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Table 1 Overview of EMR functionalities for maturity levels 1, 3 and 5

From: Ceiling effect in EMR system assimilation: a multiple case study in primary care family practices

Functional Category

Description

 

Level 1

Level 3

Level 5

Practice Management

Hybrid scheduling in place. Billing is printed daily. EMR used to communicate within practice.

Advance appointment tracking with EMR. EMR generates billing-related reports. Use EMR to track tasks directly related to patient record.

Appointments are managed online and linked to EMR scheduler. EMR autopopulates billing codes based on encounter notes. Communicate with other providers through EMR.

Information Management

EMR used to input patient demographics, patient visit, and encounter notes. Use varying local codes and non-standard nomenclature. Scan paper-based documents with written instructions and notes into EMR.

EMR identifies sub-population for recurrent visits or proactive care; enter clinical data for focused patients. Agreed upon nomenclature for coding standards and charting. Written protocol.

Use EMR to co-manage and reconcile patient enrollment. Send and or/receive data of individual patient records from one EMR to another. Advanced nomenclature coding standards.

Patients Results Management

Laboratory, digital imaging, hospital information is scanned into the EMR. EMR prepopulate the generic referral/consult templates. Paper-based referral reviewed for specialist.

EMR to do advanced tracking and management of laboratory and imaging results. Review and analyze information from hospital. Advanced tracking and management of referrals and consults.

EMR to generate longitudinal lab, imaging, and information analysis from different care settings. Patients manage online appointment booking.

Diagnosis Support

Follow-up care and resources are combination of EMR and paper.

EMR generates recommendations for patient assessment tools. Autopopulate regional registries and do advanced tracking of preventative care such as proactive profiling. EMR updated with emerging, changing, and appropriate evidence and guidance.

EMR linked to regional health record for most effective diagnostic procedures. EMR linked to regional repository to access provider-specific preventative/follow up care. EMR aggregated database to conduct real time analysis of de-identifiable data.

Treatment Planning Support

Subjective, Objective, Assessment and Plan (SOAP) notes for care planning and coordination. EMR is used to create basic prescription and renewals. EMR manages at least one chronic condition using templates for chronic disease management (CDM).

Customized templates for care planning and coordination. Customized prescription creation. Manage multiple chronic conditions using customized templates/forms.

EMR to access regional registries for care planning and coordination. EMR to share information with regional disease registries regarding CDM. EMR linked to regional system for medication management.

Patient Engagement and Communication

Educate patients via EMR screen and input patient results into EMR with scanned copies.

EMR develops customized educational modules. Set up customized templates for self-care/co-management.

Patients have access to regional web portals for education and self-management.

Evaluation and Monitoring

EMR to set up system-wide alerts and reminders for health outcomes. EMR to generate reports on infectious diseases.

EMR to monitor Health Quality Indicators (HQI), Health Outcomes (HO), and Public Health, and generate reports.

EMR receives information from regional reporting system regarding health outcomes. Generate up-to-date information based on symptoms for public health. Receive information to define sub-population for health quality indicators.