HIMSS Analytics has released a new EMR Adoption Model, focused on ambulatory facilities. The Ambulatory EMR Adoption Model (A-EMRAM) tracks IT adoption in more than 28,000 ambulatory facilities in the HIMSS Analytics Database that are part of a hospital or hospital system, such as physician practices, clinics outpatient centers and specialty clinics.

With more than 26 percent of healthcare expenditures related to ambulatory care, according to the Centers for Medicare &  Medicaid Services, HIMSS Analytics recognized a need for an ambulatory version of its hospital-targeted EMRAM, which was first developed in 2005.

[See also: Ohio State University Wexner Medical Center achieves Stage 7.]

The EMRAM scores hospitals in the HIMSS Analytics Database on their progress in completing eight stages – from Stage 0 to Stage 7 – toward creating a paperless patient record environment.


“We want to identify the vital health IT systems and best practices around the use of those systems, while at the same time provide industry research to help guide ambulatory facilities as they strive to adopt health IT systems that improve outcomes and patient convenience,” says John P. Hoyt, executive vice president of HIMSS Analytics.

HIMSS officials say software and healthcare providers reviewed the A-EMRAM during its development, providing valuable feedback and guidance to HIMSS Analytics in establishing realistic and achievable metrics for each stage.

Just as with hospitals, HIMSS Analytics will conduct an on-site visit of ambulatory facilities to verify a Stage 7 ranking.

The A-EMRAM offers a framework for dialogue on IT implementation not only in the United States, but also, in Canada, Europe, the Middle East and Asia, where HIMSS Analytics will use this tool.

[See also: HIMSS Analytics Europe to launch EMR Adoption Model in UK.]

“We want to ‘push the market’ because we believe ambulatory facilities should be able to reach Stage 7 with the health IT software now available in the marketplace," says Hoyt. "However, we also know it will take some time for these same facilities to achieve this level of sophistication, which requires participation in a health information exchange, use of a community medical record and analysis and application of clinical and business intelligence to help improve patient care.”

The A-EMRAM now measures those ambulatory facilities tethered to a hospital or hospital system, but it can be adapted to include independent physician practices and other untethered ambulatory sites, officials say.

[See also: Climbing the ladder: Step by step, inpatient EMRs are finding their level.]

As the current data on the A-EMRAM indicates, of the 9,247 ambulatory facilities now reporting data in the HIMSS Analytics database, none is at Stage 7 and just 1.2 percent rank at Stage 6. More than one-third of them (34 percent) have achieved Stage 2.

Nearly half (48 percent) of those facilities are still at Stage 0, and based on paper charts.

Visit the HIMSS Analytics website for more information on the A-EMRAM.