Nurses' Perspective of Barrier Structure and Promotion Strategies for Digital Health Transformation: An Interpretive...

Potentially complex structures underlie the barriers to digital health transformation. This study aimed to identify the elements of barriers to digital health transformation and clarify the relationships among them using Interpretive Structural Modeling and Cross Impact Matrix-Multiplication Applied to Classification. We identified 11 barriers through a brainstorming session conducted by 3 nursing researchers in Japan. These elements were analyzed via mathematical processing, and a hierarchical structural diagram was constructed. The characteristics of each element were classified using the Cross Impact Matrix-Multiplication Applied to Classification analysis. The results demonstrated consistency with those of previous studies, thus indicating content validity. Furthermore, this study succeeded in systematically organizing the multilayered barriers and visualizing a comprehensive model that even individuals unfamiliar with the cultural context of health care could easily understand. These findings suggest that the organizational culture of nursing plays a fundamental role in the promotion of digital health transformation and emphasize the importance of collaboration among stakeholders at the clinical, developmental, and policy levels. Future strategies for digital health transformation should incorporate more flexible approaches using SWOT analysis and the Decision-Making Trial and Evaluation Laboratory technique.