Analyzing and Ranking Barriers to the Adoption of Artificial Intelligence in the Iranian Healthcare Industry: An Approach Based on Interpretive Structural Modeling
Subject Areas : Multimedia Processing, Communications Systems, Intelligent SystemsSolmaz Hashemi 1 , Arash Zaretalab 2
1 - Department of Business Management, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran.
2 - Department of Business Management, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
Keywords: Artificial intelligence, healthcare sector, Interpretive structural modeling,
Abstract :
Introduction: Recent decades have seen a tremendous growth in the capabilities and applications of artificial intelligence. Healthcare is one of the many industries that will apparently experience significant changes in the coming years. Healthcare practitioners and stakeholders in both the private and public sectors are striving to use emerging technologies to enhance the patient experience, reduce costs, and improve patient outcomes. IoT, cloud computing, wearables, and artificial intelligence are examples of areas of innovation that have the potential to meet the needs of the healthcare industry. The successful implementation of emerging technologies such as artificial intelligence will change the healthcare service model from traditional approaches to a value-based care approach, where personal care of patients is prioritized. The healthcare industry is a complex industry with various stakeholders such as patients, doctors, hospital administrators, suppliers, regulatory authorities and pharmaceutical companies. Emerging technologies such as artificial intelligence, Internet of Things, and cloud computing are important to enhance healthcare services and overcome challenges in the field of medicine. Among these, artificial intelligence is expected to play an important role in addressing many challenges in healthcare, including patient access to medical services and increasing workloads in non-value-added areas that reduce their ability to serve their patients.
Method: The main goal of the current research is to identify the ranking of obstacles to the adoption of artificial intelligence in the healthcare industry of the country. This research is descriptive-survey research and is considered as applied research in terms of its purpose. The statistical population of this research includes senior managers working in public hospitals in Tehran province. In this research, two library and field methods were used for data collection, and the data collection tool was a pairwise comparison questionnaire, which was given to 20 experts from the senior managers of the healthcare industry. In order to analyze the data, the interpretive structural modeling method was used. After extracting the obstacles to the adoption of artificial intelligence in the healthcare industry through studying and reviewing the background and research literature, using the Delphi technique, the obstacles to the adoption of artificial intelligence in the healthcare industry were extracted by interviewing 10 experts and They were chosen as barriers to the adoption of artificial intelligence in the healthcare industry.
Results: The results of the Delphi method showed that the moral and social factors and government policies are at the basic and low levels of the interpretive structural model, which indicate the importance of these factors in the adoption of artificial intelligence in the country's healthcare industry.
Discussion: Overall, the results of this study suggest that healthcare organizations should improve data collection systems and create shared data platforms for health data. Developers should focus on creating AI systems that provide output in a language that human users can understand. This can facilitate the psychological acceptance of the technology. Healthcare organizations should also implement change management programs, ongoing training, and incentive systems to encourage employees to use new technologies. The practical implications of these results can help policymakers, hospital administrators, and AI technology developers more effectively overcome these barriers.
Artificial intelligence has the potential to overcome staff shortages in developing and developed countries, increase organizational efficiency, and improve diagnostic accuracy as well as patient outcomes by providing minimal results. Comparable in terms of quality compared to humans, to maximize. As a result, AI may reduce costs by avoiding inefficiencies, unnecessary treatments and late diagnoses. In general, it can be said that artificial intelligence in health care can support doctors, automatically analyze clinical documents and medical images, and also help in virtual observation, diagnosis and informing the patient.
1. Ho M.-T., Lee N.-T.B., Mantello P., Ho M.-T., Ghotbi N., (2023). Understanding the acceptance of emotional artificial intelligence in Japanese healthcare system: a cross-sectional survey of clinic visitors’ attitude, Technol. Soc. 72 (2023), 102166,
2. Hajkowicz S. Sanderson, C., Karimi S., Bratanova A., Naughtin C. (2023). Artificial intelligence adoption in the physical sciences, natural sciences, life sciences, social sciences and the arts and humanities: a bibliometric analysis of research publications from 1960-2021, Technol. Soc. 74 (2023), 102260,
3. Goirand M., Austin E., Clay-Williams R. (2021). Implementing ethics in healthcare AIbased applications: a scoping review, Sci. Eng. Ethics 27 (5) (2021) 61, https:// doi.org/10.1007/s11948-021-00336-3.
4. Xu X., Mazloom R., Goligerdian A., Staley J., Amini M., Wyckoff G.J., Jaberi M. (2019). Making sense of pharmacovigilance and drug adverse event reporting: comparative similarity association analysis using AI machine learning algorithms in dogs and cats, Top. Companion Anim. Med. 37 (2019), 100366,
5. Horgan D., Romano M., Morr´e S.A., Kalra D. (2019). Artificial Intelligence: power for civilisation – and for better healthcare, Public Health Genomics 22 (2019) 145–161
6. Khanijahani A., Iezadi S., Dudley S., Goettler M., Kroetsch P., Wise J. (2022). Organizational, professional, and patient characteristics associated with artificial intelligence adoption in healthcare: a systematic review, Health Policy Technol. 11 (1) (2022), 100602.
7. Raghupathi, W., and Raghupathi, V. (2014) Big data analytics in healthcare: promise and potential. Health Information Science and Systems, 2(3).
8. Gujral, G., Shivarama, J., and Mariappan, M. (2019). Artificial Intelligence (AI) and data science for developing intelligent health informatics systems. Proceedings of the National Conference on AI in HI & VR, SHSS-TISS. Mumbai, 30-31 Aug.
9. Laï MC, Brian M, Mamzer MF: Perceptions of artificial intelligence in healthcare: findings from a qualitative survey study among actors in France. J Transl Med. 2020,
10. Jiang, F.; Jiang, Y.; Zhi, H.; Dong, Y.; Li, H.; Ma, S.; Wang, Y.; Dong, Q.; Shen, H.; Wang, Y. (2017). Artificial intelligence in healthcare: Past, present and future. Stroke Vasc. Neurol, 2, 230–243.
11. Darcy, A.M.; Louie, A.K.; Roberts, L.W. (2016). Machine Learning and the Profession of Medicine. JAMA, 315, 551–552.
12. Ahmed M, Spooner B, Isherwood J, et al. (2023) A Systematic Review of the Barriers to the Implementation of Artificial Intelligence in Healthcare. Cureus 15(10): e46454. DOI 10.7759/cureus.46454.
13. Price, I.; Nicholson, W. (2017). Artificial intelligence in health care: Applications and legal issues. SciTech Lawyer, 14, 10–13.
14. Lee, E. E., Torous, J., De Choudhury, M., Depp, C. A., Graham, S. A., Kim, H.-C. et al. (2021). Artificial Intelligence for Mental Healthcare: Clinical Applications, Barriers, Facilitators, and Artificial Wisdom. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 6, 856-86
15. Marcu LG, Boyd C, Bezak E: Current issues regarding artificial intelligence in cancer and health care. Implications for medical physicists and biomedical engineers. Health Technol. 2019, 9:375-81.
16. Ahmad OF, Stoyanov D, Lovat LB. (2020). Barriers and pitfalls for artificial intelligence in gastroenterology: ethical and regulatory issues. Elsevier, 22:80-4.
17. Alnasser, B. (2023). The Economic Impact of Artificial Intelligence on Healthcare: A Literature Review. E-Health Telecommunication Systems and Networks, 12, 35-48.
18. Ajmera, P., and Jain, V. (2019). Modelling the barriers of Health 4.0–the fourth healthcare industrial revolution in India by TISM. Operations Management Research, 12, 129–145.
19. Panch, T., Pearson-Stuttard, J., Greaves, F., and Atun, R. (2019). Artificial intelligence: opportunities and risks for public health. The Lancet Digital Health, 1(1), e13-e14.
20. Pinninti, R., and Rajappa, S. (2020). Artificial intelligence in health-care: How long to go? Cancer Research, Statistics and Treatment, 3, 133-4.
21. Paul, Y., Hickok, E., Sinha, A., Tiwari, U., Mohandas, S., Ray, S., and Bidare, P.M. (2018). Artificial intelligence in the healthcare industry in India. Bengaluru: The Centre for Internet and Society, India.
22. Bali, J., and Bali, R.T. (2020). India and the Fourth Industrial Revolution: How we should approach Artificial Intelligence in Healthcare and Biomedical Research? Journal of the Association of Physicians of India, 68, 72.
23. Mohandas, S. (2017). AI and healthcare in India: Looking forward. Roundtable Report. The Centre for Internet and Society, India.
24. Murali, A., and PK, J. (2019). India’s bid to harness AI for healthcare. Factor Daily, April 4.
25. Wahl, B., Cossy-Gantner, A., Germann, S., and Schwalbe, N.R. (2018). Artificial intelligence (AI) and global health: how can AI contribute to health in resource-poor settings? BMJ global health, 3(4)
26. Panch, T., Pearson-Stuttard, J., Greaves, F., and Atun, R. (2019). Artificial intelligence: opportunities and risks for public health. The Lancet Digital Health, 1(1), e13-e14.
27. Hoodbhoy, Z., Hasan, B., and Siddiqui, K. (2019). Does artificial intelligence have any role in healthcare in low resource settings? Journal of Medical Artificial Intelligence, 2(13).
28. Gearhart A, Gaffar S, Chang AC: A primer on artificial intelligence for the paediatric cardiologist . Cardiol Young, 30:934-45.
29. Gujral, G., Shivarama, J., and Mariappan, M. (2019). Artificial Intelligence (AI) and data science for developing intelligent health informatics systems. Proceedings of the National Conference on AI in HI & VR, SHSS-TISS. Mumbai, 30-31 Aug.
30. Patil, A. (2018). Time for Artificial Intelligence to Meet Healthcare Costs. Healthcare innovation, 4(8).
31. Yang, J., Luo, B., Zhao, C., & Zhang, H. (2022). Artificial Intelligence Healthcare Service Resources Adoption by Medical Institutions Based on TOE Framework. Digit Health, 8.
32. Sunarti, S., Fadzlul Rahman, F., Naufal, M., Risky, M., Febriyanto, K., & Masnina, R. (2021). Artificial Intelligence in Healthcare: Opportunities and Risk for Future. Gaceta Sanitaria, 35, S67-S70
33. Kumar, P., Dwivedi, Y. K., & Anand, A. (2021). Responsible Artificial Intelligence (AI) for Value Formation and Market Performance in Healthcare: the Mediating Role of Patient’s Cognitive Engagement. Information Systems Frontiers, 25, 2197-2220
34. Alsheibani, S. A., Cheung, Y. P., & Messom, C. H. (2019). Factors Inhibiting the Adoption of Artificial Intelligence at Organizational-Level: A Preliminary Investigation. In M. Santana, & R. Montealegre (Eds.), AMCIS 2019 Proceedings. Association for Information Systems.
35. Char D.S., M.D. Abramoff, C. Feudtner, Identifying ethical considerations for machine learning healthcare applications, Am. J. Bioeth. 20 (11) (2020) 7–17,
36. Davenport, T., & Kalakota, R. (2019). The Potential for Artificial Intelligence in Healthcare. Future Healthcare Journal, 6, 94-98
37. Nguyen Van, P. (2022). The Critical Factors Impacting Artificial Intelligence Applications Adoption in Vietnam: A Structural Equation Modeling Analysis. Economies, 10(9).
38. Petersson, L., Larsson, I., Nygren, J. M., Nilsen, P., Neher, M., Reed, J. E. et al. (2022). Challenges to Implementing Artificial Intelligence in Healthcare: A Qualitative Interview Study with Healthcare Leaders in Sweden. BMC Health Services Research, 22, Article No. 850
39. Solaimani, S., & Swaak, L. (2023). Critical Success Factors in a Multi-Stage Adoption of Artificial Intelligence: A Necessary Condition Analysis. Journal of Engineering and Technology Management, 69, 101760.
40. Racine, E., Boehlen, W., & Sample, M. (2019). Healthcare Uses of Artificial Intelligence: Challenges and Opportunities for Growth. The Healthcare Management Forum, 32, 272-27
41. Firouzi, F., Farahani, B., Barzegari, M., & Daneshmand, M. (2022). AI-Driven Data Monetization: The Other Face of Data in IoT-Based Smart and Connected Health. IEEE Internet of Things Journal, 9, 5581-5599
42. Secinaro, S.; Calandra, D.; Secinaro, A.; Muthurangu, V.; Biancone, P. The role of artificial intelligence in healthcare: A structured literature review. BMC Med. Inform. Decis. Mak. 2021, 21, 125.
43. Reddy, S., Allan, S., Coghlan, S., & Cooper, P. (2020). A Governance Model for the Application of AI in Health Care. Journal of the American Medical Informatics Association, 27, 491-497.
44. Weinert, L., Müller, J., Svensson, L., & Heinze, O. (2022). Perspective of Information Technology Decision Makers on Factors Influencing Adoption and Implementation of Artificial Intelligence Technologies in 40 German Hospitals: Descriptive Analysis. JMIR Medical Informatics, 10, e34678.
45. Sezgin, E. (2023). Artificial Intelligence in Healthcare: Complementing, Not Replacing, Doctors and Healthcare Providers. Digital Health, 9.
46. Brecker, K., Lins, S., & Sunyaev, A. (2023). Why It Remains Challenging to Assess Artificial Intelligence. In Proceedings of the 56th Hawaii International Conference on System Sciences (pp. 5242-5251)
47. Verma, A., Rao, K., Eluri, V., & Sharma, Y. (2020). Regulating AI in Public Health: Systems Challenges and Perspectives. ORF Occasional Paper 261.
48. Hoffmann-Riem, W. (2020). Artificial Intelligence as a Challenge for Law and Regulation. In T. Wischmeyer, & T. Rademacher (Eds.), Regulating Artificial Intelligence, Springer, 5(9), 1-29.
49. Lekadir, K., Feragen, A., Fofanah, A. J., Frangi, A. F., Buyx, A., Emelie, A. et al. (2023). FUTURE-AI: International Consensus Guideline for Trustworthy and Deployable Artificial Intelligence in Healthcare. arXiv preprint arXiv:2309.12325
50. Wolff, J., Pauling, J., Keck, A., & Baumbach, J. (2020). The Economic Impact of Artificial Intelligence in Health Care: Systematic Review. Journal of Medical Internet Research, 22.
51. Alnasser, B. (2023). The Economic Impact of Artificial Intelligence on Healthcare: A Literature Review. E-Health Telecommunication Systems and Networks, 12, 35-48.
52. Ghasemi, S. (2023). Investigating effective factors in the adoption of artificial intelligence in knowledge-based companies. The first national conference without oil, how?, Tehran, [in Persian].
53. Jafari, M; Jaji Babaei, H (2023). Investigating factors affecting the acceptance of artificial intelligence in online purchases by customers. The sixth international conference on new developments in management, economics and accounting, [in Persian].
54. Safari, I; Ansari, A, A (2022). Identifying and ranking factors affecting the adoption of artificial intelligence in the public and private sector. Smart Business Management Studies, 11(41), [in Persian].
55. Svanvik, H. A., Landin, F., Madsstuen, E. A., Sjogren, F., Stiebe, E., To, K. (2023). Mapping the Barriers to AI Implementation in Swedish Healthcare. DEPARTMENT OF TECHNOLOGY MANAGEMENT AND ECONOMICS DIVISION OF SCIENCE, TECHNOLOGY AND SOCIETY.
56. Petersson, L., Larsson, I., Nygren, J. M., Nilsen, P., Neher, M., Reed, J. E. et al. (2022). Challenges to Implementing Artificial Intelligence in Healthcare: A Qualitative Interview Study with Healthcare Leaders in Sweden. BMC Health Services Research, 22(850).