Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions

Table 2 Taxonomy of Barriers

Category		Barriers		References (Article No.)	References per category	References per barrier
A	Financial	1	High start-up costs	1/2/3/4/5/6/7/14/17/18/19/20	33	12
		2	High ongoing costs	1/2/3/4/6/7/14/17/18/19/20		11
		3	Uncertainty about Return on Investment (ROI)	2/3/4/5/17/18/20/22		8
		4	Lack of financial resources	19/21		2
B	Technical	1	Lack of computer skills of the physicians and/or the staff	1/3/6/9/15/16/19/20/21/22	41	10
		2	Lack of technical training and support	1/4/5/6/16/17/18/19/20		9
		3	Complexity of the system	3/5		2
		4	Limitation of the system	2/6		2
		5	Lack of Customizability	2/3/4/18/20		5
		6	Lack of Reliability	3/4/20		3
		7	Interconnectivity/Standardization	3/5/6/7/17/18/19/20		8
		8	Lack of computers/hardware	15/18		2
C	Time	1	Time to select, purchase and implement the system	1/3/16/19/27	28	5
		2	Time to learn the system	1/3/5/12/19/20/21		7
		3	Time to enter data	3/14/15/16/17/20		6
		4	More time per patient	3/5/6/8/15/16/17/20		8
		5	Time to convert the records	5/7		2
D	Psychological	1	Lack of belief in EMRs	1/18/20	5	3
		2	Need for control	10/18		2
E	Social	1	Uncertainty about the vendor	4/7/20	13	3
		2	Lack of support from external parties	6/7/18		3
		3	Interference with doctor-patient relationship	9/13/20		3
		4	Lack of support from other colleagues	4/18		2
		5	Lack of support from the management level	5/18		2
F	Legal	1	Privacy or security concerns	1/3/6/12/13/14/17/18/20/27	10	10
G	Organizational	1	Organizational size	4/5/6/11/12/22	8	6
		2	Organizational type	6/11		2
H	Change Process	1	Lack of support from organizational culture	4/15	8	2
		2	Lack of incentives	5/18		2
		3	Lack of participation	18		1
		4	Lack of leadership	5/18/21		3

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