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Health IT Adoption in Nursing Homes: The Role of IT Vendors

Karabi C. Bezboruah

Department of Public Affairs, University of Texas at Arlington, Texas, USA

E-mail Address: bezborua@uta.edu

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and

Darla Hamann

Saint Cloud State University, Minnesota, USA

E-mail Address: djhamann@stcloudstate.edu

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https://doi.org/10.1142/S0219877018500013Cited by:3 (Source: Crossref)

Abstract

Applying exploratory qualitative methodologies such as interviews and focus groups, we examine the role of IT vendors in health IT adoption in nursing homes in Texas. We identify three roles pertaining to IT vendors in various adoption stages — information sources and financiers, strategic consultants, and educators in the initiation, implementation, and the institutionalization phases, respectively. Thus, vendors could be a critical factor in the health IT adoption, but nursing home management must critically evaluate not only the services, but also the strategic partnerships offered by the vendors. This is because their business interests may not address nursing homes’ distinctive need, and may prevent integration and institutionalization of health IT. As such, this research has important implications for technology adoption by nursing facilities.

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References

Armstrong, E. [2000] Electronic prescribing and monitoring are needed to improve drug use. Archives of Internal Medicine, 160: 2713–2714. Crossref, Google Scholar
Attewell, P. [1992] Technology diffusion and organizational learning: The case of business computing. Organization Science, 3: 1–19. Crossref, Google Scholar
Balfour, D. C., Evans, S., Januska, J., Lee, H. Y., Lewis, S. J., Nolan, S. R., Noga, M., Stemple, C. and Thapar, K. [2009] Health information technology: Results from a roundtable discussion. Journal of Management Care Pharmacy, 15: 10–17. Crossref, Google Scholar
Bates, D. W. [2002] The quality case for information technology in healthcare. BMC Medical Informatics and Decision-Making, 2, 7: 1–9. Google Scholar
Bates, D. W., Cohen, M., Leape, L., Overhage, J., Shabot, M. and Sheridan, T. [2001] Reducing the frequency of errors in medicine using information technology. Journal of the American Medical Informatics Association, 8: 299–308. Crossref, Google Scholar
Bates, D. W. and Gawande, A. [2003] Improving safety with information technology. New England Journal of Medicine, 348: 2526–2534. Crossref, Google Scholar
Bezboruah, K., Hamann, D. and Smith, J. [2014] Management attitudes and technology adoption in long-term care facilities. Journal of Healthcare Organization and Management, 28: 344–365. Crossref, Google Scholar
Blacker, F. and Brown, C. [1986] Alternative models to guide the design and introduction on the new information technology into work organizations. Journal of Occupational Psychology, 59: 287–313. Crossref, Google Scholar
Brown, C. A., Bailey, J. H., Miller Davis, M. E., Garrett, P. and Rudman, W. J. [2005] Improving patient safety through information technology. Perspectives in Health Information Management, 2: 5. Google Scholar
Brown, L. A. [1981] Innovation Diffusion: A New Perspective. Methuen, New York. Google Scholar
Chaudhry, B., Wang, I., Wu, S., Maglione, M., Mojica, W., Roth, H., Morton, S. C. and Shekelle, P. C. [2006] Systematic review: Impact of health information technology on quality, efficiency, and costs of medical care. Annals of Internal Medicine, 144: 742–752. Crossref, Google Scholar
Cherry, B., Carter, M., Owen, D. and Lockhart, C. [2008] Factors affecting electronic health record adoption in long-term care facilities. Journal for Healthcare Quality, 30: 37–47. Crossref, Google Scholar
DesRoches, C. M., Campbell, E. G., Rao, S. R., Donelan, K., Ferris, T. G., Jha, A., Kaushal, R., Lévy, D., Rosenbaum, S., Shields, A. and Blumenthal, D. [2008] Electronic health records in ambulatory care: A national survey of physicians. New England Journal of Medicine, 359: 50–59. Crossref, Google Scholar
Dixon, B. E. and Zafar, A. (2009). In-Patient Computerized Provider Order Entry (CPOE): Findings from the AHRQ Portfolio (prepared by the AHRQ National Resource Center for Health IT under Contract No. 290-04-0016). AHRQ Publication No. 09-0031-EF. Agency for Healthcare Research and Quality, Rockville, MD. Google Scholar
Eveland, J. D. and Tornatzky, L. G. [1990] The deployment of technology. In The Processes of Technological Innovation, eds. Tornatzky, L. G. and Fleischer, M. Lexington Books, Lexington, MA, pp. 117–148. Google Scholar
Fichman, R. G. [2000] The diffusion and assimilation of information technology innovations. In Framing the Domains of IT Management: Projecting the Future through the Past (Pinnaflex Educational Resource Inc.) 105127. Google Scholar
Ford, E., Menachemi, N., Huerta, T. and Yu, F. [2010] Hospital IT adoption strategies associated with implementation success: Implications for achieving meaningful use. Journal of Healthcare Management, 55: 175–188. Crossref, Google Scholar
Gin, G. O., Shen, J. J. and Moseley, C. B. [2011] Hospital financial position and the adoption of electronic health records. Journal of Healthcare Management, 56: 337–350. Crossref, Google Scholar
Hansmann, H. B. [1980] The role of nonprofit enterprise. Yale Law Journal, 89: 835–891. Crossref, Google Scholar
Harrington, C., Olney, B., Carrillo, H. and Kang, T. [2012] Nurse staffing and deficiencies in the largest for-profit nursing home chains and chains owned by private equity companies. Health Services Research, 47: 106–128. Crossref, Google Scholar
Herriott, R. E. and Firestone, W. A. [1983] Multisite qualitative policy research: Optimizing description and generalizability. Educational Researcher, 12, 2: 14–19. Crossref, Google Scholar
Institute of Medicine, Committee on Data Standards for Patient Safety (2003). In Key Capabilities of an Electronic Health Record System. The National Academics Press, Washington, DC. Google Scholar
Kaushal, R. and Bates, D. W. (2001). Computerized physician order entry (CPOE) with clinical decision support systems (CDSSs). In Making Healthcare Safer: A Critical Analysis of Patient Safety Practices, eds. Shojania, K. G., Duncan, B. W., McDonald, K. M. and Wachter, R. M. (AHRQ Publication 01-E058. AHRQ Evidence Report/Technology Assessment: Number 43). Agency for Healthcare Research and Quality, Washington, DC. Google Scholar
Kaushal, R., Shojania, K. G. and Bates, D. W. [2003] Effects of computerized physician order entry and clinical decision support systems on medication safety: A systematic review. Archives of Internal Medicine, 163: 1409–1416. Crossref, Google Scholar
Koppel, R., Metlay, J. P., Cohen, A., Abaluck, B., Localio, A. R., Kimmel, S. E. and Strom, B. L. [2005] Role of computerized physician order entry systems in facilitating medical errors. Journal of the American Medical Informatics Association, 293: 1197–1203. Crossref, Google Scholar
Kruse, C., Mileski, M., Alaytsev, V., Carol, E. and Williams, A. [2015] Adoption factors associated with electronic health record among long-term care facilities: A systematic review. BMJ Open, 5: e006615. https://doi.org/10.1136/bmjopen-2014-006615 Crossref, Google Scholar
Lipsky, D. B. and Avgar, A. [2012] Caregivers and computers: Key lessons from the adoption and implementation of EMR in New York State nursing homes. Advances in Industrial and Labor Relations, 20: 75–104. Crossref, Google Scholar
Liu, D., Castle, N. G. and Diesel, J. [2010] Does use of advanced information technology in commercial minimum dataset systems improve quality of nursing homecare?, American Journal of Medical Quality, 25: 116–127. Crossref, Google Scholar
Mansfield, E. [1968] Industrial Research and Technological Innovation: An Econometric Analysis. W. W. Norton and Company Inc., New York. Google Scholar
McDonnell, C., Werner, K. and Wendel, L. (2010). Electronic Health Record Usability: Vendor Practices and Perspectives. Agency for Healthcare Research and Quality, Rockville (MD). Accessed from http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_3882_913591_0_0_18/EHRVendorPractices/EHR_vendor_practices_and_perspectives Perspectives.pdf. Google Scholar
Nazare, S., Or, C., Li, K. and Xu, J. [2013] What makes the implementation of clinical information systems difficult in nursing homes?, Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare, 2: 38–42. Google Scholar
Oliveira, T. and Martins, M. F. [2011] Literature review of information technology adoption models at firm level. Electronic Journal Information Systems Evaluation, 14, 1: 110–121. Google Scholar
Patton, M. [2001] Qualitative Research and Evaluation Method. 3rd edn., Sage, Thousand Oaks, CA. Google Scholar
Pillemer, K., Meador, R., Teresi, J., Chen, E., Henderson, C., Lachs, M., Boratgis, G., Silver, S. and Eimicke, J. [2012] Effects of electronic health information technology implementation on nursing home resident outcomes. Journal of Aging and Health, 24: 92–112. Crossref, Google Scholar
Poon, E. C., Jha, A. K., Christino, M., Honour, M., Femandopulle, R. and Middleton, B. [2006] Assessing the level of healthcare information technology adoption in the United States: A snapshot. BMC Medical Informatics and Decision-Making, 6: 1–9. Crossref, Google Scholar
Possant, L., Periera, J., Tamblyn, R. and Kawasumi, Y. [2005] The impact of electronic health records on the efficiency of physicians and nurses: A systematic review. Journal of the American Medical Informatics Association, 12: 505–516. Crossref, Google Scholar
Rochon, P. A., Field, T. S., Bates, D. W., Lee, M., Gavendo, L., Erramuspe-Mainard, J. et al. [2005] Computerized physician order entry with clinical decision support in the long-term care setting: Insights from the Baycrest Center for geriatric care. Journal of American Geriatric Society, 53, 10: 1780–1789. Crossref, Google Scholar
Rogers, E. M. [1995] Diffusion of Innovations. Free Press, New York. Google Scholar
Shekelle, P., Morton, S. and Keeler, E. [2006] Costs and Benefits of Health Information Technology. Agency for Healthcare Research and Quality, Rockville, MD. Evidence Report/Technology Assessment No. 132, AHRQ Publication 06-E006. Crossref, Google Scholar
Shin, D. Y., Menachemi, N., Diana, M., Kazley, A. S. and Ford, E. W. [2012] Payer mix and EHR adoption in hospitals. Journal of Healthcare Management, 57: 449–450. Crossref, Google Scholar
Spetz, J. and Keane, D. [2009] Information technology implementation in a rural hospital: A cautionary tale. Journal of Healthcare Management, 54: 337–348. Crossref, Google Scholar
Spinelli-Moraski, C. and Richards, K. [2013] Health information technology in nursing homes: Why and how?, Research in Gerontological Nursing, 6: 150–151. Crossref, Google Scholar
Tornatzky, L. and Fleischer, M. [1990] The Process of Technology Innovation. Lexington Books, Lexington, MA. Google Scholar
Tripp, J. S., Narus, S. P., Magill, M. K. et al. [2008] Evaluating the accuracy of existing EMR data as predictors of follow-up providers. Journal of American Medical Information Association, 15: 787–790. Crossref, Google Scholar
Wang, S. J., Middleton, B., Prosser, L., Bardon, C., Spurr, C., Carchidi, P., Kittler, A., Goldszer, R., Fairchild, D., Sussman, A., Kuperman, G. and Bates, D. [2003] A cost-benefit analysis of electronic medical records in primary care. American Journal of Medicine, 114: 397–403. Crossref, Google Scholar
Yin, R. K. [2002] Case Study Research: Design and Methods. 3rd ed., Sage, London. Google Scholar
Yin, R. K. [2014] Case Study Research: Design and Methods. 5th ed., Sage, Thousand Oaks, California. Google Scholar
Yuan, M., Finley, G., Long. J., Mills, C. and Johnson, R. [2013] Evaluation of user interface and workflow design of a bedside nursing clinical decision support system. Interactive Journal of Medical Research, 2: e4. Crossref, Google Scholar
Zhang, N., Lu, S., Xu, B., Wu, B., Rodriguez-Monguio, R. and Gurwitz, J. [2016] Health information technologies: Which nursing homes adopted them?, Journal of the American Medical Directors Association, 17: 441–447. Crossref, Google Scholar
Zhu, K., Dong, S., Xu, S. and Kraemer, K. [2006] Innovation diffusion in global contexts: Determinants of post-adoption digital transformation of European companies. European Journal of Information Systems, 15: 601–616. Crossref, Google Scholar