Barriers to telemedicine establishment and development in Iran:  a systematic review

Abstract

Background: Despite the rapid growth of telemedicine technology in the health system in developed and high-income countries and the undeniable benefits of this technology, its establishment and development in developing countries, including Iran, faces many barriers. Telemedicine has not been deployed in delivering routine healthcare services in Iran's health system. In this regard, precise identification of challenges and barriers to telemedicine implementation and development is necessary. This study aimed to identify barriers to telemedicine establishment and development in Iran. Methods: A systematic review was conducted according to PRISMA guidelines. Searches were conducted in Scopus, PubMed, Web of Science, Cochrane Library, SID, and Google Scholar. The inclusion criteria were non-review articles, studies that examined barriers to telemedicine in Iran, published in English and Persian, and published between 21 March 2013 and 20 March 2022. The quality of the included studies was assessed based on Joana Briggs Institute’s (JBI) Critical Appraisal tools. Data were analyzed using narrative synthesis and deductive-inductive thematic analysis. Results: Out of 825 studies identified, 21 studies met the inclusion criteria for review. The findings fell into four themes, including governance/leadership, financing, health workers, and health information system besides 11 sub-themes using the World Health Organization (WHO) health system building blocks. No specific findings were derived from the building blocks of service delivery and medical product, vaccines and technologies. Conclusions: In our study, the most significant barriers were related to the building block of governance/leadership. Governance is an integral part of other building blocks of the health system in any country. To establishment and development of telemedicine technology in Iran, ensuring the existence of strategic policy frameworks coupled with some other factors such as effective supervision, coalition building, rules and regulations, inter and intra-sectoral collaboration, and community engagement is necessary. Further studies should be conducted regarding the main causes of barriers to establishing and developing this technology.

The Potential Use of Digital Health in Iran: A Systematic Mapping Review

“…In other technologies including telehealth, healthcare professionals were less often the main users of applications. The reasons can be the lack of familiarity of healthcare professionals with technologies and the lack of cultural fit or motivation to use new tools [117]. Healthcare professionals resist the use of Telehealth which may be due to a sense of threat from this technology, reduced autonomy, and indirect costs associated with it [5].…”

Popular diffusion as an instrument for overcoming barriers to digital health in Iran: the critical role of the pandemic

“…In their study, the most significant barriers were related to the building block of governance/leadership, which was an integral part of other building blocks of the health system in any country. The authors concluded that establishment and development of telemedicine technology in Iran, ensuring the existence of strategic policy frameworks coupled with some other factors such as effective supervision, coalition building, rules and regulations, inter- and intra-sectoral collaboration and community engagement, were necessary (Mehrolhassani et al. , 2022).…”