A model to measure self-assessed proficiency in electronic medical records: Validation using maturity survey data from Canadian community-based physicians

Rayner

Birinci³

et al. 2020

Preprint

Background : Nation-wide adoption of electronic health records (EHRs) in hospitals has become a Turkish policy priority in recognition of their benefits in maintaining the overall quality of clinical care. The electronic medical record maturity model (EMRAM) is a widely used survey tool developed by the Healthcare Information and Management Systems Society (HIMSS) to measure the rate of adoption of EHR functions in a hospital or a secondary care setting. Turkey completed many standardizations and infrastructural improvement initiatives in the health information technology (IT) domain during the first phase of the Health Transformation Program between 2003 and 2017. Like the United States of America (USA), the Turkish Ministry of Health (MoH) applied a bottom-up approach to adopting EHRs in state hospitals. This study aims to measure adoption rates and levels of EHR use in state hospitals in Turkey and investigate any relationship between adoption and use and hospital size. Methods : EMRAM surveys were completed by 600 (68.9%) state hospitals in Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions and their use were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated. Results: We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which compares favourably to the results of Korean hospitals in 2017, but unfavorably to the results of US hospitals in 2015 and 2017. Our findings suggest that smaller hospitals are better at adopting certain EHR functions than larger hospitals. Conclusion: Measuring the overall adoption rates of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all state hospitals in a country using EMRAM. The bottom-up approach to adopting EHR in state hospitals that was successful in the USA has also been found to be successful in Turkey. The results are used by the Turkish MoH to disseminate the nation-wide benefits of EHR functions.

Section: Clinical Documents and Computerized Physician Order Entrymentioning

confidence: 86%

Adoption Rates of Electronic Health Records in Turkish Hospitals and the Relation with Hospital Sizes

Rayner

Birinci³

et al. 2020

Preprint

“…On the other hand, many countries, such as Japan [33], China [30], developed their maturity models. Finally, some countries such as Canada [55], Portugal [54], and Turkey, as in this study, preferred to use HIMSS EMRA M as a maturity model. Besides country-wide studies, there is an increasing number of studies about EHR adoption in the health system.…”

Section: Discussionmentioning

confidence: 98%

“…EMRAM is a powerful survey which is applied by more than 25 countries including some EU countries, Turkey, China, Russia, Saudi Arabia, etc., and very common in the USA so that there are 2039 and 285 validated hospitals against the requirements of Stage 6 and Stage 7 correspondingly in the USA only [53]. Besides Turkey, Portugal is also considering to use EMRAM as a country-wide measure for digital transformation [54], and Canada applied a customized version of it for community-based physicians [55]. Since it is an EHR adoption model, EMRAM does not focus on human and organizational capabilities but the technological functionality of the hospital [56].…”

Section: Electronic Health Record Capability In Turkeymentioning

confidence: 99%

Adoption rates of electronic health records in Turkish Hospitals and the relation with hospital sizes

Rayner²,

Birinci

et al. 2020

BMC Health Serv Res

Background Nation-wide adoption of electronic health records (EHRs) in hospitals has become a Turkish policy priority in recognition of their benefits in maintaining the overall quality of clinical care. The electronic medical record maturity model (EMRAM) is a widely used survey tool developed by the Healthcare Information and Management Systems Society (HIMSS) to measure the rate of adoption of EHR functions in a hospital or a secondary care setting. Turkey completed many standardizations and infrastructural improvement initiatives in the health information technology (IT) domain during the first phase of the Health Transformation Program between 2003 and 2017. Like the United States of America (USA), the Turkish Ministry of Health (MoH) applied a bottom-up approach to adopting EHRs in state hospitals. This study aims to measure adoption rates and levels of EHR use in state hospitals in Turkey and investigate any relationship between adoption and use and hospital size. Methods EMRAM surveys were completed by 600 (68.9%) state hospitals in Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions and their use were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated. Results We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which compares favourably to the results of Korean hospitals in 2017, but unfavorably to the results of US hospitals in 2015 and 2017. Our findings suggest that smaller hospitals are better at adopting certain EHR functions than larger hospitals. Conclusion Measuring the overall adoption rates of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all state hospitals in a country using EMRAM. The bottom-up approach to adopting EHR in state hospitals that was successful in the USA has also been found to be successful in Turkey. The results are used by the Turkish MoH to disseminate the nation-wide benefits of EHR functions.

“…EMRAM is a powerful survey which is applied by more than 25 countries including some EU countries, Turkey, China, Russia, Saudi Arabia, etc., and very common in the USA so that there are 2,039 and 285 validated hospitals against the requirements of Stage 6 and Stage 7 correspondingly in the USA only (53). Besides Turkey, Portugal is also considering to use EMRAM as a country-wide measure for digital transformation (54), and Canada applied a customized version of it for community-based physicians (55). Since it is an EHR adoption model, EMRAM does not focus on human and organizational capabilities but the technological functionality of the hospital (56).…”

Section: Electronic Health Record Capability In Turkeymentioning

confidence: 99%

Adoption Rates of Electronic Health Records in Turkish Hospitals and the Relation with Hospital Sizes

Rayner

Birinci³

et al. 2020

Preprint

Background: Nation-wide adoption of electronic health records (EHRs) in hospitals has become a Turkish policy priority in recognition of their benefits in maintaining the overall quality of clinical care. The electronic medical record maturity model (EMRAM) is a widely used survey tool developed by the Healthcare Information and Management Systems Society (HIMSS) to measure the rate of adoption of EHR functions in a hospital or a secondary care setting. Turkey completed many standardizations and infrastructural improvement initiatives in the health information technology (IT) domain during the first phase of the Health Transformation Program between 2003 and 2017. Like the United States of America (USA), the Turkish Ministry of Health (MoH) applied a bottom-up approach to adopting EHRs in state hospitals. This study aims to measure adoption rates and levels of EHR use in state hospitals in Turkey and investigate any relationship between adoption and use and hospital size. Methods: EMRAM surveys were completed by 600 (68.9%) state hospitals in Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions and their use were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated. Results: We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which compares favourably to the results of Korean hospitals in 2017, but unfavorably to the results of US hospitals in 2015 and 2017. Our findings suggest that smaller hospitals are better at adopting certain EHR functions than larger hospitals. Conclusion: Measuring the overall adoption rates of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all state hospitals in a country using EMRAM. The bottom-up approach to adopting EHR in state hospitals that was successful in the USA has also been found to be successful in Turkey. The results are used by the Turkish MoH to disseminate the nation-wide benefits of EHR functions.