Factors that promote or inhibit the implementation of e-health systems: an explanatory systematic review.

By F. Mair, Carl R. May, C. O’Donnell, Tracy Finch, Frank M. Sullivan, Elizabeth Murray. Bulletin of the World Health Organization, 2012

550 citations recorded by the source corpus.

OBJECTIVE To systematically review the literature on the implementation of e-health to identify: (i) barriers and facilitators to e-health implementation, and (ii) outstanding gaps in research on the subject. METHODS MEDLINE, EMBASE, CINAHL, PSYCINFO and the Cochrane Library were searched for reviews published between 1 January 1995 and 17 March 2009. Studies had to be systematic reviews, narrative reviews, qualitative metasyntheses or meta-ethnographies of e-health implementation. Abstracts and papers were double screened and data were extracted on country of origin; e-health domain; publication date; aims and methods; databases searched; inclusion and exclusion criteria and number of papers included. Data were analysed qualitatively using normalization process theory as an explanatory coding framework. FINDINGS Inclusion criteria were met by 37 papers; 20 had been published between 1995 and 2007 and 17 between 2008 and 2009. Methodological quality was poor: 19 papers did not specify the inclusion and exclusion criteria and 13 did not indicate the precise number of articles screened. The use of normalization process theory as a conceptual framework revealed that relatively little attention was paid to: (i) work directed at making sense of e-health systems, specifying their purposes and benefits, establishing their value to users and planning their implementation; (ii) factors promoting or inhibiting engagement and participation; (iii) effects on roles and responsibilities; (iv) risk management, and (v) ways in which implementation processes might be reconfigured by user-produced knowledge. CONCLUSION The published literature focused on organizational issues, neglecting the wider social framework that must be considered when introducing new technologies.

Subfields: General Health Professions, Health Information Management, Sociology and Political Science

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Citations in the corpus

Understanding factors affecting patient and public engagement and recruitment to digital health interventions: a systematic review of qualitative studies (2016, unknown): “NPT is a useful heuristic device to explain how people individually and collectively embed new interventions in everyday routine through four generative mechanisms: sense-making work; relational work; operational work; and appraisal work (see Table 2) and it has been used successfully in other syste”
Evaluating barriers to adopting telemedicine worldwide: A systematic review (2016, background): “User expectations, computer literacy, and privacy concerns UK Mair et al.(24) Resistance to change, technically challenged staff, time consuming UK May et al.”
Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies (2017, background): “Failures in all 4 of May and Finch’s work categories were evident in a systematic review of reasons for unsuccessful telemedicine implementation informed by normalization process theory [107].”
Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update) (2016, methodology): “A systematic review of reviews by Mair et al. [7] synthesised the literature on the implementation of e-health interventions in healthcare settings published up until 2009.”