Barriers and Facilitators to the Implementation of eHealth Services: Systematic Literature Analysis
Barriers and Facilitators to the Implementation of eHealth Services: Systematic Literature Analysis
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DOI：
10.2196/14197
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发表时间：
2019-11-22
影响因子：
7.4
通讯作者：
Bergh, Bjoern
中科院分区：
文献类型：
--
作者：
Schreiweis, Bjoern;Pobiruchin, Monika;Bergh, Bjoern
背景：电子医疗领域已有20多年的历史。在此期间，开发了许多不同的电子医疗服务。然而，影响此类服务采用的因素很少成为分析的主要焦点。因此，采用和实施电子医疗服务的组织似乎没有充分意识到影响电子医疗服务融入日常护理的障碍和促进因素。 目的：这项工作的目标是提供 (1) 需要考虑的相关障碍的全面列表，以及 (2) 帮助规划和实施成功的电子医疗服务的促进因素或成功因素列表。 方法： 本研究采用了双重方法。首先，我们通过在欧洲举行的两次健康信息学会议上的专家讨论，收集了专家对实施电子卫生服务的促进因素和障碍的当前意见。其次，我们对电子卫生服务实施的障碍和促进因素进行了系统的文献分析。最后，我们将专家讨论的结果与系统文献分析的结果合并。结果：两次专家讨论（分别为 23 名专家和 10 名专家）确定了 15 个障碍和 31 个促进因素，而在来自 12 个不同国家的最初 56 篇文章中，有 38 篇发现了 76 个障碍和 268 个促进因素。对于分析的出版物，报告的不同障碍的数量范围从 0 到 40（平均值 10.24，SD 8.87，中位数 8）。同样，文献中提到了 0 到 48 名促进者（平均值 9.18，SD 9.33，中位数 6）。两种来源的结合产生了电子卫生服务的采用和实施的 77 个障碍和 292 个促进因素。结论：这项工作提供了电子卫生服务的实施和采用的障碍和促进因素的全面清单。及早解决障碍并在实施过程中利用促进因素，可以帮助创建更好地满足用户需求并为患者和护理人员提供更高福利的电子医疗服务。
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.