Barriers to the Adoption of EHR Systems in the Kingdom of Saudi Arabia: An Exploratory Study Using a Systematic Literature Review

Asma Alqahtani, Richard Crowder, Gary Wills


Objective: Electronic Health Records (EHRs) have become a key enabler to improving patient safety, improving healthcare quality, and increasing healthcare efficiency. Governments in various countries have moved beyond the local implementation of EHRs in different healthcare organizations to the national implementation and integration of EHRs. The Kingdom of Saudi Arabia (KSA) has lagged behind significantly in this regard, with only few hospitals have implemented the EHR. The purpose of this study is to identify barriers to the adoption of EHRs in the KSA using a systematic literature review. Methods: We searched for relevant articles using six search engines (PubMed, EBSCO Host, Web of Science, ACM, IEEE and Google Scholar). The search criteria focused on peer reviewed, empirical studies conducted in the KSA. The final set that met the inclusion criteria was twelve studies. The authors extracted, analyzed, summarized, and categorized empirical results related to EHR barriers in these studies. Results: After categorization and analysis, we identified the following twelve main barriers to EHR adoption: lack of computer experience by healthcare professionals (18%), lack of perceived usefulness by healthcare professionals (15%), lack of perceived ease of by healthcare professionals (15%), technical limitations of the software system (15%), lack of user support (9%), confidentiality concerns (9%), user resistance to change (6%), lack of quality in patients’ information (3%), lack of EHR standards (3%), uncertainty about EHR vendors (3%), hospital size (3%), and hospital’s level of care (3%). Conclusion: The findings of this study will be of great potential to policy makers and EHR vendors in the KSA. They can inform strategies to design systems and tailor implementation strategies toward factors that motivate adoption. A second important contribution of this study is that it provides evidence that the extant technology adoption theories like the Technology Acceptance Model (TAM) are not sufficient in explaining EHR adoption, as only 30% of identified barriers could be categorized according to TAM. There is a need for creating a new model for EHR adoption.


Electronic Health Record (EHR); Electronic Medical Record (EMR); Barriers to implementation; Saudi Arabia; Systematic Literature Review.

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