title: The State of Nursing Home Information Technology Sophistication in Rural and Nonrural US Markets.
abstract: To test for significant differences in information technology sophistication (ITS) in US nursing homes (NH) based on location.
  
  
  
  We administered a primary survey January 2014 to July 2015 to NH in each US state. The survey was cross-sectional and examined 3 dimensions (IT capabilities, extent of IT use, degree of IT integration) among 3 domains (resident care, clinical support, administrative activities) of ITS. ITS was broken down by NH location. Mean responses were compared across 4 NH categories (Metropolitan, Micropolitan, Small Town, and Rural) for all 9 ITS dimensions and domains. Least square means and Tukey's method were used for multiple comparisons.
  
  
  
  Methods yielded 815/1,799 surveys (45% response rate). In every health care domain (resident care, clinical support, and administrative activities) statistical differences in facility ITS occurred in larger (metropolitan or micropolitan) and smaller (small town or rural) populated areas.
  
  
  
  This study represents the most current national assessment of NH IT since 2004. Historically, NH IT has been used solely for administrative activities and much less for resident care and clinical support. However, results are encouraging as ITS in other domains appears to be greater than previously imagined.
authors.affiliation: Sinclair School of Nursing, University of Missouri, Columbia, Missouri.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Alexander
authors.affiliation: Medical Research Office, University of Missouri, Columbia, Missouri.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Madsen
authors.affiliation: Department of Anthropology, University of Missouri, Columbia, Missouri.
authors.forename: Erin L
authors.initials: EL
authors.lastname: Miller
authors.affiliation: Emeritus Professor, Department of Health Management and Informatics, Center for Health Care Quality, University of Missouri, Columbia, Missouri.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Wakefield
authors.affiliation: Sinclair School of Nursing, University of Missouri, Columbia, Missouri.
authors.forename: Keely K
authors.initials: KK
authors.lastname: Wise
authors.affiliation: Lyon College, Batesville, Arkansas.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Alexander
mesh_terms: D003430:Cross-Sectional Studies; D006801:Humans; D000073256:Information Technology / Q000592:standards* / Q000706:statistics & numerical data / Q000639:trends*; D009735:Nursing Homes / Q000639:trends*; D012424:Rural Population / Q000706:statistics & numerical data / Q000639:trends; D011795:Surveys and Questionnaires; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data / Q000639:trends
keywords: health services research; long-term care; rural; technology