Online Program

291033
Capacity and use of computerized systems to supported electronic health information exchange with pharmacies and physicians and electronic health records in residential care facilities in the US


Tuesday, November 5, 2013

Samuel Towne Jr., PhD, MPH, CPH, Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, TX
Janice C. Probst, PhD, University of South Carolina, South Carolina Rural Health Research Center, Columbia, SC
Zhimin Chen, MS, South Carolina Rural Health Research Center, Columbia, SC
We examined a nationally representative sample of residential care facilities (RCFs) to ascertain whether facility's computerized systems (CS) supported electronic health information exchange (EHIE) with pharmacies/physicians and having Electronic Health Records (EHRs). RCFs include assisted living residences, board/care-homes, congregate-care, enriched-housing programs, homes for the aged, personal-care homes, and shared-housing establishments.

We used the National Survey of Residential Care Facilities (NSRCF) public-use file (2010) to conduct a cross-sectional analysis. The unit-of-analysis was facilities. Dependent variables: having EHRs and EHIE with pharmacies/physicians. Facility characteristics included in analysis: facility size (small, medium or large), ownership-type (for-profit or non-profit), Metropolitan Statistical Area (MSA) status (MSA or non-MSA), and chain-affiliation. Bivariate analysis: Chi Square; Multivariable analysis: logistic regression.

Population: Nationally representative sample of RCFs (n=2,302).

Approximately 17.4% of RCFs used EHRs (2010). Bivariate: Having EHRs was associated with location, facility-size, ownership-type and chain-affiliation. Having CS supporting EHIE with physicians was associated with size. EHIE with pharmacies was associated with chain-affiliation. Multivariable: Absence of CS supporting EHIE with pharmacies was associated with: non-chain-affiliation (OR=1.7, 1.1-2.6). Absence of EHIE with physicians was associated with: small-sized (OR=0.4, 0.3-0.7). Absence of an EHR was associated with: non-chain-affiliation (OR=1.5, 1.2-2.0) small/medium-sized (OR=1.6, 1.2-2.3; OR=1.5, 1.2-2.1, versus large respectively), for-profit (OR=1.7, 1.3-2.3) and MSAs (OR=1.4, 1.03-1.9).

Maintaining health and independence for vulnerable adults across the spectrum-of-care calls for increasing use of EHRs and CS supporting EHIE in RCFs.

As more adults enter into older age groups, resources must be in place to provide an integrated system of care across multiple settings.

Learning Areas:

Communication and informatics

Learning Objectives:
Describe gaps in the use of Electronic Health Records, and capacity and use of computerized systems to supported electronic health information exchange (EHIE) with pharmacies or physicians in Residential Care Facilities and Evaluate the need for policy alternatives that seek to eliminate gaps in the use of EHRs and computerized systems to supported EHIE with pharmacies or physicians in Residential Care Facilities.

Keyword(s): Technology, Health Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract author on the content I am responsible for because I have successfully completed a CEPH accredited MPH program, am Certified in Public Health by the National Board of Public Health Examiners and am currently in a public health PhD program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.