title: Barriers and challenges in adopting Saudi telemedicine network: The perceptions of decision makers of healthcare facilities in Saudi Arabia.
abstract: Despite emerging evidence about the benefits of telemedicine, there are still many barriers and challenges to its adoption. Its adoption is often cited as a failed project because 75% of them are abandoned or 'failed outright' and this percentage increases to 90% in developing countries. The literature has clarified that there is neither one-size-fit-all framework nor best-practice solution for all ICT innovations or for all countries. Barriers and challenges in adopting and implementing one ICT innovation in a given country/organisation may not be similar - not for the same ICT innovation in another country/organisation nor for another ICT innovation in the same country/organisation. To the best of our knowledge, no comprehensive scientific study has investigated these challenges and barriers in all Healthcare Facilities (HCFs) across the Kingdom of Saudi Arabia (KSA). This research, which is undertaken based on the Saudi Telemedicine Network roadmap and in collaboration with the Saudi Ministry of Health (MOH), is aimed at identifying the principle predictive challenges and barriers in the context of the KSA, and understanding the perspective of the decision makers of each HCF type, sector, and location. Three theories are used to underpin this research: the Unified Theory of Acceptance and Use of Technology (UTAUT), the Technology-Organisation-Environment (TOE) theoretical framework, and the Evaluating Telemedicine Systems Success Model (ETSSM). This study applies a three-sequential-phase approach by using three mixed methods (i.e., literature review, interviews, and questionnaires) in order to utilise the source triangulation and the data comparison analysis technique. The findings of this study show that the top three influential barriers to adopt and implement telemedicine by the HCF decision makers are: (i) the availability of adequate sustainable financial support to implement, operate, and maintain the telemedicine system, (ii) ensuring conformity of telemedicine services with core mission, vision, needs and constraints of the HCF, and (iii) the reimbursement for telemedicine services.
authors.affiliation: Alqwiaiah Community College, Shaqra University, Saudi Arabia; School of Computing, Staffordshire University, United Kingdom. Electronic address: alaboudi@su.edu.sa.
authors.forename: Abdulellah
authors.initials: A
authors.lastname: Alaboudi
authors.affiliation: School of Computing, Staffordshire University, United Kingdom. Electronic address: a.s.atkins@staffs.ac.uk.
authors.forename: Anthony
authors.initials: A
authors.lastname: Atkins
authors.affiliation: School of Computing, Staffordshire University, United Kingdom. Electronic address: b.sharp@staffs.ac.uk.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Sharp
authors.affiliation: The eHealth Strategy and Change Management Office, Ministry of Health, Saudi Arabia. Electronic address: abalkhair@moh.gov.sa.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Balkhair
authors.affiliation: College of Engineering at Al Leith, Umm Al-Qura University, Saudi Arabia. Electronic address: msjzahrani@uqu.edu.sa.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alzahrani
authors.affiliation: Johns Hopkins Aramco Healthcare, Saudi Arabia. Electronic address: tamara.sunbul@jhah.com.
authors.forename: Tamara
authors.initials: T
authors.lastname: Sunbul
mesh_terms: D002202:Capital Financing; D006268:Health Facilities; D006801:Humans; D012051:Reimbursement Mechanisms; D012529:Saudi Arabia; D017216:Telemedicine / Q000379:methods* / Q000592:standards / Q000639:trends*
keywords: Barriers; Challenges; Saudi Arabia; Saudi Telemedicine Network; Telemedicine