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How Hospitals Define Value through Health IT

A review of value based on quality improvement

H Stephen Lieber

H Stephen Lieber

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Steve Lieber is President and CEO of HIMSS, a global, cause-based, not-for-profit organisation focused on better health through information technology. A recognized healthcare management executive, Lieber brings to the HIMSS over 30 years of experience in healthcare, primarily in healthcare association management. He joined HIMSS in 2000 as CEO/President of the organisation.

How do hospitals define value related to quality improvement? The Electronic Medical Record Adoption ModelSM (EMRAM) is an eight-step process hospitals can use to analyse their organisation’s level of EMR adoption, chart accomplishments, and benchmark against other healthcare organisations across the country. This article will describe the model and include examples of Stage 6 and Stage 7 hospitals in Asia and other parts of the world that have demonstrated quality improvement (not profitability), improved patient outcomes, reduction of errors, and patient safety through the use of information technology.

The vision of improving health with information technology has been the focus of Healthcare Information and Management Systems Society (HIMSS) since its establishment in 1961.  Now, as a mission-driven, not-for-profit and global enterprise, HIMSS continues to focus on leveraging healthcare information technology (IT) to improve patient outcomes, reduce costs and expand access to healthcare with offices in the United States, Europe and Asia.

HIMSS leads efforts to improve health with IT solutions through thought leadership, education, events, market research and media services around the world. The organisation includes more than 60,000 individuals, of which more than two-thirds work with healthcare providers, governmental and not-for-profit organisations across the globe, plus over 650 corporations and 350 non-profit partner organisations, that share this cause. Headquartered in Chicago, Illinois, USA, HIMSS has offices and activities in Europe, Asia, Middle East, and Latin America.

Recognised as a global partner and advisor for governments and organisations, HIMSS employs 350 staff members worldwide and hosts more than 100 events across the globe and another 100+ online educational events and webinars. The largest events, from attendance perspective, are the United States (38,000+), Europe (3,000+) and the Middle East (2,000+). 

The HIMSS analytics measurement model – EMRAM

As the market research business unit within the HIMSS organisation, HIMSS Analytics collects data about information systems  deployed in healthcare systems in the US and Canada on a census basis, and on a sample basis in Asia, Europe, Latin America and the Middle East.

In 2005, HIMSS Analytics decided to use the collected data to ‘score’ each hospital based on the hospital’s sophistication in using EMR technologies. This data populates the Electronic Medical Record Adoption ModelSM (EMRAM).

The EMRAM is an 8-step process reflecting the typical manner by which hospitals rollout enterprise clinical systems from a largely paper-based environment (Stage 0) through to a highly advanced EMR environment (Stage 7). Using the EMRAM, hospitals and health systems are able to track their health IT implementation progress against healthcare organisations across Asia and other parts of the world and view all scores in the HIMSS Analytics® Database.

Reaching stage 7 on the EMR adoption model

Hospitals must follow several steps to earn the Stage 7 designation. Participation in the HIMSS Analytics Asia-Pacific Annual Study allows hospitals to receive their EMRAM score through the collection of specific health IT data. This data tracks implementation and adoption of EMR applications through each stage of the EMRAM. Hospitals receive validation of Stage 6 with phone interview followed by an on-site review by a HIMSS executive or regional designate. The Stage 7 review includes an on-site visit by a HIMSS-lead team, including a physician, to confirm this highest level of health IT adoption.