One of the most experienced and highly regarded NHS CIOs has said Cerner significantly dropped its prices to win new business through the flagship Global Digital Exemplar programme.
Speaking at the North West Informatics Skills Development conference in Blackpool last Friday, Paul Charnley, CIO for Wirral University Teaching Hospital NHS Foundation Trust, one of the leading Global Digital Exemplars and a Cerner reference site, said the US company significantly reduced prices to win GDE business.
“Ultimately, Cerner lowered their prices, rather a lot, to get into the game,” said Charnley. “We’re getting prices that nobody else is.”
The trade-off for Cerner appears to be move on prices now to gain a much greater market share and market entry for new products. Eight of the 16 hospital GDEs chosen by NHS England currently run Cerner, a number which may significantly grow depending on how the ‘follower’ programme develops.
Each of the acute GDEs are paired with so-called ‘fast follower’ sites, who are expected to take the same system as their GDE partner. Jeremy Hunt announced at NHS Expo on 12 September that Wirral will be paired with neighbouring Countess of Chester.
However, Cerner told Digital Health News that it had not negotiated with NHS England on providing discounts in return for greater market share. “Cerner can confirm that no such negotiations took place with NHS England,” the company said in a statement.
Asked whether the company had reduced prices reduced prices to GDEs and Fast Followers, the company replied: “Cerner’s pricing to clients reflects market dynamics, extent of product being purchased and services to support that.”
The statement continued: “All the GDE sites that we have partnerships with were long-time Cerner clients before becoming GDEs.”
Charnley told the 22 September Blackpool conference that subject to procurement Countess of Chester will be taking Cerner Millennium. The trust currently runs a Meditech EPR. “We have our fast follower, Countess of Chester – they are adopting our system, all of the logic within it, and all of the flows that our systems represent.”
He also strongly suggested that further Wirral follower trusts may come after Chester, and they too will take the same Cerner Millennium system. “We are talking to the rest of Cheshire and Shropshire on whether they would also want to be followers, and not slow followers.”
Charnley said that the intention was to ensure that work done first by Wirral can be templated and applied repeatedly, avoiding trusts having to rip out current systems and replace them with standardised systems without seeing any benefits. “We will be able to do this without everyone going back to the beginning and starting again.”
Much of this planned ‘blueprinting’ work will focus on trying to develop Lego-like reusable building blocks for standardised workflows and business logic and processes. The hope is that some of these will become system agnostic and applicable to any hospital.
The Wirral CIO said that he believed a similar pattern would happen across the North West, with another cluster of trusts standardizing on systems and processes, centred on fellow GDE Salford.
In an indication of how closely the GDE programme is being directed by NHS England, Charnley said he’d just received the final blueprint for what a future fully digitised acute trusts should look like and what capabilities it should have. “We’ve been sent slides on what the endpoint for GDE should be. It’s not HIMSS level 7, but it’s like it. I hope that will be shared widely very soon.”
As part of this future digital vision Wirral is pioneering population health management, with a practice in Wirral CCG becoming the first in the UK to start using Cerner’s Healthy Intent Population Health Management tool. The concept is based on joining up different patient data and ensuring that patients with chronic conditions are getting all the care they should and not falling through the gaps.
“I wanted to focus on cross-sector work, explained Charnley, who said Healthy Intent “semantically aligns data from Cerner Millennium and EMIS and so tells us for patients with diabetes, what should have happened, and what has happened.”
Wirral is beginning with diabetes, but plans to then move on to also cover asthma, COPD, coronary heart disease, stroke prevention, depression and a wellness register.
“Having these key measures available to clinicians and, ultimately, to patients, well help ensure they are getting the best care.”
He added: “In the US these tools used to lower health insurance premiums. Here in the UK we need to find ways to convince people that it will improve their health, keep them out of hospital and be there for their grandkids.”