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Letter to the Editor| Volume 22, ISSUE 2, P475-476, February 2021

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Adoption of Electronic Health Records by Practices of Nursing Home Providers and Wi-Fi Availability in Nursing Homes

Published:October 29, 2020DOI:https://doi.org/10.1016/j.jamda.2020.09.028
      Electronic health record (EHR) systems improve clinical decision making, health information exchange, and quality improvement.
      • Alexander G.L.
      • Madsen R.W.
      A report of information technology and health deficiencies in U.S. nursing homes.
      ,
      • Bjarnadottir R.I.
      • Herzig C.T.
      • Travers J.L.
      • et al.
      Implementation of electronic health records in U.S. nursing homes.
      Federal policies encourage EHR adoption through Meaningful Use programs. However, most of these policies target acute and primary care.
      • Holup A.A.
      • Dobbs D.
      • Meng H.
      • Hyer K.
      Facility characteristics associated with the use of electronic health records in residential care facilities.
      ,
      Department of Health and Human Services, Centers for Medicare & Medicaid Services
      Medicare and Medicaid programs; Electronic Health Record Incentive Program. Final Rule.
      Lacking incentives, nursing homes (NHs) historically lagged behind outpatient clinics and hospitals in EHR adoption.
      • Felix H.
      • Dayama N.
      • Morris M.E.
      • et al.
      Organizational characteristics and the adoption of electronic health records among nursing homes in one southern state.
      Recent studies suggest increased rate of EHR adoption by NHs, ranging from 40% to 84%.
      • Bjarnadottir R.I.
      • Herzig C.T.
      • Travers J.L.
      • et al.
      Implementation of electronic health records in U.S. nursing homes.
      ,
      • Vest J.R.
      • Jung H.Y.
      • Wiley K.
      • et al.
      Adoption of health information technology among US nursing facilities.
      Furthermore, NH primary care providers (PCPs) often use different EHRs from the NH themselves, which have their own EHR adoption struggles.
      • Furukawa M.F.
      • King J.
      • Patel V.
      • et al.
      Despite substantial progress in EHR adoption, health information exchange and patient engagement remain low in office settings.
      ,
      • Heisey-Grove D.
      • King J.A.
      Physician and practice-level drivers and disparities around meaningful use progress.
      Because NH practice is only a proportion of work time for many NH PCPs,
      • Katz P.R.
      • Karuza J.
      • Intrator O.
      • Mor V.
      Nursing home physician specialists: A response to the workforce crisis in long-term care.
      studies of NH EHR fail to capture EHR adoption among NH PCPs' medical practice. Ideally, NH PCPs could access wireless Internet (Wi-Fi) for secure usage of their personal EHR in NH settings. Although the rise in EHR adoption by NH has been documented by several studies,
      • Bjarnadottir R.I.
      • Herzig C.T.
      • Travers J.L.
      • et al.
      Implementation of electronic health records in U.S. nursing homes.
      ,
      • Vest J.R.
      • Jung H.Y.
      • Wiley K.
      • et al.
      Adoption of health information technology among US nursing facilities.
      to our knowledge, no studies assessing NH PCPs' EHR adoption or the availability of Wi-Fi in NH exist.
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