Digital health technology adoption factors: a rapid review of systematic reviews and checklist development

This rapid review of systematic reviews aimed to synthesize the adoption factors of digital health technologies (DHTs).

A reference search was performed on MEDLINE, EMBASE, CINAHL, PsychInfo, PubMed, EBM Review, Web of Science, Scopus, PROSPERO and Google Scholar to search systematic reviews published in the last three years. Study selection was conducted following the PRISMA guidelines. The methodological quality of the included systematic reviews was assessed with the AMSTAR 2 tool. The identified adoption factors were classified using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework, in which the self-determination factors were integrated.

Out of 4277 identified references, 45 systematic reviews were retained. The quality of most included systematic reviews, assessed by AMSTAR 2, was critically low. The most cited adoption factors included DHT's ease of use, training for using DHT, adopters' access to DHT and a high-speed internet connection, technical support, DHT's customizability, the relevance and reliability of DHT data, the demand-side value of DHT (desirability), safety, cost-effectiveness, staff and patient competence, patient relatedness with others, organizational readiness, necessary changes in team routines, capacity for innovation, along with the political, economic, regulatory and sociocultural contexts. Integrating the findings of this rapid review, a DHT adoption checklist was elaborated. This checklist would aid future developers and implementers of DHT in successfully adopting the technology.

This review synthesized the DHT adoption factors using the NASSS framework and Self-Determination Theory. When developing or implementing a DHT, the micro-, meso- and macro-level adoption factors must be considered.