HIMSS publishes overview of market gaps to ARRA compliance

The Healthcare Information and Management Systems Society (HIMSS) Analytics unit has published a white paper, “The State of U.S. Hospitals Relative to Achieving Meaningful Use Measurements,” offering an overview of market gaps in relation to American Recovery and Reinvestment Act (ARRA) compliance.

“We created the mapping to provide insights for hospitals to help assess their EMR environments and strategies relative to current ARRA meaningful use measurements for 2011, 2013 and 2015,” said white paper author Mike Davis, executive vice president for the Chicago, Ill.-based not-for-profit organization. “It provides a market assessment of adoption of some of the more sophisticated EMR applications related to where we believe these applications will impact 2011, 2013 and 2015 measurements.”

HIMSS conducted a mapping between the ARRA meaningful use measurements and the stages of the HIMSS' EMR Adoption Model (EMRAM), a seven-stage implementation model.

The organization concluded that hospitals achieving Stage 3 of the EMRAM will be better positioned for the majority of upcoming 2011 requirements, if implemented across all inpatient nursing services. Stage 3 includes the cumulative capabilities of clinical documentation, error checking capabilities in a clinical decision support system (CDSS) and PACS available outside of radiology, according to the document. 

HIMSS concluded that it is unclear whether computer provider order entry (CPOE) will have to be implemented and used by physicians for meeting the 2011 requirements.

“Hospitals can survive this upcoming transformation of healthcare delivery,” Davis said. “To do so, they must understand how and why the use of EMRs support the delivery of patient care…and understand they need to use EMRs to collect, manage, share and analyze data to improve the process of care delivery and reduce medical errors.”

CPOE will need to be implemented with the majority of physicians, states the organization. Stage 4 of EMRAM includes the cumulative capabilities of CPOE and the clinical protocol capabilities of a CDSS. The society concluded that by 2013, hospitals will need to be at Stage 4 to meet requirements which will demand more effective data analysis, management and reporting.

By 2015, hospitals will need to be engaging in using a full CDSS (including variance and compliance), physician documentation and full PACS (Stage 6), while usable data warehousing and full EMR use (included in Stage 7) will be required to meet the requirements for the improvement of care coordination and population and public health, the paper concluded.

“Ultimately, the collection of more discrete data by the government across all patient care modalities will allow the U.S. to analyze larger clinical data sets that will drive evidence-based medicine protocols and best practice guidelines that have significant positive impacts on the cost and delivery of patient care,” the report noted. 

The final definition of meaningful use is yet to be determined. A proposed definition is expected by the end of the year, followed by a public comment period in early 2010.

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