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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 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.