Implementing health information technology (HIT) is viewed as a potentially effective solution for some challenges facing the aged care industry, such as skilled staff shortages [1,2]. For example, the use of HIT, particularly electronic health records (EHRs), may help improve the quality of care by providing staff with accurate, reliable, and up-to-date information about the health issues of residents under their care, and facilitate effective decision-making and appropriate action during care provision [3].
It has also been suggested that EHRs can help facilitate more efficient documentation processes, freeing up time for staff to spend on direct care for residents [4]. However, some studies exploring time efficiency for documentation activities have shown that EHRs increase or have no effect on documentation time [[5], [6], [7]] while other studies have shown improvement in documentation times [[8], [9], [10], [11]]. In one literature review, 8 out of 12 papers that explored EHR impact on documentation times showed positive impact compared to only 5 that showed negative impact [12]. Other reported benefits of EHRs for residential aged care staff include better access to resident information, improved internal and external communication [3,8].
Studies have shown that benefits for organisations resulting from implementing EHRs include streamlined monitoring of staff work performance, efficient collection and use of data to support administrative activities, financial, regulation and compliance reporting [13], quality monitoring and securing funding [3]. In addition to these benefits, staff and management perceptions of EHRs in aged care services have been positive and there is widespread agreement that EHRs are beneficial for aged care [3,5,6].
Research on the impact of EHRs in aged care has been largely focused on perceived non-clinical benefits for consumers (e.g., improved communication and more contact time with care providers) [3,5,14] or operational efficiency for care staff and provider organisations [5,11]. However, the impact of implementing EHRs on health outcomes for residents is paramount to study as EHRs can help improve outcomes for care recipients but can also cause errors that may lead to unintended patient harm [15,16] and HIT problems in other care settings have previously been linked to patient harm and death in other studies [16,17]. As the implementation of EHRs in residential aged care grows, researchers are beginning to explore their impact on residents’ health outcomes. Installing an EHR alone may not be enough to produce favourable outcomes for healthcare consumers but it can enable other interventions which can, such as clinical decision support systems (CDSS), dashboards, real-time alerts, interoperable data exchange, data analytics and artificial intelligence. As we had no prior knowledge of whether residential aged care providers are using solely EHRs or EHR-based interventions to leverage the data contained in EHRs, we sought to include articles that describe studies of interventions building on the presence of EHRs. Therefore, our aim for this study was to:
- (i)
Examine whether implementing EHRs and/or EHR-based interventions (integrated into the EHRs or built on the EHRs) in residential aged care facilities has any impact on health outcomes for residents,
- (ii)
Review and summarise published evidence of the impact of such interventions on health outcomes for residents.