服务创新是否会影响长期护理机构采用电子健康记录？来自美国全国住宅护理设施调查的结果。

Do service innovations influence the adoption of electronic health records in long-term care organizations? Results from the U.S. National Survey of Residential Care Facilities.

作者信息

Bhuyan Soumitra S, Zhu He, Chandak Aastha, Kim Jungyoon, Stimpson Jim P

机构信息

Division of Health Systems Management and Policy, School of Public Health, University of Memphis, Memphis, TN 38152, United States; Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, United States.

Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, United States.

出版信息

Int J Med Inform. 2014 Dec;83(12):975-82. doi: 10.1016/j.ijmedinf.2014.09.007. Epub 2014 Oct 2.

DOI:10.1016/j.ijmedinf.2014.09.007

PMID:25453201

Abstract

OBJECTIVE

Healthcare organizations including residential care facilities (RCFs) are diversifying their services to meet market demands. Service innovations have been linked to the changes in the way that healthcare organizations organize their work. The objective of this study is to explore the relationship between organizational service innovations and Electronic Health Record (EHR) adoption in the RCFs.

METHODS

We used the data from the 2010 National Survey of Residential Care Facilities conducted by the Centers for Disease Control and Prevention. The outcome was whether an RCF adopted EHR or not, and the predictors were the organizational service innovations including provision of skilled nursing care and medication review. We also added facility characteristics as control variables. Weighted multivariate logistic regressions were used to estimate the relationship between service innovation factors and EHR adoption in the RCFs.

RESULTS

In 2010, about 17.4% of the RCFs were estimated to use EHR. Multivariate analysis showed that RCFs employing service innovations were more likely to adopt EHR. The residential care facilities that provide skilled nursing services to their residents are more likely (OR: 1.42; 95% CI: 1.09-1.87) to adopt EHR. Similarly, RCFs with a provision of medication review were also more likely to adopt EHR (OR: 1.40; 95% CI: 1.00-1.95). Among the control variables, facility size, chain affiliation, ownership type, and Medicaid certification were significantly associated with EHR adoption.

CONCLUSIONS

Our findings suggest that service innovations may drive EHR adoption in the RCFs in the United States. This can be viewed as a strategic attempt by RCFs to engage in a new business arrangement with hospitals and other health care organizations, where quality of care and interoperability of patients' records might play a vital role under the current healthcare reform. Future research could examine the relationship between service innovations and use of different EHR functionality in RCFs.

摘要

目的

包括住宿护理机构（RCFs）在内的医疗保健组织正在使其服务多样化，以满足市场需求。服务创新与医疗保健组织组织其工作的方式变化相关联。本研究的目的是探讨RCFs中组织服务创新与电子健康记录（EHR）采用之间的关系。

方法

我们使用了疾病控制与预防中心进行的2010年全国住宿护理机构调查的数据。结果是RCF是否采用了EHR，预测因素是组织服务创新，包括提供专业护理服务和药物审查。我们还添加了机构特征作为控制变量。使用加权多变量逻辑回归来估计服务创新因素与RCFs中EHR采用之间的关系。

结果

2010年，估计约17.4%的RCFs使用EHR。多变量分析表明，采用服务创新的RCFs更有可能采用EHR。为其居民提供专业护理服务的住宿护理机构更有可能（OR：1.42；95%CI：1.09 - 1.87）采用EHR。同样，提供药物审查的RCFs也更有可能采用EHR（OR：1.40；95%CI：1.00 - 1.95）。在控制变量中，机构规模、连锁关系、所有权类型和医疗补助认证与EHR采用显著相关。