Unfolding and Addressing the Issues of Electronic Medical Record Implementation: Evidence From Public Sector Hospitals

Unfolding and Addressing the Issues of Electronic Medical Record Implementation: Evidence From Public Sector Hospitals

Muhammad Naeem (University of Worcester, UK) and Ibrahim Alqasimi (Saudi Electronic University, Saudi Arabia)
Copyright: © 2020 |Pages: 22
DOI: 10.4018/IRMJ.2020070103
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Abstract

The social influence and competitive pressure for health technology adoption has increased among developed, developing, and emerging countries. The present study aimed to uncover and address the issues of electronic medical record (EMR) implementation in public sector hospitals in the Kingdom of Saudi Arabia (KSA). It used the social constructivism approach to understand employee attitudes, behaviors, and motivations within the local culture, structure, political forces of the KSA. Data was gathered from 40 participants. These individuals and institutional factors influence the EMR adoption and implementation efforts in public sector hospitals in the KSA. Key EMR implementation issues identified included limited IT skills, low professional qualifications, work-overload, and lack of sufficient planning for the integration of EMR with other systems. The study used a mixture of three theories, institutional, Diffusion of Innovation (DOI), and ability, motivation, and opportunity (AMO), to understand the role of these factors and to propose strategies able to increase the rate of successful EMR implementations in public hospitals in the KSA.
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Introduction

The adoption of advance health technology is increased with the purpose to improve patient health care especially in developed countries (Sood, Nwabueze, Mbarika, Prakash, Chatterjee, Ray, & Mishra, 2008; Tierney, Pageler, Kahana, Pantaleoni, & Longhurst, 2013). EMR offers efficient use of secondary data that can enhance efficiency, quality, safety, and effectiveness in the workplace (Jacob & Kamath, 2019; Lambley & Kuziemsky, 2019). Researchers have stated that EMR become the part of modern health care facilities as it accumulates information about patients related to medication prescription, laboratory test result, and patient history (Hasanain, 2015; Lambley & Kuziemsky, 2019).There are number of benefits to adopt EMR system such as increasing patient health care quality, bringing electronic record and efficient use of resources, fostering accuracy in clinical decisions, enhancing patient satisfaction, reducing chances of error, enhancing the efficiency and effectiveness in the workplace (Hasanain, Vallmuur, & Clark, 2015; Khalifa, 2017). Despite the advantages of EMR, there are many implementation barriers which increased the chances of failure up-to 90% in Arab countries (Hasanain, 2015). For example, lack of computer skills, low level of education, and lack of motivation to support EMR technology are some of the common barriers in Arab countries (Khalifa, 2017; Uluc & Ferman, 2016). The existing literature agreed that there is no universal implementation framework and practice which can address the challenges of EMR in both developed and Arab countries (Al-Hanawi, Khan, & Al-Borie, 2019; Uluc & Ferman, 2016). Researchers noticed that the challenges and barriers of EMR implementation are not even similar in public and private hospitals of both developed and Arab countries (Lambley & Kuziemsky, 2019; Hasanain, 2015).

Every health organization has unique challenges and barriers related to plan and strategy (e.g. processes, activities, and standards), environment and context (e.g. culture, structure, macro-economic, political and social aspects, attitude and acceptance), and health organizations need (e.g. speed, level of investment, mission and vision, infrastructure, and user-friendliness) (Al-Hanawi et al., 2019; Hasanain, 2015; Weber, Turjoman, Shaheen, Al-Sayyed, Hwang, & Malick, 2017). Moreover, these challenges and barriers may negatively influence the EMR implementation in both public and private hospitals. Despite the significance of EMR for health care organizations, the speed of adoption and implementation is still low especially in public sector hospitals (Aldosari, Al-Mansour, Aldosari, & Alanazi, 2018; Al-Hanawi et al., 2019). Other studies have highlighted that although the focus to adopt EMR system is increasing but employees of public sector hospital are continuously resisting to adopt this system (Heart, Ben-Assuli, & Shabtai, 2017; Kazley & Ozcan, 2007; Scholl, Syed-Abdul, & Ahmed, 2011). The public hospitals of Kingdom of Saudi Arabia (KSA) have high level of organizational politics, tall structure, low skill labour, low level of employees’ education and computer skills, high levels of employee resistance, and low future orientation about health technology compared to private hospitals (Alsadan, El-Metwally, Anna, Jamal, Khalifa, & Househ, 2015; Elbarazi, Loney, Yousef, & Elias, 2017; Hasanain, 2015). The critical literature review showed that EMR implementation is highly complicated and difficult in public sector hospitals (Hasanain & Cooper, 2014). Therefore, the level of resistance and uncertainty is high among the employees of public sector hospitals in KSA.

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