Electronic health records use and barriers and benefits to use in skilled nursing facilities

The purpose of this study was to determine the levels of automation for 21 clinical functions and the benefits and barriers to electronic health records use in skilled nursing facilities in one of the Midwestern states in the US. A cross-sectional design was implemented. Data were collected from nursing home administrators using a mail and online survey approach. A total of 156 usable questionnaires of 397 distributed were returned, for a 39.30% response rate. While many facilities reported fully automated Minimum Data Set assessments, licensed nurse clinical notes, and care plans, there remained a predominant reliance on paper for functions, such as diagnostic tests and consults. Although many facilities had advanced toward using automation to produce quality reports, they were lagging behind in the use of automated clinical decision support and summary reports. The top two barriers included the amount of capital needed and the cost for hardware and infrastructure. Facilities with paper records were more likely to identify those barriers for functions, such as clinical notes and assessments. The top three benefits were quality patient care monitoring, management control of performance, and anywhere/anytime easier access to clinical data. The study concludes with recommendations to nursing home leaders and other stakeholders.