Cornell University

May 13 2010

Empowering Employees

Electronic medical recordkeeping influenced by organizational style: ILR research highlighted at conference

Diverse perspectives from a state agency, a labor union, Weill Cornell Medical College and others fed "The Challenge and Promise of Electronic Medical Records" session of ILR's health care reform conference Wednesday.

Speakers included David Lipsky, director of ILR's Scheinman Institute on Conflict Resolution, which is leading the New York Nursing Home Quality Care Technology Demonstration Project.

Lipsky and Ariel Avgar, ILR Ph.D. '08, shared their examination of medical record technology on employment and labor relations at "A Time for Change" Restructuring America's Health Care Delivery System." The conference drew 200 people on Tuesday and 200 on Wednesday.

Avgar, a professor at the University of Illinois at Urbana-Champaign,and Lipsky, ILR's Anne Estabrook Evans Professor of Dispute Resolution, discussed their study of 20 downstate nursing homes.

Findings suggest that management style and specific adoption strategies influence the impact of technological innovation on health care costs, employee outcomes and resident care.

Employee participation in workplace decision appears to enhance the effects associated with sophisticated health information technology, according to Avgar and Lipsky, who discussed the study in a radio interview. Hear the podcast.

Computerizing more of America's patient data is expected by many to lower health care costs, decrease errors and improve patient care. Most nursing homes and hospitals are not online.

Early findings from the Cornell study show electronic records will lead to lower costs, improved employee perceptions and attitudes, and better resident care in nursing homes with visions of how the technology is linked to broader organizational goals and objectives.

In addition, positive organizational outcomes associated with the electronic medical records technology appear to be related to greater levels of staff empowerment and involvement.

In contrast, the benefits of electronic records are less apparent in homes managed in a traditional, top-down style. In those nursing homes, the new technology is seen as another tool to track mistakes and control employees, Lipsky said.

The Cornell study began more than two years ago with a phone survey of more than 1,000 nurses, aides and other workers in non-computerized facilities.

Handheld, wireless computers were then distributed to workers in 20 homes. Three follow-up surveys and face-to-face interviews with administrators, front-line staff and union representatives in 10 of the homes before and after the introduction of the technology are part of the research.

The study measures the new technology's impact on employee job satisfaction, stress and commitment, resistance to change and conflict, labor relations and workforce retention and recruitment.

The study is funded by money allocated by New York state to support the introduction of the technology in the nursing homes and also by the Commonwealth Fund, a private foundation.

All certified nursing assistants and licensed practical nurses in nursing homes surveyed are members of 1199SEIU.