Article Text

Adoption factors associated with electronic health record among long-term care facilities: a systematic review
  1. Clemens Scott Kruse,
  2. Michael Mileski,
  3. Vyachelslav Alaytsev,
  4. Elizabeth Carol,
  5. Ariana Williams
  1. Texas State University, San Marcos, Texas, USA
  1. Correspondence to Dr Clemens Scott Kruse; scottkruse{at}


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.


This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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