Baycrest Centre is one of the largest Academic Health Centres in Canada serving the aging population. As such, it has very complex information management (IM) requirements. Recently, a research project was carried out to determine the extent to which electronic health record (EHR) technologies are available and implemented within long-term care (LTC) organizations of comparable dimensions. Data collection included Internet searches and telephone interviews with targeted technology vendors and facilities. Results showed that although there are many superficial similarities between LTC and acute care, care delivery models and processes are so different, and the IM and EHR needs so unique, as to require different technology solutions and information management approaches. However, progress in development of relevant LTC solutions has been slow - 70% of vendors have chosen not to participate in LTC applications development. LTC facilities also expressed frustration with the fact that implementing an EHR is an extensive and expensive process, and yet there is minimal evidence to lobby for its implementation. Research to date has shown that benefits cannot be measured on a return-on-investment basis. Empirical data remain limited, and most benefits have historically been of a qualitative nature. Given the lack of evidence and a viable technical solution, it is not surprising that most LTC facilities have struggled to advance in the implementation of EHRs. This article presents a number of challenges to both the vendor and health informatics communities. Without appropriately addressing these challenges, relevant solutions for IM in LTC will fail to meet the well-established and much-discussed demographic of an aging population that is growing exponentially.

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