Exploring factors that Influence the acceptance of clinical decision support systems in Saudi Arabia

Adopting a useful health information system (HIS) can be considered a vital precondition for providing efficient and high-quality healthcare services. With the rapidly growing technical development in the healthcare sector over recent years, the presence of multiple diseases and increasing patient numbers, healthcare practitioners can benefit from using an advanced HIS, such as a clinical decision support system (CDSS). This is because it is vital to enhance decision-making around care. CDSS may fail as a result of failing to understand the factors that affect general practitioner (GP) acceptance of CDSS. A GP is usually the frontline healthcare professional who diagnoses patients in the early stages of illnesses and their treatment at primary healthcare centres or in hospitals. Primary healthcare centres and hospitals can have long waiting lists, and this can result in hasty medical decisions made without due consideration of other factors. Therefore, a computer-based application such as CDSS may provide better support for health care decisions, based on evidence-based analysis, and with better accuracy and error-free outcomes. Identifying the factors related to CDSS acceptance is vital to the successful adoption of such a system. This study integrates existing adoption approaches, such as the unified theory of acceptance and use of technology (UTAUT) and task-technology fit (TTF) models to support the investigation of CDSS. The combination of these models helps to create a robust research framework. The two models have been incorporated in different forms in previous studies regarding the acceptance of information technologies. In contrast, this study is significant in its examination of CDSS’s adoption in the Saudi Arabian healthcare sector. The study employs a qualitative approach for collecting views and analysing data. A total of 54 GPs were interviewed, using semi-structured questions. These professionals were selected from various primary health care centres and hospitals in Saudi Arabia to uncover the factors that affected their acceptance of CDSS. A thematic approach was used to analyse the data. The research results confirm that all UTAUT and TTF factors influence GP acceptance of CDSS. These factors include performance expectancy, effort expectancy, facilitating conditions, technology that is fit for the task, technology characteristics and task characteristics. The social influence factor of UTAUT was not explored, as most participants considered this either ineffective or irrelevant. New factors were also discovered through in-depth interviews. These include accessibility, perceived patient satisfaction, informativeness (increased knowledge), connectedness (informing patients), communication and shared knowledge, privacy and security, and perceived risk (functional performance risk and time risk). Of 13 determinants, three (performance expectancy, effort expectancy, and facilitating conditions) correspond to those found in the UTAUT model and three (task-technology fit, technology characteristics and task characteristics) match the TTF model. This research provides great value and contribution to HIS adoption research, through in-depth interviews of CDSS acceptance in Saudi Arabia. Further, the research offers a new adoption framework for CDSS and a new set of factors that influence GP acceptance, ones that go beyond the existing models. The results of this research contribute to assisting health system researchers, designers and also decision-makers in health care management, to understand what factors promote the successful provision of CDSS.