National Healthcare Disparities Report - LDI Health Economist

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Health System Infrastructure Figure 8.2. Electronic medical record use in home health and hospice agencies, by geographic location and ownership, 2009 100 Northeast South Midwest West 100 For Profit Government Private, Not for Profit 75 75 Chapter 8 Percent 50 Percent 50 25 25 0 Overall Patient Demographics Clinical Notes Clinical Decision Support CPOE 0 Overall Patient Demographics Clinical Notes Clinical Decision Support CPOE Key: CPOE = computerized provider order entry. Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Home Health and Hospice Care Survey, 2009. Note: Government agencies include city, county, State, Department of Veterans Affairs, and other Federal agencies. Data were statistically unreliable for clinical decision support systems that were located in the West and agencies that were government owned as well as for CPOE used by for-profit agencies, government-owned agencies, and agencies located in the Northeast and the West. Overall Computerized System Adoption n In 2007, agencies in the Midwest had a significantly higher overall percentage of providers of home health or hospice care with EHRs than agencies in the South and the West (Figure 8.2). n In 2007, for-profit providers of home health or hospice care had a significantly lower overall percentage of EHRs than private, not-for-profit and government providers. Patient Demographics n In 2007, of those organizations with an EHR system, nearly all providers of home health or hospice care in each region had EHRs that used a component for patient demographics. n All government providers of home health or hospice care had an EHR system with a patient demographics component. Nearly all agencies that were private, not for profit and agencies that were for profit had EHRs with a component for patient demographics. 208 National Healthcare Disparities Report, 2011
Health System Infrastructure Clinical Notes n In 2007, of those agencies that had an EHR system, 97% of agencies in the Midwest, 82% of agencies in the West, 80% of agencies in the South, and 64% of agencies in the Northeast had an EHR system with a component for clinical notes. n More than 95% of agencies that are private, not for profit, 80% of agencies that are government owned, and 70% of agencies that are for profit had EHRs with a component for clinical notes. Clinical Decision Support System n In 2007, of those agencies that had an EHR system, 60% of agencies in the Midwest, 59% of agencies in the South, and 49% of agencies in the Northeast had EHRs with a component for clinical decision support. n More than 71% of private, not-for-profit providers and 40% of for-profit providers had EHRs with a component for clinical decision support. Chapter 8 Computerized Provider Order Entry n In 2007, of those agencies that had an EHR system, 51% in the Midwest and 42% in the South had EHRs with a CPOE component. n Nearly 46% of providers of home health or hospice care that are private, not for profit had EHRs with a CPOE component. Also, in the NHQR: n In 2007, among agencies with an EHR, those with101-150 current patients had the lowest percentage of providers of home health or hospice care whose EHRs included patient demographics (96%). Of the agencies that had an EHR system, 99% of agencies with 151 or more current patients, 99.2% of agencies with 50 or fewer current patients, and 99.7% of agencies with 51-100 current patients had providers with EHR systems that had a component for patient demographics. n Three-quarters of agencies with 151 or more current patients, 67% of agencies with 51-100 current patients, and 31% of agencies with 50 or fewer current patients had EHRs with a CDS component. n Nearly 63% of organizations that had an EHR system and 51-100 current patients, 53% of organizations with 151 or more current patients, and 38% of organizations with 50 or fewer current patients had EHRs with a component for CPOE. Workforce Diversity According to the U.S. Census Bureau (2011), adults age 65 and over accounted for 13% (40.3 million) of the U.S. population in 2010 (Howden & Meyer, 2011). By 2050, that number will more than double to 88.5 million (20%). In 2010, the number of people age 100 and over reached 71,991, and this population is projected to grow to 601,000 by 2050 (U.S. Census Bureau, 2011). Older adults are at increased risk of accidental falls, which are associated with reduced levels of independence, poorer quality of life, and high levels of anxiety (Hanley, et al., 2011). In 2009, 2.2 million nonfatal falls among older adults were treated in emergency departments and more than 520,000 of these patients were hospitalized (Centers for Disease Control and Prevention [CDC], 2011). Occupational and physical therapy can help patients recover from injury and can prevent falls. National Healthcare Disparities Report, 2011 209
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