Trends in electronic health records use among residential care communities: United States 2012, 2014, and 2016

Questions for Christine Caffrey Health Statistician and Lead Author of “Trends in electronic health records use among residential care communities: United States 2012, 2014, and 2016.”

Q: Why did you decide to focus on electronic health records use and support for health information exchange among residential care communities?

CC: Since how health information is organized and shared has the potential to affect the quality and efficiency of care and improve communication and facilitate care coordination, especially during care transitions, we wanted to get a national view of how many residential care communities are using electronic health records and have support for health information exchange.

Also, as the Federal Health IT Strategic Plan 2015–2020, established by the Office of the National Coordinator for Health Information Technology, aims to advance health information technology, it is important to understand trends in EHR use and health information exchange capability over time in various health care sectors, including long-term care settings such as residential care communities.

Q: How did the data vary?

CC: We examined several characteristics of residential care communities to see whether electronic health record use and computerized support for health information exchange with physicians or pharmacies were different over time.  What we found was that the percentage of residential care communities that used electronic health records increased between 2012 and 2016 overall (20% to 26%), and increased for all bed size categories, profit and nonprofit ownership, chain and nonchain affiliation, six out of nine census divisions, and metropolitan and non-metropolitan statistical areas.

Among residential care communities reporting electronic health record use, computerized support for health information exchange with physicians or pharmacies also increased between 2012 and 2016 overall (47.2% to 55.0%), and among communities that had more than 100 beds, were for profit, chain affiliated, located in the East North and East South Central census divisions, and in both metropolitan and non-metropolitan statistical areas.

Q: Can you explain what is considered a residential care community?

CC: Residential care communities provide care to persons who cannot live independently but generally do not require the skilled care provided by nursing homes.

Residential care places are known by different names in different states. We refer to all of these places and others like them as residential care communities.  Just a few terms used to refer to these places are assisted living, personal care, and adult care homes, facilities, and communities; adult family and board and care homes; adult foster care; homes for the aged; and housing with services establishments.

Q: Was there a specific finding in the data that surprised you?

CC: In 2016, electronic health record use was higher in residential care communities in non-metropolitan statistical area (33.0%) compared with residential care communities in metropolitan areas (24.5%).

The percentage of residential care communities with more than 100 beds that used EHRs and had the capability to exchange health information increased from 48.4% in 2012 to 64.9% in 2016.

Q: What is the take home message for this report?

CC: The percentages of residential care communities that use electronic health records and have support for health information exchange with physicians and pharmacies are increasing over time, and the increases vary based on the organizational and geographic characteristics of the residential care communities.