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.

Telemedicine Healthcare Service Adoption Barriers in Rural Bangladesh

“…No conceptual or theoretical frameworks concerning the relationships between telemedicine barriers and adoption were found. Robust prior studies in telemedicine, e-Health, telehealth, and m-Health (Alaboudi et al, 2016;Bigna, Noubiap, Plottel, Kouanfack, & Koulla-Shiro, 2014;Boonstra & Broekhuis, 2010;Bullock et al, 2017;Cajita, Hodgson, Lam, Yoo, & Han, 2018;De Bustos, Moulin, & Audebert, 2009;Faber, van Geenhuizen, & de Reuver, 2017;Freed et al, 2018;Gravel, Légaré, & Graham, 2006;Jang-Jaccard et al, 2014;Johnson, 2001;Leaming, 2007;LeRouge & Garfield, 2013;Lin, Lin, & Roan, 2012;Lohmann, Muula, Houlfort, & De Allegri, 2018;Modi, Portney, Hollenbeck, & Ellimoottil, 2018;Moffatt & Eley, 2011;Ramtohul, 2015;Rogove, McArthur, Demaerschalk, & Vespa, 2012;Scott Kruse et al, 2018;Scott & Mars, 2013;Van Dyk, 2014;Whitten, Holtz, Meyer, & Nazione, 2009) were used to develop and test the hypotheses regarded as mutually exclusive and exhaustive when considered from a model parsimony perspective. These seven broad categories of barriers are encapsulated in the study's conceptual model (see Figure 1).…”

Barriers to Development of Telemedicine in Developing Countries

“…For setting an audio visual ICT platform for teleconsultation needs huge investment. Budgetary constraints become a major barrier in the development of telemedicine network in developing countries [7,18,19,24]. A sustainable financial support is needed to purchase, deploy, operate, and maintain the sophisticated telemedicine platform [19].…”

“…Budgetary constraints become a major barrier in the development of telemedicine network in developing countries [7,18,19,24]. A sustainable financial support is needed to purchase, deploy, operate, and maintain the sophisticated telemedicine platform [19]. Telecommunication expenses, training of service providers and clients, and need for newer ICT platforms require most of the expenditure.…”

“…A lack of support to newer ICT tools has been observed from both parties (providers and users). Several studies have revealed that the resistance to change has been reported toward telemedicine from providers (physicians) as well as from users (clients/patients) for newer technology [14,19,25,33,35].…”

“…There are many barriers in the adoption of telemedicine and adoption failure is serious issue, which needs to be discussed and explored. According to a study, about 75% of the telemedicine projects are abandoned or failed outright and called as failed projects and this percentage goes up to 90% in developing countries [19]. Until we are not able to find out, enlist, analyze, and understand the barriers in the deployment and development of telemedicine, we cannot ensure success of telemedicine program.…”