Health information technology in rural health care: A systematic review of its impact on critical access hospitals

Objective

This systematic review examines the profound impact of health information technology (HIT) on critical access hospitals (CAHs), focusing on the persistent challenges hindering effective implementation and utilization, and their consequences for rural health care.

Methods

Following Primary Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we systematically searched ProQuest, Web of Science, Scopus, and MEDLINE (2000–2024) for peer-reviewed articles, screening titles, abstracts, and full texts.

Results

Forty-five studies were included, with a majority (n = 31) published post-Health Information Technology for Economic and Clinical Health (HITECH) Act. Analysis revealed recurring challenges: crippling financial constraints, persistent staffing shortages, and frustrating interoperability failures. Diverse methodologies, including statistical analyses, surveys, case studies, and interviews, underscored the pervasive nature of these issues.

Discussion

Beyond financial, human, and interoperability barriers, our review identified key themes related to organizational dynamics and network effects. We discuss critical policy implications, offer actionable recommendations, acknowledge study limitations, and highlight crucial directions for future research.

Conclusion

This review provides compelling evidence of the urgent need to address the unique HIT adoption challenges facing CAHs. By understanding these barriers and leveraging HIT's potential, we can significantly improve patient care and health equity in vulnerable rural communities. These findings are critical for policymakers, health care leaders, and researchers striving to strengthen rural health care delivery.