“The price/performance of the HP Next
Generation AlphaServer systems running
OpenVMS puts these large systems within
the reach of clients who in the past haven’t
been able to step up to this level of
performance — which gives them the
opportunity to control expense creep and
provide better healthcare.” — Rod Coombs,
VP Technology Management, Cerner
Corporation Success story: HP technology helps Cerner revolutionize the
healthcare industry

Pioneering healthcare automation Technology has long offered a wellspring of hope to
healthcare institutions struggling to improve patient care and
contain costs. But while many solution providers have offered
promises, few have delivered the cure. Kansas City-based Cerner Corporation has fundamentally
transformed healthcare delivery with its revolutionary,
person-centric Cerner Millennium^™ architecture. Cerner’s
platform of choice for this proven architecture is the
HP OpenVMS operating system running on HP AlphaServer
systems. Cerner’s passion for healthcare — its sole focus since its
founding in 1979 — is driven by its large number of staff
members who came from the healthcare industry, including
physicians, nurses, med techs and X-ray techs. These people
know that healthcare is fraught with needless, redundant
paperwork. Sometimes poor decisions are made and
ineffective care is given due to the lack of having the right
information at the right time. In short, they have lived the
pain and want to make it better. “Our mission is to connect the appropriate people,
knowledge and resources at the appropriate time and
location to achieve the optimal health outcome,”
says Rod Coombs, VP Technology Management at Cerner.
“The way we realize our mission is by building a person-
centric, clinically-focused, closed-loop healthcare delivery and
management system. We provide solutions and services that
collect a patient’s healthcare information and then manage
the flow of that information among the patient’s healthcare
providers — all the way down to bar code scanners that
ensure correct medication and biometric signature devices
that read fingerprints and retina scans.” Delivering on a vision Cerner’s ground-breaking architecture enables healthcare
providers to create an electronic medical record that captures
all linear patient information and enables clients to go totally paperless. Today, Cerner serves some 1,500 clients, 80% of
whom run their Cerner applications on HP OpenVMS
AlphaServer technology. The road to making this vision a reality began in the 1980’s,
when Cerner offered a best-of-breed lab system on
OpenVMS. Ron Mustard, Director, Cerner Technology Center,
ran a hospital IT department before joining Cerner. He
recalls, “The real genius of Cerner is that they figured out
how hospitals worked. A lot of other systems wanted to work
from the accounting system back into patient care; Cerner
did it the other way. Patient care should drive accounting and
not the other way around.” Mustard explains the concept behind the Cerner Millennium
architecture. “The best designed house is one that was built
according to an architectural plan rather than one that
started as a single room and you just added on room after
room. The Cerner Millennium architecture requires that each
new system use processes and a data set that’s part of
common model. So when systems need to share data, you
don’t have to build an interface. Interfaces are what kill
new systems.” Remote hosting answers customer demand Cerner has been so successful in delivering enterprise-wide
healthcare automation systems that an increasing number of
clients have asked Cerner to manage their IT systems as well.
The result is the Cerner Remote Hosting Facility, where the
company has contracts to manage 70 clients located across
the continental United States — ranging from small doctors’
offices and clinics to large multi-hospital complexes. Mustard says, “95% of all clients we have in the center are
hosted on HP equipment. The other 5% are systems we’ve
had to take over. Since its inception in 1999, the remote
operation has delivered 99.8% uptime.” “When an application absolutely, positively
has to stay up, OpenVMS is the only
platform to use.” — Ron Mustard, Director, Cerner Technology Center, Cerner Corporation

Cerner is no stranger to remote hosting, having provided the
virtual pharmacy at the Winter Olympics, where the point
of care was in Salt Lake City but the pharmacy system was
hosted in Missouri. “Three years ago, no one asked for hosted services,”
explains Coombs. “Today, one in three customers asks for
hosted services. We host our solutions to enable our clients to
better leverage their operation dollars and capital, and get
their projects on board much faster.” Right platform for the right application Technology is critical to Cerner’s success. So is its choice of
technology partners. According to Coombs, “Cerner has
been with HP for more than 18 years, and it has been a very
solid supporting relationship on both sides. The folks
we’ve dealt with have always been very cognizant of what
we were providing. People’s health — and often their lives —
are on the line.” There are many reasons why Cerner started — and remains
with — OpenVMS. Coombs explains, “At its root, you need
a solid, dependable, high performance system. It doesn’t do
you any good to have the right answer two minutes after you
needed it. We settled on OpenVMS because of its significant
fault tolerant capabilities. Clearly, an outage in a healthcare
system is extremely critical. OpenVMS on AlphaServer
systems allows us to measure outages in milliseconds rather
than minutes — something no other operating system allows
us to do.” “When an application absolutely, positively has to stay up,
OpenVMS is the only platform to use,” agrees Mustard, who
says he makes decisions based on logic and experience
rather than “managing by magazine.” To Mustard, the biggest advantage of OpenVMS is what he
calls “real clusters.” He explains, “OpenVMS clusters give me
the ability to move clients automatically from one set of
hardware to another without ever having to take them down.
You cannot do that with other operating systems. And you
can incrementally add new disks, controllers, and servers to
the cluster and never outgrow it. The beauty of OpenVMS
clusters is that I don’t have to forklift anything.” Security is always a top concern for healthcare clients, and
OpenVMS is part of Cerner’s elegant security solution.
“OpenVMS has been determined to be virtually unhackable,”
says Coombs. “That’s certainly an attractive anchor point
around which to build your solutions. And OpenVMS version
7.3-1 offers even more security enhancements.” New technologies offer greater advantages To advance the benefits it brings to its healthcare clients,
Cerner continually looks to new technologies. Both Coombs
and Mustard share excitement about the HP Next Generation
AlphaServer systems, which Cerner and HP are jointly testing
at the HP lab in Nashua, New Hampshire. Mustard says, “The test numbers we’re seeing in the
evaluation lab are absolutely mind boggling. An HP Next Generation AlphaServer system ran 40% faster on
six CPUs than a competitive mainframe did with 28 CPUs.
In addition to offering a quantum increase in speed, these
systems are dramatically more affordable. They’ll also give
me the flexibility to partition one system into several distinct
instances of OpenVMS.” “Our joint testing shows that the HP Next Generation
AlphaServer systems running OpenVMS have significant
performance improvements over any platform or
configuration we’ve ever worked with,” states Coombs.
“And the ease of upgrading our application from the
AlphaServer GS160 to the GS1280 was seamless. We’re
very excited about getting GS1280 systems into our
installed base as soon as possible.” Coombs continues, “The price/performance of the HP Next
Generation AlphaServer systems running OpenVMS puts
these large systems within the reach of clients who in the past
haven’t been able to step up to this level of performance —
which gives them the opportunity to control expense creep
and provide better healthcare.” Cerner currently stores about 100 TB of data and backups
using HP StorageWorks storage area networks (SANs).
Mustard explains how HP SANs meet their needs for
flexibility. “At the Cerner Technology Center, where we host
client environments, our backup strategy has evolved from the
traditional backup to tape model to keeping approximately
seven days’ worth of backups online and local to the client’s
operating environment and then to tape. With our first level
of backups now disk-to-disk, having the SAN makes that
simple to implement, but also easy to modify over time as
changes are required. That’s a key factor to consider.
Regardless of what you think you need to implement for any
project, one thing for sure is that the requirements will
change over time and you need to have the ability to easily
add, reduce, modify and change the configuration to
support the changing requirements.” Another advancement for Cerner solutions will be the
implementation of Oracle 9i^™ RAC. “We’re impressed with the
scalability data we’ve obtained from our test lab and are look-
ing forward to installing it within the year,” says Coombs. Cerner is also looking forward to the benefits of the Intel^®
Itanium^® architecture. “I’m very excited about the porting of
OpenVMS to the Itanium^® architecture because I think it will
drive down the cost of an OpenVMS solution,” says Mustard. Coombs concludes, “HP and OpenVMS remain a very
strong strategic path for Cerner. I am quite confident that the
very strong reasons we have chosen OpenVMS will persist
within the OS family, and the history of migration rather than
abrupt disruption and the useful life span of code will allow
us to stay within the HP family for a long time.” Working closely together as partners, Cerner and HP are
absolutely committed to providing solutions that will ensure
the best possible care for people well into the future.

Adaptive enterprise solution overview:
Increase performance to satisfy capacity demands Challenge •  Provide system that offers high availability of critical healthcare applications •  Help clients better leverage their operation dollars and capital Cerner Remote Hosting Facility running
HP OpenVMS clusters on HP AlphaServer
systems with backup and restore of data by
an HP SAN • Guaranteed uptime of 99.8% • Fault tolerance and reduced risk of downtime • Scalability to meet future demand Solution Results At a glance • Name: Cerner Corporation • Headquarters: Kansas City, Missouri • Founded: 1979 • URL: www.cerner.com • Products/services: Cerner Corporation is taking the paper chart out of healthcare, eliminating error,
variance and unnecessary waste in the care process.
With more than 1,500 clients worldwide, Cerner is the
leading supplier of healthcare information technology. Technology highlights •Hardware: a combination of 114 HP AlphaServer DS, ES and GS systems •Storage: HP SAN consisting of 38 16-port switches configured in a dual fabric • 12 EMA 12000 and 24 EMA 16000 systems •Operating system: OpenVMS v7.3-1 •Application: Cerner Millennium •Database: Oracle 8i^™ •Services: Platinum support for supporting the OS and SAN For more information on how working with HP can benefit you, contact your local HP
service representative or visit us at www.hp.com Cerner Millennium is a trademark of Cerner Corporation. Intel and Itanium are registered trademarks of Intel Corporation in the
U.S. and other countries. Oracle 8i  and Oracle 9i  are trademarks of Oracle Corporation, Redwood City, California. © 2003 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice.The
only warranties for HP products and services are set forth in the express warranty statements accompanying such products and
services. Nothing herein should be construed as constituting an additional warranty. HP shall not be liable for technical or
editorial errors or omissions contained herein. 5982-0329EN