Existing practices within the organization can significantly promote the adoption of new systems. Key factors that enhance the personnel’s readiness for change include openness [43], encouragement [44], providing safe space for expressing concerns [44], and proactively addressing issues [45]. If the organization learns through negotiation and interaction [465], it is more capable of implementing changes. Centralized coordination and standardization functions [46], implementation practices [47], and decision-making capability [48] within the organization are also important. Change is facilitated if the organization is built around integrated processes that evolve with changes [49] and if these processes are monitored and adjusted when necessary [50]. IT governance reform [48] should be considered as market-driven solution development [46] emerging as a driving factor. The use of a same brand [51] can promote the implementation of ISs in large entities. In extreme cases, personnel can be mandated to use the system [52].

Training of the personnel and end users was highlighted in 8 studies [44,51-57]. Training should occur before the implementation of the ISs, but postimplementation training and guidance should also be emphasized. In addition to training, participation was noted in 6 studies in the dataset [43,52,55,58-60]. All stakeholders, including frontline professionals [58], should be involved from the very beginning.

Attitudinal factors can manifest within the organization as a whole and among its members. In health care, there is a noticeable sense of moral and ethical obligation among professionals to promote change [59], particularly among those in leadership roles. A positive attitude toward innovation [43] and determined efforts [51] supports the change. The organization’s ability to create space for creativity [43], agility, and communication along with confidence in the success of the change [59] eases the process.

Key aspects of development include good software designing [61] and its feasibility [46], implementation strategy [61], testing and validation practices [55,61], and the sensitivity of software developers to the client’s need [61]. Innovative solutions are more likely to emerge through local development [46], but it is crucial that solutions also pass pre-established quality gates [53].

ISs possess various features that either drive or restrain their implementation. The most significant driving factor is solution that support workflows [50,55,57,62]. Other factors include the system’s observability [54], interoperability [55], and compatibility [54]. The more the system is used, the more likely the usage will increase [56]. The IS must also fit within the organizational culture [53]. When the IS is perceived to provide more relative benefits, it further drives its adoption [54].

Ease of use was identified as a driving factor in 4 studies [50,56,58,62]. Usability of the IS was discussed in 2 studies [47,55]. It is essential that needed information must be accessible [62] and the system is available for user testing [54]. Perceived usefulness [55,56,58] and even forecasts of positive impacts [56] are considered driving factors. It is crucial that the IS has the potential to enhance aspects such as the quality of care [45] and it supports professionals in performing their tasks [63].

In the context of implementing ISs in public sector organization, management involves leadership activities, communication skills, continuous assessment, and collaboration. In terms of communication, the involvement of individuals in leadership positions emerged as significant factor [43,59]. At a more detailed level, it is essential for management to convey expectations [50] and objectives [60] related to the change. Ensuring that the organization’s vision is clearly understood in the context of the change is important [64]. Expectations are placed on leaders’ communication, as listening to concerns and doubts [55,60], thereby fostering greater understanding [59]. Managers must be able to address questions regarding changes [59] and be capable of negotiating potential tensions [65]. They should also possess the capability to motivate users [58].

Overall, leadership and change management were highlighted in 3 studies [44,52,55]. Those in leadership positions must ensure the success of the change process [60] and have confidence in the success of the change [65]. The alignment of differing perspectives [64] and the involvement of leaders [48] are also seen as driving factors. Notably, Fennelly et al [55] observed that successful implementation is more likely when the change is not managed directly by top leadership as otherwise the data emphasized the importance of active leadership engagement.

When leading the change, management should focus on preventing the consolidation of the conflicting views [64] and addressing any ambiguities or issues [60] to promote the acceptance of innovations. Managing the change process [58] and monitoring potential performance deficiencies [49] are key factors in implementation process. Management must be able to develop and communicate context-specific goals [58] for the change. Although it was previously noted that change should not be directly led by top management, a collaborative IT group led by management can promote the IS change [49].

At the beginning, it is essential to secure resources [55] and ensure clear roles and responsibilities [48,55]. A project team must be established [52] and the supporting structures for the change processes addressed [66]. Further driving factors include stakeholder involvement from the perspective of the change project [66] and the early engagement of various stakeholders [45]. Maintaining strong and trustworthy relationships with software vendors and consulting firms is critical [55]. In early stages of the change project, attention should be paid to the implementation strategy [55], as well as to the practices for adoption that will arise in later phases of the process [43].

During the implementation phase, the importance of the project management team and governance [55] becomes important. A well-planned implementation process [55] supports the change management of the project [50]. Establishing a command center for the adoption phase [48], involving operational-level leadership roles [55], facilitates the actual system rollout. The change project must have clear and measurable goals from a monitoring perspective [55]. Strong communication practices are essential to promoting the desired practical implementation [46].

Regarding user characteristics, a high level of education [56], technological proficiency [62], and overall competence [53] are identified as factors that drives the adoption of the IS. In addition, the motivation [44], commitment [44], and efforts [65] of end users are critical. In 1 study, being female was also identified as a driving factor [56].

Institutional factors refer to government guidance and external elements that influence the organizational environment. They are essential factors from the perspective of public sector organizations. National strategies [51] and standards [55] guide the development of the social and health care sectors. Legislative changes [51] and regulations [67] can support or accelerate system reforms within organizations. Government oversight [52] and political factors [67] are also driving forces.

Concerns related to personnel and the work environment include various issues as the loss of professional identity, patient safety, reduced visibility of work and workforce retention, which negatively impact change processes related to ISs [44]. There are concerns about the possibility of professional expertise being replaced by technology or technology being designed for management rather than professionals [63]. There may be difficulties in harmonizing different interpretations of the technology within the organization [64]. Professionals are worried about potentially having less time with patients [44], compromising core values [63] and experiencing general fear [60]. The reluctance of personnel to adopt new systems [52] and resistance to change [54] are barriers that may be related to a lack of incentive systems [49]. Poor job satisfaction [44] and experienced stress among personnel [60] can restrain the change process and may trigger a wave of resignations due to the reform or stress it brings [66].

Factors restraining change also include phenomena related to the direction of the organization concerning the transformation. There may be active resistance to change within the organization, with a lack of belief in improvements as well as concerns about successful implementation [59]. In addition, there may be covert resistance [67] to change. If there is a sense of being an outsider in the organization concerning the development and planning of ISs [44], the reform is likely to face opposition. The organization’s inadequate learning capacity [49], especially the lack of administrative learning [46], restrain the change process. Factors restraining the direction of the reform within the organization may involve viewing technology as a limiting factor [63] or simply a lack of information [57]. External factors include a heavy reliance on partners or their lack of commitment to common changes, both of which can be obstructive factors [54].

As its worst, organizational culture can inherently restrain change [47]. Passive resistance and indifference embedded in its structures may surface during cycles of change [59]. The lack of a shared vision [49] and collaboration [53] are factors that inhibit change as well as a lack of trust between organizations [49]. Insufficient communication and tensions within the organization negatively impact not only the organization itself but also the implementation of change and ISs [64]. Hidden power dynamics [67], inappropriate behavior [60], and problems in social interactions [48] are restraining factors.

The complexity of the technology being implemented was identified as a restraining factor in 4 studies [46,50,53,54]. Another technological barrier may arise when software developers do not operate in the same environment where the software and tools are used [61]. If ISs are developed with a tool-centric rather than a user-centric approach [55], issues such as system underutilization [52], may occur. Technical problems [57], system downtime [44], and slow performance [44] can delay the stabilization of change. Technology can impose limitations [54] and cause workflow issues [48], which may lead to the adoption of undesirable practices [63]. Delays in transferring data from the old system to the new one [52] and the complete absence of data [44] do not support the wanted change.

In terms of user experience, the inflexibility of the system was highlighted in 2 studies [50,53]. Concerns related to the reform of ISs include issues regarding data protection, information security, and the doctor-patient relationship [55]. The potential narrowing of professional discretion [63] may be a concern for professionals. The lack of clinical efficiency and safety [65] affects the user experience. Negative previous experiences of professionals [54] influence their attitudes toward changes.

Cost factors related to ISs were identified in 2 studies [48,53]. In an ever-changing operational environment, costs can easily escalate [53]. The extensive need for customization [53] and the requirement for unique system adjustments [48] increase costs when using so called off-the-self-software. If the IS demands the use of specialized resources [53], this raises associated costs. High maintenance costs and inadequate support from the system provider to the organization are restraining factors [53].

Leadership must not leave strategic objectives vaguely defined [53]. A lack of communication regarding the vision [66], insufficient communication of the purpose [66], and inadequate presentation of goals [58] create significant obstacles to change. The lack of information [66] is one of the greatest challenges in transformations. Change initiatives may be deemed unsuccessful due to their scale [53]. If the upcoming implementation project is not adequately communicated to the personnel [59], the consequences may restrain the change.

The leader’s role is to be visible and committed to the change [66], as lack of responsibility [52] is unfavorable from the perspective of reform. It is also common for personnel to not be informed at all due to uncertainty [59], leading to feelings of abandonment among employees [66]. Challenges arise especially when management’s expectations for change conflict the values of the employees [66], such as with productivity expectations. In terms of collaboration, failure can occur in estimating the size of the project [53], often resulting in the project being larger than initially anticipated. Another identified barrier is the lack of close cooperation between clinical leadership and IT professionals [65].

Inadequate communication about the project’s tasks [48] provides an undesirable start to a change project. If the participation efforts of various stakeholders are not considered [59], this can increase resistance to change. Involving end users appropriately in the selection of the system [53] drives the implementation. Regarding the implementation process, the lack of transparency and improper execution [59] were identified as barriers. Poor planning [53], delays [53], and the inability to manage a centralized timeline [48] are challenges related to project planning and execution. Budget constraints and overruns [53] are restraining factors. As for supplier collaboration, inadequate screening of suppliers [53] and a nontransparent and nonopen relationship with the supplier can hinder the process.

End users experience concerns and fears about the impact of artificial intelligence, data privacy, and the replacement of humans by technology [45]. Among user characteristics, advanced age was identified as a restraining factor [56]. In terms of attitudes, user frustration [44] and general resistance to acceptance [57] are also barriers.

As with driving factors, institutional barriers have been identified in only few studies, but they are included due to their significance. Legislative obstacles refer to factors such as data protection and security laws [46]. Regulatory factors [58] can restrain or delay IS reforms, especially in the public sector.