EMRs in the fourth stage: the future of electronic medical records based on the experience at Intermountain Health Care.

In the third stage of electronic medical record development, key features of EMR systems have converged, making them more difficult to differentiate from a cost/benefit standpoint. Fourth stage EMR systems are likely to introduce new, more effective decision support capabilities, offering a competitive advantage to hospitals that use them. Intermountain Health Care's HELP systems, which developed along different paths than other early EMR systems, offer unique decision-support capabilities that provide significant additional benefits.

Benefits planning for advanced clinical information systems implementation at Allina hospitals and clinics.

Allina Hospitals and Clinics is implementing an enterprise-wide information system with inpatient and ambulatory clinical documentation and orders, clinical decision support, and revenue cycle applications. Allina has adopted a rigorous approach to planning for and realizing the expected clinical and financial benefits from this investment. Allina's strategies include: Forming a benefits realization team with formal responsibility for analysis, education, facilitation, and measurement; Studying system design to consider requirements for benefits realization; Integrating cultural, organizational and process change plans with system implementation plans; Measuring benefits using a measurement framework that matches organizational reporting, enables multi-level sequential analysis and adjusts for bias in quantifying benefits; Assigning accountability for achieving benefits by matching every benefit with an individual and an operational group; system executives, hospital executives, and department managers are held accountable for benefits within their scope of responsibility, and expected financial benefits are part of their yearly budgets.