Alaggad, Noha
(2025)
Exploring factors influencing healthcare professionals acceptance of use of cloud-based Health Information System: qualitative case study in Saudi hospitals.
PhD thesis, University of Nottingham.
Abstract
Background: Cloud computing is increasingly a default technological platform in healthcare, with obvious advantages such as reducing costs, offering flexibility, and ubiquitous internet access to data. However, it has risks related to security and complexity issues. Having a Cloud-based Health Information System (CBHIS) is becoming an ambition for most developing countries, including Saudi Arabia. There is a need to identify technology acceptance factors concerning CBHIS in Saudi healthcare, in order to facilitate successful adoption. Most previous studies focused on the organisational level of acceptance, but this study addresses the crucial individual level, not only focusing on experts but also considering the end-users, and ascertaining how they can affect the success of system implementation. Therefore, this study identifies factors in the acceptance of CBHIS among patients and healthcare professionals (HCPs) based on technology acceptance frameworks.
Aim: To explore factors that influence HCPs’ acceptance of CBHIS in Saudi hospitals, and the extent to which they influence the successful implementation of the system.
Methods: A qualitative, multiple-case study methodology was used in two hospitals in Jeddah: Dr Soliman Fakeeh Hospital (private) and King Fahad General Hospital (public). The study gathered and triangulated data from semi-structured interviews with 30 HCPs, document reviews, and observations, to strengthen reliability. A thematic analysis framework utilising both inductive and deductive approaches was applied, followed by cross-case analysis, for a deeper understanding of influencing factors.
Findings: Seven themes were derived from the synthesised study findings: level of knowledge, level of exchange patient data, roles and responsibilities of system development and implementation, users’ benefits from using the system, data security and privacy, and users’ experience. These factors were mapped into the Unified Theory of Acceptance and Use of Technology (UTAUT) model, leading to extending its constructs to include “organisational change maturity” (OCM) and “perceived risks” (PR) as important factors of CBHIS acceptance in the Saudi healthcare context. The study results also led to creating a mature organisational learning framework, highlighting the mechanisms between policy, practice, and knowledge, focusing on formal and informal learning as tools that motivate the learning cycle.
Implications: This study provides a better understanding of factors that contribute to HCPs’ acceptance of CBHIS usage, illuminating both practical and theoretical implications for enhancing the acceptance of CBHIS among HCPs in Saudi hospitals. Practically, it proposes an organisational learning framework to boost HCPs’ knowledge and engagement, addresses system interoperability to facilitate patient data exchange, emphasises robust security measures to protect patient information, and confirms the importance of involving HCPs in the decision-making and development process of adopting the system. Theoretically, the study enriches the UTAUT model by integrating OCM and PR, offering a nuanced understanding of the dynamics influencing CBHIS adoption in healthcare settings. These contributions advance the theoretical foundations of technology acceptance models and provide actionable strategies to implement and optimise CBHIS effectively.
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