# Barriers and Facilitators of Digital Transformation in Health Care: Mixed Methods Study

## TL;DR

This study explores what helps and hinders doctors in Russia from adopting digital health technologies, finding that concerns about errors and legal issues are major barriers.

## Contribution

The paper provides a mixed-methods analysis of physician perspectives on digital health adoption in Russia, highlighting region-specific barriers and facilitators.

## Key findings

- Fear of making erroneous decisions and legal insecurity are significant barriers to digital health adoption among physicians.
- Time saving and practical benefits are the most important facilitators for implementing digital health technologies.
- Free training and study leave are crucial motivators for physicians to adopt digital solutions.

## Abstract

Digital transformation is now a fundamental component of health care systems worldwide. To develop effective digital health strategies, it is essential to examine physicians’ perspectives on the barriers and facilitators of implementation, with particular attention to regional and cultural factors influencing technology adoption.

This study aims to identify and analyze key barriers and facilitators to the implementation of digital health technologies from physicians’ perspectives in Russia.

A 2-phase nationwide mixed methods study was conducted involving 460 physicians from various specialties. The first phase comprised in-depth interviews with 10 physicians to develop a specialized questionnaire. The second phase involved a nationwide cross-sectional survey with 450 physicians using the developed questionnaire. Inclusion criteria were working in a Russian city with a population of more than 100,000, age 22 years and older, at least 3 years of specialty experience, and employment in public or private health care institutions. The analysis focused on 4 categories of digital health technologies: remote consultations, remote monitoring, digital diagnostic solutions, and clinical decision support systems.

The main barriers identified were fear of making erroneous decisions (25% of physicians), technical difficulties (up to 25%), and legal insecurity (21% of physicians). Notably, the barrier profile varied depending on the type of technology. Key drivers for implementation included time saving (59% of physicians), practical benefits (55% of physicians), and legal security (54% of physicians). Additionally, a convenient training organization was a crucial motivator, with the availability of free training (53% of physicians) and provision of study leave (52% of physicians). These facilitators were consistent across all categories of digital solutions. Based on these findings, key recommendations for the implementation of digital transformation in medical organizations were formulated.

The findings highlight the need for comprehensive, technology-specific digital implementation strategies to improve health care digital transformation effectiveness, considering physician concerns about decision-making accuracy, technical challenges, and legal frameworks.