Table 4 Summary of findings of the important factors of implementation of technological interventions aimed at improving professional practice

What works

Type of intervention

Healthcare professional decision support

[10, 34, 38, 41, 57, 62, 65, 67, 69, 73, 74, 78, 80, 84, 88]

Reminders and alerts

[4, 8, 37, 47, 58, 64, 71]

BCTs

Instruction on how to perform the behaviour (BCTTv1 4.1)

[8, 10, 37,38,39,40, 47, 50, 57, 58, 64, 74, 78, 86]

For whom interventions work for

Target healthcare professional behaviour

Adherence to clinical guidelines for patient management

[38, 57, 58, 62, 64, 74, 78, 79, 88]

Prescribing behaviours

[10, 37, 40, 65,66,67, 73, 80, 81]

Increasing knowledge or self-efficacy / confidence

[34, 39, 86, 61]

Increasing screening / testing rates

[4, 8, 41, 47, 69, 71, 76]

Clinical intervention / management

[68, 80, 83, 84, 86]

Target healthcare professional

GPs

[4, 8, 10, 34, 37, 39, 40, 47, 64,65,66,67,68, 71, 73, 74, 84,85,86]

Multiple healthcare professionals (more than two different types of healthcare professional)

[37, 41, 47, 57, 62, 73, 74, 76, 79, 81]

Under what circumstances

Role of the healthcare professional

Increases confidence in decision making

[43, 96, 103]

Facilitator

Attitudes and perceptions towards technology important in terms of uptake and usage

[43, 99,100,101,102, 107]

Facilitator

Importance of endorsement from senior peers

[99, 104]

Facilitator

Engagement important factor for implementation

[95, 100, 104]

Facilitator

Assigning responsibility to using the system

[34, 100, 106]

Facilitator

Facilitator

Design, content and technical issues

Pilot testing - iterative modification to meet staff needs

[100, 101,104, 106, 108]

Facilitator

Insufficient access to IT resources

[34, 92, 99, 104]

Barrier

Physical location of computer

[94, 100, 106]

Barrier

Technical issues such as computer performance and software updates

[94, 95, 98, 100, 102, 104, 105, 108]

Barrier

Links to external patient information resources important

[92, 95, 99]

Facilitator

Links to patient guidelines must be readily available, consistent and relevant

[43, 97,98,99,100]

Facilitator

Usability and benefit for patient care

Provides access to important information relevant to the clinical encounter

[98, 99, 103, 109]

Facilitator

Technology / interface must not be difficult to use

[43, 93, 96, 97, 99, 104,105,106, 109]

Barrier

Technical training for staff

[34, 42, 99,100,101, 103,104,105, 107, 108]

Facilitator

Importance of a learning period / time for familiarisation of the technology

[95,96,97,98, 108]

Facilitator

Considers complexities of individual patients (for example patients with specific conditions, or comorbidities)

[42, 43, 97, 105]

Facilitator

Helps facilitate discussions with patients

[100, 102]

Facilitator

Practice and workload issues

Use of technology increases workload and may cause disruption

[34, 42, 97, 106]

Barrier

Time taken to use the system / requirement of additional staff members

[34, 93, 98–100]

Barrier

Improves communication between healthcare professionals

[92, 98, 103]

Facilitator

Must be easily integrated into day-to-day workload

[34, 43, 97, 106]

Facilitator

Technology aligns with current practice initiatives, and wider organisational context

[43, 92, 95, 98, 105, 108]

Facilitator