Doctor reading medical records on a digital tablet.
(Credit: DjelicS / Getty Images)

Electronic health records can provide information about residents that enable providers to be part of value-based care efforts, and if they are used to their potential, they can boost efficiencies and profitability. Their use in assisted living, however, greatly trails use in nursing homes, according to recently released data.

As the Federal Health IT Strategic Plan aims to advance health information technology, it is working to understand trends in EHR use and health information exchange capability over time in various healthcare sectors, including residential care communities.

The use of electronic health records in such communities, such as assisted living communities and personal care homes, is increasing but still is less than the usage rate in nursing homes. 

From 2018 to 2022, the percentage of residential care communities using EHRs increased from 36% to 48%, according to an article in the May 2 Morbidity and Mortality Weekly Report, published by the US Centers for Disease Control and Prevention. 

Use of EHRs increased during this time regardless of community size, although larger communities were more likely to use EHRs compared with smaller ones. Communities with four to 50 beds increased their use of EHRs from 26% in 2018 to 35% in 2022, whereas communities with more than 50 beds went from 64% usage of EHRs to 80% during that time. 

Data came from the National Post-acute and Long-term Care Study in 2018, 2020 and 2022. The study is conducted by the CDC’s National Center for Health Statistics.

By comparison, a study published in December 2023, prepared for the Department of Health and Human Services  Office of the Assistant Secretary for Planning and Evaluation by RTI International, found EHR adoption in nursing homes at 84%.

The RTI study noted that long-term care and post-acute care providers are adopting EHRs to support their clinical and business needs, but interoperable exchange of health information is not routine or widely used. And without incentive or policy mandates, use of interoperability features available in EHRs will lag.

Maximizing EHR use

EHR software can integrate with other software solutions to improve care and maximize efficiencies. But a new LeadingAge Center for Aging Services Technologies annual EHR Matrix update, issued Monday, reported that most providers have not expanded their use of EHRs in the past year. This reality, according to LeadingAge CAST, raises concerns that providers are not accessing capabilities to enable interoperability and health information exchange to improve care.

The 2024 update, covering all types of long-term care and post-acute care providers, revealed little to no expansion in the use of higher interoperable functionalities of EHRs. Most providers (25%) said they are using a basic integration between the EHR and other external or ancillary systems. Almost 20% of providers said they engage with different care team members and use basic information exchange capabilities. Only 8% of providers said they take full advantage of interoperability offerings.

“This stagnation prompts critical questions about the obstacles and challenges (lack of funding) that organizations encounter in elevating their EHR systems to more advanced levels of interoperability,” LeadingAge CAST Vice President Scott Code said in a statement

The SAL, or Shake a Leg, Management group, which operates assisted living communities in Utah, was cited in the update as a success case in EHR use. SAL overhauled its operations to improve resident care, implementing the technology across all 19 of its communities in two weeks. The communities reported a 12.4% increase in care revenues per resident per day and increased occupancy since implementation, among other benefits. 

Long-term care providers of all sorts need to be included in the federal government’s strategy plan for information technology, a coalition of industry advocates recently told the federal Office of the National Coordinator for Health Information Technology, which is part of HHS.

The LTPAC Health IT Collaborative — with members that include the American Health Care Association / National Center for Assisted Living, LeadingAge and AMDA–The Society for Post-Acute and Long-Term Care Medicine, among others — recently sent a letter to the ONC with comments and recommendations on the plan. The group said that the federal government should integrate the needs and requirements of senior living and other long-term care providers into its health IT strategy to address the varying needs and complexities of the residents served in those settings, as well as demands for data-sharing across the entire healthcare continuum.