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Implementing a Large-scale Electronic Health Record System in the Primary Healthcare Centres in Saudi Arabia / Haitham A. Alzghaibi

DOI (Published version): 10.23889/Suthesis.52386

Abstract

There is worldwide demand for the implementation of electronic health systems and a transformation to electronic transactions in healthcare organisations. This move to e-health transformation stems from the perceived positive impact that e-health systems have in improving the quality of healthcare a...

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Published: 2019
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
URI: https://cronfa.swan.ac.uk/Record/cronfa52386
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first_indexed 2019-10-09T14:24:15Z
last_indexed 2019-10-11T20:22:58Z
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spelling 2019-10-11T14:47:31.8872719 v2 52386 2019-10-09 Implementing a Large-scale Electronic Health Record System in the Primary Healthcare Centres in Saudi Arabia 2019-10-09 There is worldwide demand for the implementation of electronic health systems and a transformation to electronic transactions in healthcare organisations. This move to e-health transformation stems from the perceived positive impact that e-health systems have in improving the quality of healthcare and, in turn, reducing expenses. Despite this, more than half of previous Electronic Health Record System (EHRS) implementation projects have failed due to several barriers and challenges. There has been no previous research that has explored the implementation of an EHRS in Primary Healthcare Centres (PHCs). In addition, barriers and facilitators to the implementation of large-scale EHRS in PHCs are not well defined and there is little known about the impact of Financial Resources (FR) and Centralised Management (CM) on such implementation. Thus, this thesis aims to explore the large-scale implementation of EHRS in PHCs in Saudi Arabia (SA). To achieve this aim, a mixed-methods approach comprising both quantitative and qualitative methods was adopted. Data were collected via questionnaire-based studies and semi-structured interviews. Three different populations were targeted: project team members, PHC staff, and EHRS end-users. Descriptive and inferential statistics were applied to the quantitative data, and thematic analysis was used to analyse the qualitative data. The findings revealed high PHCs readiness at the organisational and individual level when compared with the technological level. Both FR and CM were documented to have a positive impact on the implementation of a large scale EHRS. Several facilitators to the implementation of the EHRS were identified, including: strong leadership and appropriate management, PHC specifications, system usability, perceived usefulness and efficiency. The scale of the project, shortage in Health Informatics (HI) expertise, lack of training and support, geographic challenges, software selection and end-user involvement were identified as the main barriers to implementing a large-scale EHRS in the PHCs. No relationships were detected between individual demographic differences, such as age and gender, and level of readiness or satisfaction. Based on the Saudi experience, there may be some important transferable lesson for similar projects elsewhere. Large-scale EHRS projects need to adopt CM. In addition, due to shortage in HI expertise, policymakers may need to carry out some consultations to formulate good implementation plane. Large-scale projects also need to be implemented by more than one vendor and include training and technical support to increase end-user satisfaction. Inadequate infrastructure, lack of interoperability, changing executives and lack of technical support were the main possible causes to the failure of large-scale EHRS projects. Implementation needs to ensure sufficient budget and time have been allocated to mitigate the challenges identified. E-Thesis Electronic Health Record Systems, Health Informatics, Implementation, Saudi Arabia, Primary Healthcare Centres 31 12 2019 2019-12-31 10.23889/Suthesis.52386 COLLEGE NANME COLLEGE CODE Swansea University Doctoral Ph.D Saudi Cultural Bureau, Royal Embassy of Saudi Arabia 2019-10-11T14:47:31.8872719 2019-10-09T13:43:13.2501926 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Haitham A. Alzghaibi 1 0052386-11102019144657.pdf Alzghaibi_Haitham_A_PhD_Thesis_Fianl.pdf 2019-10-11T14:46:57.7770000 Output 13105993 application/pdf E-Thesis – open access true 2019-10-10T00:00:00.0000000 true
title Implementing a Large-scale Electronic Health Record System in the Primary Healthcare Centres in Saudi Arabia
spellingShingle Implementing a Large-scale Electronic Health Record System in the Primary Healthcare Centres in Saudi Arabia
,
title_short Implementing a Large-scale Electronic Health Record System in the Primary Healthcare Centres in Saudi Arabia
title_full Implementing a Large-scale Electronic Health Record System in the Primary Healthcare Centres in Saudi Arabia
title_fullStr Implementing a Large-scale Electronic Health Record System in the Primary Healthcare Centres in Saudi Arabia
title_full_unstemmed Implementing a Large-scale Electronic Health Record System in the Primary Healthcare Centres in Saudi Arabia
title_sort Implementing a Large-scale Electronic Health Record System in the Primary Healthcare Centres in Saudi Arabia
author ,
author2 Haitham A. Alzghaibi
format E-Thesis
publishDate 2019
institution Swansea University
doi_str_mv 10.23889/Suthesis.52386
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description There is worldwide demand for the implementation of electronic health systems and a transformation to electronic transactions in healthcare organisations. This move to e-health transformation stems from the perceived positive impact that e-health systems have in improving the quality of healthcare and, in turn, reducing expenses. Despite this, more than half of previous Electronic Health Record System (EHRS) implementation projects have failed due to several barriers and challenges. There has been no previous research that has explored the implementation of an EHRS in Primary Healthcare Centres (PHCs). In addition, barriers and facilitators to the implementation of large-scale EHRS in PHCs are not well defined and there is little known about the impact of Financial Resources (FR) and Centralised Management (CM) on such implementation. Thus, this thesis aims to explore the large-scale implementation of EHRS in PHCs in Saudi Arabia (SA). To achieve this aim, a mixed-methods approach comprising both quantitative and qualitative methods was adopted. Data were collected via questionnaire-based studies and semi-structured interviews. Three different populations were targeted: project team members, PHC staff, and EHRS end-users. Descriptive and inferential statistics were applied to the quantitative data, and thematic analysis was used to analyse the qualitative data. The findings revealed high PHCs readiness at the organisational and individual level when compared with the technological level. Both FR and CM were documented to have a positive impact on the implementation of a large scale EHRS. Several facilitators to the implementation of the EHRS were identified, including: strong leadership and appropriate management, PHC specifications, system usability, perceived usefulness and efficiency. The scale of the project, shortage in Health Informatics (HI) expertise, lack of training and support, geographic challenges, software selection and end-user involvement were identified as the main barriers to implementing a large-scale EHRS in the PHCs. No relationships were detected between individual demographic differences, such as age and gender, and level of readiness or satisfaction. Based on the Saudi experience, there may be some important transferable lesson for similar projects elsewhere. Large-scale EHRS projects need to adopt CM. In addition, due to shortage in HI expertise, policymakers may need to carry out some consultations to formulate good implementation plane. Large-scale projects also need to be implemented by more than one vendor and include training and technical support to increase end-user satisfaction. Inadequate infrastructure, lack of interoperability, changing executives and lack of technical support were the main possible causes to the failure of large-scale EHRS projects. Implementation needs to ensure sufficient budget and time have been allocated to mitigate the challenges identified.
published_date 2019-12-31T04:04:43Z
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score 11.017797

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