A Report of Information Technology and Health Deficiencies in U.S. Nursing Homes

Abstract

Objective-Investigate the impact of nursing home information technology sophistication on publically reported health safety deficiency scores documented during standard inspections. Methods-The sample included 807 NHs from every US state. A total of 2187 health inspections were documented in these facilities. A national IT sophistication survey describing IT capabilities, extent of IT use, and degree of IT integration in resident care, clinical support, and administrative activities in US NHs was used. The relationship between NH health deficiencies and IT sophistication survey scores were examined, using weighted regression. Results-Controlling for RN hours per resident day, deficiency scores decreased as total IT sophistication increased. Controlling for total IT sophistication score, deficiency scores decreased as RN hours per resident day increased. Ownership status significantly influenced health deficiency scores. Conclusions-These results highlight the necessity to understand benefits of implementing NH IT and demonstrating its impact on patient safety.

Nursing Home Implementation of Health Information Technology: Review of the Literature Finds Inadequate Investment in Preparation, Infrastructure, and Training

“…The mix of negative evidence on training and productivity, versus positive evidence on staff communications and teamwork, may explain why we found no clear evidence that HIT enabled staff to improve quality of care. Alexander et al have found that higher HIT sophistication in NHs is associated with improved quality of resident care, 1 , 39 but it is not clear if HIT led to improvements, versus if the types of NHs that invest in more sophisticated HIT are also more likely to have higher quality of care. If HIT-related benefits are seen only in NHs with higher levels of staffing, this suggests that HIT adoption by other NHs may not produce the desired results.…”

“…Health information technology (HIT) systems have the potential to improve safety, communication, and productivity in nursing homes (NHs). Early research suggests HIT can improve scores on NH quality indices 1 ; resident outcomes such as maintenance of activities of daily living, range of motion, and bed mobility 2 ; and clinical support to reduce rates of adverse drug events and increase identification of medication errors. 3 , 4 The most recent survey of information technology (IT) in NHs reported that IT sophistication remains greatest for administrative support, such as billing functions, with growing incorporation in resident care functions such as bed availability and discharge management, and relatively slow uptake for clinical support functions such as documentation of vital signs, incident reporting, and medication administration.…”

“…The progression from HIT capability to integrated use depends on multiple factors, including staff training, skills, perceived value of HIT, and integration into organization workflows. 1 Early research on HIT adoption in NHs has found that training and the need for culture change are important barriers to implementation. 6 Greater satisfaction with HIT in NHs is associated with good training resources and effective implementation strategies, including carefully planned change management procedures, hiring adequately trained IT staff, and offering a system support plan.…”

Nurses' Views on Infection Control in Long-Term Care Facilities in South Korea: A Focus Group Study

“…However, the extent and current capabilities of health technology in LTCFs is limited owing to diverse organizational environment systems. As a result, gaining an understanding of its limits should be a prioritized objective, while an integration of sophisticated health technology systems into long-term care should be further emphasized [31].…”

Organizational Characteristics and the Adoption of Electronic Health Records Among Nursing Homes in One Southern State

“…The 2014 federal report, Adverse Events in Skilled Nursing Facilities, estimated the cost of adverse events in NHs to be greater than 2.8 billion dollars and that two thirds of the adverse events that resulted in harm were preventable. Examples of adverse events identified by the report include medication errors, poor management of conditions, and preventable infections, among others (Office of the Inspector General, 2014).Previous research has shown that Health Information Technology (HIT) can improve quality of care and patient safety in a variety of health care settings, including some NHs (Alexander & Madsen, 2017;Kruse et al, 2017;Olsho et al, 2014; Rantz et al, 2010). HIT comprises an "array of computer applications for health care" to be used by health care providers, administrators, and patients for a variety of clinical and administrative functions, such as census management, billing, and maintaining and using electronic health records (EHRs;Richard et al, 2009).…”