Value Propositions for Health Information Exchange Toward Improving Nursing Home Hospital Readmission Rates.

The importance of health information technology use in nursing home (NH) care delivery is a major topic in research exploring methods to improve resident care. Topics of interest include how technology investments, infrastructure, and work-force development lead to better methods of nursing care delivery and outcomes. Value propositions, including perceived benefits, incentives, and system changes recognized by end-users, are important resources to inform NH leaders, policymakers, and stakeholders about technology. The purpose of the current research was to identify and disseminate value propositions from a community of stakeholders using a health information exchange (HIE). Researchers used a nominal group process, including 49 individual stakeholders participating in a national demonstration project to reduce avoidable hospitalizations in NHs. Stakeholders identified 41 total anticipated changes from using HIE. Ten stakeholder types were perceived to have experienced the highest impact from HIE in areas related to resident admissions, communication, and efficiency of care delivery. [Journal of Gerontological Nursing, 48(1), 15-20.].

To Text or Not to Text? That is the Question.

Texting is ubiquitous with a text frequency of 145 billion/day worldwide. This paper provides partial results of the national demonstration project called the Missouri Quality Improvement Initiative (MOQI). MOQI goals were to reduce avoidable hospitalizations using APRNs to infuse evidence-based practices, model appropriate decisions and improve communication among workers responsible for nursing home resident care. This is a retrospective content analysis of text messages sent and received via a secure, password protected, encrypted mobile text message platform called Mediprocity. Text messages were created by 15 APRNs and a PhD-RN project supervisor working in 16 nursing homes over 6 months (January 1-June 30 2018). During the 6 months of data collection 8,946 text messages were captured, coded and analyzed. Data included 1,018 sent messages and 7,928 received messages. The most common messages sent (n=324) and received (n=2319) were about patient updates. The second most common texts included messages confirming information (n=1312).

Exploring Health Information Exchange Implementation Using Qualitative Assessments of Nursing Home Leaders.

OBJECTIVES: Limited research exists on nursing home information technologies, such as health information exchange (HIE) systems. Capturing the experiences of early HIE adopters provides vital information about how these systems are used. In this study, we conduct a secondary analysis of qualitative data captured during interviews with 15 nursing home leaders representing 14 nursing homes in the midwestern United States that are part of the Missouri Quality Improvement Initiative (MOQI) national demonstration project. METHODS: The interviews were conducted as part of an external evaluation of the HIE vendor contracting with the MOQI initiative with the purpose of understanding the challenges and successes of HIE implementation, with a particular focus on Direct HIE services. RESULTS: Emerging themes included (1) incorporating HIE into existing work processes, (2) participation inside and outside the facility, (3) appropriate training and retraining, (4) getting others to use the HIE, (5) getting the HIE operational, and 6) putting policies for technology into place. DISCUSSION: Three essential areas should be considered for nursing homes considering HIE adoption: readiness to adopt technology, availability of technology resources, and matching of new clinical workflows.