HIMSS EMRAM Assessment for Lincolnshire Partnership NHS Foundation Trust


Lincolnshire Partnership NHS Foundation Trust wanted to assess the level of digital maturity across all its mental health services that delivers services and support for dementia, learning disabilities and autism in the county, to ensure alignment with the Lincolnshire ICS digital strategy and with national expectations set out by NHSE for all hospitals to reach a HIMSS level 5. To ensure a thorough and objective analysis of the Trust’s current status and draw upon experience of leading HIMSS assessments within the region, LPFT selected Apira to help guide them through the process.


LPFT had already taken proactive steps towards digital transformation by aligning their development plans with the shared digital roadmap set out by Lincolnshire ICS. The Trust is also already submitting data into the Lincolnshire Care Portal.

This collaborative approach to digital expansion meant that several factors assessed as part of the EMRAM criteria could not be included within the final score, despite the intention to do so and the acknowledgement that such a gap exists. This is because the Trust is not yet able to implement these aspects as it is beholden to the ICS implementation timeline.

It was therefore important to factor in LPFT’s ongoing efforts to adhere to the ICS roadmap of digital initiatives; this work was acknowledged and incorporated into the recommendations identified following this assessment.


LPFT contracted Apira to conduct the HIMSS EMRAM assessment. Work included engagement with staff to capture assessment responses, workshops to validate findings and weekly check-in sessions with the project lead to talk through any gaps, answer questions and prepare for the next stage of the assessment process. Apira then submitted the initial draft of the EMRAM assessment to the HIMSS portal on the Trust’s behalf.

Following the submission, Apira continued to work with LPFT to prepare for the site visit by the external HIMSS assessor. Preparation work for the visit included sharing brief sheets for staff to ensure they knew what to expect on the day, and the collation of a slide deck to provide an overview of the digital strategy, systems and user experience across the Trust. The site visit took place over one day, with the HIMSS lead visiting different Trust sites and speaking with leads from various teams to review their usage and understanding of the Trust’s digital systems.

After the site visit, HIMSS generated a gap assessment report highlighting the key areas for improvement. Apira incorporated these findings into a final report, complete with recommendations the Trust could follow to improve its digital maturity status.


  • Bespoke data capture sheet for each HIMSS area
  • Online submission of assessment and corresponding report
  • Call sheets for staff to prep for site visit
  • Site visit slide deck conveying digital setup and strategy
  • Final gap analysis report
  • Summary slides outlining assessment and recommendations

midwife using ipad


The HIMSS EMRAM assessment revealed that LPFT is doing extremely well in its digital journey. The assessment process highlighted several initiatives already underway within the Trust that could be used to advance digital maturity; these were identified as key improvement mechanisms within Apira’s recommendations. The assessment revealed that the biggest issue the Trust currently faces regarding digital maturity is integration: LPFT has several systems, some of which are not integrated
with each other. This means that there is not one system that holds the full patient record in one place. This then impacts the Trust ability to implement electronic ordering, clinical decision support and ensure comprehensive clinical user adoption.

The Trust plans to provide further integration to increase clinical adoption and reduce paper processes. Once these gaps have been closed and new functionality is introduced to improve quality, safety and productivity of care, the Trust will jump to a much higher level of digital maturity, reflected in an increased EMRAM stage.


  1. With Apira’s support, LPFT were able to reprioritise their digital programme and realign their digital strategy to focus on areas that could potentially have been low on their agenda.
  2. The digital maturity assessment report will also give the Trust the opportunity to optimise current functionality within their digital systems.
  3. The gaps identified and the corresponding recommendations to improve these areas will help the Trust to achieve the national directive for all providers to obtain a level 5 maturity level.

”Apira were true partners in this
work; from day one they
provided experience, advice and
direction to support the Trust to
undertake its digital maturity
assessment. This enabled us to
understand where our gaps are
and what we need to do in terms
of priorities. I wouldn’t hesitate
to work with Apira again.”


Carolyn Holmes

Head of Informatics, CNIO

EMRAM Assessment:

The Trust scored highly in each of the five focus areas. Resilience management was the strongest section, with LPFT achieving a level 7 in this area. Patient engagement was also good with the Trust achieving stage 4 here. Lots of initiatives are already
underway to make further improvements to this area. Some core gaps were identified around the limited use of the EPR and clinical adoption. These areas represent the biggest opportunity for growth in developing the Trust’s level of digital maturity and ensuring they achieve at least a Stage 5 at the next assessment.

To find out more about HIMSS  and other services offered by Apira, please contact Rory Dennis, Director of Growth rory.dennis@apira.co.uk