HIMSS Says 46% of Hospitals Are at Stage 3 EMR Usage

Path toward a complete, paperless patient record requires eight stages as defined by HIMSS Analytics

ADOPTION OF ELECTRONIC MEDICAL RECORD (EMR) SYSTEMS by hospitals is occurring at a steady pace. That’s one recent finding by the Health Information and Management Systems Society (HIMSS).

In a statement made on February 17, HIMSS officials said that 46% of the nation’s hospitals had achieved Stage 3 in their use of EMRs. This stage requires: a) nursing/clinical documentation (flow sheets); b) a clinical decision support system (CDSS); and, c) a PACS that is available outside the radiology department.

Survey Of 5,299 Hospitals

These findings were based on a third quarter, 2011 survey of 5,299 hospitals. The data was gathered for the EMR Adoption Model (EMRAM) that is maintained by HIMSS Analytics.

At the extremes, the survey determined that only 1.1% of hospitals have achieved Stage 7 of EMR use. This is full adoption as defined by the EMRAM’s eight stages (0 through 7) and is recognized only after a site visit from officials of HIMSS Analytics.

At the other extreme, there are about 10% of the nation’s hospitals which have yet to start with EMR adoption—or are still in Stage 0, according to EMRAM findings.

Adoption of EMRs by hospitals represents a major operational development which requires the hospital’s laboratory to integrate its laboratory information system (LIS) to the needs of the institution’s EMR system.

Implementing a full-function EMR is a daunting challenge, and the EMRAM data demonstrates that. “It is clear, from looking at the model, that Stages 4, 5, 6 and 7 are the more difficult ones,” observed John Hoyt, Executive Vice President of HIMSS Analytics. “The numbers drop off drastically from Stage 3, which is 46% of the hospitals, to Stage 4, which is just 13% [of hospitals].”

Hoyt says that the major jump comes when hospitals implement computer physician order entry (CPOE). The next mile- stone is physician entry of notes. He says that it is best for hospitals not to attempt that until the nurses are supportive of the EMR and good users of the system.

Achieving Paperless Records

Achieving the eighth stage of the HIMSS Analytics’ EMR adoption model would mean that the hospital is operating with a true paperless patient record. In these situations, pathologists and laboratory scientists would benefit from having real time access to the complete patient record as they review clinical laboratory test results and prepare the release of lab test reports or provide consultative support to the referring physicians. The HIMSS Analytics’ findings show that most hospitals still have much implementation work to accomplish before achieving full adoption of their EMR.


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