Project Details - Ongoing
- Grant Number:R01 HS024537
- Funding Mechanism:
- AHRQ Funded Amount:$740,305
- Principal Investigator:
- Project Dates:4/1/2016 to 3/31/2020
- Care Setting:
- Medical Condition:
- Type of Care:
- Health Care Theme:
The demand for home health care is growing for a variety of reasons, including an aging population, lengthening life expectancy, increases in those that have multiple chronic diseases, and a desire by individuals and their families to remain in their homes. Over 11 million older adults per year are admitted to homecare. These admissions can be challenging because of the absence of, or limits to, electronic information flow between hospitals and homecare agencies resulting in incomplete or inaccurate patient information. Health information technology (IT) can play an important role in supporting the timely and efficient collection, transmission, and synthesis of information needed for decisionmaking during these transitions of care. However, homecare agencies have been slow to adopt electronic health records (EHRs) and mobile technology. In addition, there has been an absence of the use of standardized documents for the electronic recording of health information and a lack of clinical standards for the information received by homecare agencies.
This project will analyze and model the information requirements, decisionmaking, and workflow of homecare nurses admitting patients and characterize if and how health IT systems support their needs. The analysis will lead to the development, review, and dissemination of design and implementation recommendations.
The specific aims of this project are as follows:
- Characterize information requirements, decisionmaking, and workflow for admitting nurses at three agencies using three different health IT systems
- Characterize if and how health IT systems support homecare admitting nurses’ information requirements, decisionmaking, and workflow
- Develop and disseminate design and implementation recommendations that address homecare admitting nurses’ information requirements, decisionmaking, and workflow
A mixed methods data collection and analysis approach will be used. Outcomes of the study will include the following: (1) information requirements for homecare admitting nurses, (2) models of workflow and decisionmaking in the homecare admission process, and (3) dissemination of health IT design recommendations that efficiently fulfill information needs and support clinical decisionmaking during the homecare admission process. This study will inform improvements in real world homecare health IT systems that may ultimately reduce unplanned hospitalization readmission events. Study findings also will inform future health IT interventions related to transitions in care to and from homecare, such as Meaningful Use and clinical information exchange standards.