IT Fails To Help Nursing Home Patients: Study

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As researchers try to figure out whether health information technology (HIT) can improve quality of care, a study of 761 nursing home residents suggests that a comprehensive health IT system doesn't have any significant impact on health outcomes in this patient population.

There was "no measurable improvement in resident condition as a result of the HIT intervention. Therefore, claims that HIT in nursing homes will have direct benefits for residents should be tempered by the findings of this research," according to investigators from Weill Cornell Medical College, Columbia University Stroud Center, and the New York State Psychiatric Institute.

"Effects of Electronic Health Information Technology Implementation on Nursing Home Resident Outcomes", which was published in the June 6 online edition of Journal of Aging and Health, evaluated the impact of implementing a comprehensive HIT system on resident clinical, functional, and quality of care outcome indicators as well as measures of resident awareness of and satisfaction with the technology.

The study also suggested that if further studies do not reveal a link between HIT implementation and improvements in nursing home residents' clinical, functional, and quality of care outcome indicators, the findings should weight into the decision-making process regarding implementing HIT at nursing homes.

"Consistent with a number of studies of HIT in acute and ambulatory care, there appears to be no demonstrable positive effect of the technology on residents." the report said.

The researchers were also concerned about the possibility that HIT may have some negative effects: "Residents in the treatment facilities experienced an increase in observed disruptive behaviors, whereas a reduction over time in the control facilities was observed. Further research is needed to determine whether there is a relationship between HIT and behavioral issues and what mechanisms underlying such a relationship might exist."

To reach their conclusions, investigators conducted two personal assessments of nursing home residents in five treatment and five comparison facilities. The first assessment took place shortly before HIT was introduced; the second was conducted approximately nine months later. The nursing homes are located in the New York City metropolitan area.

Despite the negative findings, overall, residents were positive about changes in their care since the introduction of HIT at their facility. Sixty two percent felt that the care had stayed the same, and 30.6% believed it had improved, with 7.1% saying they felt care had declined. Based on their findings, researchers noted that residents generally felt that computerized technology does not appear to lead to resident dissatisfaction or poor communication.

The study also showed residents had a positive attitude toward mobile devices. Nearly three-quarters (70.8%) of respondents agreed that handheld devices help staff to better manage their care, while a similar percentage (72.8%) reported that they are pleased that staff use the handheld devices to better track and manage their care. Additionally, more than two-thirds of residents (69.3%) reported that staff using the handhelds did not interfere with the time they spent with nurses and other staff member.

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