Forecasting Content and Stage in a Nursing Home Information Technology Maturity Instrument Using a Delphi Method
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SYSTEMS-LEVEL QUALITY IMPROVEMENT
Forecasting Content and Stage in a Nursing Home Information Technology Maturity Instrument Using a Delphi Method Gregory L. Alexander 1 Richelle Koopman 5
&
Chelsea Deroche 2 & Kimberly Powell 3 & Abu Saleh Mohammad Mosa 4 & Lori Popejoy 3 &
Received: 1 November 2019 / Accepted: 22 January 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020, corrected publication 2020
Abstract Health information technology capabilities in some healthcare sectors, such as nursing homes, are not well understood because measures for information technology uptake have not been fully developed, tested, validated, or measured consistently. The paper provides a report of the development and testing of a new instrument measuring nursing home information technology maturity and stage of maturity. Methods incorporated a four round Delphi panel composed of 31 nursing home experts from across the nation who reported the highest levels of information technology sophistication in a separate national survey. Experts recommended 183 content items for 27 different content areas specifying the measure of information technology maturity. Additionally, experts ranked each of the 183 content items using an IT maturity instrument containing seven stages (stages 0–6) of information technology maturity. The majority of content items (40% (n = 74)) were associated with information technology maturity stage 4, corresponding to facilities with external connectivity capability. Over 11% of the content items were at the highest maturity stage (Stage 5 and 6). Content areas with content items at the highest stage of maturity are reflected in nursing homes that have technology available for residents or their representatives and used extensively in resident care. An instrument to assess nursing home IT maturity and stage of maturity has important implications for understanding health service delivery systems, regulatory efforts, patient safety and quality of care. Keywords Health information technology . Nursing homes . Meaningful use
Introduction The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 authorized up to This article is part of the Topical Collection on Systems-Level Quality Improvement * Gregory L. Alexander [email protected] 1
S415 Sinclair School of Nursing, University of Missouri Columbia, Columbia, MO 65211-6000, USA
2
Office of Medical Research, University of Missouri Columbia, Columbia, MO 65211-6000, USA
3
Sinclair School of Nursing, University of Missouri Columbia, Columbia, MO 65211-6000, USA
4
School of Medicine, University of Missouri Columbia, Columbia, MO 65211-6000, USA
5
Family and Community Medicine, University of Missouri, Columbia, MO 65211, USA
$40 Billion to stimulate health care providers “meaningful use” of electronic health record (EHR) systems [1]. HITECH established new regulations to create programs that would develop health information exchange, develop strategic HIT research projects, standards and EHR certific
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