New Findings: LeadingAge Ziegler 200 EMR/EHR Sophistication Survey

CAST | March 18, 2020 | by Donna Childress

More large senior living providers are using increasingly sophisticated electronic medical records.

Electronic medical record/electronic health record systems adopted by the nation’s largest not-for-profit senior living organizations have become significantly more sophisticated in the past three years.
The LeadingAge Ziegler 200 EMR/EHR Sophistication Survey asked respondents to classify the sophistication of their current electronic health records (EHRs) using CAST’s 7-Stage EHR Adoption Model. Results of the survey, fielded in Dec. 2019, found that nearly 73% of the 127 responding organizations are in the highest stages of adoption, Stages 5-7. At the 2017 survey, only 58% were that advanced, an increase of 15%.
More organizations moved into Stage 7 than into any other stage since the last survey; the increase from 2017 to 2020 was 12%. Now, 24% of responding organizations are in Stage 7, meaning they have advanced interoperability and health information exchange capabilities. These capabilities include exchanging information electronically between their EHR to another provider’s EHR directly in one-to-one fashion, or connecting to a state or regional health information exchange (HIE) entity (i.e., one-to-many).

“The results show that LeadingAge’s largest providers are increasingly recognizing the importance of maximizing the benefits that EHRs can bring, and are starting to deploy more advanced capabilities,” said Majd Alwan, LeadingAge’s Senior Vice President of Technology & Business Strategy, and Executive Director of CAST. “These capabilities, such as clinical decision support, engagement, advanced interoperability, health information exchange, including connecting to other providers not only in one-to-one fashion, but also connecting to many via HIE entities, are key to quality improvement, collaborative care, and value-based models.”

“Although the percentage of EHR adoption have dropped from 84% in 2016 to 74.5% in 2019, as a result of adding 50 smaller organizations to the largest 150 LeadingAge providers members, I am pleased to see continuing increase in the sophistication of the EHRs being deployed by providers,” said Lisa McCracken, Director of Senior Living Research and Development at Ziegler.

LeadingAge CAST 7-Stage EHR Adoption Model

The CAST 7-Stage EHR Adoption model is a generalized model that provides a framework to assess the level of adoption and sophistication of use, as opposed to just the overall rate of adoption, of EHRs in long-term and post-acute care. 

The first four stages encompass more basic systems. Organizations in the later stages have an advanced EMR/EHR with the following capabilities:

  • Stage 5: External ancillary services integration (with pharmacy integration, computerized physician order entry, and ePrescribing).
  • Stage 6: Engagement and basic information exchange capabilities (with physician portal and eSignature, sending and receiving documents electronically, not fax, directly to/from other providers).
  • Stage 7: Interoperability and health information exchange capabilities (capable of sending and receiving documents electronically, not fax, to/from other providers through a health information exchange).  

The LeadingAge Ziegler 200 EMR/EHR Sophistication Survey

The LeadingAge Ziegler 200 EMR/EHR Sophistication Survey, conducted in December 2019, asked LeadingAge Ziegler 200 organizations about their EMR/EHR adoption.
The LeadingAge Ziegler 200 (LZ 200) is an annual ranking and analysis of the nation’s 200 largest, most complex not-for-profit senior living organizations as of the end of the previous year. Ziegler, one of the nation’s leading underwriters of financings for not-for-profit senior living providers, and LeadingAge, the nation’s largest association of not-for-profit aging service providers in the country, team to provide the report. Ziegler is a LeadingAge Gold Partner with CAST Focus.