The New York State Nursing Home Health Information Technology (HIT) Demonstration Project is a publicly subsidized initiative to implement comprehensive, point-of-care electronic medical records in 20 New York City nursing homes. Because of an innovative union–employer partnership, direct-care staff of the homes were heavily involved in the planning process. Union employees were assured upfront that no layoffs would result from HIT implementation, and training was a high priority in vendor selection.
All participating homes successfully replaced paper records with electronic ones, and, after the intensive pre-implementation planning period, it took less than six months on average for facilities to make this transition. Despite this shared success, variation existed between homes regarding: 1) organizational aims for adapting HIT; 2) the technology’s perceived or real effects; and 3) implementation of quality improvement efforts as a result of newly available data.
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