Digital technologies are profoundly transforming the healthcare environment, offering solutions that enhance medical knowledge exchange, improve technical performance, and potentially reduce costs while enhancing the quality of care. The widespread adoption of digital solutions, such as telemedicine, electronic health records, and social media platforms, appears to be an inevitable global trend. However, the successful integration of these technologies into healthcare practices is influenced by various factors.
This review article, titled “Barriers and facilitators to utilizing digital health technologies by healthcare professionals,” authored by Borges do Nascimento, Abdulazeem, Vasanthan, Martinez, Zucoloto, Østengaard, Azzopardi-Muscat, Zapata, and Novillo-Ortiz (2023), provides a comprehensive synthesis of existing evidence regarding the factors influencing healthcare professionals’ (HPs) engagement with digital health technologies (DHTs). The study addresses a significant gap in the literature by collating and assessing the overall landscape of enablers and restraints to HPs’ coordinated and integrated use of DHTs, which was previously dispersed across numerous studies.
Methodology
To achieve its objective, the authors conducted an overview of systematic reviews, also known as an umbrella review. They performed electronic searches in five major databases (Cochrane Database of Systematic Reviews, Embase®, Epistemonikos, MEDLINE®, and Scopus) from their inception until March 2023. The review included 108 systematic and scoping reviews, focusing on barriers and facilitators related to DHT use among healthcare professionals, including physicians, pharmacists, and nurses.
The methodology also incorporated a semantic-based occurrence meta-analysis to quantify the frequency of reported barriers and facilitators. Data abstraction, methodological quality assessment using the AMSTAR-2 tool, and certainty of evidence appraisal using the GRADE-CERQual approach were conducted by multiple independent authors to ensure rigor and reliability.
Key Findings
The study identified 21 overarching barriers and 19 facilitators, many of which are interconnected, affecting the design, implementation, maintenance, and evaluation of DHTs by HPs. High-quality evidence supports the following predominant factors:
Common Barriers to DHT Utilization by HPs:
- Infrastructure and technical barriers: These were the most frequently reported, including limited or insufficient network connectivity, lack of existing technologies or devices, compatibility issues with daily workflow, and the absence of standardized systems. These issues are particularly acute in rural areas. (Relative Frequency Occurrence [RFO] 6.4% [95% CI 2.9–14.1]).
- Psychological and personal issues: This complex category involves HPs’ resistance to change, difficulty understanding the technology, technophobia, low motivation, and skepticism. (RFO 5.3% [95% CI 2.2–12.7]).
- Concerns of increasing working hours or workload: HPs feared that DHTs would require additional time for purchase, setup, implementation, and training, potentially impacting the quality of care and increasing their overall workload. (RFO 3.9% [95% CI 1.5–10.1]).
- Legal- and ethical-related factors: Significant concerns were reported regarding privacy and security, national legislation, jurisdiction, and unclear legal liability concerning response protocols. (RFO 3.6% [95% CI 1.3–9.6]).
- Lack of training and educational programs: Insufficient or non-existent training was shown to lead to low self-efficacy and negative attitudes toward DHTs, hindering their successful implementation and efficiency. (RFO 3.4% [95% CI 1.3–8.9]).
Vital Facilitators for DHT Adoption by HPs:
- Offering training and educational activities: Providing appropriately tailored training programs and continuous technical support significantly increases positive experiences and facilitates DHT adoption. (RFO 3.8% [95% CI 1.6–9.0]).
- Healthcare provider perception of digital health technologies usefulness and willingness to use: HPs are more likely to adopt DHTs if they perceive that these technologies will enhance their performance and are willing to integrate them into practice. (RFO 3.8% [95% CI 1.8–7.9]).
- Existence of government and multisector incentives: Financial and other multisectoral incentives were found to significantly improve the effectiveness and chances of success for DHTs in large-scale healthcare systems. (RFO 3.0% [95% CI 1.4–6.6]).
- Adherence promotion campaigns: These campaigns were noted to facilitate and increase the use of DHTs by healthcare providers. (RFO 2.2% [95% CI 1.1–4.3]).
- Involvement of healthcare professionals in the process of DHT development and implementation: User engagement and collaboration with system developers from design to continued utilization are crucial to ensure applications are fit for purpose and meet HPs’ needs. (RFO 2.0% [95% CI 0.8–4.9]).
- Intuitive navigation in healthcare technology systems: User-friendly design and easy-to-use interfaces are critical for improving overall product performance and facilitating data handling. (RFO 1.9% [95% CI 0.7–5.2]).
Significance and Implications
This pioneering overview consolidates a vast body of literature to present a clear picture of the challenges and enablers in DHT adoption. The findings offer crucial insights for policymakers, health organizations, and all stakeholders involved in healthcare modernization. By understanding and addressing these identified barriers—such as improving infrastructure, providing tailored training, and acknowledging workload concerns—while strategically deploying facilitators—like promoting perceived usefulness and ensuring HP involvement—the healthcare sector can significantly enhance the successful creation, implementation, and long-term utilization of digital interventions. Ultimately, these efforts are expected to increase professional satisfaction and improve the overall quality of delivered care.
APA Reference
Borges do Nascimento, I. J., Abdulazeem, H., Vasanthan, L. T., Martinez, E. Z., Zucoloto, M. L., Østengaard, L., Azzopardi-Muscat, N., Zapata, T., & Novillo-Ortiz, D. (2023). Barriers and facilitators to utilizing digital health technologies by healthcare professionals. npj Digital Medicine, 6:161. https://doi.org/10.1038/s41746-023-00899-4
