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. 2019 Nov 22;21(11):e14197.
doi: 10.2196/14197.

Barriers and Facilitators to the Implementation of eHealth Services: Systematic Literature Analysis

Björn Schreiweis  1   2 , Monika Pobiruchin  2   3 , Veronika Strotbaum  2   4 , Julian Suleder  2   5 , Martin Wiesner  2   6 , Björn Bergh  1
Affiliations

Barriers and Facilitators to the Implementation of eHealth Services: Systematic Literature Analysis

Björn Schreiweis et al. J Med Internet Res. .

Abstract

Background: The field of eHealth has a history of more than 20 years. During that time, many different eHealth services were developed. However, factors influencing the adoption of such services were seldom the main focus of analyses. For this reason, organizations adopting and implementing eHealth services seem not to be fully aware of the barriers and facilitators influencing the integration of eHealth services into routine care.

Objective: The objective of this work is to provide (1) a comprehensive list of relevant barriers to be considered and (2) a list of facilitators or success factors to help in planning and implementing successful eHealth services.

Methods: For this study, a twofold approach was applied. First, we gathered experts' current opinions on facilitators and barriers in implementing eHealth services via expert discussions at two health informatics conferences held in Europe. Second, we conducted a systematic literature analysis concerning the barriers and facilitators for the implementation of eHealth services. Finally, we merged the results of the expert discussions with those of the systematic literature analysis.

Results: Both expert discussions (23 and 10 experts, respectively) identified 15 barriers and 31 facilitators, whereas 76 barriers and 268 facilitators were found in 38 of the initial 56 articles published from 12 different countries. For the analyzed publications, the count of distinct barriers reported ranged from 0 to 40 (mean 10.24, SD 8.87, median 8). Likewise, between 0 and 48 facilitators were mentioned in the literature (mean 9.18, SD 9.33, median 6). The combination of both sources resulted in 77 barriers and 292 facilitators for the adoption and implementation of eHealth services.

Conclusions: This work contributes a comprehensive list of barriers and facilitators for the implementation and adoption of eHealth services. Addressing barriers early, and leveraging facilitators during the implementation, can help create eHealth services that better meet the needs of users and provide higher benefits for patients and caregivers.

Keywords: eHealth; health information interoperability; policy; software design.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Barriers of eHealth usage among consumers identified in the first expert discussion at MIE 2015.
Figure 2
Figure 2
Success factors for consumer-centric eHealth services identified in the second expert discussion at eHID.
Figure 3
Figure 3
Flowchart for the identification of articles meeting the inclusion or exclusion criteria (see Textbox 1).
Figure 4
Figure 4
Included publications (before removal of missing full texts) by year and geographical location.
See this image and copyright information in PMC

References

    1. Mitchell J. From Telehealth to e-Health: The Unstoppable Rise of e-Health. Canberra, Australia: Department of Communications, Information Technology and the Arts; 1999. pp. 55–56.
    1. Wildenbos GA, Peute LW, Jaspers MW. Impact of patient-centered eHealth applications on patient outcomes: a review on the mediating influence of human factor issues. Yearb Med Inform. 2016 Nov 10;(1):113–119. doi: 10.15265/IY-2016-031. http://www.thieme-connect.com/DOI/DOI?10.15265/IY-2016-031 me2016-031 - DOI - PMC - PubMed
    1. Catwell L, Sheikh A. Evaluating eHealth interventions: the need for continuous systemic evaluation. PLoS Med. 2009 Aug;6(8):e1000126. doi: 10.1371/journal.pmed.1000126. http://dx.plos.org/10.1371/journal.pmed.1000126 - DOI - PMC - PubMed
    1. Elbert NJ, van Os-Medendorp H, van Renselaar W, Ekeland AG, Hakkaart-van Roijen L, Raat H, Nijsten TE, Pasmans SG. Effectiveness and cost-effectiveness of ehealth interventions in somatic diseases: a systematic review of systematic reviews and meta-analyses. J Med Internet Res. 2014 Apr 16;16(4):e110. doi: 10.2196/jmir.2790. https://www.jmir.org/2014/4/e110/ v16i4e110 - DOI - PMC - PubMed
    1. Choi WS, Park J, Choi JY, Yang J. Stakeholders' resistance to telemedicine with focus on physicians: utilizing the Delphi technique. J Telemed Telecare. 2019 Jul 01;25(6):378–385. doi: 10.1177/1357633X18775853. - DOI - PubMed

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