Studies of EHR implementation and operation in different countries with particular reference to Saudi Arabia : a thesis presented in partial fulfillment of the requirements of degree of Master in Information Science at Massey University, Albany campus, Auckland, New Zealand

Abstract

Electronic Health Records (EHRs) have led to a significant transformation in the healthcare sector. EHRs have improved the nature of healthcare delivery in the various healthcare organizations. While recognizing the changes in healthcare sector, this thesis studied the implementation and the use of EHRs in four developed countries, the United State (US), United Kingdom (UK), Australia and New Zealand and one developing country, Saudi Arabia. By employing primary and secondary literature, EHR’s benefits, challenges, success factors as well as lessons for developing countries were identified. The implementation of the EHRs in the ambulatory care was almost universal in the UK, Australia and New Zealand (each >90%), except the US which is lagging behind (46%). The low rate of EHR adoption in the US was attributed to factors such as lack of requirements imposing the use of computers in medical practises. Although, there is no good data for the use of EHRs in hospitals in the studied countries, EHR use remains uncommon in hospital settings. The use of EHRs in Saudi Arabia is uncommon; however several projects have been established by the government of Saudi Arabia to increase the awareness of such technologies as well as to develop strategies for implementing EHRs. Saudi Arabia and other developing countries should learn the best practices from developed countries and that it is important that they come up with initiatives and legislations to support the implementation of EHRs. Currently, all of the studied countries set the implementation of a national EHR as a priority in their healthcare system reform. Two approaches for the presentation of national EHR database were identified in the developed countries; centralised or distributed. While EHR provides various benefits to clinicians, patients and healthcare managers, its implementation poses many challenges such as confidentiality, privacy, security, lack of standards, start-up cost and content of discharge summary. To achieve successful implementation of EHRs, factors such as leadership, organization structure, goals, visions, communication, organization culture and workflow redesign should be considered.