EHR in Skilled Nursing Remains a Challenge

Although the adoption of EHRs in skilled nursing facilities has been on the increase, interoperability between hospitals and nursing homes remains a major challenge.

The trend of hospital discharges to skilled nursing facilities (SNFs) which gradually increased from 2000 to 2015, has recently changed under value-based reimbursement models. The new reimbursement models have caused operating margins and occupancy rates to decline.

Most recently, a new survey (1) reported that interoperability between hospitals and nursing homes remains a major challenge.

For years, skilled nursing facility have focused on smoothing transitions and cutting down on unnecessary hospitalizations, plus reducing readmissions. But only 60% of hospitals say that their electronic health records incorporate data from long-term care facilities.

A brief from The Office of the National Coordinator for Health Information Technology (2) presented key measures on EHR adoption and interoperability from a 2016 nationally representative sample of SNFs. Highlights from the brief included:

  • A majority (64%) of SNFs used an EHR in 2016.
  • Almost one-fifth (18%) of SNFs used both an EHR and a state or regional health information organization (HIO).
  • Three out of 10 SNFs electronically exchanged (i.e., sent or received) key clinical health information.
  • SNFs that used an EHR and an HIO could send, receive, find, and integrate patient health information at higher rates than those facilities that used an EHR alone.
  • Nearly two-thirds (62%) of SNFs had information electronically available from outside sources at the point of care.
  • SNFs that used an EHR and an HIO had patient health information available from outside sources at the point of care at higher rates than those facilities that used an EHR alone.

 

1). CliftonLarsonAllen, 32nd Edition of the Skilled Nursing Facility Cost Comparison Report: More Data and More Insight; Based on 2016 Data.

2) The Office of the National Coordinator for Health Information Technology, ONC Data Brief, No. 39, September 2017; Electronic Health Record Adoption and Interoperability among U.S. Skilled Nursing Facilities in 2016 Carla S. Alvarado, PhD, MPH; Kathleen Zook, MPH, RN; JaWanna Henry, MPH