title: Barriers and Facilitators for Sustainability of Tele-Homecare Programs: A Systematic Review.
abstract: OBJECTIVE
  To identify the barriers and facilitators for sustainability of tele-homecare programs implemented by home health nursing agencies for chronic disease management.
  
  
  METHODS
  English-language articles on home telehealth in the CINAHL, PubMed/MEDLINE, PsychInfo, Web of Science, and Cochrane Reviews databases published from January 1996 to December 2013.
  
  
  METHODS
  We performed a systematic literature review. Data extraction using PRISMA guidelines and quality appraisal using the Mixed Methods Appraisal Tool (MMAT) were conducted on relevant empirical studies. Thematic analysis across the studies and narrative summaries were used to synthesize the findings from the included studies.
  
  
  RESULTS
  Of the initial 3,920 citations, we identified 16 articles of moderate quality meeting our inclusion criteria. Perceptions on effectiveness of tele-homecare programs for achieving intended outcomes; tailoring of tele-homecare programs to patient characteristics and needs; relationship and communication between patient, nurse, and other health care professional users of tele-homecare; home health organizational process and culture; and technology quality, capability, and usability impacted the sustainability of tele-homecare programs.
  
  
  CONCLUSIONS
  The findings of this systematic review provide implications for sustained usage of tele-homecare programs by home health nursing agencies and can help such programs realize their potential for chronic disease management.
authors.affiliation: School of Nursing, University of Texas - Austin, 1710 Red River Street, Austin, TX.
authors.forename: Kavita
authors.initials: K
authors.lastname: Radhakrishnan
authors.affiliation: School of Nursing & School of Information, University of Texas - Austin, Austin, TX.
authors.forename: Bo
authors.initials: B
authors.lastname: Xie
authors.affiliation: Brookdale Home Health, Austin, TX.
authors.forename: Amy
authors.initials: A
authors.lastname: Berkley
authors.affiliation: School of Nursing, University of Texas - Austin, Austin, TX.
authors.forename: Miyong
authors.initials: M
authors.lastname: Kim
mesh_terms: D020811:Biomedical Technology / Q000379:methods / Q000592:standards; D002908:Chronic Disease / Q000628:therapy*; D003142:Communication; D003299:Cooperative Behavior; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D018670:Monitoring, Ambulatory / Q000379:methods / Q000592:standards; D009723:Nurse-Patient Relations; D015279:Organizational Culture; D018802:Patient-Centered Care / Q000458:organization & administration; D010465:Perception; D017216:Telemedicine / Q000458:organization & administration*; D013686:Telemetry
keywords: Telehealth; chronic disease management; home health nursing; sustainability; tele-homecare