Systematic Review of Factors Influencing the Adoption of Information and Communication Technologies by Healthcare Professionals
Open accessAbstract
This systematic review of mixed methods studies focuses on factors that can facilitate or limit the implementation of information and communication technologies (ICTs) in clinical settings. Systematic searches of relevant bibliographic databases identified studies about interventions promoting ICT adoption by healthcare professionals. Content analysis was performed by two reviewers using a specific grid. One hundred and one (101) studies were included in the review. Perception of the benefits of the innovation (system usefulness) was the most common facilitating factor, followed by ease of use. Issues regarding design, technical concerns, familiarity with ICT, and time were the most frequent limiting factors identified. Our results suggest strategies that could effectively promote the successful adoption of ICT in healthcare professional practices.
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Concerns about reduced autonomy or trust, independence of practice or inability to practise to full scope impeded implementation.
“Concerns about reduced autonomy or trust, independence of practice or inability to practise to full scope were all shown to impede implementation [16, 31, 35, 39, 54, 55].”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [31]
Conflict with patient expectations and concerns about patient and health professional interaction could decrease acceptability of an intervention and impede implementation.
“Conflict with patient expectations [75] and concerns about patient and health professional interaction, for example, when using the new information system, nurses spent more time on documentation than on direct care [31], could lead to a decrease in acceptability of an intervention and subsequently impede implementation.”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [31]
A lack of confidence in one's own ability to carry out specific tasks and the feeling of not having authority or enough influence to change or carry out procedures impeded implementation.
“a lack of confidence in one’s own ability to carry out specific tasks and the feeling of not having authority or enough influence to change or carry out the procedures were found to impede implementation [31, 66].”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [31]
Barriers to implementation included lack of time and resources to perform additional data entry or deal with paperwork.
“support to perform additional data entry or deal with paperwork [31, 67, 71, 72] were reported as barriers.”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [31]
Competing priorities, lack of motivation, and low awareness of the intervention were shown to impede implementation.
“Competing priorities [42, 57, 59, 62, 63, 70, 82], lack of motivation [31, 39, 42, 57, 68, 81] and low awareness of the intervention [31, 35, 38, 39, 43, 44, 68, 75, 80, 81] were shown to impede implementation.”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [31]
Competencies, e.g. adequate training and good computer experience/skills, facilitated implementation.
“competencies, e.g. adequate training and good computer experience/skills were shown to facilitate implementation [16, 17, 31, 32, 34, 41, 42, 44, 54–58, 60, 67, 70, 77, 80, 81, 84–86].”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [31]
Additional workload caused by the implementation of new complex interventions hindered adoption.
“Additional workload caused by the implementation of new complex interventions was also found to hinder adoption [17, 31, 44, 54, 66, 81, 84].”
From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [31]
The availability, or lack thereof, of time to learn new e-health systems, implement them, and train staff to use them was reported by several studies as a resource factor important for implementation.
“The availability, or lack thereof, of time to learn new e-health systems, implement them [25, 37, 53] and train staff to use them [49] was reported by several studies as a resource factor important for implementation.”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [25]
Access to ongoing support to use systems was important for system use and a barrier to implementation when lacking.
“Access to ongoing support to use systems was important for system use [21, 25, 28, 31, 37, 39, 43, 54] and a barrier to implementation when it was lacking [21].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [25]
Management support is important for implementation success.
“Management support is also important for implementation success [25, 37, 50, 54].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [25]
Education was reported to increase staff acceptance of e-health systems, including education around anticipated benefits and when those benefits could be expected.
“Education was reported to increase staff acceptance of e-health systems [16, 25, 41, 45] including education around anticipated benefits and when those benefits could be expected [54].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [25]
A frequent reason for unsuccessful implementation is that information systems do not fit well with work practices or daily clinical work.
“A frequent reason for unsuccessful implementation is that the information systems do not fit well with work practices or daily clinical work [25].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [25]
Alterations to workflows created by the introduction of e-health systems may disrupt established professional roles, responsibilities, and working styles.
“Alterations to workflows created by the introduction of e-health systems may also disrupt established professional roles, responsibilities [16, 20, 25, 36, 55] and working styles [18].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [25]
Healthcare professionals' computer skills, abilities, and experience were cited by several studies as influencing implementation and acceptance of e-health systems.
“Healthcare professionals’ computer skills, abilities and experience were cited by several studies as influencing implementation and acceptance of e-health systems [16, 18, 25, 28, 34, 36, 37, 41, 43, 52, 57].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [25]
The designation of champions may be important for implementation success.
“The designation of champions [18, 20, 25, 29, 31, 32, 36, 37, 39, 51, 54, 58] may be important for implementation success.”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [25]
The attitudes of colleagues and patients were reported to influence staff attitudes with regard to e-health acceptance, as were staff demographic factors.
“The attitudes of colleagues [25, 41] and patients [25, 27, 41] were also reported to influence staff attitudes with regard to e-health acceptance as were staff demographic factors [23, 46, 56].”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [25]
Training and financial incentives were cited as strategies to overcome skill-related barriers.
“Training [25, 37, 43] and financial incentives [37] were cited as strategies to overcome skill-related barriers.”
From Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016) · cites this paper as [25]
The foundation of the framework is based on the aforementioned principles, reviews in the field of eHealth, progressive insights from eHealth research, and multidisciplinary theories from psychology, communication, and human-computer interaction design.
“The foundation of the framework is based on the aforementioned principles, reviews in the field of eHealth [2,3,22,96-99], progressive insights from eHealth research (see Multimedia Appendix 4), and multidisciplinary theories from psychology, communication, and human–computer interaction design.”
From A Holistic Framework to Improve the Uptake and Impact of eHealth Technologies (2011) · cites this paper as [96]
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A Holistic Framework to Improve the Uptake and Impact of eHealth Technologies
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“Also, other systematic literature reviews investigated factors that influence the implementation, adaptably, sustainability, and acceptance of telemedicine services among health care professionals and health care providers [8-12].”
BackgroundBarriers and facilitators to utilizing digital health technologies by healthcare professionals
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“Competencies [3, 14–17, 31–36, 38–43, 51, 54, 56–58, 60–62, 66–70, 72, 75–80, 82, 84–87, 90, 100, 101, 105–109][55] B: Non-existent or inadequate training [31] F: Electronic medical record (EMR) implementation was found to be most effective when training for EMR system users was adequate, timely, tailored to meet the…”
BackgroundInfluentialTechnology Acceptance in Healthcare: A Systematic Review
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“The following ICTs were excluded: (1) nurse management systems, which are purely administrative and designed for the management of human resources and working conditions (eg, scheduling) and nursing staff maintenance (such as retention); (2) educational systems, for example, e-learning initiatives used for the trainin…”
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- Authors
- Gagnon, M.-P., Desmartis, M., Labrecque, M., Car, J., Pagliari, C., Pluye, P., Frémont, P., Gagnon, J., Tremblay, N., & Légaré, F.
- Affiliations
- Université Laval (CA)
- Imperial College London (GB)
- University of Edinburgh (GB)
- McGill University (CA)
- Corresponding author
- Gagnon, Marie-Pierre
- ORCID
- Venue
- Journal of Medical Systems
- Published
- 2010-03-30
- Volume
- 36
- Issue
- 1
- Pages
- 241-277
- ISSN
- 0148-5598 (ISSN-L)
- 1573-689X
- PMC
- PMC4011799
- OpenAlex
- W2079522214
- Cited by
- 637
- References
- 136
- Citations by year
- 2026: 41 · 2025: 55 · 2024: 56 · 2023: 47 · 2022: 53 · 2021: 68 · 2020: 53 · 2019: 44 · 2018: 54 · 2017: 34 · 2016: 38 · 2015: 35 · 2014: 21 · 2013: 20 · 2012: 10
- FWCI
- 1.72
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Medical Systems (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship@McGill (McGill) (submittedVersion, cc-by)
- Funders
- Centre Hospitalier Universitaire de Québec
- Canadian Institutes of Health Research (79141)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Social Sciences › Decision Sciences › Information Systems and Management › Technology Adoption and User Behaviour
- Social Sciences › Sociology and Political Science › Information Systems Theories and Implementation
- Keywords
- information and communication technologies, ICT adoption, healthcare workers, technology implementation, enabling factors, limiting factors, perceived usefulness, ease of use, system usefulness
- MeSH terms
- Attitude of Health Personnel, Attitude to Computers, Environment, Health Personnel, Humans, Information Systems, Time Factors
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