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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

January 11, 2008
August 2, 2011
September 2004
September 2008   (final data collection date for primary outcome measure)
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 ]
Same as current
Complete list of historical versions of study NCT00599209 on ClinicalTrials.gov Archive Site
costs associated with this system and the system's impact on the productivity of providers [ Time Frame: two years ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
Health Information Technology in the Nursing Home
Health Information Technology in the Nursing Home

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.

Not Provided
Interventional
Not Provided
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
  • Patient Safety
  • Prescribing Practices
  • Laboratory Monitoring Practices
Other: clinical decision support
CDS is provided to prescribers on intervention units upon ordering medication which offers advice on prescribing and monitoring practices
  • Experimental: A - coded unit ID
    Nursing home units provided the CDS intervention
    Intervention: Other: clinical decision support
  • No Intervention: B - coded unit ID
    Nursing home units not provided the CDS intervention

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
23
September 2008
September 2008   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • prescriber at the study facility

Exclusion Criteria:

  • not a prescriber at the study facility
Both
Not Provided
Yes
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00599209
11390, 5 R01 HS15430
No
Jerry Gurwitz, MD Executive Director, Meyers Primary Care Institute/University of Massachusetts Medical School
University of Massachusetts, Worcester
  • Baycrest Centre for Geriatric Care
  • Agency for Healthcare Research and Quality (AHRQ)
Principal Investigator: Jerry H Gurwitz, MD Meyers Primary Care Institute
University of Massachusetts, Worcester
August 2011

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP