Literature Review and Synthesis: Existing Surveys on Health Information Technology, including Surveys on Health Information Technology in Nursing Homes and Home Health. Literature Review and Synthesis: Existing Surveys on Health Information Technology, including Surveys on Health Information Technology in Nursing Homes and Home Health : Table 6

02/01/2009

: Table 6

LevelCriteria% of US Hospitals
Stage 7  The hospital has a paperless EMR environment. Clinical information can be readily shared via electronic transactions or exchange of electronic records with all entities within a regional health network (i.e., other hospitals, ambulatory clinics, subacute environments, employers, payers and patients).0.0
Stage 6Full physician documentation/charting is implemented for at least one patient care service area. Clinical decision-support provides guidance for all clinician activities related to protocols and outcomes in the form of variance and compliance alerts. A full complement of radiology picture archiving and communication systems provides medical images to physicians via an intranet and displaces all film-based images.0.1
Stage 5The closed loop medication administration environment is fully-implemented in at least one patient care service area. The eMAR and bar coding or other auto identification technology, such as radio frequency identification (RFID), are implemented and integrated with CPOE and pharmacy to maximize point of care patient safety processes for medication administration.0.5
Stage 4CPOE for use by any clinician is added to the nursing and CDR environment along with the second level of clinical decision-support capabilities related to evidence based medicine protocols. If one patient service area has implemented CPOE and completed the previous stages, then this stage has been achieved.1.9
Stage 3Clinical documentation required, nursing notes, care plan charting, and/or the e-MAR system are implemented and integrated with the CDR for at least one service in the hospital. The first level of clinical decision-support is implemented to conduct error checking with order entry (i.e., drug/drug, drug/food, drug/lab conflict checking normally found in the pharmacy). Some level of medical image access is available for access by physicians via the organization’s Intranet or other secure networks outside of the radiology department confines.8.1
Stage 2CDR provides physician access for retrieving and reviewing results, clinical decision-support, may have Document Imaging49.7
Stage 1Laboratory, pharmacy, and radiology are implemented20.5
Stage 0Some clinical automation present, but laboratory, pharmacy, and radiology are not implemented19.3