EMR Adoption Model

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EMR Adoption Model

Created by the HIMSS Analytics group in 2005, the EMR Adoption Model (or EMRAM) is a tool that scores healthcare facility’s levels of IT systems adoption in the United States and Canada (1). The Purpose of EMRAM is to promote and support hospitals and other health care systems to implement technology in their practice to improve healthcare delivery. This includes “ improved patient safety, quality care, health information exchange and a paperless environment.” (1)


EMRAM Scoring Levels

There are 8 levels total, 0-7, that rate the level of a facility’s EMR capabilities(2). Provided is HIMSS Analytics’ descriptive summary of each stage, from most basic to advanced (2):

Stage 0, signifies that the “3 key ancillaries”, radiology, laboratory and pharmacy departments, have not been installed .

Stage 1 indicates the 3 ancillaries have been installed at the organization.

Stage 2 reflects the organization’s abilities to submit data to a clinical data repository (CDR) from key ancillary departments. The data is then available for viewing by medical staff. The CDR must have a controlled medical vocabulary, CDS, and may have Image viewing capabilities.

Stage 3 the organization has installed clinical documentation flow sheets, a clinical decision support system has been executed, and there is image viewing accessibility.

Stage 4 Computerized physician order entry (CPOE) has been implemented. CDS have been modified to allow evidence-based medicine (EBM) practices.

Stage 5 Implementation of “closed loop medication administration environment” has occurred in a minimum of one patient service department. Auto-identification technologies have been synced with the CPOE and pharmaceutical department.

Stage 6 Structured templates are used in a minimum of one patient service department. The radiology PACS system is in use, allowing providers to view all medical images through a “intranet or secure-network”.

Stage 7 The organization has achieved the highest level of integration, and functions in a paperless environment. They have full sharing capabilities with other healthcare facilities and Health Information Exchanges (HIEs).

Please visits the HIMSS Analytics website for Current US and Canada EMR Adoption Model Statistics: http://www.himssanalytics.org/hc_providers/emr_adoption.asp

Current EMRAM Accomplishments

There are currently 57 of 5,000 hospitals in the United States that have achieved Stage 7 (3). Provided is a link to the HIMSS Analytics website to view the current list: http://www.himssanalytics.org/hc_providers/stage7Hospitals.asp



References

1) Hoyt J. State of the industry. HIMSS News [Online]. [cited 2012 May 31]; [1 screen]. Available from: URL: http://www.himss.org/ASP/ContentRedirector.asp?type=HIMSSNewsItem&ContentId=75059

2) U.S. EMR Adoption model trends. HIMSS Analytics website. 2011. [cited 2012 May 31]; [1 screen]. Available from: URL: http://www.himssanalytics.org/docs/HA_EMRAM_Overview_ENG.pdf

3) HIMSS analytics honors tucson medical center with stage 7 award. HIMSS News [Online]. 2011 Jun 15. [cited 2012 May 31]; [ 1 screen]. Available from: URL: http://www.himss.org/ASP/topics_News_item.asp?cid=77640&tid=10

Submitted by Elspeth Gygax