Identifying Barriers and Enablers to the Adoption of AI-Based Triage Tools in Emergency Departments

This study aimed to explore the perceived barriers and enablers influencing the adoption of artificial intelligence (AI)-based triage tools in emergency departments (EDs) from the perspective of frontline healthcare professionals. A qualitative research design was employed, utilizing semi-structured interviews with 19 participants—including emergency physicians, triage nurses, department managers, clinical administrators, and health informatics experts—working in emergency departments across Canada. Participants were selected using purposive sampling to ensure diversity in professional roles and institutional settings. Data collection continued until theoretical saturation was reached. Interviews were transcribed verbatim and analyzed using grounded theory methodology. Open, axial, and selective coding were conducted with the assistance of NVivo software to identify emerging themes and construct a conceptual model of AI adoption dynamics. The analysis revealed five core categories shaping AI-based triage adoption: (1) perceived risk and uncertainty, including lack of trust in AI outputs and concerns over legal liability; (2) institutional and organizational readiness, such as infrastructure limitations and workflow misalignment; (3) human capital and knowledge systems, including digital literacy gaps and lack of training; (4) system-level support and governance, highlighting the role of managerial commitment and national policy frameworks; and (5) value proposition and practical benefits, including efficiency gains, clinical decision support, and user-friendly integration. These categories reflected the interplay of technical, organizational, and human factors that either hindered or enabled AI integration in emergency care settings. Adopting AI-based triage tools in emergency departments requires addressing a complex ecosystem of trust, readiness, training, infrastructure, and systemic support. The findings underscore the importance of clinician engagement, targeted education, transparent design, and multi-level policy alignment to ensure effective and sustainable implementation.