Although nursing homes play a critical role in healthcare, they do not receive the same financial incentives as hospitals to adopt information technology systems. Nonetheless, IT-based resident care is becoming more widespread and is having a positive impact on patient outcomes as seen in quality measures.

There are about 16,000 nursing homes across the country providing care to more than 1 million Americans, according to Greg Alexander, professor in the University of Missouri’s Sinclair School of Nursing, who led the first national study of resident care linking IT sophistication and quality measures.

The study, supported by a grant from the Agency for Healthcare Research and Quality, evaluated national survey data measuring IT sophistication, including IT capabilities, the extent of IT use and IT integration, in three domains of healthcare—resident care, clinical support, and administrative activities.

Resident care IT sophistication includes activities conducted by physicians, nurses, and physical and occupational therapists that are supported by technology. Clinical support IT sophistication involves activities supported by technology related to laboratory work, radiological approaches, and pharmaceutical management. And IT sophistication in administrative activities includes IT staffing and types of technologies used to connect people or systems, such as wireless connectivity.

In addition, outcome measures are captured through the Nursing Home Compare website, a free online national database containing a set of nursing home quality measures reported quarterly.

Nursing homes were scored based on those criteria. The maximum score for a facility completing the survey was 900 and the minimum score was zero. Some 815 facilities completed surveys.

“The scores indicated that technology is becoming a greater part of resident care in areas where physicians and nurses work, not just in areas of administration and billing,” says Alexander. “We found that as IT sophistication increases in resident care, there appears to be a positive impact on quality measures. This finding means that if nursing home staff have access to the right technological tools and are using them to facilitate resident care, quality of care can and should improve.”

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He surmises that the increased adoption of IT by nursing homes is “not because of incentives” but because of “the influence of accountable care and holding facilities accountable for things like readmission rates.” As the healthcare industry moves from fee-for-service to value-based care, Alexander sees this trend continuing as communication and coordination among all members of the healthcare team on behalf of patients becomes even more critical.

“There is a benefit of having systems that allow them to communicate with their external partners that provide continuity of care for patients,” he concludes.

Results of the study, published in the Journal of Nursing Care Quality, can be found here.

Alexander is now turning his attention to Australia’s nursing homes. In January, he was awarded a Fulbright fellowship to conduct similar research in Australia, researching IT sophistication and quality measures in nursing homes at Macquarie University in Sydney as part of a project to improve patient care Down Under.

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