CHALLENGES FACED BY HEALTHCARE WORKERS IN ADOPTING TELEMEDICINE TECHNOLOGIES – UNDERSTANDING BARRIERS TO DIGITAL HEALTH INTEGRATION IN CLINICAL PRACTICE
DOI:
https://doi.org/10.71000/sa5xqt47Keywords:
Clinical Workflow, Digital Health, Health Personnel Attitudes, Pakistan, Qualitative Research, , Telemedicine, Technology AdoptionAbstract
Background: Despite the rapid global expansion of telemedicine, its effective integration into routine clinical practice in low- and middle-income countries like Pakistan remains limited. Multiple barriers hinder adoption at various levels, posing a challenge to sustainable digital health implementation.
Objective: To explore and understand the key challenges faced by healthcare workers in adopting telemedicine technologies, with an emphasis on identifying systemic, technological, organizational, and personal-level barriers in Pakistan’s clinical settings.
Methods: A qualitative study was conducted over eight months in public and private healthcare facilities across Lahore, Karachi, and Islamabad. A purposive sample of 34 healthcare professionals, including physicians, nurses, and allied health staff, was recruited. Data were collected through semi-structured, in-depth interviews. Thematic analysis was applied using Braun and Clarke’s framework with NVivo 12 software for data management. Ethical approval was obtained, and informed consent was ensured.
Results: Four primary themes emerged: systemic (policy ambiguity, inconsistent funding), technological (usability issues, lack of interoperability), organizational (insufficient training, weak administrative support), and personal (digital illiteracy, emotional resistance). Interconnected barriers revealed that infrastructural deficits and unclear institutional strategies often reinforced individual resistance and workflow disruption. Participant narratives emphasized the need for practical training and supportive leadership in fostering telemedicine acceptance.
Conclusion: This study underscores the multifactorial nature of barriers to telemedicine adoption in Pakistan. Practical implications include the urgent need for cohesive national policy, infrastructure enhancement, and provider-centric digital training to facilitate effective and sustained telemedicine integration.
References
Samaâli S, Hakiri A, Bouallaguia A, Amri G, Ghachem R. Assessment of knowledge and perceptions of Tunisian psychiatrists regarding telepsychiatry. Tunis Med. 2024;102(6):360-5.
Shouman S, Emara T, Saber HG, Allam MF. Awareness and attitude of healthcare workers towards Telehealth in Cairo, Egypt. Int J Clin Pract. 2021;75(6):e14128.
Bernabe M, Ebardo R. Barriers Leading to the Discontinuance of Telemedicine among Healthcare Providers: A Systematic Review. Data and Metadata. 2025.
Arora S, Huda R, Verma S, Khetan M, Sangwan R. Challenges, Barriers, and Facilitators in Telemedicine Implementation in India: A Scoping Review. Cureus. 2024;16.
Venkataraman A, Fatma N, Edirippulige S, Ramamohan V. Facilitators and Barriers for Telemedicine Systems in India from Multiple Stakeholder Perspectives and Settings: A Systematic Review. 2023.
Doran JM, Lawson JL. The Impact of COVID-19 on Provider Perceptions of Telemental Health. Psychiatr Q. 2021;92(3):1241-58.
Oudbier SJ, Souget-Ruff SP, Chen BSJ, Ziesemer KA, Meij HJ, Smets EMA. Implementation barriers and facilitators of remote monitoring, remote consultation and digital care platforms through the eyes of healthcare professionals: a review of reviews. BMJ Open. 2024;14(6):e075833.
Pratama RD, Mahmudah A, Septiana L, Rita R. Implementation of Telemedicine in Medical Practice: Opportunities and Barriers. Global International Journal of Innovative Research. 2023.
Shibabaw AA, Chereka AA, Walle AD, Demsash AW, Dube GN, Dubale AT, et al. Knowledge of telemedicine and its associated factors among health professional in Ethiopia: A systematic review and meta-analysis. PLoS One. 2024;19(4):e0301044.
Jossy PE, Nandini P, Nair P, S N, S N, Rahul A. Knowledge, attitude and perceived barriers to telemedicine among medical professionals: a cross sectional study. International Journal Of Community Medicine And Public Health. 2024.
Park S, Woo K. Military Doctors' and Nurses' Perceptions of Telemedicine and the Factors Affecting Use Intention. Telemed J E Health. 2023;29(9):1412-20.
Takuwa M, Mbabazi SE, Tusabe M, Mulindwa B, Makobore PN, Mulerwa M, et al. Mobile Health Access and Utilisation in Uganda: Knowledge, Attitudes and Perceptions of Health and Veterinary Workers. Telemed J E Health. 2023;29(6):912-20.
Bekelman DB, Feser W, Morgan B, Welsh CH, Parsons EC, Paden G, et al. Nurse and Social Worker Palliative Telecare Team and Quality of Life in Patients With COPD, Heart Failure, or Interstitial Lung Disease: The ADAPT Randomized Clinical Trial. Jama. 2024;331(3):212-23.
Joo JY. Nurse-Led Telehealth Interventions During COVID-19: A Scoping Review. Comput Inform Nurs. 2022;40(12):804-13.
Drossman DA, Chang L, Deutsch JK, Ford AC, Halpert A, Kroenke K, et al. A Review of the Evidence and Recommendations on Communication Skills and the Patient-Provider Relationship: A Rome Foundation Working Team Report. Gastroenterology. 2021;161(5):1670-88.e7.
White N, Franklin S, Juliet N, Amalanathan S, Kanagaraj P, Babu AS. Telemedicine and information technology in health care management: Perspectives and barriers among the nursing students. Journal of Education and Health Promotion. 2024;13.
Serra E, Magalhães T. Telemedicine as an Approach to the Mental Health of Healthcare Workers in Angola. Int J Environ Res Public Health. 2025;22(4).
Elhadi M, Elhadi A, Bouhuwaish A, Bin Alshiteewi F, Elmabrouk A, Alsuyihili A, et al. Telemedicine Awareness, Knowledge, Attitude, and Skills of Health Care Workers in a Low-Resource Country During the COVID-19 Pandemic: Cross-sectional Study. J Med Internet Res. 2021;23(2):e20812.
Shaderkin I. Telemedicine barriers and ways to overcome them. Russian Journal of Telemedicine and E-Health. 2022.
Nouira M, Souayeh N. Towards implementing telemedicine in Tunisia: A knowledge, attitude and practice study among medical doctors. F1000Res. 2023;12:1025.
Ma Q, Sun D, Tan Z, Li C, He X, Zhai Y, et al. Usage and perceptions of telemedicine among health care professionals in China. Int J Med Inform. 2022;166:104856.
Supasettaysa G, Ratchatakulpat T, Ratchatakulpat M, Maisak R. User Experience and Barriers in Telemedicine Virtual Healthcare Service Platforms. 2024 9th International Conference on Business and Industrial Research (ICBIR). 2024:1357-61.
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Copyright (c) 2025 Muhammad Abdullah Avais, Ahmar Iftikhar, Afeefa Tahira, Mehwish Mobeen, Hafzah Shah, Sohail Nasir (Author)

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