Adoption of Electronic Health Records by Practices of Nursing Home Providers and Wi-Fi Availability in Nursing Homes

A National Assessment of Access to Technology Among Nursing Home Residents: A Secondary Analysis (Preprint)

10.2196/preprints.11449 ◽

2018 ◽

Author(s):

Kimberly Ryan Powell ◽

Gregory Lynn Alexander ◽

Richard Madsen ◽

Chelsea Deroche

Keyword(s):

Information Technology ◽

Nursing Home ◽

Nursing Homes ◽

Health Information ◽

Secondary Analysis ◽

Nursing Home Residents ◽

Patient Portals ◽

Health Records ◽

Access To Technology ◽

Electronic Health

BACKGROUND According to the National Center for Health Statistics, there are over 1.7 million nursing home residents in the United States. Nursing home residents and their family members have unique needs and stand to benefit from using technology empowering them to be more informed and engaged health care consumers. Although there is growing evidence for benefits of patient-facing technologies like electronic patient portals on patient engagement in acute and outpatient settings, little is known about use of this technology in nursing homes. OBJECTIVE The purpose of this study was to report findings from a secondary analysis of data from a national nursing home study of information technology (IT) adoption, called IT sophistication. We describe the extent to which nursing homes (n=815) allow residents or their representatives to access technology including electronic health records, patient portals, and health information-exchange systems as well as the ability of the residents or representatives to self-report data directly into the electronic health record. METHODS We used descriptive statistics and regression techniques to explore relationships between information technology adoption (IT sophistication) and residents’ or their representatives’ access to technology. Covariates of location, bed size, and ownership were added to the model to understand their potential influence on the relationship between IT sophistication and resident access to technology. RESULTS Findings revealed that resident access to technology was a significant predictor of the nursing home IT sophistication (P<.001). The inclusion of covariates—nursing home location, bed size, and ownership—with their interactions produced a nonsignificant effect in the model. Residents’ or their representatives’ use of electronic health records and personal health records were both significant predictors of overall IT sophistication (P<.001). CONCLUSIONS As nursing homes continue to progress in technological capabilities, it is important to understand how increasing IT sophistication can be leveraged to create opportunities to engage residents in their care. Understanding the impact of health information technology on outcomes and which technologies make a difference will help nursing home administrators make more informed decisions about adoption and implementation.

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Implementation of Electronic Health Records in US Nursing Homes

CIN Computers Informatics Nursing ◽

10.1097/cin.0000000000000344 ◽

2017 ◽

Vol 35 (8) ◽

pp. 417-424 ◽

Cited By ~ 6

Author(s):

Ragnhildur I. Bjarnadottir ◽

Carolyn T.A. Herzig ◽

Jasmine L. Travers ◽

Nicholas G. Castle ◽

Patricia W. Stone

Keyword(s):

Nursing Homes ◽

Electronic Health Records ◽

Health Records ◽

Electronic Health

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Organizational Characteristics and the Adoption of Electronic Health Records Among Nursing Homes in One Southern State

Journal of Applied Gerontology ◽

10.1177/0733464820906685 ◽

2020 ◽

pp. 073346482090668

Author(s):

Holly Felix ◽

Neeraj Dayama ◽

Michael E. Morris ◽

Rohit Pradhan ◽

Christine Bradway

Keyword(s):

Nursing Homes ◽

Electronic Health Records ◽

Organizational Characteristics ◽

Future Research ◽

Southern State ◽

Health Records ◽

Health Care Settings ◽

Skill Mix ◽

Electronic Health

Electronic health records (EHRs) can improve quality of care and patient safety, as demonstrated in a variety of health care settings. However, greater use of EHRs in nursing homes (NHs) is needed. To understand which NHs have and have not adopted EHR systems, all federally certified NHs in Arkansas ( n = 223) were surveyed, with 27.9% responding. Non-responders were similar to responders on all characteristics except for staffing skill mix, with responders having a higher skill mix than non-responders. Two thirds of responding Arkansas NHs reported having an EHR system in use (69.8%), while only a few reported no plans for an EHR system (4.8%). NHs with greater resources and in competitive markets were more likely to implement EHR systems. Full implementation across all NHs may require intervention, which should be explored in future research. In addition, future investigation should consider the level of interoperability of EHR systems that are in place among NHs.

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Electronic Health Records in Danish Home Care and Nursing Homes: Inadequate Documentation of Care, Medication, and Consent

Applied Clinical Informatics ◽

10.1055/s-0040-1721013 ◽

2021 ◽

Vol 12 (01) ◽

pp. 027-033

Author(s):

Morten Hertzum

Keyword(s):

Patient Safety ◽

Nursing Homes ◽

Electronic Health Records ◽

Home Care ◽

Long Term Care ◽

Adverse Drug Events ◽

Term Care ◽

Health Records ◽

Electronic Health

Abstract Background Electronic health records (EHRs) are used in long-term care to document the patients' condition, medication, and care, thereby supporting communication among caregivers and counteracting adverse drug events. However, the use of EHRs in long-term care has lagged behind EHR use in hospitals. In addition, most EHR research focuses on hospitals. Objective This study gives a countrywide status of the documentation-related risks to patient safety in Danish home care and nursing homes, which are the two main providers of long-term care. Such a status provides a basis for national improvement efforts and international comparisons. Method The study is based on the reports from 893 inspections of home care and nursing homes by the Danish Patient Safety Authority (Styrelsen for Patientsikkerhed [STPS]). Results As much as 69% of the inspected institutions document inadequately to an extent that has led to demands (i.e., issues the institution is legally obliged to rectify) or requests (i.e., issues the institution is merely asked to rectify) from STPS. Documentation issues about the patients' condition and care are present in nearly all institutions that receive demands (97%) and in the majority of those that receive requests (68%). Documentation issues about medication and consent to care are also common, but less so. The predominant risk to patient safety is incomplete documentation. It covers 72% of the documentation issues identified in the institutions that received demands; the remaining risks concern inconsistent (11%), nonexistent (7%), inaccessible (5%), and noncompliant (5%) documentation. The documentation inadequacies are similar for home care and nursing homes. Conclusion Inadequate EHR documentation is a widespread problem in Danish long-term care. While previous research mainly focuses on how EHR documentation affects patient medication, this study finds that documentation issues about the patients' condition and care are more prevalent and that issues about their consent are also common.

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