Factors affecting front line staff acceptance of telehealth technologies: a mixed-method systematic review

J Adv Nurs. 2014 Jan;70(1):21-33. doi: 10.1111/jan.12196. Epub 2013 Jun 20.


Aim: To synthesize qualitative and quantitative evidence of front-line staff acceptance of the use of telehealth technologies for the management of Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.

Background: The implementation of telehealth at scale is a governmental priority in countries including the UK, USA and Canada, but little research has been conducted to analyse the impact of implementation on front-line nursing staff.

Data sources: Six relevant data bases were searched between 2000-2012.

Design: Mixed-method systematic review including all study designs.

Review methods: Centre for Reviews and Dissemination approach with thematic analysis and narrative synthesis of results.

Results: Fourteen studies met the review inclusion criteria; 2 quantitative surveys, 2 mixed-method studies and 10 using qualitative methods, including focus groups, interviews, document analysis and observations. Identified factors affecting staff acceptance centred on the negative impact of service change, staff-patient interaction, credibility and autonomy, and technical issues. Studies often contrasted staff and patient perspectives, and data about staff acceptance were collected as part of a wider study, rather than being the focus of data collection, meaning data about staff acceptance were limited.

Conclusion: If telehealth is to be implemented, studies indicate that the lack of acceptance of this new way of working may be a key barrier. However, recommendations have not moved beyond barrier identification to recognizing solutions that might be implemented by front-line staff. Such solutions are imperative if future roll-out of telehealth technologies is to be successfully achieved.

Keywords: attitudes; chronic obstructive; health services research; heart failure; pulmonary disease; systematic reviews and meta-analyses; technology.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Attitude of Health Personnel
  • Diffusion of Innovation
  • Education, Nursing, Continuing
  • Epidemiologic Methods
  • Heart Failure / nursing*
  • Humans
  • Interprofessional Relations
  • Nurse-Patient Relations
  • Nursing Staff / psychology*
  • Patient Safety
  • Professional Autonomy
  • Pulmonary Disease, Chronic Obstructive / nursing*
  • Risk Assessment
  • Social Support
  • Telenursing*