Table 2 Summary of determinants influencing the actual utilization of HTs

Financial support and adequate budgeting

Hospital financial resources hinders actual utilization

[22,23,24,25,26,27, 35, 36, 39,40,41, 45, 48, 54, 55]

High cost technologies force the hospital to consider other priorities

[48]

Financial difficulties impact on recruiting and retaining technical staff

[41, 48]

Reimbursement policies might facilitate HT utilization

[53, 54]

Financial self-sufficiency represents a necessary condition

[34]

Funding model for specialist clinician reimbursement facilitates HT utilization

[53]

Leadership

Leadership enables to:

-shorten the gap between implementation team and end users

[52]

-overcome resistance to change

[48]

-ameliorate understanding of HT and tasks

[27]

-involve end users in the decision-making process

[24, 27, 34, 37, 44, 49]

-positively influence attitude toward new HTs

[29, 34, 44, 53]

-adapt the HT integration to the needs of the work environment

[34, 41]

Champions and top opinion leaders drive the integration

[45]

Champions facilitate communication and team work

[54, 25]

Human Resources Management

Human Resources Management enables to:

- define and resource new roles capable of supporting and sustaining the change

[34, 37, 41, 44, 54]

- appropriately manage staff recruitment preventing staff shortages and contractual tensions

[26, 27, 31, 33, 34, 38, 39, 48, 51]

- ensure appropriate training to end users

[24, 32, 33, 37, 38, 38, 41, 44, 49, 51, 52]

- take into account concerns about time-consuming training

[39, 49, 36]

- address concerns about new HT (e.g. changes to workload, workflow)

- improve cooperation and team working

[22, 26, 31, 36, 44, 47, 51, 34, 44, 48, 53, 54]

Structure

Technological capability is a latent process that enables HT utilization

[23, 28, 33, 34, 36, 42, 43, 46, 50,51,52, 54]

Large size and urban location might positively influence utilization

[42, 23]

Teaching hospitals might be positively associated with utilization

[43]