Barriers to Telemedicine Establishment in Iran: A Systematic Review

Background: Despite the implementation of some experimental and temporary telemedicine projects in Iran in recent years, it has not been deployed in formal healthcare services. The first step in establishment of this technology in health system is identification of barriers of this area. Therefore, this study aimed to identify the barriers to telemedicine establishment in Iran health system. Methods: A systematic review was conducted according to PRISMA guidelines. Searches were conducted in PubMed, Web of Sciences, Scopus, Cochrane Library, Iranmedex, Magiran, SID and Google Scholar. The inclusion criteria were studies that reported barriers to telemedicine in Iran, non-review studies, published studies in English and Persian between Nov 22, 2010 and Mar 20, 2022. Data were analyzed using narrative synthesis and deductive-inductive thematic analysis and the World Health Organization building blocks framework was used in this regard. Results: Out of 1148 studies identified, 21 studies met the inclusion criteria for review. The findings fell into four themes, including governance/leadership, financing, health workers, and health information system besides 11 sub-themes. No specific findings were derived from the building blocks of service delivery and medical product, vaccines and technologies. Conclusion: Governance is an integral part of other building blocks of the health systems. Hence, overcoming the barriers in this field can be prioritized. Therefore, ensuring the existence of strategic policy frameworks along with some other factors such as effective supervision, coalition building, laws and regulations, and community participation can be the first solutions for establishment of telemedicine in Iran.