Implementing the

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HOMR Initiative

Hospitals across the country and worldwide are implementing HOMR to improve patient end-of-life care.

Join the growing community adopting HOMR

HOMR Implementation

Hospitals implementing HOMR integrate the tool into their electronic medical records system to automatically identify patients at increased risk of death and prompt clinicians to assess and address patients’ unmet palliative needs.

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Hospitals implementing the HOMR tool
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Annual admissions screened by HOMR
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Electronic Medical Record platforms integrated with HOMR
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At Saint Michael’s Hospital, we strive to provide the best care experiences for individuals and their care providers. It is essential that we identify individuals with life-limiting illness to ensure that we can connect them with the best possible supports in hospital and in the community. The Hospital One-year Mortality tool allows us to identify such patients and support their best care experiences throughout their health journey.

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HOMR Versions

There are three different versions of the HOMR tool: the original ‘HOMR’, modified or ‘mHOMR’, and ‘HOMR Now!’. Each version is slightly different in its clinical use and data points used to generate the mortality risk score.


Hospital One-Year Mortality Risk

The original HOMR calculates a 12-month mortality risk for patients admitted to hospital using 12 administrative data points, some of which are only routinely coded at the time of discharge. This means HOMR cannot be used in real-time to help with clinical decision making during the patient’s admission. It can be used retrospectively for research or quality improvement.



Modified Hospital One-Year Mortality Risk

mHOMR is a modified version of HOMR that uses 9 administrative data points, all of which are available at the time of hospital admission. mHOMR is integrated into a hospital’s electronic medical record system to automatically calculate mHOMR scores for all patients in real-time as they are admitted to hospital.

mHOMR Logo


Hospital One-Year Mortality Risk Now!

HOMR Now! is an updated version of mHOMR that is also used in real-time upon admission to hospital. It is calculated using 10 data fields and an interaction term available in many hospitals’ admissions data. It is slightly more accurate than mHOMR and includes a few different clinical variables.

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Differences Between the HOMR Versions​
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HOMR Now Logo
Living Status (Home, Long-Term Care Home, Rehabilitation, Chronic Hospital)
Death Risk (Life Tables)
Home O2
Admitting Diagnosis
LAPS Score
Charlson Comorbidity Index

(previous admission)
Health Service Use
Admitting Service
Urgent 30 Day Readmission
Number of Emergency Department Visits in Past 12 Months
Admission by Ambulance in the Past 12 Months
Admission Urgency / Ambulance
Direct to ICU
Seen in Cancer Clinic in the Past 12 months
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