We live in a digital age. We use electronic systems to connect with others, to entertain ourselves, and to compare the quality of myriad goods and services, including—as users of U.S. News know—hospital care.
Yet inside the walls of many hospitals, doctors and nurses still rely on reams of paper charts and antiquated systems to track patient health, order tests and treatments, and perform other essential duties. While many of these professionals provide quality medical care, they do so without the use of a suite of technologies broadly known as electronic medical records, or EMRs, that could make patients safer and their care more efficient.
By contrast, a relatively small number of hospitals have readily embraced EMRs and use them to connect healthcare providers to one another and to the information each needs to do his or her job.
An even smaller subset of those hospitals also succeed in delivering the superior care that U.S. News recognizes in its Best Hospitals. U.S. News developed Most Connected Hospitals to highlight that group of institutions, which are both digitally forward and clinically excellent.
We began with a list of all institutions we either have ranked among the best in the nation or have identified as "high-performing" in at least one medical specialty in the 2011-12 Best Hospitals and Best Children's Hospitals rankings.
We compared that roster of top hospitals to a list of institutions publicly identified as early adopters of EMR technology by HIMSS Analytics, a division of the non-profit Healthcare Information and Management Systems Society. Through surveys of hospital executives and, in some cases, site visits, HIMSS Analytics evaluates how far hospitals have progressed toward fully incorporating health information technology into every aspect of clinical care. A Stage 7 hospital has gone all the way. A Stage 0 hospital has yet to start.
At Stage 7, explains John Hoyt, executive vice president of organizational services at HIMSS Analytics, a hospital "no longer uses paper charts to deliver and manage patient care." The system also has the ability to analyze electronic data to assess the quality of care, potentially leading to improvement. Patients typically can look at their own medical records on a restricted web page.
At Stage 6 hospitals, doctors in at least one inpatient unit personally enter their medical orders into a computer system that offers them real-time guidance, for example, by calling their attention to a potentially dangerous treatment combination. Doctors also electronically document their clinical interactions with patients. And EMRs are used in the hospital's nursing, pharmacy, laboratory and radiology services. Nevertheless, the majority of doctors at some Stage 6 hospitals may continue to rely on paper records.
About 1 percent of U.S. hospitals are at Stage 7, and 3.5 percent are at Stage 6, according to HIMSS.
U.S. News defines a hospital as Most Connected if that hospital, or a major unit of it such as a children's hospital within the larger institution, has met twin standards: achieving Stage 6 or 7 of EMR adoption and earning either a national Best Hospital or Best Children's Hospital ranking or a high-performing designation in one or more medical specialties.
Most Connected Hospitals itself is not a ranking. Hospitals appear higher on the unranked list if they are at Stage 7 in EMR adoption rather than Stage 6, and they appear higher if they are nationally ranked in Best Hospitals or Best Children's Hospitals rather than high-performing, a lesser distinction.
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