Most nursing homes do not have the technology to communicate with clinical partners.

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When it comes to communicating electronically with external clinical partners, new survey results show that most nursing homes are not yet up to speed. This skill lag can affect resident care, researchers say.

Investigators from Columbia University’s School of Nursing measured the level of health information technology (HIT) adoption — or “maturity” — at a sample of 719 facilities. Participants were randomly recruited using the Nursing Home Compare database from all 50 states and Washington, DC.

Participants responded to a validated HIT maturity survey consisting of nine subscales. These include HIT skills, extent of HIT use, and degree of integration of HIT into resident care, clinical support, and administrative activities. Each facility’s HIT maturity level was graded from 0 (no HIT) to 6 (residents or their caregivers can use the system to generate clinical data and self-manage).

Lack of communication

68% of facilities were unable to communicate electronically with other facility staff, including outside clinics, laboratories or pharmacies (HIT maturity level 3 or below).

The results also revealed factors associated with these differences. HIT maturity levels were more likely to be higher in larger nursing homes. And the number of confirmed beds and facility space is significantly correlated with the level of HIT maturity. Ownership, chain status, and occupancy rates were not.

The researchers theorized that these differences could be due to inadequate infrastructure, availability of skilled labor or lack of financial resources. Either way, gaps in electronic communication with external partners have a significant negative impact on resident care and operational capacity, he said.

“This lack of communication reduces electronic information sharing, which leads to care delivery deficiencies, standardized care coordination activities, and poor resident outcomes,” he said.

Encouraging HIT adoption

Stone and colleagues encouraged nursing home leaders to “encourage and increase the adoption of HIT to balance structural disparities and improve resident outcomes” to promote equal opportunities in health care services.

By increasing transparency and public reporting on the state of nursing home HIT maturity in the United States, it is critical that we begin to consistently identify mechanisms to address these disparities and implement national policies to address these gaps. Colleagues concluded.

In particular, smaller facilities were overrepresented in the study sample than the national nursing home population, the researchers said.

The study was published in the journal JMIR Aging.

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