As outlined by the Healthcare Information and Management Systems Society’s (HIMSS) Electronic Medical Record Adoption Model (EMRAM), the journey towards digital maturity in healthcare is critical for enhancing patient care and operational efficiency.

Mobile computing and medication workstations offered by Capsa Healthcare, play a pivotal role in minimizing medication errors—a significant concern in healthcare today. Rafael Candido, our Vice President of International Sales, shares his expert view on how these technologies support healthcare facilities across the EMRAM spectrum.

What is HIMSS and EMRAM? 

The Healthcare Information and Management Systems Society’s (HIMSS) is a global non-profit organization committed to improving healthcare through information technology.

HIMSS Analytics developed the Electronic Medical Record Adoption Model (EMRAM). It is a framework to track electronic medical records (EMRs) implementation in healthcare facilities. EMRAM outlines seven stages, from basic digital data collection to advanced analytics in patient care, positioning mobile computing workstations as critical for managing patient data and enhancing clinical operations, particularly in advanced stages. 

The Significance of Technology in Reducing Medication Errors 

The World Health Organization states medication errors cost $42 billion annually. As a result, this emphasizes the urgent need for integrating mobile computing and medication workstations in healthcare. Such technologies are crucial for progressing through the EMRAM stages, enhancing patient care from basic data management to advanced analytics. Their importance escalates in later EMRAM stages, playing a key role in EHR and closed-loop medication management to ensure accurate dispensing and administration. 

Rafael notes, “EMRAM is a strategic tool that directs healthcare organizations to digital maturity. It enhances patient care with data, and ultimately reduces medication errors. Additionally, mobile computing and medication workstations play a key role in this process. They are essential for managing patient data and improving clinical operations at the later stages of EMRAM.”

The Seven EMRAM Stages and How to Implement Them 

Stage 0: Ancillary System Absence 

At this stage, healthcare facilities do not have any of the three key ancillary department systems (Laboratory, Radiology, and Pharmacy) installed. As a result, healthcare data is primarily paper-based, and there is no foundational electronic system to support digital records. 

Stage 1: System Installation and Resilience Planning 

The facility has operational major clinical systems, with the Clinical Data Repository (CDR) storing over 90% of lab data and images. Additionally, more than 25% is accessible online for clinicians. Business resilience plans are established for system outages. 

Stage 2: Clinical Data Repository Access 

At Stage 2, healthcare facilities prioritize improving Clinical Data Repositories (CDR). They can improve it with controlled medical vocabularies and implementing basic Clinical Decision Support (CDS) for error checking against evidence-based standards. 

Capsa Product Suggestion: Documentation Workstations 

Integrating mobile computing solutions like Capsa Healthcare’s SlimCart Documentation Cart becomes increasingly important at this level. The SlimCart workstation supports the clinical environment by enabling healthcare providers to access and interact with the CDR from various points of care.  

“It allows clinicians access the CDR anywhere in the hospital. Therefore, this ensures immediate access to support resources and patient information. Such access is crucial for precise and effective care. By incorporating a workstation at this stage, we’re not just enhancing current workflows—we’re paving the way for seamless progression to higher levels of EMR functionality,” says Rafael.   

Stage 3: Electronic Clinical Documentation 

Rafael states, “In Stage 3, clinical documentation and clinical decision support are fully digitized and readily accessible. In other words, care recipients have access to a range of digital tools and technologies to support their journey through care. Point-of-care is essential, and mobile computing workstations provide a cost-effective platform to manage this solution. Also, they ensure secure EMR access and record logins for compliance and security.”

Capsa Product Suggestion: Non-Powered Solutions

• Trio Non-Powered Computing Workstation: Simple function, non-powered cart, ideal for light duty care applications
• T7 Non-Powered Mobile Technology Cart: A versatile, mobile solution for updating patient records and eMAR data across the facility. The Trio or T7 Cart is indispensable in Stage 3, ensuring clinicians have the flexibility to provide care with accurate, up-to-date patient information. 

These newfound time savings allow healthcare professionals to forge meaningful connections with their patients. Connections ultimately improve care quality. In an era of prevalent workforce challenges, fostering these personal connections and refining workflows becomes crucial. Consequently, innovative solutions that simplify processes and reduce paperwork while maintaining accuracy are key in tackling the high demands and resource constraints.

Stage 4: Advanced Clinical Orders and Documentation

In Stage 4 of HIMSS EMRAM, over half of clinical documentation is online and stored in the Clinical Data Repository (CDR). In other words, clinicians have improved access to patient data for informed decision-making. Additionally, they use Computerized Physician Order Entry (CPOE) systems for various orders, including medications, lab tests, imaging, and referrals.

“At this level, the significance of medical mobile computing workstations escalates, particularly for executing CPOE tasks and tracking clinical outcomes effectively,” notes Rafael.  

Capsa Healthcare Product Suggestion: Powered Documentation Carts and Medication Workstations

Capsa’s mobile medication workstations streamline medication administration by supporting e-prescribing and integrating clinical workflows for enhanced efficiency. 

• Trio Mobile Computing Workstation: Ideal for dynamic healthcare environments. It offers ergonomic mobility and sustained battery life for continuous access to patient data
• The Trio Medication Workstation, offers touch-screen navigation and secure storage options, including standard bins or larger MaxBins. It also has a robust, scalable power system for enhanced mobility, security, and reliability.
• M38e Computing Workstation: Proven and reliable point-of-care computing cart celebrated for its superior ergonomics, ease of use, and flexibility. It supports diverse healthcare workflows, maximizing clinical efficiency and enhancing health IT programs.
• The M38e Medication Cart, offers superior ergonomics and secure storage with multiple drawer options to cater to the needs of busy healthcare settings.

These solutions from Capsa Healthcare support critical functions in Stage 4. They contribute to seamless operation and increased capacity for effective medication management and clinical documentation. 

Stage 5: Data Integration and Telehealth 

Rafael explains, “Stage 5 is the key phase for integrating telehealth. With over 75% of clinical documentation and more than half of medical orders processed electronically through CPOE.” Additionally, this stage is supported by Clinical Decision Support (CDS) for conflict verification.

He adds, “At this stage, digital systems monitor key patient metrics like vital signs or lab results.” As a result, this enables real-time alerts to healthcare teams about potential declines in patient health, elevating care standards.

The CDR can integrate external documents. Also, emergency cases have a defined strategy to verify treatment accuracy and enable team communications, including bidirectional interfaces. 

Capsa Product Suggestion: Tryten and Trio Telehealth Solutions

Telehealth carts are crucial for managing alerts and warnings, supporting telehealth services, and accessing integrated data from external sources like monitoring devices. Customizable solutions enable global reach and support integrating peripherals like ultrasound, blood pressure monitors, and pulse oximeters.

• Tryten S1 Tablet Cart: Optimized for versatility, this cart securely holds iPads or tablets at adjustable heights, facilitating mobile digital interactions in healthcare settings. Perfect for use in various clinical scenarios, from patient education to remote consultations.
• Tryten S5 Monitor Cart: This adaptable and space-efficient rolling computer stand is ideal for enhancing telehealth and virtual patient observation. It features customizable options, a minimal footprint, and a secure and hygienic design.
• Trio Telehealth Workstation: Engineered with built-in power, ensuring reliable performance for telehealth consultations in remote facilities, mobile clinics, and hospitals. Its design prioritizes mobility and integration with healthcare technologies, enhancing the telehealth experience.

Stage 6: Medical Device Integration and HIE 

EMRAM Stage 6 emphasizes medical device integration and HIE. Integrating external data and using mobile computing workstations enables full implementation of:

• Integration of remote medical devices for streamlined data collection  
• Real-time support during surgeries with high-tech mobile workstations  
• Enhanced communication between clinicians, staff, and lab technicians  
• Increased patient engagement through digital tools for effective clinician-patient interaction  

Capsa Product Suggestion: MedLink Medication Management Cart

The MedLink Medication Management Cart is a secure medication management system designed to minimize human error and enhance patient safety. It features lockable drawers and patient wristband scanning, ensuring accurate medication administration.

It also establishes a closed-loop system by electronically assigning individually loaded medication drawers to specific patients, streamlining the process from pharmacy to patient care.  

“At this stage, Barcode Medication Management (BCMA) is fully implemented, allowing nursing staff to scan barcodes on the patient’s wristband and medication packaging. BCMA has been shown to improve patient safety by increasing adherence to the ‘five rights’ of medication administration (right patient, drug, dose, route, and time)”, states Rafael.

Stage 7: Comprehensive Data Integration and Patient Engagement

Your facility can now use EMR to improve patient safety, increase patient satisfaction, support clinicians, and guide policy-making. By using tablets, mobile computer workstations, and medical devices, you can add and access EMR information wherever needed — inside your healthcare facility.

Rafael emphasizes, “The digitization of healthcare empowers patients to take an active role in their care. They can directly interact with your digital system to report on medication adherence, share therapy outcomes, and update their health status online, fostering a more engaged and informed patient experience.” 

A critical component of Stage 7’s digital maturity is achieving a 95% closed-loop medication administration rate alongside a 90% rate for Computerized Physician Order Entry (CPOE) and documentation. But what does closed-loop medication management entail, and why is it so vital at this advanced stage? 

Closed-Loop Medication Management Explained 

Closed-loop medication management is an integrated system designed to ensure the accuracy and safety of the medication administration process. It encompasses several critical steps: 

• Ordering: Doctors enter medication orders into the computer, making it clear and error-free right from the start. 
• Dispensing: The pharmacy receives the order and prepares the medication, using technology to ensure that it is the right medication for the right patient. 
• Administration: When giving the medication to the patient, nurses check that it matches the patient’s ID through barcode scanning, ensuring the medication is given correctly. 
• Monitoring: The system keeps track of all this, watching how patients respond to the medication and making sure everything is going as planned. 

Achieving a 95% closed-loop medication administration rate signifies that nearly all medication processes are electronically integrated and verified, significantly enhancing patient safety by reducing the risk of medication errors. The 90% rate for CPOE and documentation further ensures that medication orders are accurately recorded and implemented, maintaining a high standard of care. 

In essence, Stage 7’s emphasis on closed-loop medication management reflects a commitment to leveraging digital tools to achieve the highest levels of safety, efficiency, and patient-centered care in the medication administration process. This approach not only minimizes the risk of errors but also enhances overall healthcare delivery by ensuring that patients receive the most appropriate, timely, and safe medications.  

Capsa Product Suggestion: MedLink Closed-Loop Medication Management  

MedLink’s Mobile Medication Management Cart streamlines med passes and enhances patient safety. The cart’s barcode reader scans the patient’s bracelet and unlocks the right drawer to dispense the proper medication to the patient automatically. 

Mobile Medical Carts Are Essential for Implementing EMRAM 

Through Rafael Candido’s expertise, we understand that mobile computing workstations are vital in reducing medication errors and enhancing patient safety across the HIMSS EMRAM levels. These technologies play a crucial role in ensuring accurate medication dispensing and administration, particularly with closed-loop medication management systems.

Capsa’s products are crucial in digitizing healthcare, turning it into a journey focused on efficiency, effectiveness, and compassionate care. Consider how you can leverage mobile computing workstations in your healthcare institution and stay informed about emerging technologies in healthcare IT.