Barriers and facilitators to exchanging health information: a systematic review

ObjectivesWe conducted a systematic review of studies assessing facilitators and barriers to use of health information exchange (HIE).MethodsWe searched MEDLINE, PsycINFO, CINAHL, and the Cochrane Library databases between January 1990 and February 2015 using terms related to HIE. English-language studies that identified barriers and facilitators of actual HIE were included. Data on study design, risk of bias, setting, geographic location, characteristics of the HIE, perceived barriers and facilitators to use were extracted and confirmed.ResultsTen cross-sectional, seven multiple-site case studies, and two before-after studies that included data from several sources (surveys, interviews, focus groups, and observations of users) evaluated perceived barriers and facilitators to HIE use. The most commonly cited barriers to HIE use were incomplete information, inefficient workflow, and reports that the exchanged information that did not meet the needs of users. The review identified several facilitators to use.DiscussionIncomplete patient information was consistently mentioned in the studies conducted in the US but not mentioned in the few studies conducted outside of the US that take a collective approach toward healthcare. Individual patients and practices in the US may exercise the right to participate (or not) in HIE which effects the completeness of patient information available to be exchanged. Workflow structure and user roles are key but understudied.ConclusionsWe identified several facilitators in the studies that showed promise in promoting electronic health data exchange: obtaining more complete patient information; thoughtful workflow that folds in HIE; and inclusion of users early in implementation.     

Patients’ perspectives on shared decision making in secondary mental healthcare in Taiwan: A qualitative study

ObjectiveThe aim of this study is to explore patient perspectives on shared decision making in secondary mental healthcare in Taiwan.MethodsQualitative semi-structured interviews were used to explore patient perspectives on shared decision making in secondary mental healthcare in Taiwan. Individual semi-structured interviews were conducted from July to August 2017 with a purposive sample of twenty patients using halfway houses. Data were analysed using thematic analysis.ResultsAnalysis of the interviews identified two themes: barriers to shared decision making; facilitators of shared decision making. Patients perceived that they were not involved in decision making due to: the professional status of health professionals; negative perception of making decisions; and limited time resources. However, patients reported a desire to be involved and felt sufficient information exchange would be a necessary step towards collaboration/sharing decisions about treatment with clinicians.ConclusionThe findings provided an understanding of significant barriers to and facilitators of implementing shared decision making to aid further professional training and the development of national policies.Practice implicationsThe findings could be the basis for developing effective strategies to overcome barriers to shared decision making and improve the process quality of delivering shared decision making.     

Healthcare professionals’ behaviour regarding the implementation of shared decision-making in screening programmes: A systematic review

ObjectiveTo explore the barriers to and facilitators of healthcare professionals’ implementation of SDM regarding screening programmes.MethodA systematic review was conducted in PubMed, Cochrane Library, CINHAL, and PsyscInfo. The barriers and facilitators identified were classified into three factors based on their origin: patients, healthcare system performance, and healthcare professionals themselves.ResultsEight studies were selected: seven related to cancer screening. The most significant facilitators were literacy and interest in active participation, both of which have their origins in patients. The most significant barriers identified for the first time in a systematic review were legal conflict, lack of remuneration and lack of flexibility in clinical guidelines in screening programmes.ConclusionThe results of this study show that there are differences between barriers and facilitators for SDM when it is applied in the context of healthy people who perform preventive activities, particularly screening, in contrast to general medical consultation contexts.Practical implicationsThe authors suggest that to advance in the practice of SDM, we need to develop and disseminate training documents. Further, SDM should be incorporated into clinical guidelines. There should be more studies focusing on healthcare professionals’ behaviour within the context of the uncertainty of screening programmes.     

Patient participation during oncological encounters: Barriers and need for supportive interventions experienced by elderly cancer patients

ObjectiveTo enhance patient participation during (oncological) encounters, this study aims to gain insight into communication barriers and supportive interventions experienced by elderly patients with cancer.MethodA mixed method design, including both quantitative (secondary survey data analysis) and qualitative (interviews) methods Survey data were used to identify communication barriers and need for supportive interventions of elderly cancer patients, compared to younger patients. Next, interviews provided in-depth insight into elderly patients’ experiences and underlying mechanisms.ResultsA majority of the 70 participating elderly cancer patients (53%) felt confident in communicating and participating during medical encounters. However, 47% of patients experienced barriers to effectively communicate with their healthcare provider and felt the need for supportive interventions. The 14 interviewed patients mentioned barriers and facilitators related to attributes of themselves (e.g. feeling sick, self-efficacy), the provider (e.g. taking patient seriously) and the healthcare system (e.g. time constraints).ConclusionsAlthough many elderly cancer patients feel confident, offering support to patients who feel less confident in communicating with their provider is recommended.Practice implicationsThe outcomes of this study can be used as a first step for developing interventions for elderly cancer patients to overcome communication barriers, and help providers to facilitate this process.     

Barriers and facilitators to implementing shared decision-making in clinical practice: Update of a systematic review of health professionals’ perceptions

ObjectiveTo update a systematic review on the barriers and facilitators to implementing shared decision-making in clinical practice as perceived by health professionals.MethodsFrom March to December 2006, PubMed, Embase, CINHAL, PsycINFO, and Dissertation Abstracts were searched. Studies were included if they reported on health professionals’ perceived barriers and facilitators to implementing shared decision-making in practice. Quality of the included studies was assessed. Content analysis was performed with a pre-established taxonomy.ResultsOut of 1130 titles, 10 new eligible studies were identified for a total of 38 included studies compared to 28 in the previous version. The vast majority of participants (n = 3231) were physicians (89%). The three most often reported barriers were: time constraints (22/38) and lack of applicability due to patient characteristics (18/38) and the clinical situation (16/38). The three most often reported facilitators were: provider motivation (23/38) and positive impact on the clinical process (16/38) and patient outcomes (16/38).ConclusionThis systematic review update confirms the results of the original review.Practice implicationsInterventions to foster implementation of shared decision-making in clinical practice will need to address a range of factors.     

The influence of mobile health applications on patient - healthcare provider relationships: A systematic,narrative review

ObjectiveTo explore the influence of mobile health applications on various dimensions of patient and healthcare provider relationships.MethodsA systematic, narrative review of English literature reporting experiences and outcomes of using mobile health applications was performed, evaluating communication and relationships between patients and healthcare professionals. Findings were framed thematically within the four dimensions of relationship-centred care. The methodological quality of included articles was appraised.ResultsThirty-seven articles were included, all of them meeting tenets of relationship-centred care. After adopting mobile health applications patients perceived an overall positive impact on their relationship with healthcare providers, indicating they are ready to transition from traditional clinical ecounters to a different modality. Use of the applications supported patients in assuming active roles in the management of their health in collaboration with health professionals. Reluctance of providers to using mobile health needs to be acknowledged and addressed when encouraging wider use of applications in clinical practice.ConclusionThe use of mobile health applications can influence communication and relationships between patients and providers positively, facilitating relationship-centered healthcare.Practice implicationImplementation of mobile health can support patients’ self-efficacy, improve access to healthcare services and improve relationships between patients and providers in ambulatory and hospital settings.     

An integrative review of stakeholder views on Advance Care Directives (ACD): Barriers and facilitators to initiation,documentation, storage,and implementation

ObjectiveTo examine the views and experiences of patients and their health care providers on developing advance care planning (ACP) and advance care directives (ACD); and determine barriers and facilitators to ACD development, storage, and use, including implications for people with communication disability.MethodAn integrative review of 93 studies, analysed according to their content themes.ResultsContent themes encapsulated the initiation, documentation, and implementation stages of ACP/ACD. Lack of guidance for initiating and supporting ACP/ACD impedes discussions, and both patients and healthcare providers avoid discussions owing to fear of dying and reluctance to think about end-of-life.ConclusionsThere are several barriers and facilitators to the initiation of ACP discussions, documentation and implementation of ACD, and little research exploring the views of legal professionals on the development, storage, or use of ACP documents. Further research is needed to explore the timing and responsibility of both legal and health professionals in initiating and supporting ACP discussions.Practice ImplicationsIt is important for healthcare providers to raise ACP discussions regularly so that patients have time to make informed advance care decisions. Storage of the document in an electronic health record might facilitate better access to and implementation of patients’ end-of-life care decisions.     

Implementation of complementary interventions in the Netherlands: Experiences of pioneers

ObjectiveAlthough many Dutch patients desire integration of complementary interventions in conventional healthcare, implementation is in its infancy in the Netherlands. The objective of this study was to describe the implementation process of complementary interventions in Dutch healthcare organizations.MethodsData in this qualitative study were collected in two steps: by questionnaires and by interviews. In five organizations the project leader and a professional who provides the interventions participated in the study.ResultsMain facilitators for implementation are: enthusiasm and support of colleagues; appreciation of patients; effectiveness of the interventions; positive publications in media; possibility to link the project to objectives of the organization; and accessibility of the interventions. Main barriers for implementation are: ignorance and skepticism of professionals; lack of research; lack of budget; lack of integration of the interventions in daily practice. Participants developed strategies to overcome barriers and to exploit facilitators.ConclusionProfessionals play a leading role in the implementation of complementary interventions in Dutch healthcare organizations. They use several methods to deal with facilitators and barriers.Practice implicationsOrganizations and professionals that aim to implement complementary interventions in their service may learn from experiences of pioneer organizations.     

Barriers and facilitators to discussing HPV with head and neck cancer patients: A qualitative study using the theoretical domains framework

ObjectiveThe incidence of human papillomavirus-associated head and neck cancers (HPV-HNC) is increasing worldwide. Research in other clinical contexts has shown that healthcare professionals (HCPs) can find discussing HPV with patients challenging. However, limited research has been conducted in HNC. This study aimed to investigate barriers and facilitators to, discussing HPV among HCPs caring for patients with HNC in Ireland.MethodsSemi-structured telephone/face-to-face interviews were conducted with HCPs. Barriers and facilitators to discussing HPV with patients were identified using the Theoretical Domains Framework (TDF).Results20 HCPs (8 clinicians, 3 nurses, 9 allied healthcare professionals) were interviewed. Barriers to discussing HPV included professionals' lack of HPV knowledge, difficulties in talking about sexual issues with patients and lack of privacy to discuss HPV in busy clinic settings. Facilitators included increasing public and patient awareness of the link between HPV and HNC and professional education and skills development.ConclusionsThis is the first theoretically informed study to identify barriers and facilitators to discussing HPV with HNC patients. HCPs consider HPV discussions to be an essential part of HNC patient care.Practice implicationsUnderstanding the issues associated with patient-provider HPV communication will help develop effective interventions to support HCPs in their HPV discussions.     

Building ground for didactics in a patient decision aid for hip osteoarthritis. Exploring patient-related barriers and facilitators towards shared decision-making

ObjectiveThe aim of the present study was to explore patient-related barriers and facilitators towards shared decision-making (SDM) during routine orthopedic outpatient consultations as part of the process of developing a patient decision aid (PDA) for patients with hip osteoarthritis (OA).MethodsConsultations comprising nineteen hip OA patients referred to an orthopedic surgeon for treatment decision-making were observed, audio recorded and transcribed. Iterative thematic analysis proceeded, based on a taxonomy of generic patient-related barriers towards SDM grounded in the Theory of Planned Behavior (TPB).ResultsA targeted taxonomy provided a structured overview of 26 factors influencing hip OA patients’ intention to engage in SDM. Patients’ perceived ability to change the agenda of the visit emerged as seminal factor and was added to the generic taxonomy.ConclusionUsing a TPB-based taxonomy, we were able to identify and structure generic and context specific SDM barriers. Addressing patients’ communication self-efficacy should be included as didactic feature in PDAs.Practice implicationsPDAs for hip OA should be designed for the broad spectrum of decision-making support needs occurring throughout the continuum of the disease. The provided taxonomy may contribute as guidance within implementation strategies that aim to support patients’ intentions to engage in SDM.     

Patient coaching in specialist consultations. Which patients are interested in a coach and what communication barriers do they perceive?

ObjectiveTo characterize patients interested in support by a patient coach to guide them in medical specialist consultations.MethodsWe compared 76 patients interested in a patient coach with 381 patients without such an interest, using a representative panel of patients with a chronic disease in the Netherlands. Independent variables were demographic factors, socio-economic status, perceived efficacy in patient-provider interaction, communication barriers, health literacy, (duration and type of) disease(s) and activation level.ResultsIn univariate analyses, patients who are interested in a coach were significantly older, had lower health literacy skills and less self-efficacy and, overall, experienced more communication barriers (>4), than patients without such interest (1–2 barriers). Multivariate analyses indicated three communications barriers as determinants of patient interest in a coach: feeling tense, uncertainty about own understanding, and believing that a certain topic is not part of a healthcare providers’ task.ConclusionPatients interested in a coach perceive specific barriers in communicating with their medical specialist. In addition, patients who are > = 65 years, have lower health literacy and low self-efficacy may have interest in a coach.Practice implicationsCharacterizing patients interested in a patient coach facilitates identification of those who could benefit from such a coach in clinical practice.     

Sustained resiliency building and burnout reduction for healthcare professionals via organizational sponsored mindfulness programming

PurposeTo measure healthcare professional (HCP) result sustainability following implementation of an organizationally sponsored Mindfulness Based Intervention (MBI), Mindfulness in Motion (MIM), in areas of burnout, perceived stress, resilience, and work engagement.MethodsA follow-up survey was sent via email to healthcare professionals (n = 220) who previously participated in the 8-week MIM intervention. Survey assessed burnout, perceived stress, resilience, work engagement, and included open-ended questions pertaining to barriers, facilitators, and sustained impact of practicing mindfulness after program end.ResultsAnalysis included 66 healthcare professionals with sustainability time frames ranging from 3 to 28 months from initial program finish. Average time since intervention end was 12.2 months. Based on 12.2 months sustained results post MIM, there were significant differences from pre-MIM to sustainability follow-up in burnout (*p = 0.0047), perceived stress (*p = 0.00001), and resilience (*p = 0.0004). Work engagement benefits were non-significant from pre-test to follow-up (p = 0.4008). There were no significant differences in results when comparing the length of time since participant was enrolled in the initial study. Additionally, analysis of the qualitative data revealed multiple subthemes relating to facilitators of sustained mindfulness, barriers to practicing mindfulness, and lasting impacts of the MIM intervention.ConclusionsFor Healthcare Professionals, the organizationally sponsored mindfulness intervention outcomes were sustained beyond the 8-weeks of the initial MIM intervention for all but one outcome variable. Post 8–week intervention end, participants were given the option of receiving weekly “Mindful Moment” emails and attending monthly mindfulness booster sessions. Organizational support may be a pivotal factor in sustaining positive results achieved via mindfulness programming.     

Examining individuals’ adoption of healthcare wearable devices: An empirical study from privacy calculus perspective

BackgroundWearable technology has shown the potential of improving healthcare efficiency and reducing healthcare cost. Different from pioneering studies on healthcare wearable devices from technical perspective, this paper explores the predictors of individuals’ adoption of healthcare wearable devices. Considering the importance of individuals’ privacy perceptions in healthcare wearable devices adoption, this study proposes a model based on the privacy calculus theory to investigate how individuals adopt healthcare wearable devices.MethodThe proposed conceptual model was empirically tested by using data collected from a survey. The sample covers 333 actual users of healthcare wearable devices. Structural equation modeling (SEM) method was employed to estimate the significance of the path coefficients.ResultsThis study reveals several main findings: (1) individuals’ decisions to adopt healthcare wearable devices are determined by their risk–benefit analyses (refer to privacy calculus). In short, if an individual’s perceived benefit is higher than perceived privacy risk, s/he is more likely to adopt the device. Otherwise, the device would not be adopted; (2) individuals’ perceived privacy risk is formed by health information sensitivity, personal innovativeness, legislative protection, and perceived prestige; and (3) individuals’ perceived benefit is determined by perceived informativeness and functional congruence. The theoretical and practical implications, limitations, and future research directions are then discussed.     

Older adults: Are they ready to adopt health-related ICT?

BackgroundThe proportion of older adults in the population is steadily increasing, causing healthcare costs to rise dramatically. This situation calls for the implementation of health-related information and communication technologies (ICT) to assist in providing more cost-effective healthcare to the elderly. In order for such a measure to succeed, older adults must be prepared to adopt these technologies. Prior research shows, however, that this population lags behind in ICT adoption, although some believe that this is a temporary phenomenon that will soon change.ObjectivesTo assess use by older adults of technology in general and ICT in particular, in order to evaluate their readiness to adopt health-related ICT.MethodWe employed the questionnaire used by Selwyn et al. in 2000 in the UK, as well as a survey instrument used by Morris and Venkatesh, to examine the validity of the theory of planned behavior (TPB) in the context of computer use by older employees. 123 respondents answered the questions via face-to-face interviews, 63 from the US and 60 from Israel. SPSS 17.0 was used for the data analysis.ResultsThe results show that although there has been some increase in adoption of modern technologies, including ICT, most of the barriers found by Selwyn et al. are still valid. ICT use was determined by accessibility of computers and support and by age, marital status, education, and health. Health, however, was found to moderate the effect of age, healthier older people being far more likely to use computers than their unhealthy coevals. The TPB was only partially supported, since only perceived behavioral control (PBC) emerged as significantly affecting intention to use a computer, while age, contrary to the findings of Morris and Venkatesh, interacted differently for Americans and Israelis. The main reason for non-use was ‘no interest’ or ‘no need’, similar to findings from data collected in 2000.ConclusionsAdoption of technology by older adults is still limited, though it has increased as compared with results of the previous study. Modern technologies have been adopted (albeit selectively) by older users, who were presumably strongly motivated by perceived usefulness. Particularly worrying are the effects of health, PBC, and the fact that many older adults do not share the perception that ICT can significantly improve their quality of life. We therefore maintain that older adults are not yet ready to adopt health-related ICT. Health-related ICT for the elderly should be kept simple and demonstrate substantial benefits, and special attention should be paid to training and support and to specific personal and cultural characteristics. These are mandatory conditions for adoption by potential unhealthy and older consumers.     

Predictive factors of telemedicine service acceptance and behavioral intention of physicians

PurposeDespite the proliferation of telemedicine technology, telemedicine service acceptance has been slow in actual healthcare settings. The purpose of this research is to develop a theoretical model for explaining the predictive factors influencing physicians’ willingness to use telemedicine technology to provide healthcare services.MethodsWe developed the Telemedicine Service Acceptance model based on the technology acceptance model (TAM) with the inclusion of three predictive constructs from the previously published telemedicine literature: (1) accessibility of medical records and of patients as clinical factors, (2) self-efficacy as an individual factor and (3) perceived incentives as regulatory factors. A survey was conducted, and structural equation modeling was applied to evaluate the empirical validity of the model and causal relationships within the model using the data collected from 183 physicians.ResultsOur results confirmed the validity of the original TAM constructs: the perceived usefulness of telemedicine directly impacted the behavioral intention to use it, and the perceived ease of use directly impacted both the perceived usefulness and the behavioral intention to use it. In addition, new predictive constructs were found to have ramifications on TAM variables: the accessibility of medical records and of patients directly impacted the perceived usefulness of telemedicine, self-efficacy had a significant positive effect on both the perceived ease of use and the perceived usefulness of telemedicine, and perceived incentives were found to be important with respect to the intention to use telemedicine technology.ConclusionsThis study demonstrated that the Telemedicine Service Acceptance model was feasible and could explain the acceptance of telemedicine services by physicians. These results identified important factors for increasing the involvement of physicians in telemedicine practice.     

Oncology healthcare professionals’ knowledge,attitudes, and practices regarding young carers

ObjectiveIncreasing numbers of youths are facing a relative’s cancer. In this context, some are required to provide significant support and are called young carers (YCs). However, little is known about how these youth are viewed and supported by health professionals. The aim of this study was to investigate the knowledge, attitudes, and practices of oncology healthcare professionals regarding YCs.MethodsThirty-one oncology professionals working in France (adult and pediatric departments and homecare services) participated in semi-structured interviews.ResultsThe results indicated that almost all professionals had already met a YC and could identify several situations in their professional context. Their knowledge of YCs appeared to influence their attitudes and practices. They perceived this situation in a rather superficial way when their discourse and ideas were explored in-depth. They mentioned some ideas for improving support for YCs, but also many barriers.ConclusionThe results highlight a moderate level of awareness. Thus, it is necessary to enhance providers’ awareness and knowledge of YCs.Practice implicationsAwareness campaigns and training programs need to be developed for oncology healthcare professionals to help them better identify, understand, and support YCs and their families. This type of action would positively impact patient care.     

Definitions and use of the teach-back method in healthcare consultations with patients: A systematic review and thematic synthesis

ObjectiveTo review and synthesise definitions of the teach-back method in the literature. The second aim is to synthesise the barriers, facilitators and perceptions of teach-back use in healthcare consultations with patients.MethodsA systematic review and thematic synthesis following Braun and Clarke’s method.ResultsThe primary search found 1429 citations and the secondary search added 221 citations. Screening identified 66 citations eligible for data extraction. We contrasted and synthesised operational definitions of the teach-back method. The synthesis generated seven themes related to healthcare provider (HCP) and patient perceptions of teach-back (effectiveness, stigma and time-related perceptions), the universal application of teach-back, patient health outcomes and healthcare provider training.DiscussionOperational definitions of the teach-back method varied in the literature and contained implied steps. HCPs and patient perceptions of teach-back operated as both enablers and barriers to its use. HCPs training programs for the teach-back method were identified as beneficial for altering HCPs perceptions about the method and increased its use with patients.Practice implicationsStandardising operational definitions of the teach-back method can support replicability of research and enhance HCPs communication skills training programs. HCPs training on teach-back use can support the increased use of the technique with broader patient populations.     

Comparison of the middle-aged and older users’ adoption of mobile health services in China

ObjectiveGiven the increasing number of older people, China has become an aging society. A mobile health service is a type of health informatics that provides personalized healthcare advice to those who require it, especially the older people and the middle-aged. However, few studies consider the adoption of mobile health services with regard to older and middle-aged users. This paper explored a research model based on the value attitude behavior model, theory of planned behavior, and four aging characteristic constructs to investigate how older and middle-aged citizens adopted mobile health services.MethodThe hypothesized model was empirically tested using data collected from a survey of 424 residents older than 40 years in China. Structural equation modeling was used to estimate the significance of the path coefficients.ResultsThe findings revealed that (1) perceived value, attitude, perceived behavior control, and resistance to change can be used to predict intention to use mobile health services for the middle-aged group; (2) perceived value, attitude, perceived behavior control, technology anxiety, and self-actualization need positively affected the behavior intention of older users; and (3) subjective norm and perceived physical condition showed no significant effects on the behavior intention to use mobile health services for the two groups. The theoretical and practical implications and contributions of this study are then discussed.     

Continuance compliance of privacy policy of electronic medical records: the roles of both motivation and habit

Background

Hospitals have increasingly realized that wholesale adoption of electronic medical records (EMR) may introduce differential tangible/intangible benefits to them, including improved quality-of-care, reduced medical errors, reduced costs, and allowable instant access to relevant patient information by healthcare professionals without the limitations of time/space. However, an increased reliance on EMR has also led to a corresponding increase in the negative impact exerted via EMR breaches possibly leading to unexpected damage for both hospitals and patients. This study investigated the possible antecedents that will influence hospital employees’ continuance compliance with privacy policy of Electronic Medical Records (EMR). This is done from both motivational and habitual perspectives; specifically, we investigated the mediating role of habit between motivation and continuance compliance intention with EMR privacy policy.

Methods

Data was collected from a large Taiwanese medical center by means of survey methodology. A total of 312 responses comprised of various groups of healthcare professionals was collected and analyzed via structural equation modeling.

Results

The results demonstrated that self-efficacy, perceived usefulness, and facilitating conditions may significantly predict hospital employees’ compliance habit formation, whereas habit may significantly predict hospital employees’ intention to continuance adherence to EMR privacy policy. Further, habit partially mediates the relationships between self-efficacy, perceived usefulness, facilitating conditions and continuance adherence intention.

Conclusions

Based on our findings, the study suggests that healthcare facilities should take measures to promote their employees’ habitualization with continuous efforts to protect EMR privacy parameters. Plausible strategies include improving employees’ levels of self-efficacy, publicizing the effectiveness of on-going privacy policy, and creating a positive habit-conducive environment leading to continued compliance behaviors.

     

The impact of clinical leadership on health information technology adoption: Systematic review

PurposeTo conduct a systematic review to examine evidence of associations between clinical leadership and successful information technology (IT) adoption in healthcare organisations.MethodsWe searched Medline, Embase, Cinahl, and Business Source Premier for articles published between January 2000 to May 2013 with keywords and subject terms related to: (1) the setting – healthcare provider organisations; (2) the technology – health information technology; (3) the process – adoption; and (4) the intervention – leadership. We identified 3121 unique citations, of which 32 met our criteria and were included in the review. Data extracted from the included studies were assessed in light of two frameworks: Bassellier et al.’s IT competence framework; and Avgar et al.’s health IT adoption framework.ResultsThe results demonstrate important associations between the attributes of clinical leaders and IT adoption. Clinical leaders who have technical informatics skills and prior experience with IT project management are likely to develop a vision that comprises a long-term commitment to the use of IT. Leaders who possess such a vision believe in the value of IT, are motivated to adopt it, and can maintain confidence and stability through the adversities that IT adoptions often entail. This leads to proactive leadership behaviours and partnerships with IT professionals that are associated with successful organisational and clinical outcomes.ConclusionsThis review provides evidence that clinical leaders can positively contribute to successful IT adoption in healthcare organisations. Clinical leaders who aim for improvements in the processes and quality of care should cultivate the necessary IT competencies, establish mutual partnerships with IT professionals, and execute proactive IT behaviours to achieve successful IT adoption.