Adoption Factors Associated with Electronic Health Record Among Long-Term Care Facilities: A Systematic Review




Kruse, Clemens S.
Mileski, Michael
Alaytsev, Vyachelslav
Carol, Elizabeth
Williams, Ariana

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BMJ Publishing Group


Objectives: The Health Information Technology for Economic and Clinical Health (HITECH) Act created incentives for adopting electronic health records (EHRs) for some healthcare organisations, but long-term care (LTC) facilities are excluded from those incentives. There are realisable benefits of EHR adoption in LTC facilities; however, there is limited research about this topic. The purpose of this systematic literature review is to identify EHR adoption factors for LTC facilities that are ineligible for the HITECH Act incentives. Setting: We conducted systematic searches of Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete via Ebson B. Stephens Company (EBSCO Host), Google Scholar and the university library search engine to collect data about EHR adoption factors in LTC facilities since 2009. Participants: Search results were filtered by date range, full text, English language and academic journals (n=22). Interventions: Multiple members of the research team read each article to confirm applicability and study conclusions. Primary and Secondary Outcome Measures: Researchers identified common themes across the literature: specifically facilitators and barriers to adoption of the EHR in LTC. Results: Results identify facilitators and barriers associated with EHR adoption in LTC facilities. The most common facilitators include access to information and error reduction. The most prevalent barriers include initial costs, user perceptions and implementation problems. Conclusions: Similarities span the system selection phases and implementation process; of those, cost was the most common mentioned. These commonalities should help leaders in LTC facilities align strategic decisions to EHR adoption. This review may be useful for decision-makers attempting successful EHR adoption, policymakers trying to increase adoption rates without expanding incentives and vendors that produce EHRs.



HITECH Act, electronic health resources, long-term care facilities, Health Information Technology for Economic and Clinical Health Act, Health Administration


Kruse, C. S., Mileski, M., Alaytsev, V., Carol, E., & Williams, A. (2015). Adoption factors associated with electronic health record among long-term care facilities: A systematic review. BMJ Open, 5(1).


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