Information technology (IT) has been recommended to improve the quality of health care. Nursing homes use very little IT, but they have been required by the federal government to electronically submit resident assessments (via commercial Minimum Data Set [MDS] software). This article examines whether use of the advanced IT features commonly found in commercial MDS software is associated with better quality of care. This study employed a national survey of US nursing home administrators (N = 2397) regarding the use of 12 advanced IT features in commercial MDS software. Overall, the effects of using advanced IT features in commercial MDS software on quality were highly significant (P < .01) when controlling for the prior years quality as well as facility characteristics. Although nursing homes have been slow to adopt IT, the use of the identified IT in MDS software packages appears to offer the promise to improve quality of care.
Gawande AA, Bates DWThe use of information technology in improving medical performance. Part II. Physician-support tools. MedGenMed. 2000;2(1):E13.
2.
Gawande AA, Bates DWThe use of information technology in improving medical performance. Part I. Information systems for medical transactions. MedGenMed. 2000; 2(1):E14.
3.
Information systems for monitoring quality. In: Wunderlich GS, Kohler PO, eds. Improving the Quality of Long-Term Care. 4th ed. Washington, DC: National Academies Press; 2001:110-134.
4.
Chaudhry B., Wang J., Wu S., et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med. 2006;144:742-752.
5.
Shekelle PG, Morton SC, Keeler EBCosts and Benefits of Health Information Technology (AHRQ Publication No. 06-E006). Rockville, MD: Agency for Healthcare Research and Quality; 2006.
6.
American Health Information and Management Association.A Road Map for Health IT in Long-Term Care. Chicago, IL : American Health Information and Management Association ; 2005.
7.
Kaushal R., Bates DW, Poon EG, Jha AK, Blumenthal D., Harvard Interfaculty Program for Health Systems Improvement NHIN Working Group. Functional gaps in attaining a national health information network. Health Aff (Millwood). 2005;24:1281-1289.
8.
Poon EG, Jha AK, Christino M., et al. Assessing the level of healthcare information technology adoption in the United States: a snapshot. BMC Med Inform Decis Mak . 2006;6:1.
9.
Liu D., Castle NGHealth information technology in nursing homes. J Appl Gerontol . 2009;28:38-58.
10.
Coleman EA, Boult C.Improving the quality of transitional care for persons with complex care needs . J Am Geriatr Soc. 2003;51:556-557.
11.
Agency for Healthcare Research and Quality.Making health care safer: a critical analysis of patient safety practices. http://www.ahrq.gov/CLINIC/PTSAFETY/ . Accessed October 17, 2009.
12.
Gurwitz JH, Field TS, Judge J., et al. The incidence of adverse drug events in two large academic long-term care facilities. Am J Med. 2005;118:251-258.
13.
Spoeri RK, Ullman R.Measuring and reporting managed care performance: lessons learned and new initiatives. Ann Intern Med. 1997;127(8, pt 2):726-732.
14.
Mor V.A comprehensive clinical assessment tool to inform policy and practice: applications of the minimum data set. Med Care. 2004;42(4 suppl):I1150-I1159.
15.
Pasupathy K.Knowledge management in long-term care: what you need to know. Nursing Homes Magazine. 2006:20.
16.
Mor V., Angelelli J., Jones R., Roy J., Moore T., Morris J.Inter-rater reliability of nursing home quality indicators in the U. S. BMC Health Serv Res. 2003;3(1):20.
17.
Perlin JB, Kolodner RM, Roswell RHThe Veterans Health Administration: quality, value, accountability, and information as transforming strategies for patient-centered care. Am J Manag Care. 2004;10(11, pt 2):828-836.
18.
Kramer A., Bennett R., Fish R., et al. Case Studies of Electronic Health Records in Post-Acute and Long-Term Care. Washington, DC: US Department of Health and Human Services; 2004.
19.
National Center for Health Statistics.National Nursing Home Survey. http://www.cdc.gov/nchs/nnhs.htm . Accessed June 4, 2007.
20.
Gilbert NHProviders face the computer revolution. Provider. 1999;25:73-75.
21.
Harris M., Chute C., Harvell J., White T., Moore T.Toward a National Health Information Infrastructure: A Key Strategy for Improving Quality in Long-Term Care. Washington, DC: US Department of Health and Human Services; 2003.
22.
Greenland S. , Brumback B.An overview of relations among causal modelling methods. Int J Epidemiol. 2002; 31:1030-1037.
23.
Schnelle JF , Bates-Jensen BM, Chu L., Simmons SFAccuracy of nursing home medical record information about care-process delivery: implications for staff management and improvement . J Am Geriatr Soc. 2004;52:1378-1383.
24.
McDonald CJThe barriers to electronic medical record systems and how to overcome them. J Am Med Inform Assoc. 1997;4:213-221.
Harrington C., Zimmerman D., Karon SL, Robinson J., Beutel P.Nursing home staffing and its relationship to deficiencies. J Gerontol B Psychol Sci Soc Sci. 2000;55:S278-S287.
27.
Castle NGProviding outcomes information to nursing homes: can it improve quality of care? Gerontologist. 2003;43:483-492.
28.
O’Neill C., Harrington C., Kitchener M., Saliba D.Quality of care in nursing homes: an analysis of relationships among profit, quality, and ownership. Med Care. 2003;41: 1318-1330.
29.
Konetzka T. , Stearns S., Park J.The staffing-outcome relationship in nursing homes. Health Serv Res. 2008;43: 1025-1042.
30.
Leape LL, Woods DD, Hatlie MJ, Kizer KW, Schroeder SA, Lundberg GDPromoting patient safety by preventing medical error. JAMA . 1998;280:1444-1447.
31.
Stead WW, Kelly BJ, Kolodner RMAchievable steps toward building a national health information infrastructure in the United States. J Am Med Inform Assoc. 2005; 12:113-120.
32.
National Committee on Vital and Health Statistics.Work Group on National Health Information Infrastructure Charge. http://www.ncvhs.hhs.gov/nhichrg.htm. Accessed June 25, 2007.
33.
Martin RD, Brantley D., Dangler D.Essential But Not Sufficient: Information Technology in Long-Term Care as an Enabler of Consumer Independence and Quality Improvement. Mclean, VA: BearingPoint, Inc; 2007 .
34.
Carter J., White T., Harvell J., Shipley S.Making the "Minimum Data Set" Compliant With Health Information Technology Standards. Washington, DC: US Department of Health and Human Services; 2006.
35.
Health Level Seven.Version 2.4. An application protocol for electronic data exchange in healthcare environments. Ann Arbor, MI: Health Level Seven;2002 .
36.
McDonald CJ , Huff SM, Suico JG, et al. LOINC, a universal standard for identifying laboratory observations: a 5-year update. Clin Chem. 2003;49:624-633.
37.
Systematized Nomenclature of Medicine Clinical Terms.SNOMED-CT. http://www.snomed.org/ . Accessed April 10, 2007.
38.
Brailer DJInteroperability: the key to the future health care system. Health Aff (Millwood). 2005;(suppl Web exclusives):W519-W5-21.
39.
Accu-Med Services. http://www.accu-med.com/main/Home.asp. Accessed February 17, 2007.
40.
American HealthTech. http://www.healthtech.net/. Accessed February 17, 2007.
41.
Stuart B., Simoni-Wastila L., Baysac F., Shaffer T., Shea D.Coverage and use of prescription drugs in nursing homes: implications for the Medicare Modernization Act. Med Care. 2006;44:243-249.
42.
Stevenson DG , Huskamp HA, Newhouse JPMedicare Part D and the nursing home setting . Gerontologist. 2008;48:432-441.
43.
US General Accounting Office.Medicare Part D: Challenges in Enrolling New Dual-Eligible Beneficiaries. Washington, DC: US General Accounting Office; 2007.
44.
Halamka JDHealth information technology: shall we wait for the evidence? Ann Intern Med. 2006;144:775-776.
45.
Castle NG, Engberg J., Liu D.Have nursing home compare quality measure scores changed over time in response to competition? Qual Saf Health Care. 2007 ; 16:185-191.
46.
Nursing Home Compare.Five-Star Quality Rating System: Technical Users Guide. October 2009. Available at: http://www.cms.hhs.gov/CertificationandComplianc/13_FSQRS.asp . Accessed November 15, 2009.
