The purpose of this study is to identify factors that influence the replacement of handwritten patient medical records with their electronic versions in a tertiary care hospital in Saudi Arabia. The literature on this topic was studied to determine the main objectives of the study and the issues necessary for the survey. The reviewed articles study both the Technology Acceptance Model (TAM) and its components, as well as other barriers affecting the implementation of Electronic Medical Records (EMR).
In addition, a possible field of application of the results was studied to determine the relevance of the work. However, the literature review showed that despite a large number of scientific papers on the topic of Electronic Medical Records, studies on tertiary care hospitals in Saudi Arabia are almost absent and the data are not systematized.
The basis of this research work is the TAM, which has been repeatedly used in the studies of EMR. The current study is based on an article by Handy, Whiddett, and Hunter (2001), who modernized the classical TAM model by dividing the factors into three categories of perceived ease of use, usefulness, and acceptability.
The most useful part of this work is accessibility factors, which scientists investigate from the angle of the need to obtain specific information by different categories of medical staff (Whiddett & Hunter, 2001). However, almost two decades have passed since the publishing of this study, and its results applied to New Zealand.
The article by Aldosari, Al-Mansour, Aldosari, and Alanazi (2018) also uses this model by applying it to the realities of modern Saudi Arabia but without taking into account the factors of information accessibility and with sampling within a single hospital. Therefore, although both articles have the necessary data for the current research, their results do not cover all the information or require updating.
For complete coverage of the factors that impede the use of EMR, literature that analyses various barriers to the introduction of these technologies in Saudi Arabia by using both TAM and other assessment systems has also been studied. The research by AlJarullah, Crowder, and Wills (2017) uses the TAM model, namely perceived ease of use and usefulness, and also considers factors such as the confidentiality of information, involvement, and autonomy of physicians.
Thus, the article discovers a new barrier that can be explored in the context of the accessibility of information or confidentiality, since not all categories of employees may have the same information about the patient. The article by Jabali and Jarrar (2018) also explores this side of the accessibility issue because one of its main points is the protection of electronic medical records from hacking, stealing, and using by intruders. However, these studies have a wide range of respondents, which do not match with tertiary care hospitals in Saudi Arabia.
An article by Hasanain, Vallmuur, and Clark (2015), whose main purpose is to study the usability and ease of use of EMR, was also considered. This work confirmed the hypotheses and findings of other authors about the barrier preventing the use of EMR by staff and identified such an essential aspect in this category as complicated interface and inability to use programs due to the lack of Arabic translation.
The research of Rafiei, Shahin, Tavakoli, Jahanbakhsh, and Mokhtari (2013) also refers to the part on the ease of use, or more precisely, on the appearance of EMR because the authors study the flaws of the interface and its impact on the use of programs. Since this research was conducted in Iran, the question may also apply to the study of EMR acceptance in Saudi Arabia.
Moreover, it was necessary to study the issue of the medical service providers and KFSH & RC impact on the implementation of EMR to confirm the relevance and applicability of the results. Alfarra (2016) notes that providers and KFSH & RC have a direct influence on the adoption of computer programs and the replacement of hand-written copies of medical records. Therefore, the results obtained during the study can be applied and aimed at accelerating and improving the transition to the electronic system for storing medical data, which makes this topic relevant.
However, all the literature examines different aspects and barriers to the adoption of EMR by healthcare providers and does not present complete, systematic information. Most studies have a limited sample of respondents and do not study the proposed scientific question in a tertiary care hospital in Saudi Arabia. For this reason, the current research paper intends to bridge this gap and provide the necessary scientific information.
In conclusion, the review of the scientific literature on this topic showed that although the issue of introducing EMR has been studied, there is a lack of knowledge about a tertiary care hospital in Saudi Arabia. The studied articles provide a versatile view of the issues that will be proposed in this research and identify the area of the results’ application. However, the information obtained requires systematization and use for a more accurate category of hospitals.
References
Aldosari, B., Al-Mansour, S., Aldosari, H., & Alanazi, A. (2018). Assessment of factors influencing nurses acceptance of electronic medical record in a Saudi Arabia hospital. Informatics in Medicine Unlocked, 10, 82–88.
Alfarra, N. (2016). A qualitative study of an electronic health record: Perspectives on planning objectives and implementation at King Faisal Specialist Hospital & Research Centre (KFSH&RC), Saudi Arabia. IOSR Journal of Business and Management, 18(4), 70-75.
Aljarullah, A.A., Crowder, R., & Wills, G. (2017). A framework for the adoption of EHRs by primary healthcare physicians in the kingdom of Saudi Arabia. International Journal of e-Healthcare Information Systems, 5(1), 126–137.
Handy, J., Whiddett, R., & Hunter, I. (2001). A Technology Acceptance Model for inter-organisational electronic medical records systems. Australasian Journal of Information Systems, 9(1), 39–50.
Hasanain, R., Vallmuur, K., & Clark, M. (2015) Electronic medical record systems in Saudi Arabia: Knowledge and preferences of healthcare professionals. Journal of Health Informatics in Developing Countries, 9(1), 23-31.
Jabali, A. K., & Jarrar, M. (2018). Electronic health records functionalities in Saudi Arabia: Obstacles and major challenges. Global Journal of Health Science, 10(4), 50–57.
Rafiei, M., Shahin, A., Tavakoli, N., Jahanbakhsh, M., & Mokhtari, H. (2013). Users′ acceptance and attitude in regarding electronic medical record at central polyclinic of oil industry in Isfahan, Iran. Journal of Education and Health Promotion, 2(1), 1-5.