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


Boonstra and Broekhuis BMC Health Services Research 2010 10:231   doi:10.1186/1472-6963-10-231

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