Resistance to change is often a challenge that any new system faces. There are operators who use old communication systems to the point that the acceptance of electronic services becomes a challenge. The same resistance is also found among patients who prefer to use methods with which they are familiar. This makes it difficult to implement new programs aimed at improving the quality of communication. In addition to resistance, there are also cost implications for medical facilities. Initial start-up costs are considerable (DePhillips, 2011). You need to purchase expensive equipment such as workstations, routers, servers, data cables, printers and software. Most of these costs are not borne by patients. There are also cumulative maintenance costs that must be realized with the continued use of electronic communication