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:''See: Electronic health record#United States'' The move to electronic medical records (EMRs) is becoming increasingly prevalent in health care delivery systems in the United States. ==Methods== Due to the enactment of the American Recovery and Reinvestment Act of 2009, there has been a rise in the number of federal investments in programs that increase EMR adoption. The Health Information Technology for Economic and Clinical Health Act portion of this stimulus law provides payments for providers that show they have reached the standard for “meaningful use”.〔 This has led more hospitals to adopt EMR, though they have had different experiences in adopting electronic medical records. There are several steps that need to be taken in order to adopt electronic medical records. # A supportive environment, adequate training and resources, a clear direction, and engaged people are a few things needed. # A strong leader is also necessary in order to facilitate the changing environment and using meetings and announcements as adoption promotion tactics have been shown to be useful. # Having the clinical staff involved is also a key feature in successfully adopting electronic medical records. Many hospitals use “physician champions,” who are essentially physicians who educate their peers on the benefits of electronic medical records.〔 # Furthermore, the importance of quality department leaders has been stressed in order to make sure the electronic medical records system is beneficial in providing quality care.〔 Hospitals have been using different suppliers of health data systems in order to adopt electronic medical records. The key suppliers of health data systems are Epic Systems, Allscripts, Meditech, Cerner, IBM, McKesson, Siemens, Healthland, CPSI, and GE Healthcare. The decision of choosing an EMR vendor like Epic or Meditech can fall on either hospital leadership or the corporate level based on the size of the system.〔 If an organization only has one hospital, the hospital leaders select the vendor. If the system is larger, the decision is made at the corporate level, though several people from the hospitals remain involved.〔 There are several criteria for deciding the vendor. Sentara Healthcare was able to make their selection by looking for a vendor with high outpatient care integration, technical support at all levels of integration, and one that customized a system to their needs.〔 The length of time it takes to implement electronic medical records can vary but usually takes two to three years.〔 The first stage of implementation is called “design, build, validate,” where the vendor is selected and the plans are put in place. This is followed by a “big bang” implementation, which means all the departments transfer to the system at once, due to the interconnectedness of hospitals this is necessary. Though the adoption of electronic medical records is increasing, there is a range in the level of implementation. The HIMSS Analytics Database shows the eight stages of adoption in their United States EMR Adoption Model. Stage 0 implies “All three ancillaries not installed,” while in Stage 7 there is a shift to complete EMR. The EMR Adoption Model shows that in 2011, the number of acute care hospitals achieving Stage 5 or Stage 6 increased by more than 80 percent.〔 Meanwhile, the number of hospitals at Stages 0, 1, 2, and 3 has decreased. Furthermore, adoption has increased most among large hospitals and those in urban areas.〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Adoption of Electronic Medical Records in U.S. Hospitals」の詳細全文を読む スポンサード リンク
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