Most U.S. Hospitals within Two Steps of Having Essential
EMR Tools in Place

CHICAGO (April 2, 2009) — With the Medicare and Medicaid incentives for health information technology use announced, almost 70 percent of U.S. hospitals are only two steps or less away from having the health IT applications necessary to deliver the likely objectives of ‘meaningful use’ for the electronic medical record, according to the HIMSS Analytics EMR Adoption ModelSM  (EMRAM). While only six percent of hospitals report comprehensive adoption of health IT applications often associated with the American Recovery and Reinvestment Act (ARRA), EHR criteria (major ancillary department information systems, clinical documentation, computerized physician order entry and clinical decision support), 67 percent need to add only one or two of these applications to have this threshold of EHR functionality available for their clinicians’ use.      

 “Our data show that the majority of US hospitals tracked by the HIMSS Analytics Database™ are just two stages or less away from having the applications implemented to achieve an electronic medical record tool capable of realizing ‘meaningful use’ objectives,” said David E. Garets, HIMSS Analytics president/CEO. “That means that almost three quarters of US hospitals are on the right track to EMR implementation. We believe that when hospitals reach Stage 4 on the EMRAM, they will be able to meet many, if not most, of the pending criteria for the current definition of ‘meaningful use’ of the EMR.”

“We fully recognize that implementing the technology is necessary but not sufficient as change management must also be a component of the EMR implementation process. We believe that “meaningful use” will demand measurement and reporting of clinical quality, patient safety, and cost reduction data, for example. That data should be available to hospitals as a byproduct of their EMR’s clinical documentation and reporting tools.”

Developed in 2005, the EMRAM has become an industry standard to measure the progress in EMR implementation for healthcare organizations. As of December 2008, in the 8-stage EMR implementation process, EMRAM data show:

• 31.2 percent of hospitals rank at Stage 2, meaning that they have implemented a clinical data repository that contains orders, lab, radiology, and pharmacy data and allows clinicians to review results electronically
• 35.7 percent are at Stage 3, meaning that they’ve implemented nursing documentation capabilities on at least one unit of their hospital and have clinical decision support to support nursing procedures; and
• 6 percent rank at or beyond Stage 4 meaning they have advanced EMR capabilities such as computerized practitioner order entry, physician documentation, data warehousing and mining capabilities, and full radiology PACS.

HIMSS Analytics collects data from 5,166 hospitals, a census of the non-federal, medical/surgical hospitals in the U.S.

 “The data are also clearly showing a rapid rise in adoption as well,” Garets said. “Since 2006, the percentage of hospitals within two or fewer steps to this threshold has increased significantly.”

Visit the HIMSS Analytics Web site to view the EMRAM comparison data from 2006 to 2008.

 About HIMSS
The Healthcare Information and Management Systems Society (HIMSS) is the healthcare industry's membership organization exclusively focused on providing global leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare. Founded in 1961 with offices in Chicago, Washington D.C., Brussels, Singapore, and other locations across the United States and the globe, HIMSS represents more than 20,000 individual members and over 350 corporate members that collectively represent organizations employing millions of people. HIMSS frames and leads healthcare public policy and industry practices through its advocacy, educational and professional development initiatives designed to promote information and management systems’ contributions to ensuring quality patient care.  Visit www.himss.org for more information.

About HIMSS Analytics: HIMSS Analytics is a wholly owned not-for-profit subsidiary of the Healthcare Information and Management Systems Society (HIMSS).  The company collects and analyzes healthcare data related to IT processes and environments, products, IS department composition and costs, IS department management metrics, healthcare trends and purchase-related decisions.  HIMSS Analytics delivers high quality data and analytical expertise to healthcare delivery organizations, healthcare IT companies, state governments, financial companies, pharmaceutical companies, and consulting firms.  Visit www.himssanalytics.org/ for more information.

The EMRAM stages follow below (see chart for current data).

Stage 0: Some clinical automation may be present, but all three of the major ancillary department systems for laboratory, pharmacy and radiology are not implemented.

Stage 1: All three of the major ancillary clinical systems are installed:  laboratory, pharmacy and radiology.

Stage 2:  Has all three major ancillary clinical systems that feed a clinical data repository, the database that gathers results from the ancillary systems.  The CDR provides clinician access for retrieving and reviewing results, a controlled medical vocabulary and the foundation for a clinical decision support system.

Stage 3:  This stage must have clinical/nursing documentation that includes vital signs and flow sheets.

Stage 4:  Computerized Practitioner Order Entry is active for use by any clinician.
 
Stage 5: The hospital has implemented closed loop medication administration , the hallmark of medication safety processes.  The “5 rights” are being followed:  right patient, right medication, right dose, right time, and right route.  Bar coding is in place on the patient, medication and caregiver. The electronic medication administration record (eMAR), the pharmacy system, and CPOE work together to create the closed loop medication administration process.

Stage 6:  Physicians are using online documentation and charting with structured templates.  Clinical decision support and a full complement of radiology picture archiving and communication system modalities are operational.

Stage 7:  The hospital has a paperless EMR environment.  It also has data warehousing and data mining capability to analyze and improve clinical protocols and the capability to send standard summary data to health information exchanges, physician offices and other patient care facilities, and patients’ personal health records.

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