Forecasting Content and Stage in a Nursing Home Information Technology Maturity Instrument Using a Delphi Method
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.
KeywordsHealth information technology Nursing homes Meaningful use
The authors would like to thank Keely Wise, Project Coordinator, who help keep us all organized, moving forward through this project, and on target to accomplish goals. Further, this study would not be possible without the contributions of many nursing home leaders across the country who were consistent partners in our research.
This project was supported by grant number R01HS022497 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
Compliance with Ethical Standards
Conflicts of Interest
Dr. Alexander is Founder and Owner of TechNHOlytics, LLC. A company that provides feedback to nursing homes about information technology.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
All methods were approved by the universities Institutional Review Board (IRB) under IRB #2009109 HS.
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