Use of Clinical Health Information Technology in Nursing Homes: Nursing Home Characteristics and Quality Measures

This study compares quality measures among nursing homes that have adopted different levels of clinical health information technology (HIT) and examines the perceived barriers and benefits of the adoption of electronic health records as reported by Nursing Home Administrators and Directors of Nursing. A cross-sectional survey distributed online to a convenience sample of Nursing Home Administrators and Directors of Nursing (n=163) requested information on the adoption of electronic health records, computerized provider order entry, and clinical decision support within their nursing home. These responses were linked to nursing home characteristics and the quality measures for antipsychotic use, pressure ulcers, and falls with injuries reported by the Centers for Medicare and Medicaid Nursing Home Compare secondary data set.;Analysis of data found 29% fewer long-stay residents on antipsychotic medications when a computerized provider order entry system was in place compared to nursing homes with just an electronic health record system. Results also indicated 27% fewer residents taking antipsychotics when a clinical decision support system was used compared to just an electronic health record. Nursing homes using computerized provider order entry had 45% fewer long-stay residents with pressure ulcers compared to nursing homes using paper charting. Results examining nursing home leaders' perceptions of barriers to the adoption of technology found compatibility with other existing systems to be an important concern to all nursing home leaders. Nursing home leaders with existing EHR systems considered costs the most important barrier. One of the most important benefits reported by nursing home leaders was the ability to monitor quality of care. Nursing home leaders with an EHR system reported access to clinical data and staff oversight as other significant benefits.;These findings suggest nursing homes can benefit from the adoption of clinical health information technology through improvements in quality of care, especially when advanced technology such as computerized provider order entry and clinical decision support systems are in place.