Layperson Perceptions and Attitudes Towards a National Electronic Health Record Introduction in Saudi Arabia

Introduction: Since patients and the general public may interact with a national electronic health record (EHR), including them during implementation of an EHR is important. Such acceptance has been documented as one of the critical areas in the development of a national EHR. However, only a few studies have considered public perceptions and attitudes regarding use of their health information in a universal EHR. This is the first study that concentrated on Saudi patients and citizens’ attitudes regarding a national EHR. . Objectives: The purpose of this quantitative study was to understand perceptions and attitudes regarding the introduction of a national EHR among the Saudi citizenry. Methodology: This study used a cross-sectional survey, which was designed based on a literature review and interviews with a small subset of the target population. The final survey was distributed by hand as well as through the internet. Analysis: The data was analyzed by conducting descriptive, bivariate and logistic regression tests. Results: Most of the Saudi citizens supported the development of a national EHR system, which might be used for several services, such as healthcare, health services planning and health research. Twelve percent of respondents reported being undecided in their view and only 2% of them would be opposed to such a system. In terms of accessing health records in a national EHR, most were in favor of accessing their complete record. The study results also highlighted that more than 70% of respondents would be concerned about the security of their health record if it were to become part of a national EHR. The results also revealed significant differences in levels of support depending on sociodemographic characteristics. Working in health related jobs and level of education were important factors related to level of support for the development of a national EHR. Furthermore, it indicated that there is no significant relationship between preferences for access to a national EHR and demographic, education and health related characteristics. Conclusion: These findings support the need for expediting the incorporation of health information technology, especially an EHR in healthcare organizations in Saudi Arabia. Making a national EHR as an optimal goal before adoption of a local EHR in each healthcare institution will help to facilitate the complex implementation. Findings of this study can be generalized and extrapolated to other societies that have similar cultural factors. Furthermore, the results potentially benefit the policy makers in Saudi Arabia

The role of health data standards in developing countries

Healthcare organizations have recognized that there are potential limitations with their clinical information systems. Interoperability barriers between different systems have resulted in medical information being collected by different people or systems which has made it difficult to understand, compare and exchange. There are many health data standards to try and overcome these issues, but in many developing countries these have not been adopted. This paper investigates health data standards and their roles in Saudi tertiary hospitals and provides insights into the issues, and recommendations which can be used by academics and practitioners to develop the planning of health data standards

Quality of primary care from the patient perspective in Saudi Arabia : a multi-level study.

Objectives: To assess primary care performance for measures of patients’ experience in Community-based Primary Care (CPC) and Employer-based Primary Care (EPC) systems in Saudi Arabia, to examine variations in performance across the two systems, and to explore factors at both the individual-level and the organizational-level that explain variations in primary care performance. Design and Methods: This is an observational and cross-sectional study, using comparative design and survey research methods. The newly revised and re-translated Arabic version of the Primary Care Assessment Survey (PCAS) was used to measure patients’ experience of primary care. PCAS operationalizes the IOM definition of primary care, which identified core domains of primary care as accessibility of care, continuity of care, comprehensiveness of care, coordination of care, interpersonal treatment, communication, and community orientation. A two-stage cluster, matched sampling was employed to select 16 primary care centers (eight CPC and eight EPC centers) in Riyadh, the capital and largest city (population \u3e 5.5 million) in Saudi Arabia. A systematic random sampling was employed to collect primary survey data from 612 adult patients visiting the selected primary care centers. Results: After adjusting for differences in the patient-mix and taking into account the multi-level structure of data by means of multi-level modeling, EPC performed statistically significantly better than CPC in interpersonal care (Mean EPC = 68.3, 95% CI [± 6.3] vs. Mean CPC = 59.5, 95% CI [± 5.9], p = 0.024, Effect Size (d) = 0.36) and communication (Mean EPC = 69.8, 95% CI [± 4.9] vs. Mean CPC = 64.4, 95% CI [± 5.5], p = 0.035, d =0.22), in addition to the total quality score (Total PCAS EPC = 60.4, 95% CI [± 2.9 ] vs. Total PCAS CPC = 56.1, 95% [± 3.3], p = 0.009, d =0.31). CPC performed statistically significantly better than EPC in community orientation (Mean CPC = 47.8, 95% [± 5.7] vs. Mean EPC = 35.5, 95% [± 6.2], p = 0.003, d =0.50) and accessibility of care (Mean CPC = 67.4, 95% [± 5.7] vs. Mean EPC = 63.5, 95% [± 4.5], p = 0.025, d=0.23). There were no significant differences between CPC and EPC in coordination of care (p= 0.098), comprehensiveness of care (p = 0.208), and visit-based continuity of care (p = 0.354). Patient-level (compositional) variables explained a significant proportion (R2 = 0.14) of the observed level-one (within-centers) variations in measures of patients’ experience. Those variables include gender, self-perceived health status, and patient-reported co-morbidity. Female patients, reporting poor health, and reporting chronic conditions are each statistically significantly associated with lower ratings of patients’ experience of care. Organizational-level (contextual) variables explained a significant proportion (R2 = 0.78) of the observed level-two (between-centers) variations in measures of patients’ experience. Those organizational variables include practice type and proportions of family physicians in a center. EPC centers and those centers with higher proportions of family physicians are each statistically significantly associated with better patients’ experience. Finally, aspects of care that were statistically significantly associated with better patients’ experience include knowing the name of the physician and being with the same physician for longer durations. Conclusion: Enhancing continuity and quality of patient-physician relationships may improve the overall patients’ experience of care. Healthcare systems in Saudi Arabia might embrace the Bio-Psycho-Social model to foster a culture of health and caring. Effective, community-oriented primary care systems have the potential to re-orient health systems’ from a sole focus on sickness and disease, to include additional approaches for prevention and wellness at the societal level. Positive indicators of health, at both the individual and community levels, are needed to better align existing healthcare systems with this goal, mission and vision to improve population health

Barriers to the Adoption of EHR in GCC Countries: Exploratory Study

Electronic Health Records (EHRs) have become a focus of research in health informatics due to the increasing awareness of its importance in healthcare. The call for use and adoption of EHR systems by governments around the world and in the GCC countries in particular have increased over the years in an effort to improve healthcare, reduce cost and ensure patient safety. This study examines to the challenges and barriers affecting the use and adoption of EHR by GCC countries. Investigation and analysis are based on research studies, health reports, and published data by GCC countries in the last ten years. The results revealed repeating patterns and themes with regard to the challenges and barriers to the implementation of EHR systems in the GCC countries. We hope the findings from the study would benefit healthcare institutions in GCC countries in their efforts of overcoming the challenges and barriers to the use and adoption of EHR systems

Ubiquitous Electronic Medical Record (EMR) for Developing Countries

Around the globe, Healthcare Information Technology (HIT) has been evolved either by governments or healthcare providers. The utilization of these technologies has resulted in the improvement of healthcare services all over the world. This evolution has been characterized by availability, reliability, serviceability to patients, and has been enhanced with increased cost and time efficiency. As such, new systems and terms have been established. Electronic Medical Record (EMR), which can also be used interchangeably with Electronic Health Record (EHR) is considered to be the main transformation in healthcare information technologies. EMR has been aimed to reduce and eliminate existing paper based approaches. Many countries have adopted the use of EMR systems all over the world. However, these systems differ from country to country even though they serve the same purpose. The differentiation of implementing the EMR system often leads to incompatibility, which complicates cooperation between healthcare providers, and also compromises the efficient use and analysis of data that can be gathered from different locations or systems. This thesis highlights and addresses the implementation of EMR on cloud-based systems to enable improvements in HIT. In particular, the scope of this research focuses on the use of EMR or EHR in Saudi Arabia, and establishes clinical information transaction standards that can be easily adopted by the different EMR application architectures available. Furthermore, the implementation of a cloud-based system is proposed for standard EMR to be used by both public and private healthcare providers in Saudi Arabia. The advantage that cloud technologies facilitate is the availability of data regardless of the patient, clinician, or physician’s location. Similarly, these technologies enable a linkage and utilization of the Health Information Exchange (HIE) by healthcare researchers and providers to invest in data through online and offline cooperation. Support for the standardization of the EMR system on cloud-based technology will minimize or at best prevent human’s errors, repetition or duplication of records, and reduce cost of operation and time

Electronic Health Records Challenges and Barriers in Iraq

Developing countries are slow adopters of new technologies, particularly with regards to the health services of these countries. This study explores the challenges to applied EHRs system in Iraq hospital. The Technology Acceptance and Barriers of this technology in the Iraqi medical section this study is probably the one of the few studies of its kind in Iraq; there have been some limited studies of EHR early trials in some developing countries assessing the challenges of implementation. This study briefly mentions barriers EHR projects to applied in Iraq. Some challenges that would impede the implementation of EHR in an Iraqi hospital are the initial huge startup costs, poor computer skills of healthcare professionals, poor maintenance culture, and people embedding political meaning(s) into the system. The weak state of information infrastructure at the hospital would be another challenge in an EHR implementation. EHR could potentially reduce waiting times for patients, reduce the cost of the hospital‘s operations, improve interdepartmental communication and collaboration, provide opportunity for sharing best practices among physicians within Iraqi  hospitals, and enhance better resource allocation. The data an EHR could primarily capture would be patients 'demographics, care plans, laboratory results, billing and claims information. Keyword: EHR, WHO, ICT, I

Internet of Things Adoption for Saudi Healthcare Services

Background: Recent studies in information systems have predicted that applications of the Internet of Things (IoT) innovations will revolutionise various sectors including healthcare. Besides the issues and opportunities of IoT based innovations, existing studies have shown limitations to advance the adoption of IoT-understanding and relevant interventions to benefit researchers and healthcare practitioners. Method: In this context, a systematic literature review study was conducted to re-position a qualitative, phenomenological investigation that could offer useful insights into the factors affecting IoT-adoption in a developing country’s healthcare service. In addition to it, five participants who worked in hospitals and clinics in Jazan, Saudi Arabia, took part in the semi-structured interviews developed based on the diffusion of innovation theory. Results: The study explored the relevant literature and evaluated how the outcome is used to identify the key delivers of IoT in healthcare. Conclusions: According to the findings, the capacity of the Saudi healthcare sector to accept and implement a new IT with IoT technologies is increasing and its integrations remains a debated issue

Designing a GIS Web Base for Locating Health Care Locations in KSA using Google Earth

This study focuses on the development of a web-based GIS for public healthcare system using GIS web base application choosing Google Earth as a sample . The development of this system is motivated to provide opportunities for the healthcare workers to gain access to vital information that can aid him/her in the location of viable hospitals for the patients to fully enjoy available enhanced  healthcare services. Currently, three major problems still exist in the healthcare geographic applications. This relate to health mapping methods, reusability of health applications, and interoperability issues. To handle these problems, we design a Web based GIS for Public healthcare system to support health data sharing and representation. The developed model makes it possible to locate the nearest hospitals as well as the services they rendered.   With Google Earth, you'll be able to see math concepts in a different light.  They're worth exploring and understanding fully.  In Google Earth you'll be able to interact with the concepts and see how they're evident in real life. These lessons are sure to be more interesting than just another page in a math text. Keywords: Web-based GIS, Public healthcare, Decision Support System. Google Earth ,ArcGS10.3,GP