Health Information Technology in the Nursing Home

Patient Safety Clinical Trial

Official title:

Health Information Technology in the Nursing Home

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00599209
• Other study ID #: 11390
• Secondary ID: 5R01HS015430
• Status: Completed
• Phase: N/A
• First received: January 11, 2008
• Last updated: August 2, 2011
• Start date: September 2004
• Est. completion date: September 2008

Study information

• Verified date: August 2011
• Source: University of Massachusetts, Worcester
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 23
• Est. completion date: September 2008
• Est. primary completion date: September 2008
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Both
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• prescriber at the study facility

Exclusion Criteria:

• not a prescriber at the study facility

Study Design

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research

Related Conditions & MeSH terms

• Laboratory Monitoring Practices
• Patient Safety
• Prescribing Practices

Intervention

Other:
• clinical decision support
CDS is provided to prescribers on intervention units upon ordering medication which offers advice on prescribing and monitoring practices

Locations

Country	Name	City	State
United States	Meyers Primary Care Institute	Worcester	Massachusetts

Sponsors (3)

Lead Sponsor	Collaborator
University of Massachusetts, Worcester	Agency for Healthcare Research and Quality (AHRQ), Baycrest Centre for Geriatric Care

Country where clinical trial is conducted

United States, 

References & Publications (1)

Subramanian S, Hoover S, Gilman B, Field TS, Mutter R, Gurwitz JH. Computerized physician order entry with clinical decision support in long-term care facilities: costs and benefits to stakeholders. J Am Geriatr Soc. 2007 Sep;55(9):1451-7. Review. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	extent to which a computer-based clinical decision-support system (accompanying computerized provider order-entry) can improve the quality of medication ordering and monitoring		two years	Yes
Secondary	costs associated with this system and the system's impact on the productivity of providers		two years	No