Table 8 Examples of perceived barriers related to environmental factors

     -     Limited time available

          •     “In daily practice I can’t manage to create time for this. It just doesn’t fit in the regular consultation hours”.

     -     Too much additional work required

          •     “These systems, the way they’re currently introduced, just take too much time. And then I deliberately choose not to use them”.

          •     “It’s a lot of extra work! It has almost become a task of its own. With all the items you have to fill out”.

     -     Lack of integration with other systems

          •     “The alert screen should directly be linked to follow-up actions that need to be done! So, if you are to prescribe a statin, it should go directly to that screen. If you have to register blood pressure, you should be able to register it right there”.

     -     Fear of misuse of data by third parties

          •     “And then the healthcare inspectorate comes down to visit and asks: why didn’t you do this or that when there was an alert. It shouldn’t be used for this purpose!”.