An annual LeadingAge CAST survey reveals that most aging services providers are using electronic health record (EHR) systems in advanced ways, improving patient outcomes.
The CAST 7-Stage EHR Adoption Model benchmarks the level of sophistication of EHR use in senior living. The 2025 survey indicates that most organizations are using EHRs in ways that improve care quality, integrate with other systems, involve various members of the care team, and provide basic information exchange.
”While many providers have adopted higher-functionality EHR systems and are making meaningful use of those capabilities, only a small percentage have reached Stage 7—the level that enables true interoperability and full participation in health information exchange,” said Scott Code, vice president at LeadingAge CAST.
To assist CAST members and other industry providers in choosing the best EHRs for their needs, CAST has updated and expanded its EHR Technology Selection Tool. In addition, CAST has updated its Health Information Exchange (HIE) Selection Tool, to empower providers to participate in the secure and timely exchange of protected health information and improve patient care.
Findings from CAST 7-Stage EHR Adoption Model
For this tenth annual survey, CAST followed its established approach of asking EHR vendors to report how their clients are using EHRs and to indicate the percentage of clients at each stage of adoption using the CAST 7-Stage EHR Adoption Model. The 2025 results were remarkably similar to those in 2024, with most aging services providers in stages 4-6:
- Stage 1 – Basic Information System: Without the clinical elements of an EHR (5.67% of respondents)
- Stage 2 – Basic EHR (11.48%)
- Stage 3 – Ancillary & Clinical Administration (Non-Integrated) – Extends the EHR beyond its basic setting-specific functionalities to other ancillary areas and adds efficiency capabilities (11.44%)
- Stage 4 – Advanced EHR (Internal Quality-Focused) – Adds functionalities and capabilities that allow providers to use their EHR to improve care quality inside their organization (17.27%)
- Stage 5 – External Ancillary Services Integration – Focuses on basic integration between the EHR and other external and ancillary systems (26.34%)
- Stage 6 – Engagement & Basic Information Exchange – Focuses on tools and capabilities that aim to engage different members of the care team, including the physician and possibly the patient/resident/client, as well as basic information exchange capabilities (19.12%)
- Stage 7 – Interoperability & Health Information Exchange – Represents the ideal full interoperability stage the sector strives for that allows the exchange of information in a standards-based data format that other EHRs can both understand and consume (8.69%)
The steady progress in stages 4 through 6 reflects continued investment and maturity in how EHR systems are used. However, the relatively small percentage at Stage 7 signals that true interoperability remains a work in progress for most providers—highlighting both a challenge and an opportunity for the field.
CAST Announces Technology Selection Tool Updates
The updated EHR Technology Selection Tool and Health Information Exchange Selection Tool are among CAST’s 10 Technology Selection Tools, designed to guide providers in understanding key technologies and in choosing the solutions that best match their organizations’ unique requirements. Each tool includes a white paper with invaluable information about the technology, an online selection matrix, an online selection tool, and provider case studies to enable peer-to-peer learning.
EHR Technology Selection Tool Update
The 2025 update to the EHR Technology Selection Tool includes updated information on 13 products, so that providers can make their selections based on the latest product features. A new case study, “Built for Scale: How Navion Standardized Clinical Operations Across 50+ Communities with ECP,” explains how Navion Senior Solutions, a senior living provider in the Southeastern United States, implemented assisted living software from ECP across more than 50 communities in seven states.
As testament to ECP’s benefits, Navion nearly eliminated missed medications, made almost all medications available by time of administration, decreased late medications—and received ECP’s 2024 Med Management Award. In the operational space, Navion’s regional directors now rely on real-time dashboards to track adoption, compliance, and clinical performance, and a unified system has created consistent workflows and documentation practices.
HIE Selection Tool Update
The latest version of the Health Information Exchange (HIE) Selection Tool includes updated information on 44 HIEs and adds these HIEs to the list of available options:
Budget Reconciliation 2025
