Barriers to Telemedicine Establishment in Iran: A Systematic Review

Area of Science:

• Health Informatics
• Telemedicine Implementation
• Healthcare Systems Research

Background:

• Telemedicine has seen limited experimental use in Iran, lacking formal integration into healthcare services.
• Identifying barriers is crucial for successful telemedicine adoption.
• This study addresses the need to understand obstacles to telemedicine establishment in Iran's health system.

Purpose of the Study:

• To systematically identify and analyze the barriers hindering the establishment of telemedicine in the Iranian health system.

Main Methods:

• A systematic review adhering to PRISMA guidelines was performed.
• Searches included major databases (PubMed, Scopus, etc.) and Iranian academic repositories.
• Data from 21 eligible studies (2010-2022) were analyzed using narrative synthesis and thematic analysis, guided by the WHO building blocks framework.

Main Results:

• Twenty-one studies identified key barriers across four main themes: governance/leadership, financing, health workers, and health information systems.
• Eleven sub-themes further detailed these barriers.
• The WHO building blocks of service delivery and medical products/vaccines/technologies did not yield specific findings related to barriers.

Conclusions:

• Governance and leadership barriers are paramount and should be prioritized for overcoming.
• Establishing strategic policy frameworks, effective supervision, coalition building, clear laws and regulations, and community participation are essential first steps.
• Addressing these governance-related issues is critical for successful telemedicine implementation in Iran.