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Ambulatory EMR Adoption ModelSM

The waiting is over…

The A-EMRAM is the next generation tool in monitoring EMR adoption in ambulatory settings. This new evaluation model creates a framework for dialogue among your key stakeholders. It helps you focus on key IT systems that need to be implemented for achieving higher levels of access, quality, efficiency and safety.

United States EMR Adoption Model SM
Stage Cumulative Capabilities 2013 Q4 2014 Q1
Stage 7 Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP 2.9% 3.1%
Stage 6 Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS 12.5% 13.3%
Stage 5 Closed loop medication administration 22.0% 24.2%
Stage 4 CPOE, Clinical Decision Support (clinical protocols) 15.5% 15.7%
Stage 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology 30.3% 27.7%
Stage 2 CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable 7.6% 7.2%
Stage 1 Ancillaries - Lab, Rad, Pharmacy - All Installed 3.3% 3.2%
Stage 0 All Three Ancillaries Not Installed 5.8% 5.6%
Data from HIMSS Analytics® Database ©2012 N = 5458 N = 5449
PLEASE NOTE: These graphics are an abbreviated version of the HIMSS Analytics EMR Adoption Model. All organizations must secure permission to post our model on any public notices and to obtain their score they must complete the HIMSS Analytics study prior to validation of their score.
Canada EMR Adoption Model SM
Stage Cumulative Capabilities 2013 Q4 2014 Q1
Stage 7 Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP 0.0% 0.0%
Stage 6 Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS 0.6% 0.6%
Stage 5 Closed loop medication administration 0.0% 0.5%
Stage 4 CPOE, Clinical Decision Support (clinical protocols) 3.8% 3.6%
Stage 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology 32.2% 32.5%
Stage 2 CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable 29.1% 28.9%
Stage 1 Ancillaries - Lab, Rad, Pharmacy - All Installed 14.5% 14.5%
Stage 0 All Three Ancillaries Not Installed 19.8% 19.4%
Data from HIMSS Analytics® Database ©2012 N = 640 N = 640
PLEASE NOTE: These graphics are an abbreviated version of the HIMSS Analytics EMR Adoption Model. All organizations must secure permission to post our model on any public notices and to obtain their score they must complete the HIMSS Analytics study prior to validation of their score.
US Ambulatory EMR Adoption Model SM
Stage Cumulative Capabilities 2013 Q4
Stage 7 HIE capable, sharing of data between the EMR and community based EHR, business and clinical intelligence 4.33%
Stage 6 Advanced clinical decision support, proactive care management, structured messaging 3.27%
Stage 5 Personal health record, online tethered patient portal 5.58%
Stage 4 CPOE, Use of structured data for accessibility in EMR and internal and external sharing of data 0.76%
Stage 3 Electronic messaging, computers have replaced the paper chart, clinical documentation and clinical decision support 11.39%
Stage 2 Beginning of a CDR with orders and results, computers may be at point-of-care, access to results from outside facilities 27.29%
Stage 1 Desktop access to clinical information, unstructured data, multiple data sources, intra-office/informal messaging 37.64%
Stage 0 Paper chart based 9.73%
Data from HIMSS Analytics® Database ©2013
N = 23,241
We expect the % distribution across the stages to fluctuate until our sample size includes all tethered ambulatory facilities.

PLEASE NOTE: These graphics are an abbreviated version of the HIMSS Analytics EMR Adoption Model. All organizations must secure permission to post our model on any public notices and to obtain their score they must complete the HIMSS Analytics study prior to validation of their score.

Designed for the unique needs of the ambulatory setting.

HIMSS Analytics created the A-EMRAM due to a combination of compliance, market trends and healthcare delivery factors impacting your ambulatory setting today.

  • More than 70% of all healthcare activities involve a face-to-face physician visit
  • More than 26% of healthcare expenditures relate to ambulatory care
  • Incentive-eligible facilities have a methodology for demonstrating meaningful use
  • A new industry metric will help ‘push the market’ towards Stage 7 with available software from leading edge suppliers

Software and healthcare providers reviewed the A-EMRAM during its development providing valuable feedback to HIMSS Analytics. This guidance helped establish realistic and achievable metrics for each stage.  Just as with hospitals, HIMSS Analytics will conduct on-site visits to verify the Stage 7 ranking.  

How to get started.

A-EMRAM scores may be obtained through your participation in the HIMSS Analytics Annual Study. Once you have your A-EMRAM score, you can:

  • Start meeting application requirements and become operational stage by stage, working toward the final level, Stage 7
  • Compare your progress with other ambulatory facilities
  • Align IT initiatives with your overall business strategy and shape strategy for future IT investments
  • Map your progress in meeting meaningful use requirements to gain funding

Visit our FAQs to learn more.

Ready to move your facility forward and get
your A-EMRAM score? 
E-mail or call us at 866.546.2900.

“HIMSS Analytics’ EMR data helps us explain and justify plans and initiatives with upper management.” – Jim Begin, Director of Information Technology at Golden Valley Memorial Hospital

Learn more about the EMR Adoption Model, how it is used and its advantages. Watch the Video.
If you are a healthcare provider and would like more information on how to obtain your hospital’s EMRAM score, e-mail us or call us at 866.546.2900.