From data to practice: a systematic review of knowledge transfer in digital health

The persistent gap between the rapid development of digital health innovations and their effective clinical adoption—often termed the “implementation chasm”—is largely attributed to suboptimal knowledge transfer (KT) processes. This study aimed to systematically identify, categorize, and evaluate the effectiveness of KT strategies in digital health through a socio-technical lens. This systematic review and meta-analysis followed the PRISMA 2020 guidelines. A comprehensive search was conducted in PubMed/MEDLINE, Scopus, Web of Science, IEEE Xplore, and Cochrane Library for interventional studies published between January 2015 and December 2025. Screening and data extraction were performed independently by two reviewers. Methodological quality was assessed using RoB 2 (for RCTs) and the Newcastle-Ottawa Scale (for quasi-experimental studies). A random-effects meta-analysis was conducted to calculate pooled Odds Ratios (OR) and Standardized Mean Differences (SMD) with 95% Confidence Intervals (CI). From 2,302 initial records, 32 interventional studies (18 RCTs, 14 quasi-experimental) were included in the meta-analysis. We developed a four-dimensional integrated KT framework: (1) Technology-Embedded (e.g., CDSS, automated feedback); (2) Interactive-Facilitative (e.g., local champions, coaching); (3) Organizational-Managerial (e.g., incentive structures, change management); and (4) Educational-Empowering (e.g., simulation-based training). Meta-analysis revealed Interactive-Facilitative strategies had the strongest impact on adoption (OR: 2.1; 95% CI: 1.6–2.8), followed by Technology-Embedded approaches (SMD: 0.51; 95% CI: 0.32–0.70). Quality appraisal indicated 72% of studies had low risk of bias. Moderate heterogeneity was observed (I² = 64%), attributable to diverse clinical contexts. The translation of digital health innovation into sustainable practice necessitates an integrated socio-technical strategy, moving beyond mere technology procurement to the cultivation of synergistic learning ecosystems through coordinated investment in human, organizational, and interactive dimensions.