Understanding the factors impacting Clinicians’ adoption of Mobile Health tools and their implications for organizational practices: A multiple-case study

Background: Mobile health (mHealth) have shown promise for their potential to enhance clinical workflows, improve patient access to care, and the quality of that care. However, there remain persistent barriers to adoption, and some users continue to resist the use of these new tools. Objectives: This research investigated factors influencing clinicians’ mHealth adoption, and expounded these and the potential implications for their workflow and quality of patient care. Methods: A multiple-case study of three mHealth tools was conducted. Data were collected via 41 in-depth interviews with clinicians, technology providers, and medical informatics experts in 9 countries from April 2017 to March 2020. The case studies were examined in the context of relevant literature, identified by a systematic review that included171 studies published between 2008 and 2018. Results: Findings confirmed that the use of mHealth can provide numerous benefits such as efficacy and time-saving, improved safety and quality of patient care, improved accessibility, and better data security and validation. They can also positively impact workflow through better transparency and collaboration, empowerment, and efficiency. However, the factors impacting adoption go beyond material features such as usefulness, ease of use, privacy and security, interoperability and costs. Social factors like clinicians’ attitudes, awareness, experience, or culture are key. Organizational and policy factors are also vital and include user engagement, infrastructure, training, existing workload and resources, decision making, in addition to absence or ambiguity of regulations. Conclusions: Factors impacting clinicians’ adoption go beyond the material aspects of mHealth to also encompass substantial social and organizational elements. Therefore, from a practical perspective, mHealth providers should work together with clinicians and decision makers to address potential barriers and improve adoption. From a theoretical perspective, the study proposes an expansion of Leonardi’s methodological guidance to better account for user engagement; and a consolidated framework that better factors in the complexity of healthcare’s sociotechnical structure, and the interaction between the technical, social and organizational factors.