Are we using EMRs to their fullest potential?

Written by Dr. Darren Larsen, Chief Medical Officer, OntarioMD

So we use our EMRs every day for every aspect of care. We bought them, we trained on them, we became moderately proficient, but then what? As experienced EMR users and skilled clinicians, how far did we go beyond that? Are we using EMRs to their fullest potential? Do we understand all the opportunities to do more with the data we produce? Do we see beyond record keeping? Have we automated workflows wherever possible to make our lives easier?

At OntarioMD, it is our business to know and help you find out as well. Seven years ago, a maturity model for measuring EMR use was created. The EMR Maturity Model (EMM) was tested and compared to other similar models such as the HIMSS EMRAM tool. It was put in the hands of EMR expert users. It was re-written and expanded to be relevant to daily community practice. It was also converted to a self-administered online tool, now known as the EMR Progress Assessment (EPA). The EPA was Ontario born, but now is used by other provinces as well to measure effective use of their same EMR systems.

Despite the clinical validity of the tool after years of use and its practical nature, the model itself had never been scientifically tested. We thought it should be subject to the same academic standards as other measurements. So, we asked such questions as: what does the tool actually measure? How well does it measure it?

We engaged in a systematic process of validating the EMM via statistical tests of validity and reliability on the data collected by the EPA tool. This study was recently published in the International Journal of Medical Informatics. Here’s what we learned:

  1. We measure one major thing well – EMR maturity! This means that, when you take the EMR Progress Assessment, you can be confident that your results are a sign of whether or not there is more of your EMR you could use. It can point you to areas you might want to expand or improve on. It can prompt thoughts about quality and efficiency.
  2. Measures are consistent across the list on how we measure maturity.  They line up so that a level 3 is the same level 3 over time and across clinicians.
  3. Maturity is not an indicator of performance. Using an EMR for good proficiency in care gets us to the maturity level of just over level 2. We can be great clinicians, but never move higher than that level.  Beyond level 2 is more about how the practice’s EMR is used within the larger health system. It involves system integration. It revolves around data. A fully integrated system and standardized, high quality data are super helpful when you’re trying to do the most with your practice in designing care for populations.

If you are a clinician who wants to know more about your EMR use, as well as wants to carry your practice further into automation, integration and use of data, then an EPA is a great place to start. You can take the complete survey in about 20 minutes. You will not only learn where you are in terms of EMR proficiency, but also be able to compare your level according to the EMM with where you want to be. And then you can drive out a plan of attack. And there is help. OntarioMD can move your practice ahead exactly the way you want it to be moved.