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Title: Issues concerning the adoption and usage of Electronic Medical Records in Ministry of Health hospitals in Saudi Arabia
Author: Al Aswad, Amal Mohammad
ISNI:       0000 0004 5346 1337
Awarding Body: University of Sheffield
Current Institution: University of Sheffield
Date of Award: 2015
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Background: There is a lack of research with regard to understanding the factors that motivate hospitals to proceed with implementing Electronic Medical Record Systems (EMR). The Health Information Management and System Society (HIMSS) outlines eight levels of EMR implementation from 0 (no implementation) to 7 (full use and implementation of the system). Some hospitals proceed to implement EMR and achieve a high level of implementation, while others stop at a certain level of EMR implementation or may even regress to lower levels. Aims and Methods: This research aimed to develop a framework to understand the motivational and de-motivational factors for proceeding with EMR implementationto uncover which hospitals have implemented EMR, to which levels, and how hospitals perceive EMR. In order to accomplish this,a mixed method design was adopted including a survey and case studies of a sample of hospitals in Eastern Saudi Arabia. The three case study sites were: a large hospital located in the capital city, a medium hospital located in a town, and a small hospital located in an isolated rural area. Results: The study found that 3 out of 29 hospitals in the area had implemented EMR. Contrary to expectations, the largest hospital located in the central city had regressed from level four of EMR implementation to level one, whereas the smallest hospital located in anisolated rural location achieved the highest EMR level. It was found that there were common factors that affected all the case study sites, whileother factors varied among them. Shared factors motivating sites to adopt EMR included a desire to escape from the manual system, whereas shared de-motivational factors included funding and technical problems. As these factors were common across sites at different levels of implementation, it is suggested that they do not sufficiently explain the variance in implementation level. It is argued that factors which varied between sites, however, may shed more light on the main motivators for implementation. For example, although there were technical problems across the sites,the way these technical problems were treated made the difference in terms of the success of the implementation. Additionally, top management commitment, users’ involvement in the EMR development and other factors varying between sites appeared to make the difference in the implementation’s success. Conclusion:The study concluded that all these common and varied factors affectedstaff attitudes toward the system. However, the site-related factors were perceived to be the main driver for the variance in the implementations. Since all site-related factors are controllable by top management, it is recommended that EMR implementation should be managed and supervised by a committee consisting of representatives from among clinical staff and IT staff. Based on this research, it is believed that such a committee is necessary for proceeding with an EMR implementation. However, there is no empirical evidence from this research about that. Therefore, it is advised that future research should find the rules, authorities and compositions of such committees that would make the committee effective.
Supervisor: Baxter, Susan ; Jonathan, Nicholl Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available