Health Information Technology Implementation: Implications for the Nursing Home Workforce

UCSF Health Workforce Research Center authors Michelle Ko, MD PhD, Laura M. Wagner, PhD RN FAAN, Onyinyechi Okwandu, MPH and Joanne Spetz, PhD have published their report, Health Information Technology Implementation: Implications for the Nursing Home Workforce. The authors find that although Health Information Technology (HIT) has the potential to improve quality of care, resident quality of life, and health in nursing homes, its implementation in these sites may be delayed due to the new demands it places on staff. This combined literature review and qualitative study interviewing key informants in NHs characterizes the effect of HIT on workforce perceptions and care processes, the training needs associated with HIT implementation, and the infrastructure needed for the workforce to effectively use HIT.

The report finds that nursing homes generally lacked systematic processes for HIT implementation and underinvested in training. New staff evidenced greater interest in learning HIT implementation skills and serving as point persons for other staff. Evidence for productivity gains due to HIT was inconclusive, with unreliable wireless connectivity cited as the most frequent barrier to uptake. No study or interview revealed a direct relationship between HIT impact on the workforce and patient health outcomes or the delivery of care.

The authors conclude that nursing homes are unlikely to realize potential gains in productivity and quality of care without initial investment in training of their workforce. Future research should examine whether HIT leads to improved health and quality of life for residents.