BM Core PPT 12.17.21 2

Cerner Millennium: Building and Maintaining Core
Date: 12/17/21 Version 13 Document ID # 1121552545
© Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation
1 and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner.
1
Course Description
Building and Maintaining Core is designed to help you:
Develop skills focused on building and maintaining Cerner Millennium

Core. You’ll gain knowledge of Core workflow, design
considerations, build tools, troubleshooting techniques and work
steps.
You’ll participate in analyzing design, reviewing work processes,

identifying solution integration points, performing common build
activities, and using basic troubleshooting techniques specifically
related to Core.
2
What to Expect
• Participation in discussions
• Completion of activities
• Completion of Final Activity
• Evaluation
3
Nursing Accreditation
In support of improving patient care, Cerner

Corporation is jointly accredited by the Accreditation
Council for Continuing Medical Education (ACCME),
the Accreditation Council for Pharmacy Education
(ACPE), and the American Nurses Credentialing
Center (ANCC), to provide continuing education for
the health care team.
This CE activity provides 26.75 contact hours

of continuing nursing education.
4
Continuing Education
Learning objectives
After participating in this activity learners should be

able to:
1. Demonstrate skills that focus on building and

maintaining their EMR solution
2. Analyze design, review work processes, and

identify integration points in their EMR solution
3. Perform common build activities and use basic

troubleshooting techniques in their EMR solution
5
Continuing Education FAQ
How do I receive • Attend the entire activity and
continuing education
credits? complete the evaluation survey.
Where do I complete • The survey link will be emailed to

the evaluation survey? you upon conclusion of the event.
When will I receive my • Certificates will be sent by email

certificate? immediately following attestation.
What happens if I • Contact [email protected]

misplace or do not
receive my certificate? to request a copy.
6 and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner. 6
6
Disclosure Information
The speakers, content

managers, and planners
from Cerner Corporation do
not have any relevant
financial interests to
disclose.
7
Evaluation
• Complete course evaluation
• Provide feedback about the course, content, and

instructor
• The evaluation is rated on a scale of 1-9, with 1 being

the least and 9 being the most
8
Agenda
Day 1 Day 2
Course Overview Final Activity Pt. 1
Bedrock Interfaces
Before Core Person
Organizations, Locations & Alias Pools
Day 3 Day 4
Results Troubleshooting
Security Evaluation
Maintenance Final Activity Pt. 2
9
Course Resources
• Course Participant Guide

• Course Domain
• uCern Wiki
• Reference Pages
• Help Pages
• uCern Connect
• Knowledge Base
10
Class Expectations
• Participation in discussions
• Ask questions!
• Completion of activities
• Completion of Final Activity

• Part 1 and 2
11
Introductions
Tell us about you:
• Name
• Role
• What’s a day in your life like in your current role?
• Experience with Cerner
12
Building and Maintaining Core
• Domain Access:
• http://train.cerner.com
• USERNAME:
• PASSWORD:
• Front End Tool Access:

• USERNAME: DL#
• PASSWORD: DL#
13
Bedrock
14
Bedrock
• Bedrock includes:
• Intuitive Wizards designed to aid in the build and maintenance of Millennium
• Reporting features
• Bedrock Help files
• Security for restricting access as needed
• Ability to configure as desired
15
Bedrock
• Bedrock Wizards relative to Core

• Organizations and Facilitates Wizard
• Organization Group Wizard
• Location Wizard
• Insurance Wizard
• Alias Pools Wizard
• Positions Wizard
• Personnel Wizard
• Reset Password Wizard
• Code Set Management Wizard
• Code Set Alias Builder Wizard
16
Bedrock
• Design and Build Reports:

• Core Organizations and Locations
• HealthPlans
• Organization Groups
• Organizations
• Insurance Companies and Employers
• Locations
• Unauthenticated Health Plans
• Unauthenticated Organizations
• Core Settings
• Unauthenticated Code Values
• Preferences
17
Questions?
18
Before CORE
19
Before CORE
• What is CORE?
• The sharing of common tasks, processes and content across clinical domains, technical activities,
and project tasks
• Leverage through reuse - building elements of the data base once and reusing them through various
solutions.
20
Before CORE
• Core is the pre-requisite to all solution build
21
Before CORE
• Standard Design:
• Collection of Reference Data supporting clinical and administrative processes
• Data is predefined by Cerner
• Client review and modifications are necessary
• Designed to simplify the build process while managing the

implementation scope
22
Before CORE
• Standard Design
• Clients must:
• Review and regionalize the reference data.
• Manage all aliases necessary for interfaced feeds
• Add necessary needed reference data.
23
Before CORE: Millennium Architecture
End user applications:

PowerChart, PMOffice, and
HIMRequestManager
Client
Application servers process all

tier 1 requests and
Middleware
communicate to tier 3
Receives the translated request
Database
and updates/queries the table
structure
24
Before CORE
• Common Data Model (CDM)

• Contains most Millennium tables and their interdependencies to each other.
• Contains over 5800 tables
• Most recent version can be found in the ‘Data Model Reports’ uCern group
25
Data Model Example
ENCNTR_ALIAS PERSON_ALIAS_ID
ENCNTR_ALIAS_ID PERSON_ALIAS_ID
---------------------------- ----------------------------
ENCNTR_ID (FK)
PERSON_ID (FK)
UPDT_TM UPDT_CNT
PERSON
ACTIVE_IND UPDT_DT_TM
ALIAS_POOL_CD ACTIVE_IND
ENCNTR_ALIAS_TYPE_CD PERSON_ID
ALIAS_POOL_CD
ALIAS ----------------------------
PERSON_ALIAS_TYPE_CD
CONSTRIBUTOR_SYSTEM_CD UPDT_DT_TM
ALIAS
ACTIVE_IND
CONSTRIBUTOR_SYSTEM_CD
NAME_LAST_KEY
NAME_FIRST_KEY
ENCOUNTER NAME_FULL_FORMATTED
BIRTH_DT_TM
MARITAL_TYPE_CD
ENCNTR_ID
RACE_CD
----------------------------
SEX_CD
PERSON_ID (FK)
VIP_CD
UPDT_DT_TM
ACTIVE_IND
ENCNTR_CLASS_CD
ENCNTR_TYPE_CD CODE_VALUE CODE_VALUE_ALIAS
ENCNTR_STATUS_CD
REG_DT_TM
LOCATION_CD CODE_VALUE ----------------------------
LOC_FACILITY_CD ---------------------------- CODE_SET
LOC_BUILDING_CD CODE_SET CONTRIBUTOR_SOURCE_CD
LOC_NURSE_UNIT_CD CDF_MEANING ALIAS
LOC_ROOM_CD DISPLAY CODE_VALUE
LOC_BED_CD DISPLAY_KEY UPDT_DT_TM
DISCH_DT_TM DESCRIPTION
ORGANIZATION_ID DEFINITION
ACTIVE_ID
Note: This Data Model excerpt does not contain all the
tables, attributes, primary keys, and foreign keys in the
Cerner Data Model (Standard). The number of tables,
attributes, and keys noted are truncated for educational
purposes.
26
Before CORE
Types of data stored in the database
• Reference: Data that is built one time and used over and over—static data
• Such as states, positions, frequencies
• Activity: Data that is patient specific and changes from patient to patient and encounter to
encounter—dynamic data
• Such as a patient’s sodium level or weight
• Meta: Information about the data base itself

• Such as what columns are on what tables
27
Before CORE
_CD
• Always a numeric value assigned by Cerner Millennium to
represent an individual reference data element.
MARITAL_TYPE_CD
• Query the Code_Value table to determine what this numeric value
represent within the database.
_ID
• Always a numeric value assigned by Cerner Millennium to
ENCNTR_ID represent activity data within the tables.
• This value is not present to end users.
Understanding the Data Model

_IND
• True or False indicator – always a 1 or 0 value
ACTIVE_IND
• Every table will have an ACTIVE_IND column.
_dt_tm
• Columns with this suffix are data and time values.
DISCH_DT_TM
• All tables will have an UPDT_DT_TM column.
_key
• This is a column that is used for indexing free text values.
It is unique in that it:
DISPLAY_KEY • Forces the values to store in all uppercase.
• Suppresses punctuation, special characters and spaces within the
stored data.
28
Before CORE
• Discern Explorer
• Tool used to perform database queries, troubleshoot issues, design reports and build programs.
• Patterned after SQL+
• Basic Query structure:

•Select attribute from table where attribute = data value
•Select * from person_alias where person_id = 9954.00
29
Questions?
30
Organizations, Locations,
and Alias Pools
31
Organizations
• What is an organization?
• Any business entity that is relevant to the healthcare process
• An organization is any business entity affiliated with the health system:
• Organizations may include:

• The health system itself
• Hospitals
• Clinics
• Insurance Companies
• Major Employers in the area
• Reference Laboratories
32
Organizations
• Organizations include business entities not owned by the health

system.
• Organizations are identified by organization types.

• Each organization must have at least one organization type assigned.
• Most organizations will have multiple organization types assigned.
33
Organizations
• Organizations may be identified with multiple organization types
• Organization Types may include:
• Facility
• Client
• Employer
• Insurance Company
• Physician Office
• Ambulatory Clinic
• Donor Group (used in PathNet Blood Bank)
• Destruction Service (used in PathNet Blood Bank)
• Blood Bank Manufacturer (used in PathNet Blood Bank)
Although these entities may all be necessary, no direct

relationship exists between them – no hierarchy exists
around organizations in the Cerner Millennium
architecture which adds flexibility to the architecture.
34
Organizations: Facility/Client Organization Type
Classify an organization as a facility/client if it meets one or more of the following criteria:
 The organization is a physical location where in-patient locations will be defined such as nurse units,
ambulatory locations, rooms, and beds.
 One or more physical locations exist inside the organization that security must restrict for viewing patient
demographic and result information such as psychiatric floors, employee health, clinics, and physicians' offices.
 One or more interfaces associated with the organization (such as an interface for registration, orders, results, or
billing) exist.
35
Organizations: Facility/Client Organization Type
Classify an organization as a facility/client if it meets one or more of the following criteria:
 A unique billing system is defined for this organization (example: the organization realizes revenue separately
from another organization using the same Cerner Millennium system)
 More than one location in the organization can place orders based on patient population, and one location
wants to view orderables differently than the other location (example: Location A is a small women's clinic that
does not want to view the entire order catalog defined for Location B, which is a large inpatient location).
 A physical location in this organization exists that must maintain its own pharmacy formulary.
36
Organizations
Design Considerations:
• Define physical locations
• Separate hospitals
• MRN/FIN assignment
• Affiliating interfaces with the organization
• Printing reports for client organizations
• Encounter Organization Security
• Restricting users from accessing encounters from organizations not assigned to the user.
Physical locations are important because you need to know where each patient is in your
hospital such as the registration location.
You cannot define locations without defining an organization as a facility first.
37
Organizations
Design Considerations (continued)
• Consider the interface because each interface must be associated with an organization and a
facility. This association establishes which alias pools that interface uses for the purpose of
translating person, encounter, personnel, order, and organization aliases.
• Several of Cerner's solutions use the facility organization type in very specific ways. If you will be
installing Outreach Services, build organizations as facilities so you can print the result reports at
the appropriate location.
38
CORE: Organizations
• Building Organizations within Millennium

• Bedrock
• Organizations and Facilities Wizard
• Populates organizations that provide patient care or outreach services
• Populates organizations that do not provide patient care
• Insurance Wizard
• Populates insurance companies, employers and health plans
39
Organizations
• Associating organizations to users:

• Organization Group
• Collection of organizations grouped together for ease of assignment.
• Built within Bedrock: Organizations Group Wizard
• Maybe modified as needed
• Individual assignment
• Relation of organizations/organization groups:
• HNAUser.exe
• Bedrock: Personnel Wizard
• Content Manager
40
Alias Pools
• Alias Pools are necessary for NON-PREDEFINED aliases.

• Non-predefined aliases are those that Cerner cannot anticipate based on the alias.
• Examples: MRN, FIN, SSN, NPI, Order Accession Number
• Alias Pools are used to stop potential duplication.
Hospital A Hospital B
Alias Pool: Alias Pool:
Hospital A MRN Hospital B MRN
Alias Pool: Alias Pool:

Hospital A FIN Hospital B FIN
41
Alias Pools
• Alias Pools are used for identification
MRN 9943
Patient Robbie Hospital A Robbie’s MRN
Robbie presents at Hospital A and is assigned 9943 as

her Hospital A MRN.
42
Alias Pools
• Robbie’s MRN is received by Millennium from the foreign

registration system and must be checked for duplication.
Cerner Hospital A MRNS

Millennium 1134 1455
MRN 9934
Database 1156 2654
1290 2790
1365 3743
• Robbie’s Hospital A MRN is compared to

other Hospital A MRNs for duplication.
43
Alias Pools
SSN Alias Pool
• Shared Alias Pools
• Used when aliases represent
the same value at multiple
organizations
• Social Security Number Hospital A Hospital B Hospital C
(SSN)
• Community Medical Record CMRN Alias Pool
Number (CMRN)
44
Alias Pools
• Alias Pool Types:
45
Alias Pools
• Encounter Organization Alias Pool stamps the encounter row with

the organization_id that created it.
• Organization alias is found in the MSH 4 segment of an HL7 message
• Used for:
• Billing
• Report distribution
• Security
46
Alias Pools
• Alias Pools are built using Bedrock

• Bedrock Alias Pool Wizard
• This wizard allows for build, maintenance and association to appropriate organization(s)
• Provides additional functionalities around alias pools
• Format masking
• Security masking
• Sequencing (if the alias is assigned by Millennium)
• Combine functions
47
Locations
Hierarchies within Facility Organizations
• Location (Patient Care) Hierarchy
• Common to Core
• One per facility
• Service Resource (Ancillary) Hierarchy

• NOT part of Core
• Used for the scheduling of a service for a patient
• Used in ancillary solutions
• PathNet (Gen Lab, Specimen Management, AP)
• Radiology Management
• Surgical Management
48
Locations
The Patient Care Hierarchy
Facility •REQUIRED
Each level must have a predecessor.
• A bed must have a room
• A room must have a unit
Building •REQUIRED
Unit
Unit • Optional
Room • Optional
Bed • Optional
49
Locations
Patient Care Hierarchy Example:
Baseline
West Medical •FACILITY REQUIRED LEVEL
Center
BWMC MAIN •BUILDING REQUIRED LEVEL
SICU
Unit • Unit
SI-6 • Room
D • Bed
50
Locations
Ambulatory Locations:
• Should be identified during the design process
• Must be separate organizations
• This will ensure ambulatory flexibility for Millennium Solution functionality such as:
• Virtual Views for Orders
• Defining Workflows for Order Entry Formatting
• Custom Chart Formats based on Location
• ePrescribing Address flexing
• Security
51
Questions?
52
CORE: Interfaces
53
Interfaces
• What is an Interface?
• A foreign (external) system sending data to Millennium and/or receiving data from Millennium.
• The data received [by Millennium] must be translated to a standardized, consistent display format
for the end user.
• Millennium can receive a variety of data in many different formats
54
Interfaces
• Health Level 7 (HL7) is the preferred format for these interfaced

transactions.
• HL7
• Voluntary standard for healthcare transactions
• Standard format
• Ensures data can be translated correctly by receiving system
55
Interfaces
Elements of an HL7 Message
• Segments - Groupings of related information
• MSH – Message Header
• PID – Patient Demographic Information
• PV1 – Patient Visit Information
• Fields - Further breakdown of segments
• Represented by two vertical lines called pipe symbols | |
• Patient Name
• Marital Status
• Components - Further breakdown of field data
• Represented by the carat character within a field ^
• First Name
• Last Name
• City
• State
56
Interfaces
Sample HL7 Message
MSH|^~\&|CERNER|KPH|MEDIC|OHH|20020806095826||ADTÂ01|Q1193764T
984880X81||2.3
PID|1|1000717^^^^MRN|1000717^^^MRN
Pool^MRN||Rouse^Ruby^Mae^^^^Current||1937090000000|F|||1912 Dollar
Ave^4E^Gautier^MS^36954ÛSA^home^^Mississippi||2289492113^Home|||
Married||2521^^^FIN# Pool^FIN NBR|133455666||2521||||0
NK1|1|Mincoff^Mavis^^^^Current||^^MS^^^^Mississippi|2289491122||Next of Kin
NK1|2|Williams^Myrtle^^^^Current||^^ÂL^^^Âlabama|2519515488||Emergency
Contact
PV1|1|Inpatient|Pod A^201^Bed 1^KPH| Elective |||Hosp^Delmas^Jon^^^
^^^^Current|||||||Physician Referral|||^Schulz^Velma^^^^^^^Current|Inpatient||Blue
Cross/Blue Shield|||||||||||||||||||Knollwood Park Hospital||Active|||20020806094900
57
Interfaces
• What is an ‘alias’?
• Values sent from a foreign system that must be translated into a consistent, standard display
format for our end users.
• Examples:
• System A sends 884 which must be translated to ‘Married’ within Millennium.
• 884 = alias
• Married (code value display)= display presented to end user
• This alias is predefined.
• Predefined aliases are mapped to the translated value using the appropriate code value.
58
Interfaces
• Code Value Alias

• Value sent from a foreign (external) system representing a piece of reference data
• Marital Status
• Encounter Type
• State
• Each interfaced system may send unique code value aliases to represent the same reference
data
• Pre-defined aliases
• Used for TRANSLATION
• Mapped directly to a code value
59
Interfaces
• Code Values
• Numeric values assigned by Millennium to represent each piece of reference data
• When the display value for a piece of reference data is entered, a new code value is assigned
• Individual data elements of code sets
• May have CDF Meanings associated
• Common Data Foundation
• Internal processing within Millennium
Code Value = 1167 Display = Bloke CDF Meaning = Male
60
Interfaces
• Code Sets Marital Status

• Groupings of like reference data elements • Married
• Marital Status (38) • Single
• Divorced
• Counties (74)
• Confused
• Locations (220)
• Numeric value assigned for identification
• Most provided by Cerner Counties/Parrish
• Mobile
• Custom code sets may be built as needed
• Baldwin
• Orleans
• Jefferson
61
Interfaces
SUNQUEST CERNER
IDX
CLASSIC
Interface Interface Interface
AUTHENTICATED UNAUTHENTICATED
contributor system: Cerner Millennium contributor system:
one that OWNS the Data Base one that does NOT
patient own the patient
demographic data. demographic data.
Such as a Such as a lab or rad
registration system. system.
62
Interfaces
• Contributor Source
• Set of reference data that a foreign system could send
• Translation dictionary containing all predefined aliases
• Used to translate the aliases received by the external feed into a standardized, consistent display
in Millennium.
• Tied directly to contributor system(s)
63
Interfaces
• Contributor System to Contributor Source relationship

• One to One
64
Interfaces
Contributor Source to Contributor System Relationship
• One to many
• Aliases must be identical
Classic
PathNet
Millennium
Cerner Database
Classic
Classic
RadNet
Contributor Contributor
Systems Source
65
Interfaces
How do you add code values and code value aliases?
66
Interfaces
67
Interfaces
Encounter Class/Encounter Type Linking
• Connects Cerner defined processes with encounter types sent from a contributor system.
• Ensures standardization of processed transactions-regardless of sending system.
• Required for proper system functionality
Encounter Encounter
(Visit) Class 69 (Visit) Type 71
• Inpatient • Acute Care
• Recurring • Oncology
• Outpatient • OP Surgery
• Emergency • Urgent Care
68
Questions?
69
CORE: Person
70
Person
•How does person data get written to the Millennium database?
Cerner Millennium Millennium

Contributor Data Base
System Solution
Such as PM Reg,
Emergency
Management,
Scheduling
71
Person
• Main goal of the Person Identification process:

•Maintain one active row per person on the person table.
72
Person
• Focusing on Contributor Systems
Contributor Contributor
System System
Authenticated Unauthenticated
Owns the patient demographic data Does NOT own the patient demographic data
Usually a registration system Usually an ancillary system
Client determines authenticity Examples: Radiology system, Lab system, Dietary
system
73
Person
Alias Pools
• Necessary for NON-PREDEFINED aliases
• Examples: MRN, SSN, CMRN, FIN, NPI
• Used to stop potential duplication when receiving data from a contributor system.
• Associated to organizations
• Critical for set up of Interface within Millennium
• Examples of identifiers used in other countries
• United States example:
• Social Security Number (SSN)
• Australian Example – Medicare Number
• Brazilian example:
• Registry of Individuals Number (CPF)
• Canadian example:
• Provincial Health Number (PHN)/Health Card Number (HCN)
• Government issued insurance number used to uniquely identify patients
Note:
The format of the alias pool is determined by the
organization that assigns them. Clients customize the
length, sequence, and pattern of the alias pools that are
used.
There are many different ‘non-predefined’ aliases across the
world. These are sometimes country specific.
74
Person
• Alias pools are built using Bedrock

• Alias Pool Wizard
• Builds and associates to organizations
• Organization and Facility Wizard automatically associates alias pools to newly built organizations
75
Person
• Core Alias Pool Types:

• Person
• MRN, CMRN, SSN
• Personnel
• NPI, DEA, Employee Number, License Number
• Order
• Accession Number, Requisition Number, Specimen Number
• Organization
• Encounter Organization Alias
• Encounter
• FIN
76
Person
•How do Alias Pools work?

North Hospital South Hospital
Dairyland Epic
ADT ADT
NH MRN NH FIN SH MRN SH FIN
SSN
77
Person
• Person Identification
• Occurs every time a transaction is received by Millennium
• Utilizes alias pools
• Two step process
• Match—REQUIRED
• Uses PRIMARY IDENTIFIERS
• Reconcile—optional
• Uses SECONDARY IDENTIFIERS
78
Person
• MUST be unique.
• Common Primary Identifiers: • MUST be present for all
persons.
• Person Match—MRN
Primary Identifiers: • CANNOT have a null
• Encounter Match—FIN establish the identity value.
of the person
79
Person
• Common Secondary Identifiers:

• Last Name
• First Name
• Social Security Number or Regional/National • NOT necessarily unique.
Identifier) Secondary • MAY be missing or null.
Identifiers:
• Sex
confirm the identity
• Date of Birth of the person
• Designated by the client
80
Person
• Secondary Identifiers and Person Match

• Used in conjunction with primary identifiers to confirm patient identity.
• Mismatched/missing secondary identifiers
• Will not stop successful person match
• Listed on back end reports for investigation
81
Person
•What happens during Match?

North Hospital
MRN Alias Pool North Hospital
Secondary
Identifiers NH MRN
FIN Alias Pool
used for 11693
confirmation
NBH FIN
NH MRN 4439439
11654 NBH
FIN
NH MRN NBH 544492
11699 FIN
NBH 63495
Successful NH MRN FIN
Person 12883 54454
Match
Successful
Encounter
Match
NH FIN
4439439
82
Person
•During Reconciliation?
If person match Unauthenticated
does not occur, ?
data is written to DONE!
the tables or
Authenticated
?
Update:
1. Inactivate old Person_id
2. Change old person_id to active Do all
person_id (in all tables but secondary
Person)
identifiers
3. Inactivate all SSN EXCEPT the
one associated to the active match?
person_id
83
Person
Reverse Combine Logic
• Inactivates new person record and maintains new record demographics
• More efficient
• Disabled by default
• May be engaged in three capacities:
• For Combines performed in HNACombine.exe
• For A34 trigger events
• For Reconciliations
84
Person
• What gives a contributor source permission to add data?

• ENSURE PARAMETERS
• Rules that determine how a transaction is processed
Most common
ensure parameter
for
UNAUTHENTICATED
systems
Most common
ensure parameter
for AUTHENTICATED
systems
85
Person
• Other Ensure Parameters:
86
Person
• Other Ensure Parameters:
87
Person
• Ensure Parameters are set for areas of the database within the
build of the contributor system
88
Person
Designing the Contributor System
• Name of the Contributor System to configure
• Contributor Source(s) used
• Organization
• Authenticated?
• Aliases within HL7 that require the use of alias pools
• Ensure Parameters (security/permissions)
• Person Match criteria
• Encounter Match criteria
• Reconciliation criteria (if authenticated)
89
Questions?
90
CORE: Results
91
Results
• Key Terms/Definitions
• Results – clinical data, either textural or discreet; can be written directly to the data base or interfaced
• Temperature
• Sodium level
• Radiology Transcription
• Progress Note
• Order – an item that a healthcare provider deems is necessary to diagnose or treat a patient’s ailment.
• Sodium order
• Ultrasound of the head
• Transfer to critical care unit
• Ambien for sleep apnea
92
Results
• Terms:
• Orderable – Cerner term identifying any item/service that can be ordered.
• Discreet Task Assay (DTA) – Reference data item that defines the constraints and options for a
specific result to be documented. Could include type of result entered (numeric, textual, etc.), unit
of measure, reference range parameters, and many others.
• Temperature Oral—numeric result measured in Celsius
• PowerForms—DTAs are associated based on the build of the orders
93
Results
• Event Code: place holder/storage area for the actual result value
• NOT THE ACTUAL RESULT
• Required for all result values
• Provides consistent display of results to the end user—regardless of contributor system
• May be associated to a DTA to ensure that results match its criteria
4773
4773 Sodium Level
94
Results
• How are results entered into the database?

• Manually entered via Millennium solutions
• Received from a contributor system
• If received from an interface:

• Event code must be aliased in the Contributor Source
Alias
OBX 3.1
Actual result
OBX 5
95
Results
• Add on the Fly

• Optional
• Turned on at the domain level
• Allows UNALIASED results to write to the data base
• Results added this way will not be seen by the end user
• Allows the interface to create a new event code and primitive event set
and place it in a special location within the event set hierarchy
• With AOF turned off, the segment or message will be rejected
96
Results
• Event codes added on the fly

• Use Bedrock to review
97
Results
• Event Set All OCF

• Logical grouping of other event sets and/or primitive
Event
event sets
• Form the organizational structure of the results All Result All Specialty
on
the Flowsheet within PowerChart Sections Sections
• 7 Required event sets All Service All Document

• Remaining event sets Sections Sections
• are client defined
Other
Other Results Documents
98
Results
• Primitive Event Sets

• Display name of the result as the end user sees.
• Lowest viewable value in the Event Set Hierarchy
• Associated to event codes
• MUST HAVE EVENT CODE ASSOCIATED WITH EACH PRIMITIVE EVENT SET
• For the end users to view the result value in Millennium.
99
Results
All OCF
Events
• Event Set Hierarchy
All
All Result Specialty
Required Sections Sections
event sets
colored All
All Service Document
green. Sections Sections
Client
defined event Other Other
Laboratory
sets colored Results Documents
white.
Chemistry
100
Results
• How does the end-user view results?

• Using PowerChart:
101
Results
• To view the current Event Set Hierarchy in PowerChart
102
Results
• Grouper Event Sets

• Parent event sets that contain only child event sets.
• Not linked to event codes.
• Any event set that is not a Primitive Event Set may be called a grouper event set.
• Recommended that each parent event set contain only primitive event sets or other grouper event
sets, but not both
• Could cause results to display incorrectly on specialty flowsheets
103
Results
• Let’s identify the Grouper Event Sets and Primitive Event Sets
All OCF
All OCF
All
All Result
Result All
All Specialty
Specialty
Sections
Sections Sections
Sections
All Documents
Grouper All Service
Sections
Sections
Sections
Event
Sets Other
Laboratory Other Results Documents
Chemistry
Primitive Carbon Dioxide

Event Sets
104
Results
• Building and managing the Event Set Hierarchy

• Spreadsheets
• Event Code Spreadsheet
• Unload not necessary

• Unload to modify existing Event Codes
• Event codes are tied to Primitive Event Sets using the Event Set Name column
105
Results
Building and managing the Event Set
Parent Child
• Spreadsheets Event Event
Set Set
• Event Set Spreadsheet
Child Event
Set becomes
Parent
Child Event
Sets
Child Event
Set Becomes
Parent
106
Results
• Event Set Spreadsheet

• Unload is required
• Unload a working copy
• Unload a saved copy
• Recommended check in/check out process for maintaining the unloaded spreadsheet
• Only one spreadsheet is uploaded; all subsequent uploads overwrites current version
• No completely blank rows allowed
107
Results
• Other ways to build and maintain event codes and the Event Set
Hierarchy
• Discern Explorer Scripts
• Millennium Build tools
108
Results
• Building and Managing the Event Set Hierarchy

• CoreEventManager.exe
• All in one tool, may build/modify event sets, primitive event sets, event codes, DTAs and event code
aliases.
• Open to allowed users to view the Event Set Hierarchy
• Only one user at a time can lock tool to modify
• Lock timed for 120 minutes
• Best method of quick modifications
Core Event Manager Help Page:
https://wiki.cerner.com/display/public/1101resultservices
HP/Adding+an+Event+Set+in+Core+Event+Manager
109
Results
• CoreEventManager.exe
110
Results
• Considerations
• Take a fresh spreadsheet(s) unload prior to updating
• Utilize check-out process
• Stop Chart Servers before importing ESH updates
• Cycle Clinical Event Servers (200, 205 and 209) after updating the ESH
• Once Clinical Event Servers have cycled, start Chart Servers
• Alert Clinical Reporting if grouper event set changes were made, could touch Master Chart
Format Build
• Any organizational level defined considerations
111
Questions?
112
CORE: Security
113
Security
• How does security affect our lives daily?
114
Security
• The Cerner Millennium database stores information for patients

from the Cerner Electronic Medical Record (EMR).
• Visits, Orders, Results, and more…
• Positives
• Represents the continuum of the patient has received across facilities
• Increases the quality of patient care
• Efficient access of patient information by anyone treating the patient on site
115
Security
• Risks
• Efficient, unauthorized access to patient information
• Patient demographic information
• Sensitive results
• Mental Evaluations
• Pregnancy Tests
• Toxicology Reports
• Unauthorized disclosure of organization information or trade secrets
• Drug studies for groundbreaking treatments
• Data corruption
• Software virus
• Natural disasters like floods, hurricanes, and fires
116
Security
• Paper Records were just as vulnerable

• Missing Records
• Lost portions of the record
• Stayed with the patient
• Accessible
• Storage/transportation
117
Security
• The reality is no method of security is 100% secure

• Millennium offers many different and robust methods to mitigate
risks
Cerner Millennium
Data Base
118
Security
• Security within Millennium is included
Authentication Security
in the design and configuration of the
Application/Task Security
database.
Encounter Access:
Encounter Org & Confidentiality
Chart Access
Security/Relationships
• Not applied after go live
Data Access • Six different types of security

Security/Privileges
Note:
The bull’s eye shows us moving from access to the system as a whole
(Authentication) in to access to individual data elements (Data Access). You
should always try to implement security at the outer-most level as this makes
maintenance and troubleshooting easier.
119
System Request Workflow
Security is a workflow initiated by the request of the user to
access an application and the data therein.
Application Encounter
Authentication Chart Access Data Access
Authorization Access
Note:
Workflow outlines what Millennium system must check.
Application authorization, encounter access, chart access, and data access are
all parts of authorization, because they control what you have permission to do.
120
Six Security Types
Security is a workflow initiated by the request of the user to
access an application and the data therein.
Application Encounter
Authentication Chart Access Data Access
Authorization Access
Authentication Application/Task Encounter/ Chart Access Data Access

Security Security Organization Security Security
Security
Confidentiality
Level Security
These six security types fall withing five work steps.

Note:
Security is designed to be part of the workflow, not something added in later.
The security types are set up during the overall security build. Here we see them
mapped to the high-level security areas in the system request flow.
121
Security
Authentication
• Is the act of positively identifying the user
• Defined by:
• Username
• Password
• Domain
122
Security
Authorization - Application/Task Security
• Occurs only after successful authentication. Determines the Cerner
Millennium applications and functions a user has access to:
• Position
• Groups of users with similar access needs, not HR job descriptions
• Stored in Codeset 88
• Each user will have 1 position
• Application Group/Tasks
• Groups of tasks associated with multiple positions
• Individual tasks: granted or revoked
• One or more application groups associated to a position
• Built in TaskAccess.exe
123
Security – Application Task Cont’d
• Positions are created and modified using:

• CoreCodeBuilder.exe
• Code set 88
• Bedrock Position Wizard
• Writes to code set 88
• Additional functions available
• Positions have application groups associated using:

• HNAUser.exe
• Bedrock Position Wizard
124
Security - Application Task Cont’d
Application Groups
• Created and maintained using
TaskAccess.exe
• create, modify, view app groups
(grant/revoke tasks)
• Comprised of applications and

individual tasks
125
Security - Application Task Cont’d
My Experience Console
• Used within PowerChart
• Allows user selection of position,
default organizer view, behavior of specific MPages view
• Requires set up and education
126
Security
Encounter Access
• Determines which encounters a user can access based on
Encounter Organization and Confidentiality Level Security
• Both are optional
• Encounter Organization Security is recommended
• Encounter Organization Security MUST be engaged to employ Confidentiality Level Security
127
Security
Encounter Organization Security
• Grants or restricts user access based on the organization that the encounter occurs within. The
user account must have a relationship with that organization to view the encounter
Springdale
Springdale Patient Encounters
Nurse Mavis Medical
Medical Occurred at:
Associated to: Complex
Complex
Troy
Hospital
128
Security
Confidentiality Level Security
• Provides more granularity to the Encounter Organization Security
• Encounter Organization Security must be engaged
• 9 Confidentiality Levels offered
• No more than 5 recommended
• Stored in code set 87
• Each encounter is assigned a level
• Each user’s organization is assigned a level
• User’s level must be equal or higher than the encounter to have permission to view the encounter
129
Security
Confidentiality Level Security
• Example
Springdale Patient Encounters Springdale

Nurse Mavis Occurred at: Medical 3
Medical 7
Associated to: Complex
Complex
Springdale Springdale
Behavioral 2 Behavioral 3
Health Health
130
Security
Confidentiality Level Security Cont’d
• Organization groups – aids in the organization relationship assignment
to users
• Cannot exceed 100 organizations per group
• Created using Bedrock
• Organization Groups Wizard
• Client defined
• Used to associate organizations to users in:
• HNAUser.exe
• Bedrock Personnel Wizard
• Content Manager
131
Security
Chart Access Security
• Defines what encounters a user has access to based on patient
provider relationships (PPR).
• Relationships:
• Required to open a patient chart
• Defines the clinical affiliation the end-user has to a patient whose chart is
being opened
• Typically used for auditing purposes
• Associated to the position
• One-to-One
• One-to-Many
132
Security
Chart Access Security Cont’d
• Relationships are associated to positions
• PrivMaint.exe
• Two types
• Lifetime (Person level)
• Code set 331
• Expirable (Encounter level)
• Code set 333
133
Security
Chart Data Access
• Determines what components of a patient’s chart can be viewed
by the user.
• Uses Privileges
• Provider Level Privileges
• These follow the user-regardless of the position
• Patient-Provider Relationship (PPR) Privileges
• Use with caution
• Position Level Privileges
• Most commonly used
• Assigned using PrivMaint.exe
134
Security – Chart Data Access Cont’d
Privileges Application Group Privilege
• Application/task access grants
ALL orders Order
• Privileges determine which orders Catalog
Nursing
may be placed
Order
Orders
Catalog
• Application/task access grants

ALL results review Vital
Patient
• Privileges determine which
Chart
sensitive results may be viewed Signs
135
Security
How Do Users Get Added to The Millennium Database?
• HNAUser
• Used to add and/or modify single user accounts
• Bedrock Personnel Wizard
• Used to add a single user
• Used to modify groups of users’ association to organizations, confidentiality levels or positions
• Content Manager
• Used to add bulk masses of new users
• Used to modify groups of users
136
Thank you!
137

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Cerner Millennium: Building and Maintaining Core

Date: 12/17/21 Version 13 Document ID # 1121552545

Building and Maintaining Core is designed to help you:

Develop skills focused on building and maintaining Cerner Millennium

You’ll participate in analyzing design, reviewing work processes,

• Completion of Final Activity

In support of improving patient care, Cerner

This CE activity provides 26.75 contact hours

After participating in this activity learners should be

1. Demonstrate skills that focus on building and

2. Analyze design, review work processes, and

3. Perform common build activities and use basic

Where do I complete • The survey link will be emailed to

When will I receive my • Certificates will be sent by email

What happens if I • Contact [email protected]

The speakers, content

• Complete course evaluation

• Provide feedback about the course, content, and

• The evaluation is rated on a scale of 1-9, with 1 being

• Course Participant Guide

• Completion of Final Activity

Tell us about you:

• Experience with Cerner

• Front End Tool Access:

• Bedrock Wizards relative to Core

• Design and Build Reports:

• Core is the pre-requisite to all solution build

• Designed to simplify the build process while managing the

End user applications:

Application servers process all

Receives the translated request

• Common Data Model (CDM)

• Meta: Information about the data base itself

• This value is not present to end users.

Understanding the Data Model

• Basic Query structure:

•Select * from person_alias where person_id = 9954.00

• Organizations may include:

• Organizations include business entities not owned by the health

• Organizations are identified by organization types.

Although these entities may all be necessary, no direct

• Building Organizations within Millennium

• Associating organizations to users:

• Alias Pools are necessary for NON-PREDEFINED aliases.

• Alias Pools are used to stop potential duplication.

Alias Pool: Alias Pool:

• Alias Pools are used for identification

Patient Robbie Hospital A Robbie’s MRN

Robbie presents at Hospital A and is assigned 9943 as

• Robbie’s MRN is received by Millennium from the foreign

Cerner Hospital A MRNS

• Robbie’s Hospital A MRN is compared to

• Alias Pool Types:

• Encounter Organization Alias Pool stamps the encounter row with

• Alias Pools are built using Bedrock

• Service Resource (Ancillary) Hierarchy

BWMC MAIN •BUILDING REQUIRED LEVEL

• Millennium can receive a variety of data in many different formats

• Health Level 7 (HL7) is the preferred format for these interfaced