The potential of the Internet of Things (IoT) to transform healthcare lies in its capacity to enable remote monitoring, improve efficiency and enhance data-driven decision-making. By connecting physical devices and sensors into a digital network, IoT technologies allow real-time tracking and data collection that support more responsive and personalised care. Yet despite these benefits, many healthcare organisations encounter significant obstacles when moving from the decision to adopt IoT systems to their actual implementation. While adoption is often examined through models focused on user acceptance, implementation introduces a broader and more complex set of challenges involving legal, organisational, human and infrastructural considerations. In healthcare environments where regulatory compliance, professional identity and resource constraints intersect, a more nuanced understanding of implementation dynamics becomes essential.
Regulation, Procurement and Legal Barriers
Laws and regulations play a central role in shaping the success or failure of IoT implementation in healthcare. Legal issues frequently arise in connection with informed consent, particularly when projects target vulnerable populations such as older adults with cognitive impairments. Inconsistent interpretations of what constitutes informed consent can lead to significant setbacks, including project termination. Additionally, ambiguity around how new technologies should be classified under existing laws can halt progress. For example, whether image-based monitoring is governed by surveillance law or data protection regulations influences the legal permissibility of implementation.
To navigate these challenges, some projects embedded their work within academic research studies, which benefit from less restrictive legal frameworks. This strategy allowed technology trials to proceed without triggering the full set of regulatory requirements. Others encountered delays linked to cloud data storage, with IT departments raising concerns about the security and legality of external cloud services. Public procurement added further complexity. Existing frameworks are often seen as inflexible, and the fear of disqualification or legal risk discouraged experimentation with innovative procurement models. As a result, several promising IoT solutions stalled once they reached the point of broader implementation, highlighting a significant disconnect between innovation goals and procedural realities.
Organisational Commitment and Cultural Readiness
Support from leadership and alignment with organisational priorities strongly influenced project outcomes. Where management signalled a clear commitment to digitalisation and backed it with resources and encouragement, projects progressed more smoothly. This support extended to operational managers and frontline staff, whose engagement proved vital. In some cases, project champions faced opposition from departments such as IT, where technical or legal objections delayed or complicated implementation efforts. Challenges also arose when projects were not seen as a strategic priority, limiting access to personnel and reducing momentum.
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Differences in organisational readiness were apparent across various projects. Some teams benefited from leaders with a solid understanding of implementation processes, while others noted inconsistent knowledge and preparedness across levels of management. Additionally, the timing of projects often clashed with broader political or strategic cycles, creating uncertainty about continuity and support. Even when staff showed enthusiasm, structural barriers such as time constraints or limited authority to allocate resources frequently undermined their ability to contribute effectively. This disparity between enthusiasm and capability revealed the importance of a unified and informed organisational approach.
User Involvement and Infrastructure Challenges
A strong focus on users—both patients and healthcare staff—was central to more successful IoT implementations. Projects that actively engaged users in design, testing and feedback benefited from more relevant and accepted solutions. Involving a range of professionals, including medical secretaries, dietitians and therapists, helped align the service with actual needs and work practices. This collaborative approach improved usability and allowed for adjustments that technical teams alone might have overlooked.
However, the introduction of technology also generated unintended consequences. Some healthcare workers felt distanced from their caregiving roles, as the growing reliance on digital tools changed the nature of their work. This emotional and professional tension underscores the need to integrate technology in ways that respect and support care values. Communication was also critical. Clear instructions tailored to user capabilities, especially for older adults or patients with specific needs, helped ensure that technologies could be used safely and effectively.
Underlying many of these challenges were issues related to infrastructure. Poor Wi-Fi coverage, resistance to cloud services and inadequate communication tools impeded implementation in several cases. In some settings, the required equipment had already been procured, but insufficient technical preparation rendered it ineffective. Old mobile devices and slow response times undermined the reliability of IoT alerts, while inconsistent internet access—particularly when users were responsible for their own networks—further complicated deployment. In contrast, projects that secured local cloud solutions or integrated with national platforms demonstrated more resilience.
Implementation of IoT in healthcare is influenced by a web of interrelated factors that extend far beyond the capabilities of the technology itself. Legal frameworks that are slow to adapt, procurement systems that discourage innovation and fragmented organisational support often obstruct promising initiatives. Strong leadership and a shared sense of purpose within organisations are essential to navigating these barriers, as are efforts to engage users meaningfully throughout the process. Infrastructure gaps and user experience design must also be addressed to ensure solutions function in real-world settings. Lessons from the Swedish pilot projects highlight the value of approaching implementation through a sociotechnical lens, recognising that success depends not only on what technologies can do but on how well they fit into the complex environments of healthcare delivery.
Source: JMIR Human Factors
Image Credit: iStock
