Health Data Sharing in US Nursing Homes: A Mixed Methods Study

Abstract

Objectives: (1) To understand the extent to which nursing homes have the capability for data sharing and (2) to explore nursing home leaders' perceptions of data sharing with other health care facilities and with residents and family members.

Design: Exploratory, mixed-methods.

Setting and participants: We conducted a secondary analysis of data from a national survey of nursing home administrative leaders (n = 815) representing every state in the United States. Next, semistructured interviews were used to elicit rich contextual information from (n = 12) administrators from nursing homes with varying data-sharing capabilities.

Methods: We used descriptive statistics along with Rao-Scott chi-square and logistic regression models to examine the relationship between health data-sharing capabilities and nursing home characteristics such as location, bed size, and type of ownership. Qualitative data were analyzed using content analysis.

Results: Of the 815 nursing homes completing the survey, 95% had computerized (electronic) medical records, and 46% had some capability for health information exchange. Nursing homes located in metropolitan areas had 2.53 (95% confidence interval = 1.53, 4.18) times greater odds for having health information exchange capability compared with nursing homes in small towns. Perceived challenges to health data sharing with residents and family members and external clinical partners include variance in systems and software, privacy and security concerns, and organizational factors slowing uptake of technology. Perceived benefits of health data sharing included improved communication, improved care planning, and anticipating future demand.

Conclusions and implications: As health data sharing becomes more ubiquitous in acute care settings, policy makers, nursing home leaders, and other stakeholders should prepare by working to mitigate barriers and capitalize on potential benefits of implementing this technology in nursing homes.

Keywords: Nursing home; health information exchange; information technology; older adults.

Fig. 1.

Extent to which medical or resident records are computerized in the nursing home.

Fig. 2.

Extent to which resident care systems are able to interface with external entities’ computerized systems (eg, clinics, clinical laboratory, hospitals, other nursing homes, etc).