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Virtual Conference: Hospitals making progress in EMR adoption

By Jack Beaudoin

More than four in 10 hospitals stand a good chance of meeting the American Recovery and Reinvestment Act's meaningful use criteria in 2011, according to the latest data from HIMSS Analytics.

In an educational session Wednesday at the Healthcare Finance News Virtual Conference titled "A Roadmap for EMR Adoption: Ensuring Meaningful Use," HIMSS Analytics President and CEO Dave Garets unveiled Q3 2009 data showing that just more than 40 percent of hospitals had reached Stage 3 on the HIMSS Analytics EMR Adoption Model. That's up 5 percentage points from 2008 data and about 30 percentage points higher than data obtained just a few years ago, he said.

In the HIMSS Analytics model, Stage 3 hospitals typically use some nursing documentation, such as flow sheets and vital signs, clinical decision support to conduct error checking with order entry and PACS availability outside the radiology department via the organization’s Intranet.

"It's likely that in 2011 Stage 3 hospitals will meet the government's meaningful use criteria to qualify for ARRA incentives," Garets said, while reminding his audience that the definition of "meaningful use" has yet to be finalized. Furthermore, the meaningful use "bar" will rise in subsequent years.

As part of the ARRA legislation passed in February, the federal government set aside nearly $20 billion in incentives for hospitals and physician practices adopting electronic medical records. The first incentives will be paid in 2011 based on 2010 performance. Medicare and Medicaid could penalize providers who are not using certified EHRs by 2015.

The pinnacle of EMR adoption is Stage 7, in which hospitals have a completely paperless environment, using EMRs, continuity of care documentation, data warehouses and data continuity between the emergency department, ambulatory care facilities and other outpatient providers. Garets said only about two dozen hospitals in the United States have reached this level of automation.

Other indicators of increasing adoption include Stage 4 hospitals, which grew from 2.5 percent of all hospitals in 2008 to 4.1 percent in Q3 2009. These hospitals have deployed computerized practitioner order entry (CPOE) for use by any clinician, in addition to the nursing and CDR environment and with the second level of clinical decision support capabilities related to evidence based medicine protocols.

The percentage of Stage 5 hospitals has nearly doubled from just 2.5 percent to 4.8 percent. Stage 5 hospitals include all the automation of the lower stages but add closed loop medication administration, maximizing point of care patient safety processes. "This may be the hardest jump," Garets noted.

Overall, nearly half (49 percent) of American hospitals have yet to reach Stage 3 on the EMR Adoption Model.

"Where we are right now is shameful," Garets conceded. "But I believe the number of organizations implementing systems will drive disruptive innovations ... and make it easier to adopt."

The Healthcare Finance News Virtual Conference continues Thursday. To join, point your browser to http://www.himssvirtual.org/hfn/index.asp