Health Information Technologies: Which Nursing Homes Adopted Them?

Abstract

Nursing homes with more personnel or resident resources are more likely to adopt health IT. Other factors such as market competition are also important predictors. Future research is needed to examine what factors motivate nursing homes to adopt health IT.

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

“…NHs in Arkansas with a fully or partially implemented EHR system were more likely to have fewer Medicaid residents and have a higher occupancy rate compared with NHs without currently implemented EHR systems. These findings are consistent with previous research on characteristics associated with EHR adoption (Alexander & Madsen, 2017; Zhang et al, 2016). Both of these structural characteristics suggest that a NH with more resources, as income from non-Medicaid residents is typically higher than from Medicaid residents (Grabowski, 2004), and more residents (higher occupancy rate) is an indicator of more income for the NH.…”

“…It was also found that NHs with EHR systems were located in more competitive markets and counties with fewer available NH beds. Previous research has shown that NHs in highly competitive markets are more likely to innovate (e.g., adopt total quality management, open specialty units) to attract new residents (Banaszak-Holl et al, 1996; Zinn et al, 1998), which likely explains why these types of NHs in Arkansas were more likely to have implemented an EHR system (Zhang et al, 2016).…”

“…NHs’ profit status (profit or non-profit) was not found to be associated with adoption of EHR systems. Previous research has found that non-profit NHs were more likely to invest in HIT systems (Wang & Biedermann, 2012; Zhang et al, 2016) as it is presumed that their mission focus will prompt their investment of available resources into facility improvements, whereas for-profit NHs may be more selective in their investments back into the facility (Chesteen et al, 2005). Failure to support the previous research may be due to the makeup of the sample (74.6% of responding NHs were for-profit) and/or that non-profit NHs lack resources to invest in EHR systems even if their mission supports reinvestment in the facility.…”

“…Although residential NH care faces many of the same issues as clinical practice (e.g., management of chronic conditions, medication administration, and monitoring), the use of EHRs in NHs has lagged behind that of acute and ambulatory care settings. Previous research has estimated that between 18% and 84% of U.S. NHs have EHR systems in place (to some level; Abramson et al, 2014; Kramer et al, 2010; Vest et al, 2018; Wang & Biedermann, 2012; Zhang et al, 2016), whereas 96% of hospitals (Charles et al, 2015) and 87% of private medical practices have implemented an EHR (Jamoom & Yang, 2016). Federal mandates and financial subsidies, primarily made available through the 2009 Health Information Technology for Economic and Clinical Health Act (HITECH), have facilitated the rapid uptake of HIT in other care settings (Gold & McLaughlin, 2016).…”

“…Expert bodies have stressed the need for greater adoption and use of EHR among NHs (LTPAC HIT Collaborative, 2010; Office of the National Coordinator, 2013). Current research indicates that certain NHs, such as those that are non-profit (Wang & Biedermann, 2012; Zhang et al, 2016), those with more Medicaid residents, and those in more competitive markets (Zhang et al, 2016), are likely to have HIT systems. However, to consider initiatives to facilitate EHR use in NHs beyond the current rates, more information about which NHs have and have not implemented EHR systems is needed.…”