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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 2011 Q4 2012 Q1
Stage 7 Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP 1.2% 1.2%
Stage 6 Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS 5.2% 6.2%
Stage 5 Closed loop medication administration 8.4% 9.4%
Stage 4 CPOE, Clinical Decision Support (clinical protocols) 13.2% 13.2%
Stage 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology 44.9% 43.9%
Stage 2 CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable 12.4% 12.1%
Stage 1 Ancillaries - Lab, Rad, Pharmacy - All Installed 5.7% 5.5%
Stage 0 All Three Ancillaries Not Installed 9.0% 8.4%
Data from HIMSS Analytics® Database ©2012 N = 5337 N = 5318
Canada EMR Adoption Model SM
Stage Cumulative Capabilities 2011 Q4 2012 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 0.2% 0.3%
Stage 4 CPOE, Clinical Decision Support (clinical protocols) 2.3% 2.5%
Stage 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology 36.5% 36.2%
Stage 2 CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable 20.4% 21.9%
Stage 1 Ancillaries - Lab, Rad, Pharmacy - All Installed 14.5% 15.2%
Stage 0 All Three Ancillaries Not Installed 25.6% 23.5%
Data from HIMSS Analytics® Database ©2012 N = 641 N = 639