.cerner.com/solutions/population_health/healthe_intent/ Cerner HealtheIntent
  41. Cerner Partnerships. http://www.cerner.com/About_Cerner/Partnerships/
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  43. Cerner Virtual Community. http://www.cerner.com/About_Cerner/Cerner_Virtual_Community/
  44. 2013 UX Awards. http://userexperienceawards.com/ux-awards-2013-winners/#powerchart/
  45. Cerner clients recognized as elite and innovative users of IT. http://www.cerner.com/blog/cerner_clients_recognized_as_elite_innovative_users_of_it/?langtype=1033
  46. The World’s Most Innovative Companies List. http://www.forbes.com/innovative-companies/list/
  47. Cerner : Best in KLAS Awards: Software and Services. http://www.4-traders.com/CERNER-CORPORATION-8744/news/Cerner--Best-in-KLAS-Awards-Software-and-Services-18576417/
  48. 10 Most Competitive Tech Companies in the World. http://outthinker.com/outthinkerblog/?p=59/
  49. Cerner recognized as No. 2 for 2014.http://www.healthcare-informatics.com/hci100/2014-hci-100-list/
47. Cerner Pharmacies. https://www.cerner.com/solutions/Pharmacies/
48. Munson Healthcare. http://www.munsonhealthcare.org/powerchartbasicshome
49. Cerner CPOE. http://www.cerner.com/solutions/Hospitals_and_Health_Systems/CPOE/