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AHRQ--Agency for Healthcare Research and Quality: Advancing Excellence in Health Care

Topic Suggestion Description

View Topic Suggestion Disposition (PDF) 184 kB

Date submitted: August 24, 2009

Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.
What are the minimum requirements for an EHR to be considered clinically and operationally effective from a compliance and interdisciplinary care management standpoint in Skilled Nursing Facility
Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)
If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:
"It is understood that there is a difference in the requirements of an Electronic Health Record solution based on different healthcare settings namely skilled nursing facilities, acute care hospitals, long term care hospitals.
For purposes of this study, we will be focusing on the effective EHR use in SNF setting
We will compare current processes (Business workflows) with intended processes to develop a EHR blueprint. "
What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)
Skilled Nursing Facilities
Medicare and Medicaid Recipients
Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)
Elderly--Non Gender specific
Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)
"The expected positive outcomes from this study are the following
SNF will have access to this study for comparison and gap analysis of their current processes regardless of EHR
The blueprint will allow the SNF to jump start their EHR program with lesser time spent on initial study, vendor selection and functional requirement gathering.
The blueprint will allow the SNF to recognize the interdisciplinary care communication needed to optimize their operations ; clinical and administrative.
The blueprint will provide a baseline for SNF to engage with stakeholders (staff, investors, consumers, vendors etc.) when planning for EHR implementation
This will become important given the numerous healthcare reforms in the making encouraging practices and settings to be integrated in patient centered care"
Describe any health-related risks, side effects, or harms that you are concerned about.
None at this time

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?
Which priority area(s) and population(s) does this topic apply to? (check all that apply)
EHC Priority Conditions (updated in 2008)
AHRQ Priority Populations
  • Elderly
  • Individuals with special health care needs, including individuals with disabilities or who need chronic care or end-of-life health care
Federal Health Care Program
  • Medicaid
  • Medicare


Describe why this topic is important.
"Under the HITECH Act, there is a major thrust on hospitals to embrace an EHR solution. Although adoption is voluntary for hospitals, there are financial gains for them to participate in this initiative. SNF does not have a mandate or a financial gains to implement EHR. It will be fair to assume that the SNF may end up participating in some form of EHR in near future given the patient centered care considerations
However, given the proposed reimbursement cuts for SNF and shortage of available personnel resources, it will take significant time, money and effort to develop and adopt EHR that is satisfactory for all stakeholders.
In addition, variations in EHR implementation across Sniffs could result in fluctuating outcomes
With well explored blueprint made available, the SNF will be able to respond quickly to the anticipated needs in an integrated healthcare environment"
What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)
Observation of inconsistent documentation, absence of standards, costly reviews and denial process affecting CMS, fiscal intermediary and the provider, lack of research in this area, HITECH Act 2009, lack of the bridge between IT and Healthcare
Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)
If yes, please explain:

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?
It will help the SNF to respond proactively to the future demands of regulatory and technology changes
It will allow them to plan well in advance in terms of cost, time, resource, compliance, efficiency, technology as part of overall program management.
Describe the timeframe in which an answer to your question is needed.
Quarter 1 - Statement of work, reach out to participants/stakeholders
Quarter 2 - Preparation of questionnaire and circulation
Quarter 3 and 4 - Receiving response, synthesis
Quarter 5 and 6 - Review and Conclusion
Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

Nominator Information

Other Information About You: (optional)
Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
  • Other Health Care Professional
  • Other
Are you making a suggestion as an individual or on behalf of an organization?