In the context of healthcare information technology, the HIMSS (Healthcare Information and Management Systems Society) has developed a framework known as the HIMSS Analytics EMR Adoption Model (EMRAM) to assess the level of electronic medical record (EMR) adoption and maturity within healthcare organisations, including the NHS.
The HIMSS EMRAM consists of eight stages 0-7:
Stage 0: Trust that hasn’t yet implemented an EMR system.
Stage 1: Has implemented an EMR system in a limited capacity.
Stage 2: Expanded the use of EMR systems across multiple departments and is considered to have more comprehensive electronic documentation.
Stage 3: Achieved a higher level of integration and data sharing between departments and functionalities, enabling improved clinical processes.
Stage 4: Implemented advanced clinical decision support tools and are using data insights to improve quality.
Stage 5: Achieved sophisticated clinical decision support integration. They are engaging with data with a focus on performance.
Stage 6: Achieved a near-paperless environment, with clinical data used throughout patient care.
Stage 7: Achieved a fully optimised and integrated EMR system. Has sophisticated data-driven processes and data analytics that support continued healthcare transformation.
In 2022, the Health secretary at the time Sajid Javid announced that the government set the NHS EMRAM targets:
90% of NHS trusts to have an EPR in operation by December 2023
The additional 10% must be within the implementation lifecycle
The government is prioritising the EPR agenda within the NHS, ensuring that trusts progress through the stages of the EMRAM to achieve standardisation and consistency throughout the NHS transforming outcomes for patients across the UK and Ireland.
A year has passed since the targets were set. There have been growing fears that trusts still have some way to go and that early adopters of the EPR technologies could be prioritising implementing an EPR without the right emphasis on scaling through the stages.
Oracle Cerner UK VP, Distie Profit, has recently spoken out about the dangers of approaching EPR (Electronic Patient Record) projects as solely IT projects. Profit warned how leading with this mentality severely caps the technological potential of newly implemented systems. By adopting this approach, what could end up happening instead, is that project teams could force existing processes where they are no longer fit for purpose. Whilst investing in an EPR system appears to be a huge stride forward, limiting its capabilities with outdated processes could seriously impact the intended revolutionary effect on patient care.
This being the case, it’s clear that viewing an EPR system in isolation is not in itself ‘transformation’. Instead, what a Trust must do, is enter into projects with true change and transformation as the goal. This starts with investments both financially and in the right project teams.
Looking to progress through the HIMSS stages and want to understand what skillsets are available in the market to enable you to do this? We are currently working throughout the NHS to support Trusts with planning and sourcing their EPR project teams, and we are in a position to support you too, wherever you are in the HIMSS roadmap.
