Health information technology (HIT) is increasingly adopted by nursing homes to
improve safety, quality of care, and staff productivity. We examined processes
of HIT implementation in nursing homes, impact on the nursing home workforce,
and related evidence on quality of care. We conducted a literature review that
yielded 46 research articles on nursing homes’ implementation of HIT. To provide
additional contemporary context to our findings from the literature review, we
also conducted semistructured interviews and small focus groups of nursing home
staff (n = 15) in the United States. We found that nursing homes often do not
employ a systematic process for HIT implementation, lack necessary technology
support and infrastructure such as wireless connectivity, and underinvest in
staff training, both for current and new hires. We found mixed evidence on
whether HIT affects staff productivity and no evidence that HIT increases staff
turnover. We found modest evidence that HIT may foster teamwork and
communication. We found no evidence that the impact of HIT on staff or workflows
improves quality of care or resident health outcomes. Without initial investment
in implementation and training of their workforce, nursing homes are unlikely to
realize potential HIT-related gains in productivity and quality of care. Policy
makers should consider creating greater incentives for preparation,
infrastructure, and training, with greater engagement of nursing home staff in
design and implementation.