Factors impacting the adoption decision of health data standards in tertiary healthcare organisations in Saudi Arabia
Authors: Alkraiji Abdullah Ibrahim , Jackson Thomas , Murray Ian 
Published: August 2016

Purpose
Recent studies indicated that the level of adoption of health data standards in healthcare organisations remains frustratingly low worldwide although health data standards have been perceived to be an essential tool for interoperability barriers within health information systems. The relevant literature still lacks significant studies concerning the issues of the adoption process of health data standards in healthcare organisations, and in particular those in developing nation. In addressing this gap in knowledge, the purpose of this paper is to investigate the adoption decision of health data standards in tertiary healthcare organisations in Saudi Arabia, and to develop a technology-organisation-environment list that contains the critical factors influencing their adoption.

Design/methodology/approach
A multiple-case study methodology was conducted in Saudi Arabia and different data collection methods were used included semi-structured interviews with different decision makers at various levels and departments of the subject organisations, and documents analysis to identify critical factors to the adoption decision of health data standards.

Findings
The findings demonstrated a list of key factors from different aspects impacting the adoption decision of health data standards in the subject organisations. The technological factors are complexity and compatibility of health data standards, IT infrastructure, switching costs, market uncertainties, systems integration and enhancing the use of advanced systems. The main organisational factors are the lack of adequate policies and procedures and information management plan, resistance to change, data analysis and accreditation. The core environmental factors are the lack of national regulator and data exchange plan, national healthcare system and the shortage of professionals.

Research limitations/implications
The results from the qualitative data were difficult to generalise to other populations. For example, the structure of the health sector varies from country to country as each health sector has its own characteristics that affect and are affected by national circumstances. In order to provide a more grounded theory resulting from a qualitative study, further examination by conducting quantitative studies is required. In addition, the TOE approach does not take into account the sociotechnical issues and further research is required in this area.

Practical implications
The investigation into the adoption decision of health data standards in tertiary healthcare organisations in Saudi Arabia has led to the development of a technology-organisation-environment list that contains the critical factors influencing their adoption. The research outcome has addressed the gap in knowledge of the adoption of health data standards in healthcare organisations. It also provides the decision maker, and in particular those in developing nations, with better understanding of the adoption process of those standards to better judge and to develop suitable strategy of adoption interventions.

Originality/value
Although recent studies indicated that the level of adoption of health data standards in healthcare organisations remains frustratingly low, the prior studies related to health data standards missed out on the exploration of the adoption decision of different types of health data standards in healthcare organisations and the critical factors influencing their adoption. Research on health data standards adoption based out of a developing country such as Saudi Arabia can also potentially provide several new insights on standards practices.