Outpatient Electronic Medical Record Adoption Model (O-EMRAM)
The HIMSS Outpatient Electronic Medical Record Adoption Model (O-EMRAM) is used to assess EMR implementation for outpatient facilities of hospitals and health systems globally, guiding the data-driven advancement of facilities through EMR technology.
With the O-EMRAM, optimize the continuation of care for patients and populations outside the walls of the acute care setting, and ensure all care documentation is available online to the clinical team when and where they need it. Organizations can leverage the O-EMRAM to improve the person-enabled health and governance and workforce dimensions of digital health in the outpatient setting.
Assess the value provided to patients through the use of tools like patient portals, scheduling tools, lab test result alerts and communication platforms with care teams. Understand how your organization’s outpatient facility is communicating and measuring protocol adherence for patient registries. Expand the care capabilities for effectively facilitating virtual care and improved population health management.
Increase the efficiency of your EMR implementations in the outpatient setting based on your organizational and workforce goals. Assess how data is used to monitor and manage performance and outcomes so clinicians can make incremental operational improvements.
Create the governance needed to ensure outpatient EMR technology provides value, functionality and communication with disparate care teams to deliver the best possible patient outcomes.
Every health system is different, as are its goals. Use the O-EMRAM as a model to improve the use of resources; manage population health, especially for at-risk populations; improve medication administration; and use real-time data to lead the health system and its workforce toward improved outcomes.
- The ambulatory facility no longer uses paper charts.
- The EMR has a mixture of structured documentation; discrete data elements to drive analytics and clinical advice; data from connected intelligent medical devices, images, test results; etc.
- The organization is participating in health information exchange (HIE) with the same vendor systems as well as other vendors.
- Disaster recovery and business continuity plans exist and are tested routinely.
- System governance is solid and has a demonstrable history of solving problems and adapting to requested change.
- Business and clinical analytics are able to demonstrate improved patient care and improved population health through patient engagement.
- Advanced clinical decision support, such as protocols and pathways, are in use and can be demonstrated.
- Health status and preventive care reminder flags are set, in use and can be demonstrated.
- Evidence exists and results can be shown of the beneficial use of the patient engagement program, with improved health status indicators in the served patient population.
- There are some connected medical devices operating in the patient care areas.
- The clinic maintains and utilizes disease registries for case management and population health improvement
- A patient portal exists with capabilities to see testing results, obtain patient education material, interact with caregivers, update demographic and allergy information, and schedule or request appointments.
- Evidence that the provider has an activity to promote patient engagement exists, and a proportion of the patient population using the portal is known.
- All types of orders are entered via computerized practitioner order entry (CPOE) by the physician or other licensed provider during the patient encounter, and clinical decision support (CDS) interacts with the orders.
- Physicians document in the record in structured templates that produce some discrete data for interaction with CDS.
- All lab results are electronically imported and stored in a discrete structured form enabling CDS interactions.
- Reporting to various external registries such as state immunization registries, tumor registries and others is submitted electronically.
- Charting is conducted and at the point of care by nursing and support personnel who room the patient and record medication history, vital signs, some history of present illness, etc.
- Physicians maintain an online problem list and generate e-prescribing orders during the patient encounter.
- The beginning of a clinical data repository (CDR) exists, where results from diagnostic tests reside no matter where they are generated.
- Items like patient demographics, basic clinical documentation from nursing personnel, etc. are implemented.
- Physicians and nurses have desktop access to online reference material, patient eligibility information and outside testing results in view-only mode.
- The organization is paper-based, without any online access to clinical content data or reference material.