Barriers for the Using of Information Systems in Hospitals: AQualitative StudyMohammad Keshvari,1 Ali Reza Yusefi,2 Abbas Homauni,3 Roudabe Omidifar,4 and Samin Nobakht5,*1 Health Policy, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran2 Health Care Management, Student Research Committee, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, IR Iran3 Health Care Management, Department of Health Economics and Management, School of Public Health and Institute of Public Health Research, Tehran University of MedicalSciences, Tehran, IR Iran4 Lorestan University of Medical Sciences, Khorramabad, IR Iran5 Science and Research Branch, Islamic Azad University, Tehran, IR Iran* Corresponding author: Samin Nobakht, Science and Research Branch, Islamic Azad University, Tehran, IR Iran. Tel: +98-9141865293, E-mail: [email protected] 2018 January 16; Revised 2018 June 30; Accepted 2018 July 01.AbstractBackground: Information technology is one of the most important issues in health systems. It has been developed in health sectorsand is widely used by hospital managers. Identifying barriers in the use of hospital information systems can be the first step forbetter information management and better implementation of quality improvement and clinical governance plans.Objectives: The aim of this study is to investigate the barriers for the using of information systems in hospitals.Methods: This is a qualitative study, which used content analysis for analyzing to achieve study objectives. Sampling was done usingpurposive and heterogeneous methods and data collection continued until data saturation. The researcher was referred to hospitalmanagers to identify individuals who had the most information regarding health information systems to identify barriers of usinginformation system.Results: Results of this study showed that challenges and barriers of information management and use of information systems arerelated to each other. Based on the results of this study the most important challenges of using information systems are knowledgefactors.Conclusions: Designing a comprehensive plan can eliminate barriers of using information systems because barriers and chal-lenges are integrated and related to each other.Keywords: Hospital Information Systems, Information Management, Decision Making, Evidence-Based1. BackgroundNowadays, information technology and its use is oneof the most important issues. Information technology hasbeen developed in medical and health sectors and is widelyused by health system managers. The healthcare industrydepends on information technology, which has a vital rolein medical performance and hospital management (1).Information management has been defined as: tech-nology of receiving, storing, processing, transferring, andpresenting of information (2). It is believed that informa-tion technology can enhance organizational capabilities(3). Information management and use of information sys-tems can improve quality of care, safety, cost saving, andcan also create new innovations (4).The literature review indicates that the use of hospitalinformation system (HIS) can increase efficiency and effec-tiveness of care and cost saving (5, 6). In addition, these sys-tems improve the readability of data recorded, user satis-faction, and reduce medical errors (7-9). Considering thatinformation technology creates a great potential for im-proving quality of care, efficiency and effectiveness of per-sonnel, particularly in hospitals and medical centers (10).Therefore, it seems necessary to set up a proper informa-tion system in order to understand the problem and usethe best available data for providing on time and scientificinformation (11).The proper use of information system enables hospitalmanagers to access information for decision making everytime and place; in addition, it also helps them make deci-sions based on actual information. This fact increases effi-ciency and hospital performance development (12). Imple-mentation of information technology in health systems of-ten require changes in work tasks and processes simulta-neously or before applying new technologies (13). One ofthe most important reasons for failing in projects is the dis

Barriers and facilitators to a health informationexchange system between general practitionersand hospitals: a qualitative study in SouthernSwitzerlandNicolò Saverio Centemeroa, Bernd Rechelba Clinical Informatics Unit, Ente Ospedaliero Cantonale, Bellinzona, Switzerlandb European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, United KingdomSummaryBACKGROUND: Health information exchange (HIE) sys-tems are computer tools that healthcare providers useto share patients’ medical information electronically. Ourstudy aimed to identify barriers and facilitators perceivedby general practitioners (GPs) when using an HIE systemin the Canton of Ticino, a region in southern Switzerland.METHODS: We performed a qualitative study using semi-structured interviews. Ten GPs participated in the study.We analysed transcripts using thematic content analysisand following an abductive approach (a mix of deductiveand inductive approaches).RESULTS: Our findings indicate the following main facili-tators of the HIE system: (a) the perception of having todo with a secure system; (b) the possibility of delegatingits management to secretaries and healthcare assistants;(c) technical support and training; (d) high quality of the in-formation exchanged; (e) positive impact on clinical prac-tice; and (f) regional context. However, major challengesstill persist, and GPs reported the following main barriersto using an HIE system: (a) a frequent lack of all the pa-tient documentation they needed; (b) no effective workflowimprovements; and (c) lack of some technical features.CONCLUSIONS: The results of our study provide a quali-tative perspective of opinions and experiences of GPs thatcan inform improvements of the current HIE system andfuture federal and cantonal HIE initiatives in Switzerlandand elsewhere

Barriers and facilitators to utilizing digital health technologiesby healthcare professionalsIsrael Júnior Borges do Nascimento 1,2 , Hebatullah Abdulazeem 3 , Lenny Thinagaran Vasanthan 4 , Edson Zangiacomi Martinez 5 ,Miriane Lucindo Zucoloto 5 , Lasse Østengaard 6 , Natasha Azzopardi-Muscat 1 , Tomas Zapata 1 and David Novillo-Ortiz 1 ✉Digital technologies change the healthcare environment, with several studies suggesting barriers and facilitators to using digitalinterventions by healthcare professionals (HPs). We consolidated the evidence from existing systematic reviews mentioning barriersand facilitators for the use of digital health technologies by HP. Electronic searches were performed in five databases (CochraneDatabase of Systematic Reviews, Embase®, Epistemonikos, MEDLINE®, and Scopus) from inception to March 2023. We includedreviews that reported barriers or facilitators factors to use technology solutions among HP. We performed data abstraction,methodological assessment, and certainty of the evidence appraisal by at least two authors. Overall, we included 108 reviewsinvolving physicians, pharmacists, and nurses were included. High-quality evidence suggested that infrastructure and technicalbarriers (Relative Frequency Occurrence [RFO] 6.4% [95% CI 2.9–14.1]), psychological and personal issues (RFO 5.3% [95% CI2.2–12.7]), and concerns of increasing working hours or workload (RFO 3.9% [95% CI 1.5–10.1]) were common concerns reported byHPs. Likewise, high-quality evidence supports that training/educational programs, multisector incentives, and the perception oftechnology effectiveness facilitate the adoption of digital technologies by HPs (RFO 3.8% [95% CI 1.8–7.9]). Our findings showedthat infrastructure and technical issues, psychological barriers, and workload-related concerns are relevant barriers tocomprehensively and holistically adopting digital health technologies by HPs. Conversely, deploying training, evaluating HP’sperception of usefulness and willingness to use, and multi-stakeholders incentives are vital enablers to enhance the HP adoption ofdigital interventions.npj Digital Medicine (2023) 6:161 ; https://doi.org/10.1038/s41746-023-00899-4INTRODUCTIONRecent developments in health technology have positivelyaffected multiple and essential sectors of the economy, especiallythe healthcare sector, by providing solutions that guarantee theexchange of medical knowledge and information and establishlong-lasting health outcomes 1,2 . Digital health technologies, suchas wearables devices, computerized decision support systems, andtelemedicine improve the technical performance and satisfactionof healthcare employees, demonstrate potential to decrease directand indirect costs of medical services, and enhance the quality ofdelivered care3 . Worldwide, using digital solutions in practiceseems inevitable, with modality-specific prevalence (e.g., 50.8% fortelemedicine, 89.9% for electronic health records, and 91.9% forsocial media platforms) 4–6 . However, the prevalence of use mightbe even higher, as no previous study has collated and assessedthe overall prevalence of using digital health technologies byhealthcare providers. Likewise, several studies have suggestedthat ethnicity, race, geographic location, age, and medicalspecialty directly interfere in the adoption of technology use,evidencing the importance of understanding variables accountingfor the digital divide and disparity of access7–9 .Several barriers to healthcare’s overall quality, transparency, andefficiency naturally arise during or following the creation,implementation, and maintenance of digital health technologies.Therefore, during the design of any health-related project, it isessential to identify and quanti-qualitatively analyze its risks andfacilitators, enhancing the likelihood of obtaining favorableoutcomes and optimizing the chances of success. The efficientimplementation of digital technologies, characterized by properimplementation of a systematic management approach, includingstrategic planning, resource allocation, and control and evaluationprocesses, is fundamental to refining healthcare services, equip-ment, and technologies 10–12 . In reaction to these aforementionedelements, multiple efforts have strengthened healthcare systemsthrough employing DHTs for healthcare professionals andstakeholders from low-, middle-, and high-income countries. Forinstance, the World Health Organization (WHO) endorsed in the73rd World Health Assembly the institution of the Global Strategyon Digital Health 2020–2025, in which four guiding principles relyon the acknowledgment that the institutionalization of digitalhealth in a national system requires a decision and commitmentby countries, recognition that successful digital technologiesrequire an integrated strategy, promotion of the appropriate useof digital interventions for health, and recognition of the urgentneed to address the major impediments faced by least-developedcountries implementing digital health technologies 13 . Further-more, the Regional Digital Health Action Plan for the WHOEuropean Region 2023–2030 has a critical regional focus area onstrengthening digital literacy skills and capacity-building in thegeneral population, with particular attention to the healthworkforce, for the use of digital health services and diseaseprevention and management 14 . Due to these global actions

A Western development organization is working tointroduce digital hospital management systems inAfrica. It is known that such systems often raisefierce concerns about privacy in their home country,and that some information and communicationtechnology (ICT) solutions do better than others inthis respect. Yet the local population and partnerorganization do not seem at all concerned aboutprivacy and there are pressing health care challengesthat the systems help to solve. The organizationchooses not to pay any attention to privacy. Should adifferent decision have been made, or would it beunjustifiable paternalism for the developmentorganization to impose “Western” values on Africansociety?

Examine the challenges and concerns related to ICT in global healthcare, such as data security, interoperability, and accessibility.Incorporate insights from local articles that address specific local challenges.

In an effort to increase efficiency and lower costs, many hospitals have begun implementing digital health records. However, medical researcher Grace Mitchell suggests that while digital records may cut costs, they could also increase instances of miscommunication and errors, ultimately lowering the quality of patient care.11 Mark For ReviewWhich finding, if true, would most directly support Mitchell's suggestion?A) Hospitals that have implemented digital health records have experienced a significant reduction in administrative costs.B) Several hospitals that transitioned to digital records have seen an increase in patient recovery times.C) Doctors at hospitals with digital records report higher job satisfaction compared to those at hospitals with paper records.D) The implementation of digital health records has led to more streamlined communication among different hospital departments.