Student First Name: Shiekha. Student Second Name: Al kheliwi. Copyright subsists in all papers and content posted on this site.

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1 Student First Name: Shiekha Student Second Name: Al kheliwi Copyright subsists in all papers and content posted on this site. Further copying or distribution by any means without prior permission is prohibited, except for the purposes of non commercial private study or research, as defined in the Copyright, Designs and Patents Act 1988, or as otherwise authorised by statute. To obtain permission, please contact the author of the relevant paper in the first instance or with details of your request.

2 Health Information Management In E-health system Adoption Electronic Medical Record And Cultural Effect Study case ( KFSH&RC) Saudi Arabia,Riyadh city Adoption Electronic Record & Culture Effect

3 Abstract : Across the globe e-health systems are beginning to be rapidly adopted. Combine information communication technology (ICT) and Electronic Management Record (EMR).the new system aim to reduce healthcare errors, lower costs and enhance medical outcomes. Additionally they have the potential for increasing safety and improving healthcare coordination. The implementation of e-health systems in developing countries is now a challenge shared by United Nations agencies and other government agency (MOH), national and local levels. The research seeks to exploratory the e-health effort in Saudi Arabia by giving a comprehensive overview of the current literature available; by developing a framework for adoption of EMR or HER in the health sectors. By identifying the barriers to the adoption of both system in a Saudi context and describing the effect of culture on adoption. Challenges EMR or EHR in Saudi Health systems The Ministry of health plays a central role in providing and financing healthcare services in the Saudi Arabia. The challenges faced are: How can they provide access to high quality healthcare to an increasingly wealthy population that spread across a large country? According to (WHO, 2010) there are a variety factors affect on adoption the health care system (Economic, Demographic, structure and chronic diseases) the most common disease in the kingdom: diabetes, pressure, asthma, heart disease, cholesterol..obesity, osteoporosis and breast cancer. Despite the high expectations and interest in EMRs worldwide, their overall adoption rate is almost law and faces a several problems. For Instant they are find different traditional working style, they require a greater capability with installing system and financial resources. ( Boonsra, A, Albert, Broekhus, M; 2010) Accoding to Fahad Al Otaibi 2012, there are (7) health services providers in different regional. They are using different (Health information system). Where we are

4 In develop countries they are advanced in adoption of e-health systems and EMR or EHR in their health sectors. They are transfer to the next stage which called Level 7, which is the last stage in adoption EMR or EHR. Between in developing countries still we are faced a lot of barriers to adoption EMR or EHR in our health sector. Why? 1- Different health service providers. 2- Different health information system depends on implantation stage, and agencies capacity. 3- Lake of communication and integration between the different systems. 4- Increasing the income earned by Saudi nationals in comparison to the low cost of healthcare to the high availability of medical care staff and lack of some of services in government hospitals and GPs. These factors have led to the increased private health care centres. Saudis are able to use more than centre in the same time. Which lead to distributed amongst different caregivers due to the various local specialist centres available? 5- Infrastructure requires 6- Literacy of Computer. 7- Culture What is the EMR or EHR? EMR: An application environment composed of the clinical data. It is the legal record of what happened to the patient during their at CDO and is owned by the CDO EHR : A subset of each care delivery organization EMR presently assumed to be summaries like ASTM s continuity of Care Record or HL 7s is owned by patient and he has access What is the different between them?

5 EMR : The legal record of the CDO A record of clinical services for patient encounters in a CDO Owned by the CDO These systems are beig sold by enterpris vendors and instaleed by hospitasls, health systems, clinics, e May have patient access to some results info through a portal-but is not interactive Does not contain other CDO encounter information EHR: Subset (i.e.ccr or CCD) of information from various CDOs where patient has had encounters. Owned by patient or stakehoder Communiy, state, or regional emergence today(rhios) or nationwide in the future Proides interactive patient access as well as the ability for the patient to append information. Connected by NHIN What is Mean the HL7 s? EMR Adoption Model: the level of EMR capabilities in hospitals is a challenge in the US healthcare IT. Stage 7: the hospital has a paperless EMR environment. Clinical information can be redial shared via electronic transactions or exchange of electronic records with all entities within a regional health network. This stage allows the HCO to support the true electronic health record as envisioned in the ideal model. Meaningful use: Certified HER technology used in A Meaningful way is one piece of broader health information. Technology, infrastructure needed to reform the health care system and improve a health care quality, efficiency, and patient safety. Wihe two htag. Most common health problems in developing countries like Saudi Arabia Increasing death rate. Suffering various diseases.

6 Increasing disabilities with new born babies. Increasing expenditure. Abuse of drugs. What is the benefit of Adoption of EMR? Ensures that appropriate information to guide medical decisions is available at the time and place of care; Improves health care quality, Reduces medical errors, and advances the delivery of appropriate, evidence-based medical care; Reduces heath care costs resulting from inefficiency, medical errors inappropriate care, and incomplete information; Promotes a more effective market place, Increase choice through the wider availability of accurate information on health care costs, quality, and outcomes. Improves the coordination of care and information among hospitals laboratories, physician offices and other, ( Cellucci, L,etc 2011(MR implementation and the import of theory and culture) How the culture impact on adoption of EMR or EHR

7 There are many study show s that Most of Adoption of EMR or HER in health sector. Is not full Successfully even they are in a high level, as some of study provide physicians may face a range of briers when they approach EMR implementation ( Boonstra, A; Broekhuis, M: 2010,Health services Researc. What level of culture: **According to dr. Maged ali. Their three level of culture. Which we can use in Research Goal and purpose The purpose of this search to find out how (e-health system ) facilities can improve the health care system by adoption Electronic Medical Record or Electronic Health Record. In the Saudi Health care system. Cities and rural areas. Thus an EMR or EHR can play a significant role to save patients data record and decrees the Errors, cost, time, access facilities in everywhere in local hospital or other in Saudi Arabia. Of health care system This research sets the following aims: 1. To identify the barriers to the adoption of EMR or EHR in the health sector of a developing country. 2. To identify the key cultural factors which have the greatest impact on applying reliable healthcare methodologies in KSA. 3. To investigate these barriers and find how they could affect the adoption of EMR or EHR systems by using a qualitative research approach. 4. To develop a framework for the implementation of EMR or EHR that will provide a guide to the Saudi governmental health care sector and shed light on the negative effects of some cultural factors in relation to this field. 5. To provide researchers and decision-makers in Saudi Arabia with recommendations for enhancing competitiveness and improving the performance of healthcare based on accurate information regarding the benefits of EMR or EHR.

8 Research Objective and Scope of work The main objective of this study is an attempt to assess the impact of Saudi local culture on the adoption of EMR or EHR in the healthcare sector and to assess how those cultural elements play a key role in that issue. Other objectives are as follows: 1. To analyze the effects of cultural factors on life aspects of healthcare in general and in healthcare methodologies for the evaluation of the adoption of EMR or EHR in particular. 2. To highlight and analyze the impact of Saudi cultural factors on the health sector and to assess the most influential, looking in particular at how they could affect the performance and outcomes of healthcare services. 3. To evaluate the present level of e-health system in Saudi Arabia. 4. To identify the barriers and benefits to adoption of EMR or EHR in the Health sector. Research Methodology We will carry out this research following the qualitative research approach ( Qualitative research method,2011). And the method we will be the case study to deeply analyze why and how culture affects adoption of EMR process. In this case we will conduct the research work in the following stages: 1. Data Collection: In this research, we will use two ways: I) review previous research work and existing (EMR or EHR) system in different countries. 2. Conducting a survey. In the first stage to identify requirement and environment. By using the questionnaires to find out the impacts of culture on adoption of EMR or EHR. To the citizens. The survey focuses on the real situation about the current health condition among the local people 3. Data Analysis : Significance of the research The study intends to fill an existing gap in the literature about the Saudi culture and its impact on applying e health system particularly the adoption of EMR or EHR in the governmental health sector. To the best of the researcher s knowledge, there are no academic studies that have discussed the specific area of interest in Saudi Arabia. Plus, as I am the researcher I can contribute positively in this study taking into account that I'm from the same culture. I am able to get access to

9 the required data from the related Saudi medical organisations especially King Faisal Specialist Hospital & Research Centre