DefinePK

Abstract

Background: Despite the rapid global expansion of telemedicine, its effective integration into routine clinical practice in low- and middle-income countries like Pakistan remains limited. Multiple barriers hinder adoption at various levels, posing a challenge to sustainable digital health implementation.
Objective: To explore and understand the key challenges faced by healthcare workers in adopting telemedicine technologies, with an emphasis on identifying systemic, technological, organizational, and personal-level barriers in Pakistan’s clinical settings.
Methods: A qualitative study was conducted over eight months in public and private healthcare facilities across Lahore, Karachi, and Islamabad. A purposive sample of 34 healthcare professionals, including physicians, nurses, and allied health staff, was recruited. Data were collected through semi-structured, in-depth interviews. Thematic analysis was applied using Braun and Clarke’s framework with NVivo 12 software for data management. Ethical approval was obtained, and informed consent was ensured.
Results: Four primary themes emerged: systemic (policy ambiguity, inconsistent funding), technological (usability issues, lack of interoperability), organizational (insufficient training, weak administrative support), and personal (digital illiteracy, emotional resistance). Interconnected barriers revealed that infrastructural deficits and unclear institutional strategies often reinforced individual resistance and workflow disruption. Participant narratives emphasized the need for practical training and supportive leadership in fostering telemedicine acceptance.
Conclusion: This study underscores the multifactorial nature of barriers to telemedicine adoption in Pakistan. Practical implications include the urgent need for cohesive national policy, infrastructure enhancement, and provider-centric digital training to facilitate effective and sustained telemedicine integration.