A Statewide Assessment of Electronic Health Record Adoption and Health Information Exchange among Nursing Homes

Authors

  • Erika L. Abramson,

    Corresponding author
    1. Department of Pediatrics, Weill Cornell Medical College, New York, NY
    2. Department of Public Health, Weill Cornell Medical College, New York, NY
    3. Department of Medicine, Weill Cornell Medical College, New York, NY
    4. New York-Presbyterian Hospital, New York, NY
    5. Health Information Technology Evaluation Collaborative (HITEC), New York, NY
    • Address correspondence to Erika Abramson, M.D., M.S., Assistant Professor of Pediatrics and Public Health, Weill Cornell Medical College of Cornell University, 525 East 68th Street, Rm M-610A, New York, City, NY 10065; e-mail: err9009@med.cornell.edu.

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  • Sandra McGinnis,

    1. Health Information Technology Evaluation Collaborative (HITEC), New York, NY
    2. Center for Health Workforce Studies, University at Albany, Albany, NY
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  • Jean Moore,

    1. Health Information Technology Evaluation Collaborative (HITEC), New York, NY
    2. Center for Health Workforce Studies, University at Albany, Albany, NY
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  • Rainu Kaushal,

    1. Department of Pediatrics, Weill Cornell Medical College, New York, NY
    2. Department of Public Health, Weill Cornell Medical College, New York, NY
    3. Department of Medicine, Weill Cornell Medical College, New York, NY
    4. New York-Presbyterian Hospital, New York, NY
    5. Health Information Technology Evaluation Collaborative (HITEC), New York, NY
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  • and with the HITEC investigators


Abstract

Objective

To determine rates of electronic health record (EHR) adoption and health information exchange (HIE) among New York State (NYS) nursing homes.

Data Sources/Study Setting

Primary data collected from a novel survey administered between November 2011 and March 2012 to all NYS nursing homes.

Study Design

We used a cross-sectional study design to assess level of EHR implementation, automation of key functionalities, participation in HIE, and barriers to adoption.

Data Collection/Extraction Methods

We used descriptive statistics to characterize rates of EHR adoption and participation in HIE and logistic regression to identify nursing home characteristics associated with EHR adoption and HIE.

Principal Findings

We received responses from 375 of 632 nursing homes (59.3 percent). Of respondents, almost one in five (n = 66, 18.0 percent) reported having a fully implemented and operational EHR and a majority (n = 192, 54.4 percent) reported electronically exchanging information. Nursing homes with 100–159 beds were significantly less likely than other facilities to have implemented or be in the process of implementing an EHR (p = .011).

Conclusions

Our findings present an important systematic look at EHR adoption and HIE by NYS nursing homes. Although the nursing home sector has been reported to lag in health information technology adoption, our results are encouraging. However, they suggest much room for growth and highlight the need for targeted initiatives to achieve more widespread adoption in this important health care sector.

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