Barriers and facilitators for the adoption of telemedicine services in low-income and middle-income countries: a rapid overview of reviews

Abstract

ObjectiveTo identify the barriers and facilitators for uptake of telemedicine services in low-income and middle-income countries (LMICs).DesignThe rapid review approach to identify the barriers and facilitators for the uptake/delivery of telemedicine in health system from both the provider and the patient’s perspective. A two-stage sequential screening process was adopted. Data extraction was done using a piloted data extraction form.Data sourcesA search on PubMed (NCBI), Embase (Ovid), the Cochrane Library (Wiley), Scopus (Elsevier) and the WHO Global Index Medicus was conducted.Eligibility criteria for selecting studiesStudies published between 1 January 2012 and 1 July 2022 on barriers and facilitators for uptake of telemedicine services in LMICs were included.ResultsDatabase search identified a total of 2829 citations. After removing 1069 duplicates, 1760 were taken forward for title and abstract screening. A total of 43 articles were included at full text stage and 8 articles were included in this overview for narrative synthesis. Barriers and facilitators to telemedicine adoption and use were categorised under four subheadings, namely organisational and environmental, individual and cultural barriers, financial barriers and technological barriers. Providers, patient and health policy-makers perspectives were captured.ConclusionAny development of telemedicine services should engage the primary users such as patients and their family caregivers to design people-centred digital health systems and services. Usability studies must be commissioned by the governments and host agencies to enhance the interaction experience pending which investments would remain futile. Future research should employ mixed methods or multi methods approaches to understand the interaction between patients and providers.