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A comprehensive overview of barriers and strategies for AI implementation in healthcare: Mixed-method design
Halmstad University, School of Health and Welfare.ORCID iD: 0000-0001-7610-0954
Halmstad University, School of Health and Welfare.ORCID iD: 0000-0003-4438-6673
Halmstad University, School of Health and Welfare.ORCID iD: 0000-0002-4341-660X
Halmstad University, School of Health and Welfare.ORCID iD: 0000-0002-3576-2393
2024 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 19, no 8, article id e0305949Article, review/survey (Refereed) Published
Abstract [en]

Implementation of artificial intelligence systems for healthcare is challenging. Understanding the barriers and implementation strategies can impact their adoption and allows for better anticipation and planning. This study’s objective was to create a detailed inventory of barriers to and strategies for AI implementation in healthcare to support advancements in methods and implementation processes in healthcare. A sequential explanatory mixed method design was used. Firstly, scoping reviews and systematic literature reviews were identified using PubMed. Selected studies included empirical cases of AI implementation and use in clinical practice. As the reviews were deemed insufficient to fulfil the aim of the study, data collection shifted to the primary studies included in those reviews. The primary studies were screened by title and abstract, and thereafter read in full text. Then, data on barriers to and strategies for AI implementation were extracted from the included articles, thematically coded by inductive analysis, and summarized. Subsequently, a direct qualitative content analysis of 69 interviews with healthcare leaders and healthcare professionals confirmed and added results from the literature review. Thirty-eight empirical cases from the six identified scoping and literature reviews met the inclusion and exclusion criteria. Barriers to and strategies for AI implementation were grouped under three phases of implementation (planning, implementing, and sustaining the use) and were categorized into eleven concepts; Leadership, Buy-in, Change management, Engagement, Workflow, Finance and human resources, Legal, Training, Data, Evaluation and monitoring, Maintenance. Ethics emerged as a twelfth concept through qualitative analysis of the interviews. This study illustrates the inherent challenges and useful strategies in implementing AI in healthcare practice. Future research should explore various aspects of leadership, collaboration and contracts among key stakeholders, legal strategies surrounding clinicians’ liability, solutions to ethical dilemmas, infrastructure for efficient integration of AI in workflows, and define decision points in the implementation process. Copyright: © 2024 Nair et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Place, publisher, year, edition, pages
San Francisco, CA: Public Library of Science (PLoS), 2024. Vol. 19, no 8, article id e0305949
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health Innovation, IDC
Identifiers
URN: urn:nbn:se:hh:diva-54491DOI: 10.1371/journal.pone.0305949ISI: 001288771300011PubMedID: 39121051Scopus ID: 2-s2.0-85201062305OAI: oai:DiVA.org:hh-54491DiVA, id: diva2:1892323
Funder
Knowledge FoundationVinnova
Note

This research is included in the CAISR Health research profile.

Available from: 2024-08-26 Created: 2024-08-26 Last updated: 2024-12-03Bibliographically approved

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Nair, MonikaSvedberg, PetraLarsson, IngridNygren, Jens M.

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