Measuring IT Sophistication in Nursing Homes

Objective: Little activity has occurred in nursing home (information technology) IT adoption. The purpose of this study was to describe the range of IT sophistication for resident management processes and explore the association of IT sophistication with nursing home ownership, bedsize, and regional status. Methods: This descriptive, exploratory, cross-sectional study used an IT sophistication survey that was adapted for nursing home environments. The survey was administered between December 2006 and August 2007. All 491 nursing homes in Missouri were invited to participate. Results: Of the 491 nursing homes asked to participate, 349 initially agreed to complete the survey, but only 199 (41 percent) responded. The degree of functional sophistication adopted was most related to bedsize and location; ownership and location were also factors. IT integration was mostly affected by type of ownership. Conclusion: Nursing home administrators have a long way to go before they will be able to achieve the goals suggested by the Institute of Medicine in their report on IT adoption. Introduction People who make up the oldest of the old population have more complex health care needs and a higher probability of entering a nursing home, and they are at greater risk for receiving poorer quality of care. 2, 3 There is growing recognition that a stronger information technology (IT) infrastructure is needed to address the complex health care needs of nursing home residents and the quality of care delivered in these facilities. Technologic strategies designed to improve quality of care in nursing homes must include methods to achieve valid, reliable, and timely care processes. 6 However, technology for nursing homes has been overlooked by most agencies that have advocated for its wider use. The lag in IT implementation has been attributed to such factors as significant cost of infrastructure, lack of onsite IT expertise, variable staff competency levels, and high staff turnover leading t high training costs 7, 8 o . IT. IT development has the potential to improve the safety, quality, and efficiency of health care in the United States. Increasing attention to errors in health care and concern for patient safety have prompted general recommendations for the development of technologies to support clinical decisionmaking, promote data standards, and develop systems that communicate with each other. In acute care situations, sophisticated technology that assists in diagnosis and supports chronic care management can improve clinical decisionmaking, enhance adherence to clinical guidelines, and provide increased focus on patients with chronic disease states. 12 Despite these known benefits, little activity has occurred in nursing home