Interoperability, EHR integration top priorities for skilled nursing facilities

Electronic health records (EHRs) have become an integral part of high-quality care, yet organizations struggle with the sharing of patient data across systems. A brief from the Office of the National Coordinator (ONC) for Health Information Technology examines key measures in EHR integration and interoperability from skilled nursing facilities (SNFs) in 2016.

Long-term post-acute care (LTPAC) and SNFs were ineligible to participate in the Medicare and Medicaid Electronic Health Record Incentive Programs. Regardless, LTPAC providers have increased their interoperability and sharing capabilities. This report presented findings on current EHR use and interoperability to provide healthcare professionals with an inside look into how different types of care facilities are utilizing EHRs and improving interoperative measures.

Patients in SNFs often have complex medical needs and have received care at a range of facilities. The ability to share a patient’s data is crucial in maintaining a high-quality of care to patients with SNFs, and may possibly be the reason why EHR utilization and interoperability are top priorities at SNFs. According to the report, 64 percent of SNFs used EHRs to manage patient health information with the rate increasing for non-profit SNFs at 70 percent and 62 percent at for-profit facilities. There was no difference in EHR adoption based on having a rural or urban location and 46 percent of SNFs solely used EHRs but 18 percent utilized EHRs and health information organizations (HIOs).

Some 30 percent of SNFs were able to electronically exchange patient health information with 20 percent of information coming from outside sources. Information was easily integrated in SNFs systems according to only 9 percent of staff and only seven percent of facilities were able to achieve all four interoperative domains of sharing, receiving, finding and integrating data.

The larger the SNF, the more patient health information was integrated, with 12 percent of large SNFs integrating outside data while only 6 percent of medium facilities could do the same. Additionally, non-profit SNFs were more likely (36 percent) to exchange data than for-profit facilities (27 percent).

“In spite of barriers, SNFs' EHR adoption is higher than those of other long-term and post-acute care service providers such as adult day service centers," stated the report. “Our findings suggest that factors like HIO participation are also important to advancing interoperability among SNFs. Future research on the adoption and use of EHRs and other health IT (e.g., telehealth) among LTPAC providers, including hospice providers, home health agencies, and home and community-based services providers, is necessary to identify and address barriers that hinder the coordination and continuity of care for patients in these settings.”