expectedly, another common theme found in the search was that pertaining to financial concerns. costs cited as deterrents to health, costs cited as deterrents to health information systems adoption were system costs, and lost opportunity cost due to ramp up system down time [87,88]. narrative reviews commented that, physicians would often not adopt health information system [87,89,90] simply because they do not see the return on investment value in them [91]. organizationally [92] physician advocates seemed to be aggravated by benefits of systems adoption accruing largely to payers as opposed to physicians. physician advocates suggested that some of the costs should be supported to drive adoption proposals from narrative review papers suggest cost sharing or financial sponsorship from government entities is required to support the high cost of adoption [90,93,94]. our review showed that adoption is influenced by financial factors to varying degree in different jurisdiction a more detailed investigation of financial reimbursement models for adoption and their implications to physician remuneration models is required and is the subject of our next research