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. 2014 Sep 30;2(2):e26. doi: 10.2196/medinform.3625

Table 2.

Barriers by the year published.

Barriers 2009 2010 2011 2012 2013 2014 Instances of the barrier
Cost 4 2, 10, 20 12, 13, 22, 23 27, 28, 29 32, 34, 37, 38
15 15%
Efficiency/workflow
10, 20 13, 23, 24 14, 26, 27, 30 33, 35, 37 39 13 13%
Lack of technical support/tech gap
2, 10, 19 12, 13, 21, 23, 24, 25 27, 29, 30, 31

13 13%
Impedes competition
2, 10 12, 13 14, 28 34, 36, 37, 38
10 10%
Value of HIE is difficult to measure
18 21, 22, 25 27, 28, 29, 30 32, 38
10 10%
Privacy/security concerns
2, 18 23 14, 26, 29, 31

7 7%
Clinical data missing when needed

12, 24, 25 26, 28 33
6 6%
Usability
10 12, 13
33 39 5 5%
Heavily dependent on leadership of the organization
2 21, 22
37
4 4%
Liability concerns
2 23 14, 26

4 4%
Lack of standards



33, 34, 36
3 3%
Physician resistance 4 20



2 2%
Misaligned incentives

13
32
2 2%
Decreases quality
20



1 1%
Increases error
20



1 1%
Lack of awareness



33
1 1%
# barriers (n=16) 2, 13% 12, 75% 11, 69% 8, 50% 10, 63% 2, 13% 97
# articles (n=28) 1, 4% 5, 18% 7, 25% 7, 25% 7, 25% 1, 4%