Barriers to the implementation of large-scale electronic health record systems in Primary Healthcare centers
Authors: Alzghaibi Haitham , Hutchings Hayley A. 
Published: July 2024

Abstract

The incorporation of data Over the past two decades, policy-makers in healthcare organizations have placed significant emphasis on technology as a top priority. This is because of the potential advantages that technology offers in enhancing healthcare services and improving their quality. Nevertheless, approximately half of those projects did not succeed in attaining their planned objectives. This outcome was a consequence of multiple variables, which encompassed the expenses associated with these initiatives. The Saudi ministry of health intended to deploy an electronic health record system in approximately 2200 basic healthcare clinics across the country. It was recognized that this project could encounter obstacles, perhaps leading to project failure, if implementation facilitators were not identified beforehand. The Saudi Ministry of Health (MoH) states that the earlier adoption of Electronic Health Record Systems (EHRS) at Primary Health Centers (PHCs) failed due to various obstacles, including inadequate infrastructure, limited connectivity, and lack of interoperability.
Aim:
To determine the barriers that may that could potentially contribute of failure the implementation of the EHRS in the PHCs
Method:
A mixed methods approach was employed, incorporating both qualitative and quantitative methodologies. The qualitative aspect involved conducting semi-structured interviews, while the quantitative component utilized a closed survey. The objective of employing exploratory mixed-methods was to find a diverse array of facilitators that could potentially impact the implementation of EHRS. The data were collected from two distinct viewpoints: PHCs practitioners and project team members. A total of 351 practitioners from 21 PHCs participated in the online-based survey, while 14 key informants at the Saudi Ministry of Health (MoH) who were directly involved in the implementation of the Electronic Health Record System (EHRS) in the PHCs agreed to be interviewed in person.
Results:
The results from both investigations identified multiple obstacles. The constraints include the project's extensive scope, the need to adapt individuals to change, insufficient training, inadequate technical assistance, lack of compatibility between systems, geographical obstacles, software selection issues, and insufficient user engagement. However, this study offers many suggestions to decision-makers and the EHRS implementation project team to streamline the adoption of a widespread EHRS. These ideas include collaborating with telecom providers and splitting the state into clusters.
Conclusion:
The primary factors contributing to the failure of the previous initiative were insufficient connectivity, inadequate technical assistance, and significant turnover in high-level posts within the Saudi Ministry of Health. Training and support were identified as a significant obstacle, whereas confidentiality and privacy were determined to be less of a hindrance to the introduction of EHRS. Hence, authorities must allocate a enough budget to ensure seamless execution, especially when making choices about software selection and the provision of training and support.
• This study provides insights into the procedures and steps of implementing EHRs.
• The findings will enhance our understanding of how to overcome impediments that impact the success of EHRS deployment.
•This study aims to address the research gaps by specifically identifying and analyzing the implementation methods in primary healthcare centers (PHCs) in Saudi Arabia and other Arab Gulf Countries (GCCs).
This study makes a methodological addition by combining qualitative and quantitative research designs to investigate the obstacles to the implementation of EHRS.