Adopting health apps, what's hindering doctors and patients?
Open accessAbstract
There are high expectations for Mobile Health to transform health into a sustainable and prevention-based system. Unfortunately it has not reached its scale of adoption many had hoped for, due to the existence of adoption barriers. More insight into these barriers fosters adoption of mHealth and the innovation it can bring to worldwide healthcare. This study investigates the main barriers in the adoption of mHealth, their underlying causes and their breakthrough possibilities. All the data are gathered from an international and multi-stakeholder point of view. First of all we tried to identify the main barriers by doing an international literature study. Second of all we asked Dutch mHealth Key Opinion Leaders (KOLs) to rank the barriers to importance. These KOLs were from different stakeholder groups; policy-makers, users and developers. At last we asked the KOLs in interviews for underlying causes and breakthrough opportunities of the barriers. Eventually twelve main adoption barriers emerged. According to literature and to the KOLs the most important barriers are “Integration and interoperability” and “Business case”. An underlying cause for the barrier “Integration and interoperability” might be the active closed power system of technology suppliers, which exists in the Netherlands. Furthermore there seems to be a difference in the importance of the barriers “Privacy and security” and “Conservative culture” when perceptions of Dutch KOLS and international literature are compared. Within the stakeholders-groups, the KOLs think differently about the importance of the barriers “Visionless development” and “Competing payment mechanism”. The Dutch healthcare insurers could take a more leading role in the fragmented landscape of mHealth in the Netherlands, by strategically funding new initiatives that use open standards and deliver better value for end-users. Other chances might lie in the international cooperation between countries to overcome certain barriers.
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Another recent review has identified patients as having a stronger desire to be informed about underpinning scientific evidence than commercial stakeholders.
“Another recent review has also identified patients as having a stronger desire to be informed about underpinning scientific evidence than commercial stakeholders.32”
From Smartphone applications for melanoma detection by community, patient and generalist clinician users: a review (2015) · cites this paper as [32]
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Cites
Buntin, M. B., Burke, M. F., Hoaglin, M. C., & Blumenthal, D. (2011) · Health Affairs · doi:10.1377/hlthaff.2011.0178 · Cited by 1,311 · see citing works
Free, C., Phillips, G., Watson, L., Galli, L., Felix, L., Edwards, P., Patel, V., & Haines, A. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001363 · Cited by 1,187 · see citing works
Scaling Up mHealth: Where Is the Evidence?
Tomlinson, M., Rotheram-Borus, M. J., Swartz, L., & Tsai, A. C. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001382 · Cited by 673 · see citing works
The Netherlands: health system review.
Schäfer, W. L. A., Kroneman, M. W., Boerma, W. G. W., van den Berg, M. J., Westert, G. P., Devillé, W. L. J. M., & van Ginneken, E. (2010) · PubMed · Cited by 667 · see citing works
Can Mobile Health Technologies Transform Health Care?
Steinhubl, S. R., Muse, E. D., & Topol, E. J. (2013) · JAMA · doi:10.1001/jama.2013.281078 · Cited by 496 · see citing works
Barriers to innovation for SMEs in a small less developed country (Cyprus)
Hadjimanolis, A. (1999) · Technovation · doi:10.1016/s0166-4972(99)00034-6 · Cited by 471 · see citing works
Innovation in Healthcare Delivery Systems: A Conceptual Framework
Omachonu, V. K., & Einspruch, N. G. (2010) · Cited by 460 · see citing works
The use of health information technology in seven nations
Jha, A. K., Doolan, D., Grandt, D., Scott, T., & Bates, D. W. (2008) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2008.06.007 · Cited by 420 · see citing works
The adoption of mobile healthcare by hospital's professionals: An integrative perspective
Wu, I., Li, J.-Y., & Fu, C.-Y. (2011) · Decision Support Systems · doi:10.1016/j.dss.2011.03.003 · Cited by 410 · see citing works
Why Innovation in Health Care Is So Hard
Walker, A. (2006) · Harvard business review · Cited by 380 · see citing works
Status and trends of mobile-health applications for iOS devices: A developer's perspective
Liu, C., Zhu, Q., Holroyd, K. A., & Seng, E. K. (2011) · Journal of Systems and Software · doi:10.1016/j.jss.2011.06.049 · Cited by 313 · see citing works
Development and validation of an instrument to measure user perceived service quality of mHealth
Akter, S., D’Ambra, J., & RAY, P. K. (2013) · Information & Management · doi:10.1016/j.im.2013.03.001 · Cited by 276 · see citing works
Health Care Provider Adoption of eHealth: Systematic Literature Review
Li, J., Talaei-Khoei, A., Seale, H., Ray, P., & MacIntyre, C. R. (2013) · interactive Journal of Medical Research · doi:10.2196/ijmr.2468 · Cited by 250 · see citing works
Issues in mHealth: Findings From Key Informant Interviews
Whittaker, R. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.1989 · Cited by 173 · see citing works
Eysenbach, G., & Diepgen, T. L. (2001) · Clinics in Dermatology · doi:10.1016/s0738-081x(00)00202-9 · Cited by 132 · see citing works
Vishwanath, A., & Scamurra, S. D. (2007) · Health Informatics Journal · doi:10.1177/1460458207076468 · Cited by 127 · see citing works
H_pe for mHealth: More “y” or “o” on the horizon?
Labrique, A., Vasudevan, L., Chang, L. W., & Mehl, G. (2013) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2012.11.016 · Cited by 111 · see citing works
Alpay, L., Henkemans, O. B., Otten, W., Rövekamp, T., & Dumay, A. C. M. (2010) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2009.0156 · Cited by 110 · see citing works
Health Care in The Netherlands
van Weel, C., Schers, H., & Timmermans, A. (2012) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2012.02.110212 · Cited by 100 · see citing works
Mobile technologies and the holistic management of chronic diseases
Mirza, F., Norris, T., & Stockdale, R. (2008) · Health Informatics Journal · doi:10.1177/1460458208096559 · Cited by 87 · see citing works
The Challenges for the Adoption of M-Health
Yu, P., Wu, M., Yu, H. L., & Xiao, G. Q. (2006) · IEEE International Conference on Service Operations and Logistics, and Informatics (SOLI) · doi:10.1109/soli.2006.329059 · Cited by 84 · see citing works
A strategic approach to m-health
Norris, A. C., Stockdale, R., & Sharma, S. (2009) · Health Informatics Journal · doi:10.1177/1460458209337445 · Cited by 80 · see citing works
Clark, J., & McGee‐Lennon, M. (2011) · Journal of Assistive Technologies · doi:10.5042/jat.2011.0097 · Cited by 62 · see citing works
Barriers to innovation in the medical nutrition industry: A quantitative key opinion leader analysis
Weenen, T. C., Pronker, E. S., Commandeur, H. R., & Claassen, E. (2013) · PharmaNutrition · doi:10.1016/j.phanu.2013.04.001 · Cited by 19 · see citing works
Self-citationMobile Healthcare: Opportunities and Challenges
Shieh, Y. Y., Tsai, F. Y., Anavim, A., Wang, M. D., & Lin, C.-M. C. (2007) · International Conference on Mobile Business · doi:10.1109/icmb.2007.46 · Cited by 19 · see citing works
Innovation Barriers for Telemonitoring
Gruber, H. G., Wolf, B. A., & Reiher, M. (2009) · World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany · doi:10.1007/978-3-642-03904-1_13 · Cited by 11 · see citing works
Vogel, D., Viehland, D. W., Wickramasinghe, N. S., & Mula, J. M. (2013) · Electronic Markets · doi:10.1007/s12525-013-0121-y · Cited by 10 · see citing works
Strategic Intelligence Monitor on Personal Health Systems, Phase 2 - Country Study Germany
Bratan, T., Engelhard, K., & Victoria, R. (2013) · Joint Research Centre (European Commission) · doi:10.2791/85265 · Cited by 2 · see citing works
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Dhiman, N., Arora, N., Dogra, N., & Gupta, A. (2019) · Journal of Indian Business Research · doi:10.1108/jibr-05-2018-0158 · Cited by 186 · see citing works
Kassianos, A. P., Emery, J. D., Murchie, P., & Walter, F. M. (2015) · British Journal of Dermatology · doi:10.1111/bjd.13665 · Cited by 151 · see citing works
The Determinants of M-Health Adoption in Developing Countries: An Empirical Investigation
Alaiad, A., Alsharo, M., & Alnsour, Y. (2019) · Applied Clinical Informatics · doi:10.1055/s-0039-1697906 · Cited by 115 · see citing works
Liu, Y., Lu, X., Zhao, G., Li, C., & Shi, J. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.944976 · Cited by 102 · see citing works
Factors influencing e-health implementation by medical doctors in public hospitals in Zimbabwe
Furusa, S. S., & Coleman, A. (2018) · South African journal of information management · doi:10.4102/sajim.v20i1.928 · Cited by 83 · see citing works
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Luo, D., Wang, P., Lu, F., Elias, J. S., Sparks, J. A., & Lee, Y. (2018) · JCR Journal of Clinical Rheumatology · doi:10.1097/rhu.0000000000000800 · Cited by 76 · see citing works
Anastasiadou, D., Folkvord, F., Serrano-Troncoso, E., & Lupiañez-Villanueva, F. (2019) · JMIR mHealth and uHealth · doi:10.2196/12920 · Cited by 75 · see citing works
Understanding mobile health service use: An investigation of routine and emergency use intentions
Liu, F., Ngai, E. W. T., & Ju, X. (2018) · International Journal of Information Management · doi:10.1016/j.ijinfomgt.2018.09.004 · Cited by 74 · see citing works
Service innovations breaking institutionalized rules of health care
Wallin, A., & Fuglsang, L. (2017) · Journal of service management · doi:10.1108/josm-04-2017-0090 · Cited by 70 · see citing works
van den Nieuwboer, M., van de Burgwal, L., & Claassen, E. (2015) · PharmaNutrition · doi:10.1016/j.phanu.2015.09.003 · Cited by 67 · see citing works
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Nuamah, J. K., Mehta, R. K., & Sasangohar, F. (2020) · JMIR mhealth and uhealth · doi:10.2196/15752 · Cited by 53 · see citing works
A study on students’ acceptance of mobile phone use to seek health information in South Africa
Cilliers, L., Viljoen, K., & Chinyamurindi, W. (2017) · Health Information Management Journal · doi:10.1177/1833358317706185 · Cited by 49 · see citing works
Understanding the evaluation of mHealth app features based on a cross-country Kano analysis
Gimpel, H., Manner-Romberg, T., Schmied, F., & Winkler, T. J. (2021) · Electronic Markets · doi:10.1007/s12525-020-00455-y · Cited by 46 · see citing works
Luo, Y., Wang, G., Li, Y., & Ye, Q. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18115684 · Cited by 46 · see citing works
Technology push without a patient pull
Keeling, D. I., de Ruyter, K., Mousavi, S., & Laing, A. W. (2019) · European Journal of Marketing · doi:10.1108/ejm-10-2017-0692 · Cited by 39 · see citing works
Examining the infusion of mobile technology by healthcare practitioners in a hospital setting
O’Connor, Y., & O’Reilly, P. (2016) · Information Systems Frontiers · doi:10.1007/s10796-016-9728-9 · Cited by 34 · see citing works
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Lee, J., Oh, Y., Kim, M., Cho, B., & Shin, J. (2023) · JMIR mhealth and uhealth · doi:10.2196/40834 · Cited by 11 · see citing works
Hoonsopon, D., Ketkaew, C., Puriwat, W., Viriyasitavat, W., & Tripopsakul, S. (2025) · SAGE Open · doi:10.1177/21582440251378068 · Cited by 10 · see citing works
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Artificial Intelligence Approach in Melanoma
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Jacobs-Basadien, M., Pather, S., & Petersen, F. (2022) · Universal Access in the Information Society · doi:10.1007/s10209-022-00951-2 · Cited by 9 · see citing works
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Malanga, D. F. (2017) · Advances in human services and public health (AHSPH) book series · doi:10.4018/978-1-5225-2262-1.ch007 · Cited by 9 · see citing works
Vonken, L., Hussein, H., Crutzen, R., & Vluggen, S. (2022) · Family Practice · doi:10.1093/fampra/cmac066 · Cited by 7 · see citing works
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Wallin, A. (2016) · International Journal of E-Services and Mobile Applications · doi:10.4018/ijesma.2017010101 · Cited by 7 · see citing works
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van der Waal, M. B., Veldhuizen, C. K., van der Waal, R. X., Claassen, E., & van de Burgwal, L. (2020) · PharmaNutrition · doi:10.1016/j.phanu.2020.100208 · Cited by 6 · see citing works
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O’Connor, Y., Heavin, C., & O’Donoghue, J. (2015) · International Journal of Reliable and Quality E-Healthcare · doi:10.4018/ijrqeh.2015040105 · Cited by 5 · see citing works
Spierings, J. F., Willinge, G. J. A., Kokke, M. C., Twigt, B. A., de Lange, W., Geerdink, T. H., van der Velde, D., Repping, S., & Goslings, J. C. (2023) · JMIR mhealth and uhealth · doi:10.2196/51510 · Cited by 4 · see citing works
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Prokofeva, Y. A., Вадимовна, М. И., & Анатольевна, Ж. Е. (2024) · Russian Journal of Preventive Medicine · doi:10.17116/profmed20242711140 · Cited by 3 · see citing works
Polisetty, A., Chakraborty, D., Sowmya, G., Khorana, S., & Islam, N. (2025) · Systems Research and Behavioral Science · doi:10.1002/sres.3210 · Cited by 2 · see citing works
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van Gorp, A. F. (2018) · IADIS INTERNATIONAL JOURNAL ON COMPUTER SCIENCE AND INFORMATION SYSTEMS · doi:10.33965/ijcsis_2018130104 · Cited by 2 · see citing works
David, N., Kah, M. M. O., Tyndall, J., & Longe, O. B. (2020) · IADIS International Conference Information Systems · doi:10.33965/is2020_202006l012 · Cited by 2 · see citing works
Juma’h, A. H., Alnsour, Y., & Kartal, H. (2025) · Investment Management and Financial Innovations · doi:10.21511/imfi.22(1).2025.14 · Cited by 1 · see citing works
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Ferng, A. S., Punwani, V., & Gaglani, S. M. (2016) · Springer eBooks · doi:10.1007/978-3-319-45142-8_10
Jacobs-Basadien, M., & Pather, S. (2023) · Communications in computer and information science · doi:10.1007/978-3-031-37496-8_18
van der Waal, M. B. (2024) · doi:10.5463/thesis.613
Ma, X., Zhao, H., & Zhou, C. (2026) · Lecture notes in computer science · doi:10.1007/978-3-032-13022-8_12
- Authors
- Dehzad, F., Hilhorst, C., de Bie, C., & Claassen, E.
- Affiliations
- PricewaterhouseCoopers (Netherlands) (NL)
- Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Dehzad, Farhang
- Venue
- Health
- Publisher
- Scientific Research Publishing, Inc.
- Published
- 2014
- Volume
- 06
- Issue
- 16
- Pages
- 2204-2217
- ISSN
- 1949-4998 (ISSN-L)
- 1949-5005
- OpenAlex
- W2137826919
- Cited by
- 46
- References
- 28
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 7 · 2018: 6 · 2017: 4 · 2016: 4 · 2015: 3
- FWCI
- 6.62
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Health (publishedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Health Professions › Health Information Management › Health, Technology, Consumer Behavior
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- mobile health, interoperability, integration, business case, privacy and security, conservative culture, key opinion leaders, open standards, technology providers, stakeholder perspectives, Netherlands
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