3 keys to HIE implementation for nursing homes

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While few nursing homes use health information exchanges (HIEs), they will have to adapt quickly to meet policy and public demands to more effectively use technology for improving communication between healthcare providers.

That was the conclusion of researchers who interviewed 15 nursing home leaders at 14 locations for a study published in the fall edition of the American Health Information Management Association's Perspectives in Health Information Management publication. The nursing homes were part of the Missouri Quality Improvement Initiative (MOQI) national demonstration project, which focused on implementing Direct HIE services.

The study is a continuation of research that began earlier this year.

Through the interviews, the researchers determined there to be three vital factors for nursing homes considering HIE adoption:

  1. Readiness to adopt technology
  2. Availability of technology resources
  3. Matching technology with new clinical workflows

Readiness suggests that an organization has the infrastructure, technological resources, connectivity and desire to make the HIE work. Some of the facilities, for instance, had “dead spots” without connectivity. Others spoke of the difficulty of getting everyone on the same page, both inside the organization and with outside providers.

“Facilities need to decide where their greatest need is internally to support technology adoption, but this may need to be balanced with finding outside stakeholders who will support immediate technology use so that the workflow can be tested and revised as needed,” the authors stated.

There were also themes to the interviews, including:

  • Incorporating HIE into existing work processes: Some employees were not accustomed to communicating by email or in other instances, used multiple email accounts not associated with the HIE. “I think it would [help if] they try to work on one system that works for everybody,” one participant noted.
  • Appropriate training and retraining: Participants found value in recurring, hands-on training. Nursing homes have higher levels of turnover than other healthcare providers, which can have a significant impact on costs and workflow.
  • Developing policies for technology use: Proper policies are essential at rollout to prevent further delays.