Health Information Technology in Nursing Homes: Why and How?

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Perceptions of Culture Change ...</a></li><li><a href="https://web.archive.org/web/20130925035429/http://www.healio.com/nursing/journals/rgn/%7B0112dc45-fbbc-4dbe-b9ae-a7c15dc47f48%7D/understanding-nurses-decisions-to-treat-pain-in-nursing-home-residents-with-dementia">Understanding Nurses' Decisions to Treat Pain in Nursing ...</a></li><li><a href="https://web.archive.org/web/20130925035429/http://www.healio.com/nursing/journals/rgn/%7B9c0acd64-c0be-470a-bf50-ce6a819480ad%7D/variations-in-patterns-of-care-activities-for-nursing-home-residents-with-heart-failure">Variations in Patterns of Care Activities for Nursing Home ...</a></li></ul></div> <input name="layout_0$maincontent_0$seeAlsoInsertUnderParagraph" type="hidden" id="layout_0_maincontent_0_seeAlsoInsertUnderParagraph" value="1"/> <div class="journals-content"><div class="journal-tab-group"><ul class="journal-tabs"><li><a href="/web/20130925035429/http://www.healio.com/journals/rgn">Current Issue</a></li><li><a href="/web/20130925035429/http://www.healio.com/journals/rgn/m/oar">Online Advanced Release</a></li><li><a href="/web/20130925035429/http://www.healio.com/journals/rgn/m/past-issues">Past Issues</a></li></ul><div class="journal-panes"><div class="abstract-content"><p class="kicker-top">Guest Editorial </p><h2><a href="#">Health Information Technology in Nursing Homes: Why and How?</a></h2><p class="authors">Carla Spinelli-Moraski, MSN, RN-BC; Kathy Richards, PhD, RN, FAAN</p><div class="journal-info"><ul class="full-text"><li class="header">Read Full Text Article</li><li class="html"><a class="active" title="View Html Version" alt="View Html Version" rel="nofollow" href="/web/20130925035429/http://www.healio.com/nursing/journals/rgn/{a5bde41c-9b90-4861-b1e4-f48df64ecfa0}/health-information-technology-in-nursing-homes-why-and-how?fulltext=1">Html Icon</a></li><li class="pdf"><a id="pdf" href="/web/20130925035429/http://www.healio.com/~/media/Journals/RGN/2013/7_July/10_3928_19404921_20130712_01/10_3928_19404921_20130712_01.pdf" class="active" title="View Pdf Version" alt="View Pdf Version" rel="nofollow">Pdf Icon</a></li></ul><ul class="article-citation"><li>Research in Gerontological Nursing</li><li>July 2013 - Volume 6 · Issue 3: 150-151</li><li class="doi">DOI: 10.3928/19404921-20130712-01</li></ul></div><div class="copyrights" style="float:right;"><a onclick="RightsLinkPopUpV2();" href="#"><img alt="Rights and Permissions" title="Rights and Permissions" border="0" src="https://web.archive.org/web/20130925035429im_/http://213a1ca8842e5e699a80-05ce35571e92a3f7383a191aa5840bba.r66.cf1.rackcdn.com/request-permissions.gif"></img></a><script type="text/javascript" language="javascript">function RightsLinkPopUpV2() { var location="https://web.archive.org/web/20130925035429/https://s100.copyright.com/AppDispatchServlet?publisherName=slack&publication=1940-4921&contentID=10.3928/19404921-20130712-01&publicationDate=2013&copyright=Copyright%20%26copy%3B%202013%2C%20Slack%20Inc.&title=Health%20Information%20Technology%20in%20Nursing%20Homes%3A%20Why%20and%20How%3F&volumeNum=6&issueNum=3&author=Carla%20Spinelli-Moraski%2C%20MSN%2C%20RN-BC%3B%20Kathy%20Richards%2C%20PhD%2C%20RN%2C%20FAAN%26orderBeanReset%3DTRUE"; window.open(location,'RightsLink','location=no,toolbar=no,directories=no,status=no,menubar=no,scrollbars=yes,resizable=yes,width=650,height=550'); } </script></div><div class="article-tab-group"><ul class="article-tabs"><li><a id="anchor-tab-article" href="#">Article</a></li><li class="last"><a id="anchor-tab-refs" href="#">References</a></li><li class="cite-link"><a href="#" onclick="showCitation();">Get Citation</a><script type="text/javascript">function showCitation() {var w = window.open('', '', 'width=400,height=400,resizeable,scrollbars');w.document.write('Spinelli-Moraski C., Richards K.(2013). Health Information Technology in Nursing Homes: Why and How?. <i>Research in Gerontological Nursing.</i> 6(3) 150-151. doi: 10.3928/19404921-20130712-01 <a href="https://web.archive.org/web/20130925035429/http://www.healio.com/nursing/journals/rgn/{a5bde41c-9b90-4861-b1e4-f48df64ecfa0}/health-information-technology-in-nursing-homes-why-and-how">[link]</a>');w.document.close(); }</script></li></ul></div><div id="articleBody"><div class="ftContainer"> <div class="ftArticle"> <p>Despite consensus that the use of health information technology (HIT) could lead to more efficient, safer, and better quality of care, in 2006, only 1% of nursing homes reported using basic-level HIT systems, such as electronic health records ( <a href="#x19404921-20130712-01-bibr10">Martin, Brantley, & Dangler, 2007</a> ; <a href="#x19404921-20130712-01-bibr11">Poon et al., 2006</a> ). More recently, studies conducted in California and Minnesota reported a 20% to 32% rate of electronic health record implementation in nursing homes ( <a href="#x19404921-20130712-01-bibr12">Richard, Kaehny, May, & Kramer, 2009</a> ). The few randomized controlled trials on more advanced technology (i.e., clinical decision support systems) have reported reductions in inappropriate prescribing of medications when the systems are in place ( <a href="#x19404921-20130712-01-bibr6">Donovan et al., 2010</a> ; <a href="#x19404921-20130712-01-bibr8">Judge et al., 2006</a> ). Currently, there are no incentives for nursing homes to implement even basic-level HIT systems; hence, limited research supports how these systems can improve quality of care and reduce costs.</p> <p>Data from the National Nursing Home Survey conducted in 2004 indicated that 82% of nursing homes used electronic software to submit their Minimum Data Set (MDS) data to the Centers for Medicare and Medicaid Services ( <a href="#x19404921-20130712-01-bibr7">Jones, Dwyer, Bercovitz, & Strahan, 2009</a> ). This suggests that nursing homes can adopt technology into their everyday routines. However, even with this high level of MDS software use, only one third of nursing homes are using the more advanced features, such as medication tracking, available in their system ( <a href="#x19404921-20130712-01-bibr9">Liu, Castle, & Diesel, 2010</a> ). What can be done to inspire the adoption of basic and advanced technology in the nursing home setting? Nursing homes may be more inclined to adopt these technologies if data supported the effect of HIT on nursing home quality of care and cost containment.</p> <div class="ftSection"> <h3>Quality of Care</h3> <p>Poor quality of care is a significant issue in nursing homes because it is associated with pain and suffering, increased costs, and poor nursing home ratings. Research on HIT in hospitals has shown major improvements in quality of care through reduced medication errors, enhanced surveillance and monitoring, and improved adherence to evidence-based guidelines ( <a href="#x19404921-20130712-01-bibr3">Chaudhry et al., 2006</a> ). Adverse drug events and inappropriate medication prescribing in hospitals were reduced by 23% with the use of a computerized provider order entry system including a clinical decision support system ( <a href="#x19404921-20130712-01-bibr1">Bates et al., 1998</a> ; <a href="#x19404921-20130712-01-bibr5">Colpaert et al., 2006</a> ). If nursing home research showed similar results, quality of care in nursing homes would be greatly improved. These improvements may then be reflected in better nursing home ratings, as reported on Nursing Home Compare ( <a href="https://web.archive.org/web/20130925035429/http://www.medicare.gov/nursinghomecompare" target="_blank">http://www.medicare.gov/nursinghomecompare</a> ). However, research on the effect of HIT in nursing homes is scarce, even for the most fundamental systems. Research on the effect of HIT on quality of nursing home care is urgently needed, and nurses should be at the forefront of this effort. The findings of such studies may motivate nursing home owners and administrators to adopt more advanced technology systems and may lead to improved nursing home care.</p> </div> <div class="ftSection"> <h3>Costs</h3> <p>Nursing home owners and administrators report that a main barrier to the adoption of HIT is the high costs associated with both the hardware and software ( <a href="#x19404921-20130712-01-bibr4">Cherry, Carter, Owen, & Lockhart, 2008</a> ). Future research should investigate the effect of HIT on direct costs associated with medication administration and medication errors, acquired pressure ulcers, urinary tract infections, and falls. The costs of HIT systems may be offset by a reduction in direct care costs.</p> <p>Research has the potential to support additional cost savings. Advanced technology systems used in hospital settings, such as clinical decision support applications, have been shown to streamline processes, support effective decision making, integrate complex tasks, and provide real-time data, especially related to medication safety ( <a href="#x19404921-20130712-01-bibr2">Brandeis, Hogan, Murphy, & Murray, 2007</a> ; <a href="#x19404921-20130712-01-bibr13">Scott-Cawiezell et al., 2009</a> ). Improvements in processes and real-time reporting can reduce medication costs, supply costs, and staffing costs. In turn, these savings will offset hardware and software costs.</p> </div> <div class="ftSection"> <h3>Conclusion</h3> <p>Nurses should be active participants and leaders of interprofessional teams that will design and test the effectiveness of HIT systems for nursing homes. Additional descriptive research is needed on the current level of HIT adoption in nursing homes, the design features and level of IT sophistication of current systems, and the needs of users for future systems. Research is urgently needed to determine the effects of HIT on quality of care and costs in nursing homes.</p> </div> <p class="ftSignature"><em>Carla Spinelli-Moraski, MSN, RN-BC</em><br> <br> <em>Graduate Research Assistant and PhD candidate</em></p> <p class="ftSignature"><em>Kathy Richards, PhD, RN, FAAN</em><br> <br> <em>University Professor and Assistant Dean</em><br> <br> <em>Doctoral Programs and Research Development</em><br> <br> <em>George Mason University</em><br> <br> <em>College of Health and Human Services</em><br> <br> <em>School of Nursing</em><br> <br> <em>Fairfax, Virginia</em></p> <div class="ftRefList"> <h3>References</h3> <ul><a name="x19404921-20130712-01-bibr1"></a> <li>Bates, D.W., Leape, L.L., Cullen, D.J., Laird, N., Petersen, L.A., Teich, J.M. & Seger, D.L. (1998). Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. <em>Journal of the American Medical Association</em> , <em>280</em> , 1311–1316. doi:10.1001/jama.280.15.1311 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1001/jama.280.15.1311" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr2"></a> <li>Brandeis, G.H., Hogan, M., Murphy, M. & Murray, S. (2007). Electronic health record implementation in community nursing homes. <em>Journal of the American Medical Directors Association</em> , <em>8</em> , 31–34. doi:10.1016/j.jamda.2006.09.013 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1016/j.jamda.2006.09.013" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr3"></a> <li>Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E. & Shekelle, P.G. (2006). Systematic review: Impact of health information technology on quality, efficiency, and costs of medical care. <em>Annals of Internal Medicine</em> , <em>144</em> , 742–752. doi:10.7326/0003-4819-144-10-200605160-00125 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.7326/0003-4819-144-10-200605160-00125" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr4"></a> <li>Cherry, B., Carter, M., Owen, D. & Lockhart, C. (2008). Factors affecting electronic health record adoption in long-term care facilities. <em>Journal for Healthcare Quality</em> , <em>30</em> (2), 37–47. doi:10.1111/j.1945-1474.2008.tb01133.x <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1111/j.1945-1474.2008.tb01133.x" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr5"></a> <li>Colpaert, K., Claus, B., Somers, A., Vandewoude, K., Robays, H. & Decruyenaere, J. (2006). Impact of computerized physician order entry on medication prescription errors in the intensive care unit: A controlled cross-sectional trial. <em>Critical Care</em> , <em>10</em> , R21. Retrieved from <a href="https://web.archive.org/web/20130925035429/http://ccforum.com/content/10/1/r21" target="_blank">http://ccforum.com/content/10/1/r21</a> . doi:10.1186/cc3983 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1186/cc3983" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr6"></a> <li>Donovan, J.L., Kanaan, A.O., Thomson, M.S., Rochon, P., Lee, M., Gavendo, L. & Gurwitz, J.H. (2010). Effects of clinical decision support on psychotropic medications prescribing in the long-term care setting. <em>Journal of the American Geriatrics Society</em> , <em>58</em> , 1005–1007. doi:10.1111/j.1532-5415.2010.02840.x <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1111/j.1532-5415.2010.02840.x" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr7"></a> <li>Jones, A.L., Dwyer, L.L., Bercovitz, A.R. & Strahan, G.W. (2009). The National Nursing Home Survey: 2004 overview. <em>Vital and Health Statistics</em> , <em>13</em> (167). Retrieved from the Centers for Disease Control and Prevention website: <a href="https://web.archive.org/web/20130925035429/http://www.cdc.gov/nchs/nnhs/nnhs_products.htm#sr13" target="_blank">http://www.cdc.gov/nchs/nnhs/nnhs_products.htm#sr13</a> doi:10.1111/j.1547-5069.2008.00239.x <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1111/j.1547-5069.2008.00239.x" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr8"></a> <li>Judge, J., Field, T.S., DeFlorio, M., Laprino, J., Auger, J., Rochon, P. & Gurwitz, J.H. (2006). Prescribers’ responses to alerts during medication ordering in the long term care setting. <em>Journal of the American Medical Informatics Association</em> , <em>13</em> , 385–390. doi:10.1197/jamia.M1945 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1197/jamia.M1945" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr9"></a> <li>Liu, D., Castle, N.G. & Diesel, J. (2010). Does use of advanced information technology in commercial minimum data set systems improve quality of nursing home care? <em>American Journal of Medical Quality</em> , <em>25</em> , 116–127. doi:10.1177/1062860609354637 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1177/1062860609354637" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr10"></a> <li>Martin, R.D., Brantley, D. & Dangler, D. (2007). <em>Essential but not sufficient: Information technology in long-term care as an enabler of consumer independence and quality improvement</em> . Retrieved from the Center for Excellence in Assisted Living website: <a href="https://web.archive.org/web/20130925035429/http://www.theceal.org/downloads/CEAL_1335882153.pdf" target="_blank">http://www.theceal.org/downloads/CEAL_1335882153.pdf</a> doi:10.3928/19404921-20091207-98 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.3928/19404921-20091207-98" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr11"></a> <li>Poon, E.G., Jha, A.K., Christino, M., Honour, M.M., Fernandopulle, R., Middleton, B. & Kaushal, R. (2006). Assessing the level of healthcare information technology adoption in the United States: A snapshot. <em>BMC Medical Informatics and Decision Making</em> , <em>6</em> (1). Retrieved from <a href="https://web.archive.org/web/20130925035429/http://www.biomedcentral.com/1472-6947/6/1" target="_blank">http://www.biomedcentral.com/1472-6947/6/1</a> . doi:10.1186/1472-6947-6-1 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1186/1472-6947-6-1" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr12"></a> <li>Richard, A., Kaehny, M., May, K. & Kramer, A. (2009). <em>Literature review and synthesis: Existing surveys on health information technology, including surveys on health information in nursing homes and home health</em> . Retrieved from the U.S. Department of Health and Human Services website: <a href="https://web.archive.org/web/20130925035429/http://aspe.hhs.gov/daltcp/reports/2009/HITlitrev.htm" target="_blank">http://aspe.hhs.gov/daltcp/reports/2009/HITlitrev.htm</a></li> <a name="x19404921-20130712-01-bibr13"></a> <li>Scott-Cawiezell, J., Madsen, R.W., Pepper, G.A., Vogelsmeier, A., Petroski, G. & Zellmer, D. (2009). Medication safety teams’ guided implementation of electronic medication administration records in five nursing homes. <em>Joint Commission Journal on Quality and Patient Safety</em> , <em>35</em> , 29–35.</li> </ul> </div> </div> </div></div><div id="articleReferences" style="display: none;"><div class="ftRefList"> <h3>References</h3> <ul><a name="x19404921-20130712-01-bibr1"></a> <li>Bates, D.W., Leape, L.L., Cullen, D.J., Laird, N., Petersen, L.A., Teich, J.M. & Seger, D.L. (1998). Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. <em>Journal of the American Medical Association</em> , <em>280</em> , 1311–1316. doi:10.1001/jama.280.15.1311 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1001/jama.280.15.1311" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr2"></a> <li>Brandeis, G.H., Hogan, M., Murphy, M. & Murray, S. (2007). Electronic health record implementation in community nursing homes. <em>Journal of the American Medical Directors Association</em> , <em>8</em> , 31–34. doi:10.1016/j.jamda.2006.09.013 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1016/j.jamda.2006.09.013" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr3"></a> <li>Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E. & Shekelle, P.G. (2006). Systematic review: Impact of health information technology on quality, efficiency, and costs of medical care. <em>Annals of Internal Medicine</em> , <em>144</em> , 742–752. doi:10.7326/0003-4819-144-10-200605160-00125 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.7326/0003-4819-144-10-200605160-00125" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr4"></a> <li>Cherry, B., Carter, M., Owen, D. & Lockhart, C. (2008). Factors affecting electronic health record adoption in long-term care facilities. <em>Journal for Healthcare Quality</em> , <em>30</em> (2), 37–47. doi:10.1111/j.1945-1474.2008.tb01133.x <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1111/j.1945-1474.2008.tb01133.x" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr5"></a> <li>Colpaert, K., Claus, B., Somers, A., Vandewoude, K., Robays, H. & Decruyenaere, J. (2006). Impact of computerized physician order entry on medication prescription errors in the intensive care unit: A controlled cross-sectional trial. <em>Critical Care</em> , <em>10</em> , R21. Retrieved from <a href="https://web.archive.org/web/20130925035429/http://ccforum.com/content/10/1/r21" target="_blank">http://ccforum.com/content/10/1/r21</a> . doi:10.1186/cc3983 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1186/cc3983" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr6"></a> <li>Donovan, J.L., Kanaan, A.O., Thomson, M.S., Rochon, P., Lee, M., Gavendo, L. & Gurwitz, J.H. (2010). Effects of clinical decision support on psychotropic medications prescribing in the long-term care setting. <em>Journal of the American Geriatrics Society</em> , <em>58</em> , 1005–1007. doi:10.1111/j.1532-5415.2010.02840.x <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1111/j.1532-5415.2010.02840.x" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr7"></a> <li>Jones, A.L., Dwyer, L.L., Bercovitz, A.R. & Strahan, G.W. (2009). The National Nursing Home Survey: 2004 overview. <em>Vital and Health Statistics</em> , <em>13</em> (167). Retrieved from the Centers for Disease Control and Prevention website: <a href="https://web.archive.org/web/20130925035429/http://www.cdc.gov/nchs/nnhs/nnhs_products.htm#sr13" target="_blank">http://www.cdc.gov/nchs/nnhs/nnhs_products.htm#sr13</a> doi:10.1111/j.1547-5069.2008.00239.x <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1111/j.1547-5069.2008.00239.x" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr8"></a> <li>Judge, J., Field, T.S., DeFlorio, M., Laprino, J., Auger, J., Rochon, P. & Gurwitz, J.H. (2006). Prescribers’ responses to alerts during medication ordering in the long term care setting. <em>Journal of the American Medical Informatics Association</em> , <em>13</em> , 385–390. doi:10.1197/jamia.M1945 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1197/jamia.M1945" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr9"></a> <li>Liu, D., Castle, N.G. & Diesel, J. (2010). Does use of advanced information technology in commercial minimum data set systems improve quality of nursing home care? <em>American Journal of Medical Quality</em> , <em>25</em> , 116–127. doi:10.1177/1062860609354637 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1177/1062860609354637" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr10"></a> <li>Martin, R.D., Brantley, D. & Dangler, D. (2007). <em>Essential but not sufficient: Information technology in long-term care as an enabler of consumer independence and quality improvement</em> . Retrieved from the Center for Excellence in Assisted Living website: <a href="https://web.archive.org/web/20130925035429/http://www.theceal.org/downloads/CEAL_1335882153.pdf" target="_blank">http://www.theceal.org/downloads/CEAL_1335882153.pdf</a> doi:10.3928/19404921-20091207-98 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.3928/19404921-20091207-98" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr11"></a> <li>Poon, E.G., Jha, A.K., Christino, M., Honour, M.M., Fernandopulle, R., Middleton, B. & Kaushal, R. (2006). Assessing the level of healthcare information technology adoption in the United States: A snapshot. <em>BMC Medical Informatics and Decision Making</em> , <em>6</em> (1). Retrieved from <a href="https://web.archive.org/web/20130925035429/http://www.biomedcentral.com/1472-6947/6/1" target="_blank">http://www.biomedcentral.com/1472-6947/6/1</a> . doi:10.1186/1472-6947-6-1 <a href="https://web.archive.org/web/20130925035429/http://dx.doi.org/10.1186/1472-6947-6-1" target="_blank">[CrossRef]</a></li> <a name="x19404921-20130712-01-bibr12"></a> <li>Richard, A., Kaehny, M., May, K. & Kramer, A. (2009). <em>Literature review and synthesis: Existing surveys on health information technology, including surveys on health information in nursing homes and home health</em> . Retrieved from the U.S. Department of Health and Human Services website: <a href="https://web.archive.org/web/20130925035429/http://aspe.hhs.gov/daltcp/reports/2009/HITlitrev.htm" target="_blank">http://aspe.hhs.gov/daltcp/reports/2009/HITlitrev.htm</a></li> <a name="x19404921-20130712-01-bibr13"></a> <li>Scott-Cawiezell, J., Madsen, R.W., Pepper, G.A., Vogelsmeier, A., Petroski, G. & Zellmer, D. (2009). Medication safety teams’ guided implementation of electronic medication administration records in five nursing homes. <em>Joint Commission Journal on Quality and Patient Safety</em> , <em>35</em> , 29–35.</li> </ul> </div></div><h5>Authors</h5>The authors have disclosed no potential conflicts of interest, financial or otherwise.<p>10.3928/19404921-20130712-01</p></div></div></div></div> <script type="text/javascript" language="javascript"> var $artContent = $('.ftArticle').html(); $('#anchor-tab-article').click(function () { $('#articleReferences, #articleTables').hide(); $('#articleBody, #abstractPortion').show() var current = $('a.current').removeClass('current'); $(this).addClass('current'); }); $('#anchor-tab-refs').click(function () { $('#articleBody, #abstractPortion, #articleTables').hide(); $('#articleReferences').show(); var current = $('a.current').removeClass('current'); $(this).addClass('current'); }); </script> <div class="social-links"> <div class="fb-like" data-send="false" data-width="300" data-show-faces="true" data-action="recommend"></div> <ul class="share"> <li><a href="javascript:void(0)" id="twitter" class="twitter-link" target="_new">Tweet</a></li> <li><a href="javascript:void(0)" id="facebook" class="facebook-link" target="_new">Share</a></li> <li class="linkedin"><a href="javascript:void(0)" id="linkedin" class="linkedin-link">Link</a></li> <li><span class="db-wrapper"><span class="g-plusone" data-size="tall" data-annotation="none"></span></span></li> <li><a href="javascript:void(0)" id="email">Email</a></li> <li class="last"><a href="javascript:void(0)" id="print">Print</a></li> </ul> <input name="layout_0$maincontent_3$articleItemForTweet" type="hidden" id="layout_0_maincontent_3_articleItemForTweet" value="{B558A713-A12A-486F-A149-45082B898F64}"/> </div> <div id="respond"> <h4> Comments</h4> <script language="javascript" type="text/javascript"> var idcomments_acct = 'aa6ff53f9870e40f92f83e1b5df3cddf'; var idcomments_post_id = 'a5bde41c-9b90-4861-b1e4-f48df64ecfa0'; var idcomments_post_url; </script> <span id="IDCommentsPostTitle" style="display: none"></span> <script type="text/javascript" src="https://web.archive.org/web/20130925035429js_/http://www.intensedebate.com/js/genericCommentWrapperV2.js"></script> <p class="comment-notes"> Healio is intended for health care provider use and all comments will be posted at the discretion of the editors. 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Health Information Technology in Nursing Homes: Why and How? | Research in Gerontological Nursing