University of Utah
Evaluating Nursing Home EHR Data for Emerging Palliative Care Needs
Real World Data Source
LTC Data Cooperative
Dr. Block is a postdoctoral fellow at the University of Utah College of Nursing. Her research focuses on
improving care for nursing home residents, particularly those living with dementia and experiencing unmet
palliative and behavioral health needs. She uses mixed methods approaches, combining large-scale data
analysis with qualitative inquiry to identify patterns in resident symptoms and needs and to inform strategies
to improve care delivery. Her current research examines indicators of palliative care needs and seeks to
develop resident- and family-centered interventions that integrate palliative and behavioral health
approaches to improve symptom management at the end of life.
One in five older adults dies in a nursing home, where palliative care can improve symptom management and
care planning, yet many residents do not receive it in a timely way. Current approaches to identify residents
eligible for palliative care are few and rely on limited data, often missing opportunities to identify residents
with emerging palliative care needs earlier. This project will use detailed electronic health record (EHR) data,
linked to the Minimum Data Set (MDS) and Medicare claims, to identify and test indicators of emerging
palliative care needs. This award will provide Dr. Block with the necessary training and experience using the
Long-Term Care (LTC) Data Cooperative data resources to: (1) Identify and characterize EHR-derived
indicators of emerging palliative care needs among nursing home residents; and (2) Develop and evaluate an
EHR-enhanced measure of emerging palliative care needs and compare it with MDS and claims-based
approaches to assess improvements in timeliness and identification of residents who may benefit from
palliative care. This project will generate critical evidence on whether EHR-derived indicators can identify
emerging palliative care needs earlier, more accurately, and at scale compared to MDS-based approaches and
Medicare claims. These findings will inform the development of an EHR-enhanced measure that leverages high
frequency clinical data to identify actionable needs during periods when palliative care can meaningfully
influence symptom management and care planning. This work will lay the foundation for future research to
develop and implement scalable, data-driven strategies to improve timely access to palliative care among
nursing home residents.