Type of Document	Dissertation
Author	Liu, Darren
Author's Email Address	hokila@gmail.com
URN	etd-04062009-042428
Title	Health Information Technology and Nursing Homes
Degree	Doctor of Public Health
Program	Behavioral and Community Health Sciences
School	Graduate School of Public Health
Advisory Committee	Advisor Name Title Nicholas G. Castle Committee Chair Ada O. Youk Committee Member Edmund M. Ricci Committee Member Steven M. Albert Committee Member
Keywords	Health information technology MDS Nursing homes
Date of Defense	2009-04-17
Availability	unrestricted
Abstract Nursing homes are considered lagging behind in adopting health information technology (HIT). Many studies have highlighted the use of HIT as a means of improving health care quality. However, these studies overwhelmingly do not provide empirical information proving that HIT can actually achieve these improvements. The main research goal of this dissertation is to review the current development of HIT in nursing homes, to determine the nursing homes use of HIT features in MDS software, and to examine whether these uses result in better quality of care as measured by Nursing Home Compare (NHC) quality measures. This dissertation includes three parts and each part has its own emphasis and methodology centered on the main topic of the use of HIT in nursing homes. The first paper reviews the background and definitions of HIT as well as the most important applications and several standards that are currently used or under development. The second paper examines the use of commercial Minimum Data Set (MDS) software in nursing homes and identifies the HIT features that are available in the most commonly used software package. The frequency of use of each HIT feature in MDS software is also reported. The third paper evaluated whether the use of such HIT features is associated with better quality of care as measured by NHC. This dissertation reviews the HIT, summarizes a list of top 12 advanced HIT features in commercial MDS software used by the surveyed nursing homes. The study also evaluates the frequency of use of each feature. It concluded that although nursing homes were often viewed as technologically impaired, many of them had used quite advanced HIT in commercial MDS software. The findings are helpful in prioritizing the importance of future HIT development in nursing homes. Understanding the highlighted issues and the evidence of HIT use for promoting quality of care in nursing homes is a top research and public health concern. Future research should extend the list of HIT features in the current commercial MDS software and interconnect such features with available EHR systems in the continuum of health care.
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