Study Explores Tech Abandonment Impact in Nursing Homes

Approximately 28% of nursing homes nationwide are experiencing technology abandonment, which could lead to increased strain on limited resources and hinder administrators' ability to oversee clinical operations, according to a study published in the Journal of the American Medical Directors Association.

“Despite the robust body of research on [health information technology] HIT adoption, the closely related process of technology abandonment is less studied,” explained Kimberly Powell, PhD, RN, Sinclair School of Nursing, University of Missouri, Columbia, MO, and coauthors. “In this article, we define technology abandonment as the failed attempts to scale up locally, spread distantly, or sustain HIT systems,” she continued. The researchers performed a longitudinal, retrospective analysis of data from the HIT Maturity Survey and Staging model and public data from the Care Compare database to describe HIT abandonment and its association with organizational characteristics. A random sample of nursing homes representing each US state that completed the HIT maturity survey in two consecutive years was included. Year 1 (Y1) was from June 2019 to August 2020, and year 2 (Y2) was from June 2020 to August 2021.

In Year 1 (Y1), surveys were sent to 1,658 nursing homes, with a 43% response rate. In Year 2 (Y2), 719 surveys were sent out, receiving a 43% response rate again. After excluding 13 late responses from Y1, the analysis focused on 299 nursing homes with Y1 and Y2 data, representing US nursing homes in terms of location, bed size, and ownership. From Y1 to Y2, 27% of nursing homes saw no change in HIT maturity scores, 44% increased, and 28% decreased. The most significant decline in HIT maturity was observed in resident care capabilities.

No significant associations were found with total HIT maturity scores, leading to an assessment based on HIT maturity stages and subscales. Significant associations were discovered in five HIT score domains (resident care capabilities, extent of use, clinical support integration, and administrative activities capabilities and extent of use) with variables including bed size, rurality, ownership type, chain affiliation, Centers for Medicare & Medicaid Services (CMS) Five-Star Overall Rating, and staffing rating.

Nursing homes with bed sizes over 120 were 2.52 times more likely to experience technology abandonment in administrative activities and extent of use (RRR = 2.52, 95% CI 1.01-6.30). Facilities with high CMS star ratings were significantly less likely to have no change in HIT than those that showed improvement, especially in administrative activities extent of use (RRR = 5.90, 95% CI 1.31-26.49). For-profit nursing homes were more likely to abandon technology than nursing homes with no change in HIT (RRR = 2.737, 95% CI 1.380-5.430).

“This study contributes to the limited understanding of technology abandonment and can serve as a building block for others working to ensure limited resources are used effectively and sustained to improve care for [nursing home] residents,” concluded the study authors.

Reference

Powell KR, Farmer M, Liu J, Alexander GL. A survey of technology abandonment in US nursing homes. J Am Med Dir Assoc. 2024;25(1):6-11. doi:10.1016/j.jamda.2023.09.002