Trends in Electronic Health Record Use Among Adult Day Services Centers, 2016-2022: A Cross-Sectional Panel Study

Electronic health records (EHRs) use has increasingly become more common in healthcare settings, yet their adoption and use in adult day services centers (ADSCs) remains underexplored. This study investigates EHR trends from 2016 to 2022 and identifies organizational characteristics associated with their use, addressing a critical gap in community-based long-term care technology research.

Data included the 2016, 2018, 2020, and 2022 waves of the National Post-acute and Long-term Care Study (NPALS), a nationally representative survey of ADSCs. EHR use was assessed through a single survey question. Independent variables included model type, ownership type, chain status, Medicaid licensure, size, and services provision. Weighted descriptive and survey-weighted logistic regression analyses were performed using Stata SE v18.

EHR use increased from 23.9% in 2016% to 31.2% in 2022 (p < 0.001). Significantly higher odds of EHR use (p < 0.05) were associated with larger centers (50+ participants, OR = 2.33), medical model centers (OR = 1.81), chains (OR = 1.23), and Medicaid-licensed centers (OR = 1.46). For-profit centers had lower odds (OR = 0.58) than nonprofits. Geographical differences were not statistically significant.

While EHR use has grown, a significant digital divide persists. Social model, smaller, smaller, independent, non-Medicaid-licensed centers, and for-profit centers are significantly less likely to adopt EHRs. Further research could examine the role of policies, funding, and decision-making processes that may present barriers or incentives to meaningful EHR implementation and whether they provide benefits for care coordination in ADSCs.