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Exploring electronic health record systems implementation in primary health care centres in Saudi Arabia: pre-post implementation

Haitham Alzghaibi, Hayley Hutchings Orcid Logo

Frontiers in Medicine, Volume: 12, Start page: 1502184

Swansea University Author: Hayley Hutchings Orcid Logo

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DOI (Published version): 10.3389/fmed.2025.1502184

Abstract

Background: The Saudi government has allocated four billion Saudi Riyals (approximately $1,066 million) to establish the National Electronic Health Record (NEHR) and advance its e-health strategy. Over seventy projects have been identified to achieve this vision. Following the failure of previous in...

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Published in: Frontiers in Medicine
ISSN: 2296-858X
Published: Frontiers Media S.A. 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa69845
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Following the failure of previous initiatives, the Ministry of Health (MoH) in Saudi Arabia is prioritizing the implementation of Electronic Health Record Systems (EHRS) in all Primary Healthcare Centres (PHCs). This study evaluates the implementation of EHRS in PHCs at two phases: pre-implementation and post-implementation. Methods: A quantitative, self-reported questionnaire was employed at two distinct timescales (pre- and post-implementation) to assess user attitudes and experiences. The study population included all clinical and administrative staff working in Saudi PHCs (n = 38,514). A multi-stage cluster sampling technique was used, resulting in data from total 834 participants in both pre and post implementation phases. Results: Participants demonstrated a high level of awareness regarding the perceived usefulness of EHRS during the pre-implementation phase. In the post-implementation phase, agreement toward EHRS usefulness increased, with 96.6% of participants endorsing the system&#x2019;s implementation. However, dissatisfaction emerged regarding training and technical support mechanisms. Negative attitudes were also expressed, particularly regarding the time required to assist less experienced users. Variability in user attitudes was observed across scales measuring perceived usefulness, training and support, and negative attitudes. These findings highlight evolving perceptions influenced by direct system use and organizational support. Conclusion: End-user attitudes toward EHRS implementation vary over time and are influenced by system usability, organizational support, and the scale of the project. 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spelling 2025-06-30T11:33:47.6508020 v2 69845 2025-06-30 Exploring electronic health record systems implementation in primary health care centres in Saudi Arabia: pre-post implementation bdf5d5f154d339dd92bb25884b7c3652 0000-0003-4155-1741 Hayley Hutchings Hayley Hutchings true false 2025-06-30 MEDS Background: The Saudi government has allocated four billion Saudi Riyals (approximately $1,066 million) to establish the National Electronic Health Record (NEHR) and advance its e-health strategy. Over seventy projects have been identified to achieve this vision. Following the failure of previous initiatives, the Ministry of Health (MoH) in Saudi Arabia is prioritizing the implementation of Electronic Health Record Systems (EHRS) in all Primary Healthcare Centres (PHCs). This study evaluates the implementation of EHRS in PHCs at two phases: pre-implementation and post-implementation. Methods: A quantitative, self-reported questionnaire was employed at two distinct timescales (pre- and post-implementation) to assess user attitudes and experiences. The study population included all clinical and administrative staff working in Saudi PHCs (n = 38,514). A multi-stage cluster sampling technique was used, resulting in data from total 834 participants in both pre and post implementation phases. Results: Participants demonstrated a high level of awareness regarding the perceived usefulness of EHRS during the pre-implementation phase. In the post-implementation phase, agreement toward EHRS usefulness increased, with 96.6% of participants endorsing the system’s implementation. However, dissatisfaction emerged regarding training and technical support mechanisms. Negative attitudes were also expressed, particularly regarding the time required to assist less experienced users. Variability in user attitudes was observed across scales measuring perceived usefulness, training and support, and negative attitudes. These findings highlight evolving perceptions influenced by direct system use and organizational support. Conclusion: End-user attitudes toward EHRS implementation vary over time and are influenced by system usability, organizational support, and the scale of the project. Addressing training deficiencies, improving technical support, and involving end-users in the implementation process are critical to fostering positive attitudes and ensuring successful EHRS adoption in PHCs. Journal Article Frontiers in Medicine 12 1502184 Frontiers Media S.A. 2296-858X electronic health records, large-scale project, primary healthcare centers, IT project management, user attitude, Saudi Arabia, Questionnaire 16 6 2025 2025-06-16 10.3389/fmed.2025.1502184 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee The Researchers would like to thank the Deanship of Graduate Studies and Scientific Research at Qassim University for financial support (QU-APC-2025). 2025-06-30T11:33:47.6508020 2025-06-30T11:23:47.1658880 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Haitham Alzghaibi 1 Hayley Hutchings 0000-0003-4155-1741 2 69845__34623__b4fb70a28e5446f886db0485d895817a.pdf fmed-12-1502184.pdf 2025-06-30T11:23:47.1655642 Output 1629036 application/pdf Version of Record true © 2025 Alzghaibi and Hutchings. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). true eng http://creativecommons.org/licenses/by/4.0/
title Exploring electronic health record systems implementation in primary health care centres in Saudi Arabia: pre-post implementation
spellingShingle Exploring electronic health record systems implementation in primary health care centres in Saudi Arabia: pre-post implementation
Hayley Hutchings
title_short Exploring electronic health record systems implementation in primary health care centres in Saudi Arabia: pre-post implementation
title_full Exploring electronic health record systems implementation in primary health care centres in Saudi Arabia: pre-post implementation
title_fullStr Exploring electronic health record systems implementation in primary health care centres in Saudi Arabia: pre-post implementation
title_full_unstemmed Exploring electronic health record systems implementation in primary health care centres in Saudi Arabia: pre-post implementation
title_sort Exploring electronic health record systems implementation in primary health care centres in Saudi Arabia: pre-post implementation
author_id_str_mv bdf5d5f154d339dd92bb25884b7c3652
author_id_fullname_str_mv bdf5d5f154d339dd92bb25884b7c3652_***_Hayley Hutchings
author Hayley Hutchings
author2 Haitham Alzghaibi
Hayley Hutchings
format Journal article
container_title Frontiers in Medicine
container_volume 12
container_start_page 1502184
publishDate 2025
institution Swansea University
issn 2296-858X
doi_str_mv 10.3389/fmed.2025.1502184
publisher Frontiers Media S.A.
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
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description Background: The Saudi government has allocated four billion Saudi Riyals (approximately $1,066 million) to establish the National Electronic Health Record (NEHR) and advance its e-health strategy. Over seventy projects have been identified to achieve this vision. Following the failure of previous initiatives, the Ministry of Health (MoH) in Saudi Arabia is prioritizing the implementation of Electronic Health Record Systems (EHRS) in all Primary Healthcare Centres (PHCs). This study evaluates the implementation of EHRS in PHCs at two phases: pre-implementation and post-implementation. Methods: A quantitative, self-reported questionnaire was employed at two distinct timescales (pre- and post-implementation) to assess user attitudes and experiences. The study population included all clinical and administrative staff working in Saudi PHCs (n = 38,514). A multi-stage cluster sampling technique was used, resulting in data from total 834 participants in both pre and post implementation phases. Results: Participants demonstrated a high level of awareness regarding the perceived usefulness of EHRS during the pre-implementation phase. In the post-implementation phase, agreement toward EHRS usefulness increased, with 96.6% of participants endorsing the system’s implementation. However, dissatisfaction emerged regarding training and technical support mechanisms. Negative attitudes were also expressed, particularly regarding the time required to assist less experienced users. Variability in user attitudes was observed across scales measuring perceived usefulness, training and support, and negative attitudes. These findings highlight evolving perceptions influenced by direct system use and organizational support. Conclusion: End-user attitudes toward EHRS implementation vary over time and are influenced by system usability, organizational support, and the scale of the project. Addressing training deficiencies, improving technical support, and involving end-users in the implementation process are critical to fostering positive attitudes and ensuring successful EHRS adoption in PHCs.
published_date 2025-06-16T05:29:15Z
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