Ternary Trends in Nursing Home Information Technology and Quality Measures in the United States

Abstract

Nursing home information technology (NH IT) adoption trends are not measured regularly. Evidence indicates digital footprints are growing, but gaps about NH IT adoption and quality impacts remain. We hypothesize as NH IT adoption grows, quality improves. This research assessed ternary (2014-2017) trends in IT and quality measures using a primary survey of U.S. NHs. Survey measures included nine dimensions/domains and total IT sophistication. Administrators completed 815 Year 1 surveys. Each year mean total IT sophistication scores in nine dimensions/domains consistently increased. Eighteen significant correlations (r > .13, absolute value) between IT sophistication and quality measures existed. Regression shows that for every 10 units increase in administrative activity extent of IT use, a decrease of 1.3% occurs in the percentage of low-risk long-stay residents with bowel or bladder incontinence. Increases in NH IT sophistication positively impact quality. Estimating ongoing trends in NH IT sophistication provides new information that should be consistently available.

Keywords: health care surveys; informatics; information technology; nursing homes; technology assessment.

Figure 1.

A model to test nursing home quality measures and IT sophistication. Note. IT = information technology; PT/OT = physical/occupational therapist.

Figure 2.

Recruitment strategy and analysis plan for assessing 3-year trend in IT sophistication. Note. NH = nursing home; IT = information technology.

Figure 3.

Post-stratified weighted estimates of mean IT sophistication scales trends over 3 years (N = 306). Note. IT = information technology.

Figure 4.

Total IT sophistication differences Year 1-Year 3. Note. Points above central line Year 3 total IT score higher; points beyond outer reference lines total IT score differ by 150. IT = information technology.