In 2010, Seoul National University Bundang Hospital made digital health history by being the first hospital outside of the United States to achieve Stage 7 for the HIMSS Electronic Medical Record Adoption Model. 

Over a decade later, the hospital still holds on to the validation – acing its fourth evaluation for the model in December last year. 

The EMRAM measures the clinical outcomes, patient engagement, and clinician use of EMR technology in a hospital or health facility. A HIMSS Stage 7 status is valid for three years for any maturity model; organisations will need to undergo a revalidation to retain it. 

A commitment to effective use of EMR technology

According to Dr Rohini Omkar Prasad, one of the validators from HIMSS, SNUBH places a strong emphasis on the use of data and dashboards to improve operational parameters and the care it provides. 

"Robust clinical governance ensures the order sets, templates, clinical, pathways and alerts are always current and effective, and appropriate for the relevant departments," she added.

The hospital uses a fully integrated EMR system, complemented by advanced tools such as its next-generation Clinical Data Warehouse (CDW 3.0). Special attention was drawn to this repository during the validation.

"The CDW 3.0 is a powerful tool at SNUBH that consists of a research platform, clinical indicators, and department management components. The search capabilities and the rate at which results were generated is impressive. The research CDW or research engine capable of statistical analysis was also an excellent tool made available to clinicians to conduct research and improve care."

Dr Rohini Omkar Prasad, Digital Heath Strategist, HIMSS

Junghan Song, president and CEO of SNUBH, says the pursuit of the EMRAM validation signals the hospital’s dedication to quality improvement, enhancing safety, and providing efficient healthcare while adhering to international standards. 

"Successfully meeting the rigorous and high standards set by HIMSS in each evaluation cycle, SNUBH reaffirms its position not only as a leader in current healthcare standards but as a hospital constantly striving for higher levels. The robust HIMSS validation serves as the foundation for SNUBH’s commitment to leading global healthcare standards."

Junghan Song, President, CEO, and Head of Healthcare, SNUBH

Gearing up for a validation

For the hospital, a proactive approach has been key to its successful revalidations. 

"Preparation for the EMRAM validation is an ongoing process at SNUBH. We consistently review and upgrade our systems to meet the latest HIMSS standards. Our dedicated team conducts regular internal audits, training sessions, and system optimisations to ensure readiness for validation," said Dr Hoyoung Lee, director of Research and Development and former CIO at SNUBH.

He added that the team reviewed past HIMSS EMRAM surveys and result reports, analysed the necessary content for each area, and written scenarios according to the HIMSS EMRAM guidelines. The demonstration team, comprising experts in each area of the validation, completed verification preparation through testing, rehearsals, and other processes based on the prepared scenarios. This process is helpful not only for HIMSS validations but for other certifications as well. 

"To prepare for the latest EMRAM assessment, we focused on enhancing patient engagement strategies, including the development of our patient portal, Health4U. We also improved our data analytics capabilities to meet the stringent standards of the HIMSS Stage 7 validation, emphasising the use of real-time data in clinical decision-making."

Dr Hoyoung Lee, Director of Research and Development and former CIO, SNUBH

Seeing the fruits of their labour

SNUBH is able to quantify the results of its investment into digital transformation through outcomes seen at the hospital – from patient satisfaction to enhanced research capabilities to operational efficiencies. 

For instance, the robotic automation process has been helpful for research data abstraction in the EMR, allowing the hospital to focus on improving medical quality. 

"RPA was introduced for the creation of stomach and breast cancer registries, resulting in the reduction of work hours by up to 74% for each cancer type," said Sooyoung Yoo, director, Healthcare ICT Research Center, SNUBH. 

The Health4U patient portal, introduced in 2022, has enhanced patient engagement and self-care. Since its launch, the hospital has seen a 30% increase in patient portal registrations, leading to better management of patient health outcomes and a 15% improvement in patient satisfaction scores.

Additionally, the development of a nationwide medication history sharing program has helped to make the complete identification of prescription-only medicines (POMs) more accurate and efficient, allowing emergency department (ED) clinicians to serve incoming patients better.

"First, the timely identification of POMs within 24 hours of an ED visit significantly improved from 26 patients in the four-month pre-intervention period to 776 patients in the three-month post-intervention period (p<0.001). Second, the time from initial ED assessment to urgent percutaneous coronary intervention initiation was significantly reduced with querying the program by the clinicians (17.2±12.4 mins vs. 10.3±11.0 mins, p=0.037)."

Sooyoung Yoo, Director, Healthcare ICT Research Center, SNUBH

"We believe that the program improved the decision-making process in the ED to establish subsequent care plans and supported healthcare professionals as an effective and responsible hands-off process," she said.