Factores que promueven o dificultan la implementación de los sistemas de telemedicina: Revisión sistemática explicativa

Translated title of the contribution: Factors that promote or inhibit the implementation of e-health systems: An explanatory systematic review

Frances S. Mair, Carl May, Catherine O'Donnell, Tracy Finch, Frank Sullivand, Elizabeth Murray

Research output: Contribution to journalReview articlepeer-review

269 Citations (Scopus)

Abstract

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. 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: (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. Conclusion The published literature focused on organizational issues, neglecting the wider social framework that must be considered when introducing new technologies.

Translated title of the contributionFactors that promote or inhibit the implementation of e-health systems: An explanatory systematic review
Original languageSpanish
Pages (from-to)357-364
Number of pages8
JournalBulletin of the World Health Organization
Volume90
Issue number5
DOIs
Publication statusPublished - 1 May 2012

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