Identifying barriers in telemedicine-supported integrated care research: scoping reviews and qualitative content analysis

Abstract

Integrated care is said to improve the way in which care is delivered. To support integrated care by ensuring close collaboration between involved stakeholders, information and communication technologies, especially telemedicine, are needed. Despite their potential, most telemedicine solutions never make it from pilot project stage to full implementation into usual care. Especially in integrated care scenarios, understanding of the barriers hampering successful telemedicine implementation and application is limited. Four rapid scoping reviews were carried out to cover the following broad sets of barriers in telemedicine implementation: technical, behavioural, economical and organisational barriers. The identified barriers and obstacles were categorised into problem areas with sub-categories and, afterwards, combined in order to identify future research potentials for telemedicine implementation. A total of 118 studies were included for further analysis. The findings suggest that the individuals’ characteristics, as well as the surrounding social and health care system, are the most important barriers for telemedicine-supported integrated care. The information system development and application, as well as missing data and evidence for the effectiveness of telemedicine and integrated care, are hampering successful implementation. The consolidated problem areas deepen the understanding on how barriers for telemedicine solutions in integrated care settings are interrelated. Conclusively, this helps to successfully develop and implement telemedicine-supported integrated care.