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

TY - JOUR

T1 - Factors that promote or inhibit the implementation of e-health systems: an explanatory systematic review

A1 - Mair,Frances S.

A1 - May,Carl

A1 - O'Donnell,Catherine

A1 - Finch,Tracy

A1 - Sullivan,Frank

A1 - Murray,Elizabeth

AU - Mair,Frances S.

AU - May,Carl

AU - O'Donnell,Catherine

AU - Finch,Tracy

AU - Sullivan,Frank

AU - Murray,Elizabeth

PY - 2012/5

Y1 - 2012/5

N2 - <p>Objective To systematically review the literature on the implementation of e-health to identify: (1) barriers and facilitators to e-health implementation, and (2) outstanding gaps in research on the subject.</p><p>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.</p><p>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: (1) work directed at making sense of e-health systems, specifying their purposes and benefits, establishing their value to users and planning their implementation; (2) factors promoting or inhibiting engagement and participation; (3) effects on roles and responsibilities; (4) risk management, and (5) ways in which implementation processes might be reconfigured by user-produced knowledge.</p><p>Conclusion The published literature focused on organizational issues, neglecting the wider social framework that must be considered when introducing new technologies.</p>

AB - <p>Objective To systematically review the literature on the implementation of e-health to identify: (1) barriers and facilitators to e-health implementation, and (2) outstanding gaps in research on the subject.</p><p>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.</p><p>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: (1) work directed at making sense of e-health systems, specifying their purposes and benefits, establishing their value to users and planning their implementation; (2) factors promoting or inhibiting engagement and participation; (3) effects on roles and responsibilities; (4) risk management, and (5) ways in which implementation processes might be reconfigured by user-produced knowledge.</p><p>Conclusion The published literature focused on organizational issues, neglecting the wider social framework that must be considered when introducing new technologies.</p>

U2 - 10.2471/BLT.11.099424

DO - 10.2471/BLT.11.099424

M1 - Scientific review

JO - Bulletin of the World Health Organization

JF - Bulletin of the World Health Organization

SN - 0042-9686

IS - 5

VL - 90

SP - 357

EP - 364

ER -