Journal of Medical Systems

, Volume 35, Issue 4, pp 599–607 | Cite as

HIT Implementation in Critical Access Hospitals: Extent of Implementation and Business Strategies Supporting IT Use

  • James A. Bahensky
  • Marcia M. Ward
  • Kwame Nyarko
  • Pengxiang Li
Original Paper


Small rural hospitals face considerable financial and personnel resource shortages which hinder their efforts to implement complex health information technology (HIT) systems. A survey on the use of HIT was completed by 85% of Iowa’s 82 Critical Access Hospitals (CAH). Analyses indicate that low IT staffing in CAHs is a barrier to implementing HIT solutions. CAHs with fewer staff tend to employ alternative business strategies. There is a clear relationship between having IT staff at a CAH and the types of technologies used. Many CAHs report having difficulty expanding upon HIT functionalities due to the challenges of finding IT staff with healthcare expertise. Most CAHs are in the transition point of planning for or beginning implementation of complex clinical information systems. Strategies for addressing these challenges will need to evolve as the HIT investments by rural hospitals race to keep pace with the goals for the nation.


Critical Access Hospitals Rural Hospitals Health Information Technology Electronic Medical Records 



Support for this work was funded in part by the Agency for Healthcare Research and Quality through grant # HS015009.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • James A. Bahensky
    • 1
  • Marcia M. Ward
    • 1
  • Kwame Nyarko
    • 1
  • Pengxiang Li
    • 2
  1. 1.Department of Health Management and Policy, College of Public HealthUniversity of IowaIowa CityUSA
  2. 2.Division of General Internal MedicineUniversity of PennsylvaniaPhiladelphiaUSA

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