Table 2.

The maturity stages of the Electronic Medical Record Adoption Model [34].

Stage	Definition
Stage 0	The organization has not installed all of the key ancillary department systems (laboratory, pharmacy, cardiology, radiology, etc).
Stage 1	Laboratory, imaging, pharmacy, and cardiology systems produce patient-centric reports and results. Resilience management plans are in place.
Stage 2	A CDRa provides access to results and reports, governance and policy controls, clinical decision support opportunities, training records, and IT security.
Stage 3	Electronic clinical documentation is accessed remotely through the CDR. Role-based access controls are in place.
Stage 4	Computerized practitioner order entry and electronic prescribing within an electronic medicine administration record. Clinical and Information governance is well defined. Monitoring of clinical outcomes and patients’ satisfaction targets.
Stage 5	Integration of data from external sources. Change in clinical parameters is continuously monitored by alerts and warnings. Telehealth and virtual care services are available. Intruder Prevention systems manage unauthorized access. Technology supports bedside processes.
Stage 6	Integration of medical devices. Health information exchange supports data sharing. Service users submit self-reported outcomes data. Wearables and implants support remote monitoring and patient management of health and care. Online services improve access and health literacy.
Stage 7	Integration of data from multiple external sources. Service users receive alerts and reminders to support self-managed care and use automated tools to measure patient outcomes. Digital infrastructure tools enable dynamic patient engagement in managing personal health and care.

^aCDR: clinical data repository.