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IT at the front lines
Greg Alexander
Information technology is a big deal in today’s medical settings. Electronic health records and other types of technological advances in information management are gaining importance in hospitals and physician offices. But what about other locations where nurses provide front-line care?
Greg Alexander, assistant professor, is exploring the issue of IT sophistication in nursing homes with a $4,586 MU Research Council grant. His interest in the topic began during his fellowship in medical informatics at the National Library of Medicine. His current research focuses on patient safety and the human factors associated with the ways in which people use technology to make better decisions.
“Not many nursing homes have sophisticated technology,” he says. “I wondered if there is a difference in care when a nursing home implements clinical decision support systems and other forms of information technology. Does it improve care and the processes nurses use to deliver that care?”
To answer his questions, Alexander is interviewing staff in Missouri nursing homes where IT systems are in use. The information gleaned from these interviews will help Alexander develop a measurement that he can then use to determine how IT affects nursing home care. He plans to test the resulting measurement tool at 25 percent of the state’s nursing homes.
“Nursing homes have been left behind when it comes to technology,” he says. “In many cases, there’s just not enough staff to provide the kind of infrastructure needed to support such systems. Budget constraints mean that there aren’t enough funds to hire IT support staff. So the burden falls on employees who don’t have the background or training needed to implement these complex systems.”
The general learning curve, needed to adapt long-standing practices to new paradigms, and resistance to change add to the challenges faced by nursing homes that attempt to implement high-tech information systems.
Alexander hopes to learn how nursing homes successfully implement integrated delivery systems that offer computerized patient records along with clinical decision support. By understanding what strategies are used in such nursing homes, he will be able to turn his focus to more specific aspects of the technology, which may make the most practical difference.
In particular, Alexander is interested in how wireless, handheld devices can facilitate staff communication, this affecting standards of care. He plans to seek further funding to study how such technology can be used to help prevent and manage the treatment of pressure ulcers.
“Technology is a very good thing that will enhance the quality of care and make work easier for nursing home staff,” he notes. “Things are slowly improving, but there’s still a need for adequate time, resources and focus to make these technologies fit nursing homes. We’re just seeing the first stages of this process and have yet to discover exactly what kind of difference it will ultimately make.”