| Scantlebury et al.28 | 2017 | Poor staff understanding of rationale and benefits |
| Poor system integration |
| Parallel paper systems |
| Chan et al.11 | 2016 | Physician cooperation |
| Costs of maintenance and upgrades |
| Workflow changes |
| Harle et al.27 | 2016 | Lack of recognition of clinical benefit |
| Chan et al.11 | 2016 | Obtaining physician cooperation |
| Costs of maintenance and upgrades |
| McAlearney et al.12 | 2015 | Workflow and practice changes |
| Shifts in expertise |
| Patient interaction changes |
| Training and education issues |
| Clarke et al.10 | 2015 | Ensuring adequate clinician involvement limited financial and human resources |
| McAlearney et al.12 | 2013 | Poor staff IT skills |
| Resistance to workflow changes |
| Terry et al.22 | 2012 | Poor staff training for system use |
| Inadequate interoperability |
| Cresswell et al.18 | 2011 | Poor user consultation |
| Inadequate customisation |
| McAlearney et al.16 | 2010 | Resources |
| Ongoing system support |
| User interface |
| Regulatory compliance |
| Jensen et al.25 | 2009 | Data reliability |
| Samoutis et al.20 | 2007 | Staff ability to use technology |
| Wibe et al.21 | 2006 | Staff training resource |
| Crosson et al.17 | 2005 | Poor communication |
| Scott et al.19 | 2005 | Poor usability |
| Retchin et al.15 | 1999 | Lack of integration, security issues, providers who were inflexible and prohibitive purchase cost |