Report on EHR & Telehealth Adoption

A report by the Maryland Health Care Commission (MHCC) https://mhcc.maryland.gov spotlighting Health Information Technology in Nursing Homes, discusses key information on HIEs, EHRs, telehealth, and SDOHs.

Use of health IT is particularly important in supporting older patients with complex chronic care needs that often result in more frequent transitions between their homes, acute care, and nursing home settings.

The MHCC conducted interviews with representatives from eight nursing homes in Maryland to learn more about the impact of EHRs and telehealth adoption. Nursing home representatives participating consisted of three chains and five non-chains which account for about 60 nursing home sites statewide. During COVID-19, EHRs and telehealth enabled providers had to quickly adapt to shifting needs for patient care along with HIE enabled timely accurate and reliable data sharing.

According to the report, nursing homes generally use telehealth to support geriatrician, psychiatric, and palliative care consults. Nursing homes’ adoption of telehealth has increased over the last two years with most adopting the technology during the pandemic.

Maryland nursing homes have achieved a 98% EHR adoption. Among the EHR vendors used by nursing homes, one vendor PointClickCare has a sizable presence. Today, the Chesapeake Regional Information System for Our Patients (CRISP) is working with the two largest EHR vendors operating in the state. They are using  PointClickCare and Matrix Care to integrate with their EHRs.

As for HIEs, the systems are usually funded through private and public partnerships. CRISP continues to expand provider access to HIE information through EHR integration. Enabling providers to have access to HIE information in the workflow creates efficiencies in care delivery and provides timely and seamless portability of information.

As for information technology security, unfortunately, the frequency of healthcare data breaches, magnitude of records potentially exposed, and financial losses due to breached records are rapidly increasing.

Nursing homes are especially vulnerable as most lack the financial resources to invest in cybersecurity. Outsourced cybersecurity management is increasingly common in health care. Managed Security Service Providers are taking on the responsibility to monitor and initiate an appropriate response that could result in intrusion or potential exposure.

The report points out that Social Determinants of Health (SDOH) guide discharge planning, access to outpatient rehabilitation services, and other therapeutic interventions. SDOH information collected by nursing homes enables coordination with community-based support for the patient and family when returning to the community. However, less than one-half of nursing homes collect SDOH information.

Information on the “Report on Health Information Technology in Nursing Homes” with an overview of health IT use and perceived value among nursing homes in Maryland, is available at the Maryland Health Care Commission’s web site https://mhcc.maryland.gov. Also, available at https://mhcc.maryland.gov/mhcc/Pages/hit/hit/hit_documents.aspx.

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