Most Connected Hospitals List Ranks EMR Achievers

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The latest U.S. News and World Report hospital rankings includes, for the first time, a Most Connected Hospitals list, based largely on the HIMSS Analytics EMR Adoption Model (EMRAM).

The list represents the 118 hospitals that were ranked on the U.S. News Best Hospitals or Best Children's Hospitals compilation or cited as "high performing" in at least one medical specialty, and also achieved Stage 6 or 7 on the HIMSS Analytics EMRAM.

Just 140 hospitals made the national rankings among the best hospitals in at least one specialty, according to U.S. News. HIMSS Analytics, a research arm of the Healthcare Information and Management Systems Society, counts 226 hospitals, or 4% of all nonfederal hospitals in the U.S., in Stage 6, meaning they have electronic clinical documentation, full clinical decision support, and full picture archiving and communication systems (PACS) for radiology. As of midyear, 60 (1.1%) have reached the top level, Stage 7, which includes a full electronic medical record (EMR) as the legal medical record for all departments, an EMR capable of exporting patient records in the Continuity of Care Document format, and a data warehousing and mining operation.

U.S. News, which first contacted HIMSS Analytics in the spring, according to John P. Hoyt, HIMSS executive VP for organizational services, used the numbers from the first quarter of 2011 in putting together the Most Connected Hospitals list. Through March, 3.5% of U.S. hospitals had made Stage 6 and 1% were at Stage 7. More than half of the Stage 7 hospitals were Kaiser Permanente facilities.

"There is a fair amount of overlap [between the HIMSS Analytics scale and the U.S. News Best Hospitals list]," Ben Harder, general manager for health at U.S. News, told InformationWeek Healthcare. The magazine did not consider the HIMSS scale in calculating its Best Hospitals ratings, and Harder was not ready to say there is a direct causation between having an advanced EMR and hospital quality.

"It would be well worth some further study on this," Harder said. He would be particularly interested in learning if highly ranked hospitals improved after they installed their EMRs.

Hoyt was a little more optimistic. "Is it a cause-and-effect or is it coincidence? We in the industry like to think it's cause-and-effect," he said. "[An advanced EMR] has a significant input into quality when used appropriately," Hoyt said. "I think it's more evidence that hospitals that have reached this stage have real improvements in quality and efficiency."

Harder was not ready to say if U.S. News would continue to consider the HIMSS Analytics EMRAM scale or even if the magazine would cite hospitals' IT achievement in the future, as the publication reviews its methodology annually. "We've been looking at health IT for some time," Harder did say.

Find out how health IT leaders are dealing with the industry's pain points, from allowing unfettered patient data access to sharing electronic records. Also in the new, all-digital issue of InformationWeek Healthcare: There needs to be better e-communication between technologists and clinicians. Download the issue now. (Free registration required.)