Rural nursing homes lag urban facilities in health IT use

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The first national assessment of health information technology use by nursing homes in nearly 13 years has found that rural facilities are lagging behind their urban counterparts, while nursing homes located in metropolitan areas have greater IT capabilities.

Specifically, researchers said nursing homes located in urban settings had greater IT laboratory capabilities for resident registration and admission, as well as better integration to enable internal and external communication with partners and stakeholders.

In addition, metropolitan area nursing homes were shown to have better capabilities when conducting and verifying medical tests, which can impact and improve patient care, according to new research from the University of Missouri.

“There tends to be a pretty big disparity between those metropolitan and urban areas versus the small town, rural areas,” says Gregory Alexander, professor in the University of Missouri’s Sinclair School of Nursing, who led the study supported by a grant from the Agency for Healthcare Research and Quality.

“Those differences typically tend to be occurring in all the domains of healthcare,” adds Alexander. “There’s less technology used in resident care and clinical support. In other words, less labs, less pharmacy types of applications, and less radiology types of applications. And, even in administrative activities there tends to be fewer capabilities that are used.”

In particular, clinical support technologies for radiology, laboratory and pharmacy IT applications were found to be lacking in most facilities. According to Alexander, this gap in IT use has implications for patient care as nursing homes in rural areas may have less capacity to exchange information with hospitals to ensure high-quality transitions in care.

While there are about 16,000 nursing homes in the U.S. providing care to more than 1 million Americans, they do not receive the same financial incentives as hospitals to adopt IT. And, making matters worse, Alexander notes that rural nursing homes are increasingly less able to compete with urban facilities for needed IT talent.

“Policy makers need to be aware of the unique challenges facing rural health organizations and provide the necessary incentives to help rural nursing homes improve their IT sophistication,” he contends. “Improvement of IT sophistication will lead to better patient outcomes and a better quality of life for nursing home residents.”

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Nonetheless, Alexander reports that it’s not all bad news from the national assessment. Overall, the IT sophistication of nursing homes across the country appears to be growing, he says.

Likewise, historically, most IT in nursing homes was for used for administrative activities such as billing and less for resident care and clinical support, observes Alexander. “But, now, we’re finding that’s sort of shifting—resident care types of technology that are being adopted seem to be growing, and they’re becoming more integrated,” he adds.

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