CHICAGO – Only .01 percent of hospitals in the U.S. have reached a Stage 7 electronic medical record -  none until the middle of 2008.

Three panel members and winners of the Nicholas E. Davies Organizational Award of Excellence offered their experiences with implementing a Stage 7 EMR at the session "Hard Lessons: Stage 7 and Davies Award Winners Define Success" Tuesday at HIMSS09.

A Stage 7 implementation includes a paperless system and the ability to share interoperable patient data and analyze clinical data for performance, improvements and clinical decision support.

"The hard part is doing something with it," said Dave Garets, the session's moderator and president and chief executive officer of HIMSS Analytics. "At a Stage 7, you have everything, what are you going to do with it?"

Kasier Permanente officials learned that funding for the project should be planned for at least five years, and preferably 10.

The interfaces to legacy systems are also more numerous, complex and expensive than one might think, said Andrew Wiesenthal, MD, SM, associate executive director of The Permanente Federation.

"You won't have advantages until you have everyone up and running on the system," said Thomas Smith, chief information officern of the NorthShore University Health System.

Smith said NorthShore did a few things wrong the first time. Having a backup data center is important, he said, because ongoing user engagement is a priority and order sets should be taken care of.

Although EMR implementation is a hard task, Eastern Maine Medical Center in Bangor, Maine, saw an 88 percent increase in productivity in the

medications process, saved $1.3 million in blood costs and saw an 8 percent reduction in lab tests, said Catherine Bruno, FACHE, the hospital's vice president and chief information officer.

"Surprises" in implementing an EMR in the three organizations included the amount of training needed, complexity and cost of a truly redundant information center, whether it's worth getting rid of all paper documents, and the legal reaction to an EMR.

"The simple stuff can bite you," Wiesenthal said. "If you strive for perfection, you won't get anything but."