RAND Corporation, Santa Monica, CA, USA.
RAND Corporation, Pittsburgh, PA, USA.
J Appl Gerontol. 2021 May;40(5):558-565. doi: 10.1177/0733464820941364. Epub 2020 Jul 29.
Health information technology (HIT) use in home- and community-based services (HCBS) has been hindered by inadequate resources and incentives to support modernization. We sought to understand the ways the Medicaid Balancing Incentive Program (BIP) facilitated increased use of HIT to increase access to HCBS. Qualitative analysis of interviews with 30 Medicaid administrators, service agency providers, and consumer advocates. Although stakeholders perceived several benefits to greater HIT use, they highlighted critical challenges to effective adoption within the long-term services and supports (LTSS) system, including lack of extant expertise/knowledge about HIT, the limited reach of HIT among rural and disabled beneficiaries, burdensome procurement processes, and the ongoing resources required to maintain up-to-date HIT solutions. The structural reforms required by BIP gave states an opportunity to modernize their HCBS systems through use of HIT. However, barriers to HIT adoption persist, underscoring the need for continued support as part of future rebalancing efforts.
医疗保健信息技术（HIT）在家庭和社区服务（HCBS）中的使用受到资源不足和激励措施的限制，难以实现现代化。我们试图了解医疗补助平衡激励计划（BIP）促进更多使用 HIT 以增加 HCBS 机会的方式。对 30 名医疗补助管理人员、服务机构提供商和消费者权益倡导者的访谈进行定性分析。尽管利益相关者认为更多地使用 HIT 有几个好处，但他们强调了在长期服务和支持（LTSS）系统中有效采用 HIT 所面临的关键挑战，包括缺乏关于 HIT 的现有专业知识/知识、HIT 在农村和残疾受益人中的有限覆盖范围、繁琐的采购流程以及维护最新 HIT 解决方案所需的持续资源。BIP 要求的结构改革使各州有机会通过使用 HIT 来实现 HCBS 系统的现代化。然而，HIT 采用的障碍仍然存在，这突显了在未来的再平衡努力中需要持续支持。
