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Dr. Schoville is Clinical Assistant Professor of Nursing, Department of Systems, Population and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan.
The author has disclosed no potential conflicts of interest, financial or otherwise.
The implementation of health care technology is flourishing in the United States. In recent years, long-term care (LTC) facilities have begun to adopt technology ( Horn, 2016 ). These emerging innovations focus on services such as electronic health records (EHRs), interfaces between facilities, wireless data communication promoting point-of-care systems, and telemedicine. Many factors, at all levels of health care delivery, affect a successful technology implementation, including quickly and poorly implemented health care information technology systems ( Ash et al., 2007 ; Han et al., 2005 ; Koppel et al., 2005 ; Schoville, 2009 ). However, how these factors manifest within LTC settings is not well understood.
Purpose
The purpose of the current study was to examine technology implementation strategies in LTC settings to better understand factors affecting successful technology adoption.
The study aim was to explore the experience of staff and leadership in LTC settings regarding strategies used to promote adoption of an EHR. The research questions included:
- What factors influenced implementation of the EHR?
- What are the similarities and differences with EHR implementation across facilities?
Conceptual Framework
The Integrated Technology Implementation model guided the current study ( Schoville & Titler, 2015 ). The model posits that many variables result in successful technology implementation, and the implementation itself is affected by internal and external contextual factors. The internal context includes the organizational factors that influence the adoption, dissemination, and sustainability of the technology innovation through active implementation strategies. The external context includes factors outside the organization that have a synergistic relationship to the internal factors.
Method
The current exploratory, qualitative study used the grounded theory methods approach. Focus groups and individual interviews were used to explore implementation strategies that led the organization and health care provider to adopt EHR technology. The unit of analysis was informants' experience of EHR technology implementation leading to adoption of a certified EHR system for LTC. The system includes the medical record, touch-screen point-of-care documentation, finance and billing, and materials management, and offers interoperability by safely exchanging information between health care facilities. The system uses...