Free Hospital EMR and EHR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to Hospital EMR and EHR for FREE!

Hospital EMR Adoption Divide Widening, With Critical Access Hospitals Lagging

Posted on September 8, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

I don’t know about you, but I was a bit skeptical when HIMSS Analytics rolled out its EMRAM {Electronic Medical Record Adoption Model) research program. As some of you doubtless know, EMRAM breaks EMR adoption into eight stages, from Stage 0 (no health IT ancillaries installed) to Stage 7 (complete EMR installed, with data analytics on board).

From its launch onward, I’ve been skeptical about EMRAM’s value, in part because I’ve never been sure that hospital EMR adoption could be packaged neatly into the EMRAM stages. Perhaps the research model is constructed well, but the presumption that a multivariate process of health IT adoption can be tracked this way is a bit iffy in my opinion.

On the other hand, I like the way the following study breaks things out. New research published in the Journal of the American Medical Informatics Association looks at broader measures of hospital EHR adoption, as well as their level of performance in two key categories.

The study’s main goal was to assess the divide between hospitals using their EHRs in an advanced fashion and those that were not. One of the key steps in their process was to crunch numbers in a manner allowing them to identify hospital characteristics associated with high adoption in each of the advanced use criteria.

To conduct the research, the authors dug into 2008 to 2015 American Hospital Association Information Technology Supplement survey data. Using the data, the researchers measured “basic” and “comprehensive” EHR adoption among hospitals. (The ONC has created definitions for both basic and advanced adoption.)

Next, the research team used new supplement questions to evaluate advanced use of EHRs. As part of this process, they also used EHR data to evaluate performance management and patient engagement functions.

When all was said and done, they drew the following conclusions:

  • 80.5% of hospitals had adopted a basic EHR system, up 5.3% from 2014
  • 37.5% of hospitals had adopted at least 8 (of 10) EHR data sets useful for performance measurement
  • 41.7% of hospitals adopted at least 8 (of 10) EHR functions related to patient engagement

One thing that stood out among all the data was that critical access hospitals were less likely to have adopted at least 8 performance measurement functions and at least eight patient engagement functions. (Notably, HIMSS Analytics research from 2015 had already found that rural hospitals had begun to close this gap.)

“A digital divide appears to be emerging [among hospitals], with critical-access hospitals in particular lagging behind,” the article says. “This is concerning, because EHR-enabled performance measurement and patient engagement are key contributors to improving hospital performance.”

While the results don’t surprise me – and probably won’t surprise you either – it’s a shame to be reminded that critical access hospitals are trailing other facilities. As we all know, they’re always behind the eight ball financially, often understaffed and overloaded.

Given their challenges, it’s predictable that critical access hospitals would continue lag behind in the health IT adoption curve. Unfortunately, this deprives them of feedback which could improve care and perhaps offer a welcome boost to their efficiency as well. It’s a shame the way the poor always get poorer.

25% Of Hospitals Stalled On EMR Progress

Posted on October 22, 2013 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As most readers know, HIMSS has developed a proprietary scale which it uses to track how far along hospitals are in their EMR adoption process.

As I discussed previously, the predictable has happened when it comes to progress. Hospitals with extensive resources, notably academic medical centers and large suburban chains, have climbed the eight-step ladder of the scale, known as the HIMSS Analytics EMR Adoption Model (EMRAM), while smaller and rural facilities have moved more slowly.

Now, there’s evidence suggesting that making progress on EMRAM is harder than it seemed previously. New research from HIMSS comparing quarterly EMRAM progression of 4,811 hospitals during the last five years (Q2 2008 and Q2 2013) has concluded that a surprising number of hospitals are basically stuck in place.

The new report has found that 73.7 percent of  U.S. hospitals have advanced by at least one stage over the past five years, and that half of those who advanced climbed the scale by two or three stages. Another 20 percent of those advancing moved up four or more stages during the five-year period studied.

Right now, the largest number of hospitals (at 34.5 percent at Q2 2013) fall into EMRAM stage 3, which includes nursing/clinical documentation, CDSS (error checking) and PACS available. Stage 4 through 6 account for 43.3 percent all together, the most populated level being stage 5, closed loop medication administration, with 18.7 percent.

That being said, 25 percent of hospitals had made no progress whatsoever over the last five years. What’s more, four percent of hospitals have remained at EMRAM stage 0 (completely paper-based). As I see it, these are fairly surprising results given the Meaningful Use pressures hospitals face.

Meanwhile, only 2.1 percent of hospitals had what HIMSS Analytics regards as a “complete EMR” — one which includes CCD transactions to share data, data warehousing and data continuity with the ED — in place as of the second quarter of this year.

So, how’s your facility doing?  Is it able to progress toward higher EMR goals? Or is it mired down with the 25 percent?

Hospitals Slowly Moving Toward Stage 1 of Meaningful Use

Posted on February 18, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new report from HIMSS Analytics concludes that the inevitable is happening, but slowly. According to researchers, who reported their findings in December 2011, virtually all categories of hospitals are showing greater ability to achieve Meaningful Use Stage 1, including:

*  Academic medical centers

*  General med/surg hospitals

*  Hospitals with 400 to 499 licensed beds

*  Hospitals with 500+ licensed beds

*  Urban  hospitals

*  Multi-hospitals

*  Hospitals already at Stage 5, 6 and 7 on the HIMSS Analytics EMR Adoption Model (EMRAM)

According to HIMSS researchers, hospitals in the seven categories above are moving faster than their peers when it comes to IT adoption.  Hospitals at the high end of EMRAM are moving up more quickly, as well.  As hospitals geared up to meet Stage 1, researchers say, the number of hospitals at stages 6 and 7 of EMRAM is growing as well.

As we’ve previously noted here, however, calling this a success would be looking at the nearly empty glass as half-full.  Even HIMSS admits that only five percent of hospitals have achieved Stage 6 of the EMRAM model (give or take) and just 1.2 percent are at EMRAM Stage 7.

There is at least a little bit of good news.  Of the 585 hospitals surveyed by HIMSS,  about half are ready, most likely to be ready or somewhat likely to be ready to collect incentive payments this year.

The hospitals that reported being “somewhat likely” had achieved at least two menu items, and between five and nine of the core items needed to qualify for incentives.

But  hospitals with less than 100 beds — generally rural, critical access hospitals — are not doing even as well as their peers. Only 20 percent told HIMSS that they were ready or most likely to meet Stage One goals.

By the way, the HIMSS research included one discomfiting side note, on security. Of the 585 hospitals that weighed in, just 25 percent said that they protected EHR data by conducting and reviewing a security risk analysis, doing needed suricty updfates and correcting security deficiencies. Oops — there goes compliance witih 45 CFT 164.308 (a) (1), the relevant HIPAA security rule. But that’s a tale for a different blog item, isn’t it, folks?