Understanding the Costs and Benefits of Health Information Technology in Nursing Homes and Home Health Agencies

Funded by: Office of the Assistant Secretary of Planning and Evaluation,
  Department of Health and Human Services
Project Period: 09/06 - 09/08

Summary/Abstract

Increasingly, implementation of health information technology (HIT) is recognized as a tool to improve the quality, safety, and costs of patient care. However, adoption of HIT solutions in nursing homes (NHs) and home health agencies (HHAs) is widely believed to have lagged behind acute and ambulatory care settings. The purpose of this project is threefold: (i) to further our understanding of how point-of-care (POC) and health information exchange (HIE) tools are being used in select NHs and HHAs; (ii) to identify the types of costs and benefits associated with these HIT applications, including the entities to whom these costs and benefits accrue; and (iii) to develop a data collection and analysis plan that would allow for a quantitative assessment of costs and benefits from the perspective of nursing homes, home health agencies, ancillary providers, Medicare and Medicaid, and consumers.

The project plans to address the following research questions:

1. What point-of-care and HIE applications are being used in the selected NHs and/or HHAs? Is there a hierarchy that is being/has been used to prioritize the roll out of these applications at these settings? If so, what were the criteria used to create the hierarchy? What refinements may be needed to such hierarchy/categorization?
2. From the perspective of the providers and other stakeholders, what are the costs and benefits associated with the HIT applications? Which entities are incurring these costs and accruing benefits?
3. What metrics are needed to determine the costs and benefits of the specific HIT applications? What data are readily available–either from the providers or other sources–to measure the costs and benefits? What additional data are needed to complete the cost/benefit accounting?

Project activities will include a brief literature search and discussions with stakeholders involved in the development and selection of HIE tools and POC software. A categorization of HIE tools used in these settings will be prepared in a report due in month nine. Based on the information learned, a plan will be developed for conducting eight site visits. These site visits are projected to take place between Sept.-Nov. 2007 and Jan.-Mar. 2008. The information gathered from all the sources will be summarized and presented in the final case study report, which will include site visit findings and will identify policies that could promote information exchange and HIT adoption in nursing homes and HHAs. In addition, a quantitative analysis plan will be developed for consideration for possible future research.

Key Personnel: Rachael Bennett, Angela Richard, Anne Epstein, Andy Kramer

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