Even as hospitals and physician offices continue to push forward with electronic health record installations, nursing homes and other long-term skilled nursing facilities are seemingly stuck in neutral.

About three-fourths of physicians are now using EHRs, according to statistics from the Manhattan Group, a health care research firm based in New York City, up from 12 percent in 2001.

Department of Health and Human Services Secretary Kathleen Sebelius said in a May USA Today article that EHR use had reached "the tipping point" with about 80 percent of hospitals and 50 percent of physicians using EHRs in a way that complied with guidelines for meaningful use of EHRs established by the Centers for Medicare and Medicaid Services.

All welcome news, but improving the nation's health care depends on having everyone on the care continuum digitally plugged in. And a weak link in the chain is long-term care, made ever more acute by the fact that skilled nursing facilities are taking on a bigger role as the nation ages and more citizens rely on the services they provide.

Although little data is available on the percentage of the nearly 16,000 LTC/skilled nursing facilities using EHRs, health information technology experts agree that their rate of EHR adoption is significantly less than that of hospitals and physician practices. The Office for the National Coordinator for Health Information Technology, in fact, issued a 2013 policy brief on EHR use in LTC and post-acute care that confirmed those sectors are bringing up the rear.

Skilled nursing facility experts cite many reasons for this discrepancy in EHR adoption. A lack of money to purchase, install, and maintain EHR systems, more than a lack of interest, is the primary reason why many facilities have not yet made the transition, says Greg Crist, vice president of public affairs for the American Health Care Association, an association representing 12,000 LTC and post-acute care organizations. "EHRs and their value-we appreciate it," Crist says. "Funding is the key obstacle."

Julie Jacob’s feature story in the September issue of Health Data Management examines funding and other challenges--such as lack of financial incentives along with a huge cultural change and learning curve--that raise barriers to long-term care acceptance of EHRs.

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