Health Information Technology in the Nursing Home

This study has been completed.
Sponsor:
Collaborators:
Baycrest Centre for Geriatric Care
Information provided by:
University of Massachusetts, Worcester
ClinicalTrials.gov Identifier:
NCT00599209
First received: January 11, 2008
Last updated: August 2, 2011
Last verified: August 2011
  Purpose

The magnitude and intensity of medication use among our nation's 1.6 million nursing home residents matches or exceeds that of hospitalized patients. The residents of nursing homes are among the most frail patients in the population; the challenges of using medications in this setting are great, not only because of the physiologic declines and pharmacologic changes that occur with aging, but also because of the special clinical and social circumstances that often characterize nursing home care. In our previous research, we have determined that medication errors resulting in adverse drug events occur most often at the ordering and monitoring stages of pharmaceutical care. Clinical decision-support systems are clinical consultation systems that combine individual patient information with population statistics and scientific evidence to offer real-time information to health care providers. These systems have been found to improve the quality of medication prescribing in the hospital setting. In this study, we intend to determine the extent to which a computer-based clinical decision-support system (accompanying computerized provider order-entry) can improve the quality of medication ordering and monitoring for residents in the long-term care setting through a randomized trial. We will track the costs associated with this system and the system's impact on the productivity of providers. We will also assess the culture of U.S. nursing homes and the organization of the nursing home setting with respect to readiness to incorporate computerized provider order-entry with computer-based clinical decision support. Our project addresses specific areas that are of particular interest to AHRQ with special relevance to the delivery of high-quality care to a priority population--the frail elderly patient population residing in nursing homes. The project will assess the economic implications of health information technology in the nursing home environment that will be of interest to key stakeholders, including physicians, pharmacists, nurses, payers, policymakers, the nursing home industry, and pharmaceutical vendors to long-term care institutions.


Condition Intervention
Patient Safety
Prescribing Practices
Laboratory Monitoring Practices
Other: clinical decision support

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
Official Title: Health Information Technology in the Nursing Home

Resource links provided by NLM:


Further study details as provided by University of Massachusetts, Worcester:

Primary Outcome Measures:
  • extent to which a computer-based clinical decision-support system (accompanying computerized provider order-entry) can improve the quality of medication ordering and monitoring [ Time Frame: two years ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • costs associated with this system and the system's impact on the productivity of providers [ Time Frame: two years ] [ Designated as safety issue: No ]

Enrollment: 23
Study Start Date: September 2004
Study Completion Date: September 2008
Primary Completion Date: September 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: A - coded unit ID
Nursing home units provided the CDS intervention
Other: clinical decision support
CDS is provided to prescribers on intervention units upon ordering medication which offers advice on prescribing and monitoring practices
No Intervention: B - coded unit ID
Nursing home units not provided the CDS intervention

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • prescriber at the study facility

Exclusion Criteria:

  • not a prescriber at the study facility
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00599209

Locations
United States, Massachusetts
Meyers Primary Care Institute
Worcester, Massachusetts, United States, 01605
Sponsors and Collaborators
University of Massachusetts, Worcester
Baycrest Centre for Geriatric Care
Investigators
Principal Investigator: Jerry H Gurwitz, MD Meyers Primary Care Institute
  More Information

Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Jerry Gurwitz, MD Executive Director, Meyers Primary Care Institute/University of Massachusetts Medical School
ClinicalTrials.gov Identifier: NCT00599209     History of Changes
Other Study ID Numbers: 11390, 5 R01 HS15430
Study First Received: January 11, 2008
Last Updated: August 2, 2011
Health Authority: United States: Institutional Review Board

ClinicalTrials.gov processed this record on August 27, 2014