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EMR Adoption ModelSM

HIMSS Analytics, the authoritative source on EMR Adoption trends, devised the EMR Adoption Model to track EMR progress at hospitals and health systems.  The EMRAM scores hospitals in the HIMSS Analytics Database on their progress in completing the 8 stages to creating a paperless patient record environment. 

EMR Adoption Model Structure Ensures Objectivity

  • All application capabilities within each stage must be operational before that stage can be achieved.
  • All lower stages must have been achieved before a higher level will be considered as achieved. 
  • A hospital can achieve Stages 3-6 if it has met all of the application requirements for a single patient care service (e.g. single nursing floor, cardiology service).   
  • Using the rules above, additional points are given for the implementation of applications in stages higher than the one fully achieved by the healthcare organization. In this fashion, other implementation paths than those prescribed by the stages can be taken into consideration for correlation with quality and financial research. 

Read a detailed description of the stages

Please note that we have made important changes to the EMR Adoption Model which impacts the Stage 7 evaluations. These changes have been in place since September 14, 2009 and will effect EMRAM scoring moving forward. Minor clarifications were also made to Stages 2 and 3. The modifications are summarized here for your convenience.

 

EMR Scores by Hospital Type, 3rd Quarter 2011

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Hospital Type Segment

Mean

Min

Max

Median

Number

Academic/Teaching 4.2111 1.2860 7.0710 4.2470 221
NonAcademic 3.0901 0.0000 7.0710 3.2600 5,078
General Medical/Surgical 3.4286 0.0000 7.0710 3.3310 3,161
Others 2.7056 0.0000 7.0710 3.1350 2,138
Rural 2.3608 0.0000 7.0390 3.0400 1,251
Urban 3.3767 0.0000 7.0710 3.3200 4,048
IDS 3.3029 0.0000 7.0710 3.3030 3,306
Independent Hospital 2.8615 0.0000 7.0630 3.1990 1,993
Critical Access 2.3872 0.0000 6.0550 3.0720 1,323

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Hospital Type Segment

Mean

Min

Max

Median

Number

Academic/Teaching 2.3081 0.0200 6.0550 2.3080 73
NonAcademic 1.7854 0.0000 6.0320 2.0950 568
General Medical/Surgical 1.7746 0.0000 6.0320 2.0950 551
Others 2.2750 0.0200 6.0550 2.2845 90

EMR Scores by Bed Size, 3rd Quarter 2011

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Bed Segment

Mean

Min

Max

Median

Number

0-100 Beds 2.6328 0.0000 7.0630 3.1200 2,759
101-200 Beds 3.3981 0.0000 7.0710 3.3150 973
201-300 Beds 3.7498 0.0100 7.0710 3.4080 610
301-400 Beds 3.8064 0.1900 7.0710 3.4150 405
401-500 Beds 3.8185 2.0150 7.0390 3.4410 215
501-600 Beds 4.0942 2.1700 7.0710 3.5090 149
600+ Beds 4.2120 2.1020 7.0710 4.2235 188

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Bed Segment

Mean

Min

Max

Median

Number

0-100 Beds 1.5817 0.0000 6.0080 2.0550 440
101-200 Beds 2.2001 0.0000 4.2160 2.1910 79
201-300 Beds 2.2012 0.0200 5.1810 2.2470 41
301-400 Beds 2.7577 0.1300 6.0320 3.0880 37
401-500 Beds 2.6634 0.0720 6.0550 2.6530 16
501-600 Beds 2.7317 1.2230 4.2160 3.0520 12
600+ Beds 2.8208 1.0720 4.3700 3.2100 16

EMR Scores by Region, 3rd Quarter 2011

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Regions
(U.S. Census Defined)

Mean

Min

Max

Median

Number

East North Central 3.3991 0.0000 7.0710 3.3160 839
East South Central 2.8580 0.0000 6.0710 3.2000 442
Middle Atlantic 3.4383 0.0050 7.0390 3.3150 486
Mountain 2.7394 0.0000 7.0630 3.1560 419
New England 3.8923 0.1110 7.0630 3.4595 200
Pacific 3.3311 0.0000 7.0710 3.2710 584
South Atlantic 3.3794 0.0000 7.0710 3.3350 787
West North Central 2.9378 0.0000 7.0630 3.2350 708
West South Central 2.6678 0.0000 7.0390 3.1390 834

All Hospitals, 3rd Quarter 2011

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All Hospitals

Mean

Min

Max

Median

Number

Total 3.1369 0.0000 7.0710 3.2750 5,299

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All Hospitals

Mean

Min

Max

Median

Number

Total 1.8449 0.0000 6.0550 2.1040 641


EMR Scores by State/Province, 3rd Quarter 2011

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United States

Mean

Min

Max

Median

Number

Alaska 3.3329 0.0050 6.0710 3.2750 17
Alabama 2.9664 0.0000 5.1190 3.2520 99
Arkansas 2.6313 0.0050 6.0710 3.0750 86
Arizona 3.1642 0.0250 7.0630 3.2615 82
California 3.3571 0.0000 7.0710 3.2305 388
Colorado 2.7713 0.0150 6.0470 3.2495 84
Connecticut 3.9343 1.0790 6.0710 4.0960 34
District of Columbia 2.4858 0.0050 4.2770 3.0970 10
Delaware 4.1829 2.4580 7.0470 3.6050 9
Florida 3.2695 0.0000 6.0710 3.3320 239
Georgia 3.1888 0.0000 6.0710 3.3350 155
Hawaii 2.5397 0.0050 6.0480 2.1510 25
Iowa 3.4053 0.0050 6.0710 3.3680 121
Idaho 2.7576 0.0000 6.0150 3.1840 43
Illinois 3.5352 0.0450 7.0710 3.3600 199
Indiana 3.4674 0.0050 6.0710 3.3390 137
Kansas 2.2425 0.0000 6.0480 3.0750 137
Kentucky 3.0084 0.0580 6.0710 3.2350 104
Louisiana 2.5083 0.0050 6.0710 3.1395 144
Massachusetts 4.0049 0.1250 7.0630 3.4870 81
Maryland 3.8939 1.0710 6.0630 3.4155 48
Maine 3.9510 2.0950 6.0480 4.1550 35
Michigan 3.2511 0.0050 6.0710 3.2195 160
Minnesota 3.4272 0.0000 7.0630 3.2980 133
Missouri 3.4470 0.0050 7.0310 3.4000 133
Mississippi 2.3038 0.0050 6.0710 2.1620 99
Montana 1.7363 0.0000 6.0240 1.7300 56
North Carolina 3.3421 0.0100 6.0710 3.3220 122
North Dakota 2.0412 0.0000 5.1350 2.1470 45
Nebraska 2.5447 0.0000 6.0550 3.1240 87
New Hampshire 3.1196 0.1110 6.0470 3.2600 25
New Jersey 3.4309 0.0550 6.0710 3.3150 85
New Mexico 2.8459 0.0000 6.0310 3.1240 37
Nevada 2.4048 0.0000 4.2670 3.1550 41
New York 3.4579 0.0050 6.0710 3.2870 203
Ohio 3.2535 0.0000 6.0710 3.3120 207
Oklahoma 2.4634 0.0000 6.0710 3.0750 118
Oregon 3.3854 0.0420 7.0230 3.3350 61
Pennsylvania 3.4214 0.0050 7.0390 3.3350 198
Rhode Island 4.3605 1.3230 6.0710 4.2610 11
South Carolina 3.4575 0.1300 6.0710 3.3910 71
South Dakota 2.5621 0.0000 6.0470 3.1435 52
Tennessee 3.0614 0.0000 6.0710 3.2720 140
Texas 2.7711 0.0000 7.0390 3.1870 486
Utah 3.2554 0.0000 6.0710 3.3750 49
Virginia 3.9711 0.0790 7.0710 3.4190 84
Vermont 4.0035 1.0710 6.0710 3.5250 14
Washington 3.3992 0.0050 6.0710 3.3590 93
Wisconsin 3.5267 0.0000 7.0710 3.3250 136
West Virginia 3.0150 0.0100 6.0470 3.2000 49
Wyoming 2.8278 0.0150 6.0310 3.1470 27
Proprietary & Confidential to HIMSS Analytics™ LLC

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Canada

Mean

Min

Max

Median

Number

Alberta 2.5762 1.1150 3.2120 3.0240 96
British Columbia 2.4670 0.0180 6.0080 3.0600 81
Manitoba 0.6043 0.0000 4.3220 0.0770 67
New Brunswick 3.0480 2.1230 4.2160 3.1420 20
Newfoundland and Labrador 2.4825 0.0550 3.2150 3.0950 30
Northwest Territories 0.1560 0.1540 0.1620 0.1540 4
Nova Scotia 2.5603 2.0560 3.2230 2.1710 33
Nunavut 0.5025 0.0050 1.0000 0.5025 2
Ontario 2.3229 0.0000 6.0550 2.2775 124
Prince Edward Island 2.2530 2.2050 2.2610 2.2610 7
Quebec 1.2535 0.0000 4.2000 1.0760 116
Saskatchewan 0.3223 0.0000 2.1040 0.0300 59
Yukon Territory 2.5855 2.0630 3.1080 2.5855 2
Proprietary & Confidential to HIMSS Analytics™ LLC

EMRAM Trended, Summary

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EMRAM Trended 2011 Q2 2011 Q3
Stage 7 1.1% 1.1%
Stage 6 4.0% 4.4%
Stage 5 6.1% 7.1%
Stage 4 12.3% 13.2%
Stage 3 46.3% 46.1%
Stage 2 13.7% 12.6%
Stage 1 6.6% 5.9%
Stage 0 10.0% 9.6%
Total Hospitals n = 5310 n = 5299

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EMRAM Trended 2011 Q2 2011 Q3
Stage 7 0.0% 0.0%
Stage 6 0.5% 0.5%
Stage 5 0.2% 0.2%
Stage 4 1.7% 2.3%
Stage 3 33.2% 34.5%
Stage 2 23.9% 22.0%
Stage 1 12.2% 14.4%
Stage 0 28.3% 26.2%
Total Hospitals n = 639 n = 641

EMRAM, Year Over Year

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EMRAM Trended 2009 2010
Stage 7 1.0% 1.0%
Stage 6 2.8% 3.2%
Stage 5 3.7% 4.5%
Stage 4 10.3% 10.5%
Stage 3 49.7% 49.0%
Stage 2 15.4% 14.6%
Stage 1 6.7% 7.1%
Stage 0 10.5% 10.1%
Total Hospitals n = 5233 n = 5281

 

EMR stages

 

 

If you are a healthcare provider and would like more information on how to obtain your hospital’s EMR score, e-mail us or call us at 866-546-2900.


Gap Analysis of ARRA Goals/Measurements to EMR Adoption Model and the New Ambulatory EMR Adoption Model This PowerPoint presentation provides a gap analysis evaluation for both hospitals and clinics relative to goals and measures for 2011, 2013, and 2015.