Apparently, Hospital EHR Use Still Has A Long Way To Go

Posted on August 20, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

It’s fairly easy to look back at the progress hospitals have made with EHR use and be impressed. In less than 10 years, most hospitals have gone from largely paper-based processes to relying on EHRs to support a wide range of clinical processes. Even given that hospitals got meaningful use incentives for EHR adoption it’s still a big deal.

That being said, we’ve still got a long way to go before hospitals exploit EHRs fully, according to a new research study. The study, which appears in the Journal of Medical Internet Research, concludes that it will take until 2035 for the majority of hospitals to put a fully mature EHR infrastructure in place.

To conduct the study, researchers relied on the HIMSS Electronic Medical Record Adoption Model (EMRAM) dataset, which ranks a hospital’s adoption of varied EHR functions considered important to hospital care quality and efficiency. The researchers sifted through EMRAM data for 2006 to 2014 and then leveraged them to predict future adoption levels through the year 2035.

After analyzing the data, the research team found that the majority of US hospitals were in EMRAM Stages 0, 1 and 2 in 2006 and that by 2014, most hospitals had achieved Stages 3, 4 and 5. Having analyzed this data, researchers predicted that Stage 5 use should peak by 2019 and Stage 6 levels of use by 2026.

Where things really start to get interesting is the path from Stages 5, 6 or 7 EMRAM. The study concluded that while most hospitals would reach these stages by 2020, a “considerable” share of hospitals won’t achieve Stage 7 by 2035.

It’s no surprise to read that as the level of sophistication needed grows, the number of hospitals that have achieved it tails off, with just a few likely to hit the prized Stage 7 in the near future. Developing a mature infrastructure calls for an infusion of time, talent and funding, and even resource-rich health systems might not have all three at the same time.

Also, given that one of the key requirements of Stage 7 is having interoperability functionalities in place, it’s easy to see why many hospitals won’t get there anytime soon. Heck, there’s good reason to wonder whether the bulk of hospitals will ever achieve interoperability, at least as it’s currently defined.

But do we need to measure everything by EMRAM standards? I don’t know, but it does seem that the question worth asking after defaulting to these measures for many years.

Don’t get me wrong – I’m not an EMRAM critic. It certainly seems to have done a good job of tracking hospital EHR progress for quite some time and it can be used by leaders to create a common goal for a healthcare organization. On the other hand, if it predicts that it will take more than a decade for hospitals to develop a mature EHR ecosystem, despite their pouring endless resources into the game, maybe it’s worth reevaluating this model. Just a thought.