School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
Department of Health Information Technology and Management, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia.
JMIR Mhealth Uhealth. 2023 Nov 8;11:e50419. doi: 10.2196/50419.
BACKGROUND: During the COVID-19 pandemic, the provision of and access to health care have been uniquely challenging, particularly during lockdowns or when dealing with COVID-19 cases. Health care professionals have had to provide patients with the necessary health care. However, delivering health care services while reducing face-to-face interaction puts an immense strain on health systems that are already overburdened. Against this backdrop, it is now more critical than ever to ensure the accessibility of health care services. Such access has been made increasingly available through mobile health (mHealth) apps. These apps have the potential to significantly improve health care outcomes and expectations and address some of the challenges confronting health care systems worldwide. Despite the advantages of mHealth, its acceptance and adoption remain low. Hence, health care organizations must consider the perceptions and opinions of physicians if the technology is to be successfully implemented. OBJECTIVE: The objective of this systematic review was to explore and synthesize the scientific literature on the factors influencing the acceptance and adoption of mHealth among physicians during the COVID-19 pandemic. METHODS: A systematic review of the studies published between March 2020 and December 2022 was conducted using the MEDLINE, Scopus, Embase, and ProQuest databases. The database search yielded an initial sample of 455 potential publications for analysis, of which 9 (2%) met the inclusion criteria. The methodology of this review was based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). RESULTS: The factors influencing mHealth acceptance and adoption by physicians were divided into perceived barriers and perceived facilitators, which were further grouped into the following 3 major thematic categories: technological, individual, and organizational barriers and facilitators, respectively. The technological barriers were accessibility, technical issues, usefulness, and data management; individual barriers were perceived patient barriers, time and workload pressure, technical literacy, knowledge of mHealth, and peer support; and organizational barriers were financial factors, management support and engagement, data security, telemonitoring policy, and collaboration. The technological facilitators of uptake were technical factors, clinical usefulness, and data management; individual facilitators were patient-related care, intrinsic motivation, collaboration, and data sharing (individual); and organizational facilitators were workflow-related determinants, organizational financial support, recommendation of mHealth services, and evidence-based guidelines. CONCLUSIONS: This review summarized the evidence on the factors influencing mHealth acceptance and adoption by physicians during the COVID-19 pandemic. The main findings highlighted the importance of addressing organizational readiness to support physicians with adequate resources, shifting the focus from technological to patient-centered factors, and the seamless integration of mHealth into routine practice during and beyond the pandemic. TRIAL REGISTRATION: PROSPERO CRD42022356125; https://tinyurl.com/2mmhn5yu.
背景:在 COVID-19 大流行期间,医疗保健的提供和获取面临着独特的挑战,尤其是在封锁期间或应对 COVID-19 病例时。医疗保健专业人员必须为患者提供必要的医疗保健。然而,在减少面对面接触的同时提供医疗保健服务,给已经负担过重的医疗系统带来了巨大的压力。在这种背景下,确保医疗保健服务的可及性比以往任何时候都更加重要。移动医疗 (mHealth) 应用程序使这种可及性变得更加容易。这些应用程序有可能显著改善医疗保健结果和预期,并解决全球医疗保健系统面临的一些挑战。尽管 mHealth 具有优势,但它的接受度和采用率仍然很低。因此,如果要成功实施该技术,医疗保健组织必须考虑医生的看法和意见。 目的:本系统评价的目的是探索和综合 COVID-19 大流行期间影响医生接受和采用 mHealth 的科学文献。 方法:使用 MEDLINE、Scopus、Embase 和 ProQuest 数据库对 2020 年 3 月至 2022 年 12 月期间发表的研究进行了系统评价。数据库搜索产生了 455 篇可供分析的初步潜在出版物,其中 9 篇 (2%) 符合纳入标准。本综述的方法基于 PRISMA (系统评价和荟萃分析的首选报告项目)。 结果:影响医生接受和采用 mHealth 的因素分为感知障碍和感知促进因素,进一步分为以下 3 个主要主题类别:技术、个人和组织障碍和促进因素。技术障碍包括可及性、技术问题、有用性和数据管理;个人障碍包括感知患者障碍、时间和工作量压力、技术素养、对 mHealth 的了解和同行支持;组织障碍包括财务因素、管理支持和参与、数据安全、远程监测政策和协作。技术促进因素包括技术因素、临床有用性和数据管理;个人促进因素包括与患者相关的护理、内在动机、协作和数据共享 (个人);组织促进因素包括与工作流程相关的决定因素、组织财务支持、推荐 mHealth 服务和循证指南。 结论:本综述总结了 COVID-19 大流行期间影响医生接受和采用 mHealth 的因素的证据。主要发现强调了医疗机构必须做好准备,为医生提供充足的资源,从技术因素转向以患者为中心的因素,以及在大流行期间和之后将 mHealth 无缝整合到常规实践中的重要性。 试验注册:PROSPERO CRD42022356125;https://tinyurl.com/2mmhn5yu。
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