Impact of Electronic Health Records on Long-Term Care Facilities: Systematic Review

Abstract

BackgroundLong-term care (LTC) facilities are an important part of the health care industry, providing care to the fastest-growing group of the population. However, the adoption of electronic health records (EHRs) in LTC facilities lags behind other areas of the health care industry. One of the reasons for the lack of widespread adoption in the United States is that LTC facilities are not eligible for incentives under the Meaningful Use program. Implementation of an EHR system in an LTC facility can potentially enhance the quality of care, provided it is appropriately implemented, used, and maintained. Unfortunately, the lag in adoption of the EHR in LTC creates a paucity of literature on the benefits of EHR implementation in LTC facilities.ObjectiveThe objective of this systematic review was to identify the potential benefits of implementing an EHR system in LTC facilities. The study also aims to identify the common conditions and EHR features that received favorable remarks from providers and the discrepancies that needed improvement to build up momentum across LTC settings in adopting this technology.MethodsThe authors conducted a systematic search of PubMed, Cumulative Index of Nursing and Allied Health (CINAHL), and MEDLINE databases. Papers were analyzed by multiple referees to filter out studies not germane to our research objective. A final sample of 28 papers was selected to be included in the systematic review.ResultsResults of this systematic review conclude that EHRs show significant improvement in the management of documentation in LTC facilities and enhanced quality outcomes. Approximately 43% (12/28) of the papers reported a mixed impact of EHRs on the management of documentation, and 33% (9/28) of papers reported positive quality outcomes using EHRs. Surprisingly, very few papers demonstrated an impact on patient satisfaction, physician satisfaction, the length of stay, and productivity using EHRs.ConclusionsOverall, implementation of EHRs has been found to be effective in the few LTC facilities that have implemented them. Implementation of EHRs in LTC facilities caused improved management of clinical documentation that enabled better decision making.

Nursing Information Flow in Long-Term Care Facilities

“…38 A recent systematic review focusing on resident quality outcomes associated with electronic health records in LTC had mixed findings. 39 While this study sheds light on common content and information workflow across several LTC facilities, it does not replace the need for a facility-level assessment of information needs and workflow for clinical care prior to information system implementation. This study may inform and reduce the time needed for a local needs assessment.…”

Outcomes of health information technology utilization in nursing homes: Do implementation processes matter?

“…These prompts have led to slight improvements in clinician action 18 and to increased clinician compliance. 4 These mechanisms capitalize on the use of better data for clinicians to make better care-related decisions, which should ultimately improve the efficiency and quality of care (Kruse et al, 2017). 19 In addition, the data in aggregate form can help managerial staff supply data to regulators, apply for grants and thus become better funded, and make better managerial decisions.…”

“…4 These mechanisms capitalize on the use of better data for clinicians to make better care-related decisions, which should ultimately improve the efficiency and quality of care (Kruse et al, 2017). 19 In addition, the data in aggregate form can help managerial staff supply data to regulators, apply for grants and thus become better funded, and make better managerial decisions. 17,20 A third way that EMRs can improve the efficiency and quality of care is through staff oversight and productivity improvements.…”

An Approach for Data Mining of Electronic Health Record Data for Suicide Risk Management: Database Analysis for Clinical Decision Support (Preprint)

“…These tools have been on the rise in recent years due to their ability to bring evidence-based medicine to point of care. A Clinical Decision Support System (CDSS) is a health information system that is integrated into Electronic Health Records (EHR), enabling easy and effective use by physicians [9]. A CDSS incorporates individual patient data, a rule engine, and a medical knowledge base to produce a patient-specific assessment or recommendation of a management plan [10].…”