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The EMR Adoption ModelSM (EMRAM) identifies and scores hospitals using an 8 step scale that charts the path to a fully paperless environment.

United States EMR Adoption Model SM
Stage Cumulative Capabilities 2012 Q4 2013 Q1
Stage 7 Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP 1.9% 1.9%
Stage 6 Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS 8.2% 9.1%
Stage 5 Closed loop medication administration 14.0% 16.3%
Stage 4 CPOE, Clinical Decision Support (clinical protocols) 14.2% 14.4%
Stage 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology 38.3% 36.3%
Stage 2 CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable 10.7% 10.1%
Stage 1 Ancillaries - Lab, Rad, Pharmacy - All Installed 4.3% 4.2%
Stage 0 All Three Ancillaries Not Installed 8.4% 7.8%
Data from HIMSS Analytics® Database ©2012 N = 5458 N = 5441
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 2012 Q4 2013 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 0.5% 0.5%
Stage 5 Closed loop medication administration 0.3% 0.3%
Stage 4 CPOE, Clinical Decision Support (clinical protocols) 2.3% 2.2%
Stage 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology 33.8% 33.6%
Stage 2 CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable 25.3% 26.9%
Stage 1 Ancillaries - Lab, Rad, Pharmacy - All Installed 14.8% 14.8%
Stage 0 All Three Ancillaries Not Installed 23.0% 21.7%
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 Q1
Stage 7 HIE, data sharing with community based EHR, robust business and clinical intelligence 0.96%
Stage 6 Advanced CDS, proactive care management, population health management 1.2%
Stage 5 Patient engagement 5.17%
Stage 4 CPOE, physician documentation with CDS, external data exchange 0.69%
Stage 3 E-prescribing, nursing documentation, medication reconciliation, CDS 10.06%
Stage 2 CDR, access to results from outside facilities 27.67%
Stage 1 Access to clinical information, unstructured data, multiple data sources 4.51%
Stage 0 Paper chart based 49.75%
Data from HIMSS Analytics® Database ©2013
 N = 18,318
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.

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