Challenges of using artificial intelligence in Iran's health system: a qualitative study.

Background: Artificial intelligence (AI) is transforming healthcare globally, enhancing diagnostics, treatment, and efficiency. However, low- and middle-income countries (LMICs) like Iran face significant barriers to AI integration. Iran's health system, challenged by an aging population, increasing non-communicable diseases, and limited resources, could benefit from AI-driven, patient-centered care. Yet, its adoption remains limited. Understanding the barriers to AI implementation is critical for informed policymaking. Methods: This qualitative study involved semi-structured interviews with 15 stakeholders from healthcare management, policymaking, and AI sectors in Iran, conducted between January and April 2025. Participants were selected purposively to represent government, academia, healthcare, and technology. Data were analyzed thematically using Braun and Clarke's framework. Rigor was ensured through member checking, triangulation, and adherence to qualitative research standards. Results: Five major barriers to AI adoption emerged: (1) organizational and structural limitations, including poor infrastructure and fragmented governance; (2) legal and policy challenges, marked by regulatory gaps and ethical concerns; (3) data-related issues such as low data quality, lack of standardization, and security risks; (4) shortage of skilled professionals and limited training opportunities; and (5) challenges in integrating AI into policymaking, including concerns about losing human oversight in decision-making. Conclusion: AI implementation in Iran's health system faces complex and interrelated challenges. Addressing these requires a coordinated strategy focused on legal reform, infrastructure investment, capacity building, and cultural adaptation. Balancing technological innovation with ethical and human-centered care is essential for successful and sustainable integration.