Digital maturity
Move a stage without a migration
EMRAM is the scale your board already reports against. This page shows which stages an overlay can move, which stay with the record system, and what a validated change looked like.
- EMRAM and O-EMRAM as the yardstick
- Integration, not replacement
- Supportive, not certified

Stage 2 to Stage 5
in 28 months at a teaching hospital
Above the record
the requirements the higher stages need
Stage 5
Validated by HIMSS Analytics, July 2026
28 months
From the previous validation
640
Beds at the validated site
O-EMRAM
Where most of the contribution sits
How an overlay moves a stage
By adding what the higher stages require above the record.
The scale your board reports against
EMRAM inpatient, O-EMRAM outpatient. HIMSS operates and validates them. Hilbi leans on that scale rather than inventing another.
What the engagement layer adds
Patient access, structured intake, continuity across encounters, coded documentation written back, governance of who sees what.
What stays with the record
Closed-loop medication and order entry with decision support are the record system's work. We do not claim a stage that depends on them.
How it is integrated
Above the core system, through FHIR R4. A pilot goes live without deep integration, and depth follows the result.
Strong here, deliberately lighter there
Stated so a validator finds the same answer we give.
- Strong: anti-silo synchronisation with the record as master and write-back; patient engagement beyond a typical record system; structured, coded documentation; continuity through the International Patient Summary; governance of access and consent.
- Deliberately lighter: in-workflow clinical decision support (embedded support is deferred; the platform measures, triggers and records) and in-hospital closed-loop medication, which is the record system's job.
- Dependency: the continuity benefit depends on the connector to the local record system. Readiness targets: Stapro, CGM, Epic.
- Hilbi is EMRAM-supportive. It is not an EMRAM certification and it confers no stage.
A validated stage change
One organisation, the stage before, the stage after, the period and the validation reference.

Regional teaching hospital, Slovakia, 640 beds
- Stage before
- EMRAM Stage 2, validated March 2024
- Stage after
- EMRAM Stage 5, validated July 2026
- Period
- 28 months
- What Hilbi contributed
- Patient access, structured intake, continuity between encounters, and coded documentation written back through HL7 FHIR R4
- What the record system contributed
- Closed-loop medication administration and order entry with decision support
- Validation
- HIMSS Analytics, revalidation record held by the organisation
The stage change came from the requirements that sit above the record. The record system kept doing what it always did. What changed is what happens around it.
Chief medical information officer at the organisation above
Questions about maturity models
Is this a HIMSS certification?
Does Hilbi raise our stage?
What about O-EMRAM?
Where do we start?
Monthly briefing
The signal, once a month.
What changed in European health data, what we shipped, and what it means for a provider. Nothing else.