Identifying barriers in telemedicine-supported integrated care research: scoping reviews and qualitative content analysi
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ORIGINAL ARTICLE
Identifying barriers in telemedicine-supported integrated care research: scoping reviews and qualitative content analysis Lorenz Harst 1 & Patrick Timpel 2 & Lena Otto 3 & Peggy Richter 3 & Bastian Wollschlaeger 4 & Katja Winkler 3 & Hannes Schlieter 3 Received: 21 January 2019 / Accepted: 17 March 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Background 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. Objective and method 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. Results 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. Discussion 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. Keywords Integrated care . Telemedicine . Barriers for implementation . Digitisation . Scoping review
Introduction, conceptual background and problem statement Demographic change and an increasing number of people with multiple chronic diseases are among the main drivers
for transition processes in health care (Harper 2010). Integrated care as a promising concept for the handling of this transition process requires close collaboration, networking and alignment of several health or social service providers, patients and other stakeholders (Kodner 2009). The use of
Lorenz Harst, Patrick Timpel, Lena Otto, Peggy Richter and Bastian Wollschlaeger contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10389-019-01065-5) contains supplementary material, which is available to authorized users. * Lorenz Harst [email protected] 1
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Prevention and Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Tec
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