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Examining Structural Disparities of Health Information Technology Use in U.S. Nursing Homes
ABSTRACT
Background:
There are 15,632 nursing homes (NHs) in the United States. NHs continue to receive significant policy attention due to high costs and poor outcomes of care. One strategy for improving these aspects of NH care is use of health information technology (HIT). A central concept of this study is HIT maturity used to establish trends in HIT capabilities, use and integration within resident care, clinical support, and administrative activities. This concept is guided by Nolan’s Stage Theory which postulates that a system moves through a series of measurable stages.
Objective:
The purpose of this study was to identify structural disparities in NH HIT maturity and see if it is moderated by ownership, location, and bedsize.
Methods:
Nursing Homes (20%) were randomly recruited from each state using Nursing Home Compare data. Investigators used a validated HIT maturity survey with nine subscales and total HIT maturity to establish HIT Maturity stage.
Results:
Our sample (n=719) had fewer smaller and larger facilities than nationally. Integrated clinical support technology had the lowest maturity score compared to resident care HIT capabilities. The majority (60.7%) of NHs report stage 3 or lower with limited capabilities to communicate about care delivery outside their facility. Larger NHs in metropolitan areas had higher odds of HIT maturity.
Conclusions:
NH structural disparities were recognized through differences in HIT maturity stage.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.