4 Best Practices to Achieve Stage 7 in EMR Adoption: University of Iowa Hospitals & Clinics Case Study

Recently HIMSS Analytics gave the University of Iowa Hospitals & Clinics a stage 7 designation for its electronic medical record. There are eight stages (0 to 7) on HIMSS' EMR Adoption Model, which measures a hospital's implementation and utilization of information technology applications. The final stage — stage 7 — represents an advanced patient record environment.

"This designation is a positive reflection of the hard work and dedication of our clinicians and our information technology staff. We will continue that hard work to leverage our clinical information systems to improve the quality, safety and efficiency of care that we deliver to our patients every day," says Lee Carmen, CIO and associate vice president for IT at UI Hospitals & Clinics.  

According to Mr. Carmen, UI Hospitals & Clinics followed four best practices to optimize its EMR system. While it is important to recognize that not all organizations are the same, and what worked for UI Hospitals & Clinics may not work for others, these four practices may act as a guide for other hospitals hoping to receive a level 7 designation of their EMR.

1. Deploy a strategy driven by clinical outcomes, patient safety goals. According to Mr. Carmen, UI Hospital & Clinics' strategy for deploying its advanced clinical IT system has been driven by the goal of improving clinical outcomes and patient safety. "It is not something we are doing for recognition, because all other academic medical centers are doing it or because it will generate revenue. We are doing it because it is one of the right strategies to deliver better and safer care," says Mr. Carmen. IT implementations can be long, complex and difficult. Hospitals that are driven by offering better care, may find it easier to motivate staff and physicians, especially through challenges and changes in workflow.

"It is about making sure that everyone knows the system is implementing the EMR for the better of patients. For us, that was the right rallying point," says Mr. Carmen.

2. Select a vendor that is well-suited to the hospital or health system. There are a variety of clinical information systems on the market. Since each health system has different needs, Mr. Carmen recommends carefully selecting an EMR vendor to ensure it is well-suited for the hospital. "As we went down this road, we were very fortunate that we selected a system vendor that was well-suited for us. We went through almost a year-long process back in 2006, and we ended up selecting a big system that we have forged a good relationship with. It is really hard to [implement an advanced EMR] if you do not have the right tools," says Mr. Carmen.

3. Develop strong relationships with clinicians. In order for the EMR adoption to be a clinical improvement project, involvement from physicians and nurses is important. Mr. Carmen cites the relationships his IT team formed with clinicians, as well as the strength of those clinicians, as a key to the health system's success.

"We have a really strong set of nurses who focus on nursing informatics to work with us. We have a phenomenal team of physicians. With their assistance we have exceeded in making these projects clinical quality and safety projects," says Mr. Carmen.

Furthermore, when physicians and nurses are deeply involved in the project, the implementation is more effective. "They can give the IT staff direct feedback — what to do; what not to do; how much change to implement at one time; and how to prioritize certain functional enhancements. All of those things have been invaluable," he adds.

4. Form an experienced IT team. A strong IT team can navigate a hospital or health system through the inevitable challenges and changes that arise. Mr. Carmen recommends building a team of individuals that are experienced and knowledgeable with not only IT but the hospital as well. "I'm very fortunate that I have a phenomenal IT team. We are unique in that we have very long years of service on our team," says Mr. Carmen. "Two of my division directors have over 30 years each at UI Hospitals & Clinics. They know the people; they know the needs," he says.

The IT specialists at UI Hospitals & Clinics have a rich history of using sophisticated information systems to support the institution's commitment to providing patient-focused care. By advocating for and following the above four practices, UI Hospitals & Clinics was able to create an environment devoted to innovative care, patient safety and exceptional outcomes as well as develop a strong partnership between IT and clinical staff. Hospitals and health systems that want to reach stage 7 to be at the forefront of utilizing advanced EMR systems should consider applying these best practices.

More Articles on EMR Adoption:

University of Iowa Hospitals and Clinics Reaches Stage 7 in EMR Adoption
Security Fears Blunt Patient Acceptance of EHRs
Risk Assessments – What's the Big Deal? Your Responsibilities If You Adopt Electronic Health Records

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