Leveraging HIT in nursing homes improves care
COLUMBIA: Nursing homes are adopting new forms of information technology and seeing quality of care improve as a result, according to new research from the University of Missouri.
Some of the quality improvements the nursing homes are experiencing include significant decreases in urinary tract infections, decreases in patients reporting moderate to severe pain, and fewer patients with new or worsened pressure ulcers.
Although healthcare providers in hospitals and ambulatory care are currently incentivized with federal funds to adopt health IT, nursing homes have been largely left out of these incentive programs, although this sub-sector is beginning to see some benefits. Now, a new study has linked more sophisticated nursing home IT, including electronic health records (EHRs), and other digital data systems in resident care, clinical support and administrative activities, with specific improvements in quality.
Gregory Alexander, Ph.D., R.N., interim associate dean of research and professor of clinical informatics at MU’s Sinclair School of Nursing, and his colleagues, collected surveys once per year for two years from nursing homes nationwide. The responses, which rated the sophistication of a given facility’s information technology, were compared against federal data describing 18 quality measures in those same facilities, and showed that technology had positive impacts on quality of care.
Facilities reporting greater IT capabilities in administrative activities were associated with a lower percentage of residents reporting moderate to severe pain. Another example—increased use of clinical support technologies which include laboratory systems—was associated with lower percentages of residents with urinary incontinence. And, increases in technology use in resident care were associated with lower percentages of residents with new or worsened pressure ulcers.
Researchers also observed that while the overall trend was an increase in IT adoption, some nursing homes actually lost capabilities between years one and two. Though these facilities were outliers, Alexander said they reflect the challenges nursing homes face when adopting new technology.
“Federal incentive funds are going into hospitals and ambulatory care, not nursing homes,” Alexander said. “Many homes don’t have a trained expert to manage the technology, so even if they do decide to upgrade their IT capabilities, they may abandon certain ones because they are too difficult or expensive to manage. If they aren’t being reimbursed for investing in information technology, they may decide it isn’t worth the time and money.”
Alexander noted that because the study detailed the impacts of a variety of specific IT factors on different aspects of quality of care, the data could help inform nursing home administrators about which features of an IT system are important to adopt to improve quality of care. This information could be very helpful to administrators and other leadership in making decisions about how to design and implement information systems, he said.
