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. 2025 Aug 13;25(1):1076.
doi: 10.1186/s12913-025-13271-x.

Facilitators and barriers to online medical consultation in Iran: a qualitative study exploring the perspectives of healthcare policymakers and administrators using the CFIR framework

Azadeh Ghasempour  1 , Marzieh Nojomi  1 , Salime Goharinezhad  2 , Neda SoleimanvandiAzar  1 , Zahra Rampisheh  3
Affiliations

Facilitators and barriers to online medical consultation in Iran: a qualitative study exploring the perspectives of healthcare policymakers and administrators using the CFIR framework

Azadeh Ghasempour et al. BMC Health Serv Res. .

Abstract

Background: Online Medical Consultation (OMC) offers a promising avenue for improving healthcare access and efficiency in Iran. However, its integration into the national health system remains limited due to complex systemic, infrastructural, and regulatory challenges.

Objective: This study uses the Consolidated Framework for Implementation Research (CFIR) to identify and analyze the key facilitators and barriers to OMC adoption in Iran from the perspectives of healthcare policymakers and administrators.

Methods: This qualitative study employed semi-structured interviews with nine senior healthcare stakeholders. Data were analysed using inductive thematic coding, mapped onto CFIR domains, to systematically identify multilevel factors influencing OMC implementation.

Results: Key facilitators included perceived advantages of access and efficiency, Adaptability across healthcare functions, Recipient-Centred Transparency and Accountability, urban digital readiness, and increased acceptance during the COVID-19 pandemic. Barriers were identified across multiple domains, including weak infrastructure, lack of legal frameworks, limited digital literacy, Tensions between patient satisfaction and clinical standards, and absence of stakeholder engagement.

Conclusion: OMC in Iran presents clear benefits but faces entrenched barriers requiring targeted policy, infrastructure, and educational interventions. Regulatory clarity, cross-sector governance, and integration with public systems are critical for sustainable scale-up.

Keywords: Consolidated framework for implementation research; Digital health; Health policy; Online medical consultation; Qualitative research; Telemedicine.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Clinical trial number: Not applicable. Ethics approval: This study was conducted under the ethical guidelines of the Declaration of Helsinki and was approved by the Ethical Committee of Iran University of Medical Sciences (IR.IUMS.FMD.REC.1402.045). Informed consent: Informed consent was obtained from all participants before their inclusion in the study. Participants were assured of confidentiality, and their identities were anonymized when reporting findings. Consent to participate: Not applicable.

Figures

Fig. 1
Fig. 1
Finding’s Tree based on CFIR domains/constructs
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