Adoption of Health Information Technology Among US Nursing Facilities

Joshua Vest, Hye Young Jung, Kevin Wiley, Harold Kooreman, Lorren Pettit, Mark A. Unruh

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: Nursing facilities have lagged behind in the adoption of interoperable health information technology (ie technologies that allow the sharing and use of electronic patient information between different information systems). The objective of this study was to estimate the nationwide prevalence of electronic health record (EHR) adoption among nursing facilities and to identify the factors associated with adoption. Design: Cross-sectional survey. Setting & participants: We surveyed members of the Society for Post-Acute & Long-Term Care Medicine (AMDA) about their organizations’ health information technology usage and characteristics. Measurements: Using questions adopted from existing instruments, the survey measured nursing home's EHR adoption, the ability to send, receive, search and integrate electronic information, as well as barriers to usage. Additionally, we linked survey responses to public use secondary data sources to construct measurements for 8 determinants known to be associated with organizational adoption: innovativeness, functional differentiation, role specialization, administrative intensity, professionalism, complexity, technical knowledge resources, and slack resources. A series of regression models estimated the association between potential determinants and technology adoption. Results: 84% of nursing facilities reported using an EHR. After controlling for all other factors, respondents who characterized their organization as more innovative had more than 6 times the odds (adjusted odds ratio = 6.39, 95% confidence interval = 2.69, 15.21) of adopting an EHR. Organization innovativeness was also associated with an increased odds of being able to send, integrate, and search for electronic information. The most commonly identified barrier to sharing clinical information among nursing facilities with an EHR was a reported absence of interoperability (57%). Conclusions/Implications: An organizational culture that fosters innovation and awareness campaigns by professional societies may facilitate further adoption and effective use of technology. This will be increasingly important as policy makers continue to emphasize the use of EHRs and interoperability to improve the quality of care in nursing facilities.

Original languageEnglish (US)
JournalJournal of the American Medical Directors Association
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Medical Informatics
Electronic Health Records
Nursing
Organizations
Technology
Organizational Culture
Information Dissemination
Quality of Health Care
Information Storage and Retrieval
Long-Term Care
Nursing Homes
Administrative Personnel
Information Systems
Cross-Sectional Studies
Odds Ratio
Medicine
Confidence Intervals
Surveys and Questionnaires

Keywords

  • electronic health records
  • health information technology
  • Long-term care
  • nursing home

ASJC Scopus subject areas

  • Nursing(all)
  • Health Policy
  • Geriatrics and Gerontology

Cite this

Adoption of Health Information Technology Among US Nursing Facilities. / Vest, Joshua; Jung, Hye Young; Wiley, Kevin; Kooreman, Harold; Pettit, Lorren; Unruh, Mark A.

In: Journal of the American Medical Directors Association, 01.01.2018.

Research output: Contribution to journalArticle

Vest, Joshua ; Jung, Hye Young ; Wiley, Kevin ; Kooreman, Harold ; Pettit, Lorren ; Unruh, Mark A. / Adoption of Health Information Technology Among US Nursing Facilities. In: Journal of the American Medical Directors Association. 2018.
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abstract = "Objectives: Nursing facilities have lagged behind in the adoption of interoperable health information technology (ie technologies that allow the sharing and use of electronic patient information between different information systems). The objective of this study was to estimate the nationwide prevalence of electronic health record (EHR) adoption among nursing facilities and to identify the factors associated with adoption. Design: Cross-sectional survey. Setting & participants: We surveyed members of the Society for Post-Acute & Long-Term Care Medicine (AMDA) about their organizations’ health information technology usage and characteristics. Measurements: Using questions adopted from existing instruments, the survey measured nursing home's EHR adoption, the ability to send, receive, search and integrate electronic information, as well as barriers to usage. Additionally, we linked survey responses to public use secondary data sources to construct measurements for 8 determinants known to be associated with organizational adoption: innovativeness, functional differentiation, role specialization, administrative intensity, professionalism, complexity, technical knowledge resources, and slack resources. A series of regression models estimated the association between potential determinants and technology adoption. Results: 84{\%} of nursing facilities reported using an EHR. After controlling for all other factors, respondents who characterized their organization as more innovative had more than 6 times the odds (adjusted odds ratio = 6.39, 95{\%} confidence interval = 2.69, 15.21) of adopting an EHR. Organization innovativeness was also associated with an increased odds of being able to send, integrate, and search for electronic information. The most commonly identified barrier to sharing clinical information among nursing facilities with an EHR was a reported absence of interoperability (57{\%}). Conclusions/Implications: An organizational culture that fosters innovation and awareness campaigns by professional societies may facilitate further adoption and effective use of technology. This will be increasingly important as policy makers continue to emphasize the use of EHRs and interoperability to improve the quality of care in nursing facilities.",
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