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The existing Barriers and Facilitators to Mobile Technology Usage in Healthcare within Saudi Arabia

Mobile technology adoption has reshaped healthcare provision in Saudi Arabia. Through the use of mobile phones healthcare providers have enhanced communication with the patients. There is improved inter-provider communication as well as the involvement of patients in decision-making on matters concerning their healthcare needs. However, there are specific barriers and facilitators to mobile technology usage in Saudi Arabia that Health Information Systems personnel should investigate to ensure smooth integration of this technology into healthcare provision. The barriers and facilitators are experienced at the levels of patients, physicians, and other healthcare stakeholders. The most potential barriers to mobile technology usage are costs of calls and messaging, inadequate knowledge on the usage of cell phones, lack of perceived usefulness, mistrust of cell phones, technological designs of cell phones, and instability in mailing addresses.

Additionally, the Saudi Arabians are concerned about the potential risk to the security and confidentiality of their healthcare data. On the other hand, facilitators to mobile technology usage in Saudi Arabia include ease of use of cell phones, portability of cell phones, desire of patients to have control over their health data, ease access to and affordability of cell phones, and convenience. This paper is purposely documented to provide a succinct scrutiny of the potential barriers and facilitators to mobile technology usage in healthcare in the context of Saudi Arabia.

The potential Barriers to Mobile Technology Usage in Healthcare within Saudi Arabia

From the perspective of the patients

The initial barriers to mobile technology in the perspective of the patients in Saudi Arabia revolve around the cell phones. Cell phones have specific features that can deter patients from sufficient usage to satisfy their healthcare information needs. The general affordability of cell phones is outweighed by the high cost of maintenance. According to Youssef (2014), the use of telephone reminders is costly and the interactions between patients and care providers might involve repeated calls (p. 318). A cell phone needs constant money for texting and calling. Additionally, there are costs incurred for recharging cell phone batteries. AlGhamdi, Drew, & Alkhalaf (2012) argue that Saudi Arabians use various information technologies minimally because of poor structuring of the systems, lack of confidence and trust in new technologies, unclear laws and regulations, and poor knowledge in information systems (p. 773). This assertion indicates that on the patients’ perspective, the main barriers to cell phone use in Saudi Arabia are unclear regulation, lack of knowledge, and mistrust of the systems. The mistrust would make patients to be concerned about their privacy while using cell phones to receive or share their health information.

The poor structuring in the essence of mobile technology implies to the designs of various phones and applications that require substantive training before usage. According to Khalifa (2013), the field study in the Saudi Arabian hospitals redesigning of health information systems is integral in overcoming technical barriers to ensure the needs of the various are met (p. 340). The complex applications and designs in smartphones can deter patients, particularly the elderly, from using mobile technology efficiently. Patients might also lack knowledge to use cell phones. The next barrier is the security and privacy concerns of patients in Saudi Arabia. AlGhamdi, Drew, & Al-Ghaith (2011) posit that Saudi Arabians established negative attitudes towards online mobile technology due to lack of trust as a result of privacy concerns, inequality in socio-economic levels, language differences, and lack of customer services (p. 3). The privacy concerns would make patients to limit sharing their health information using mobile technology. According to Al-Khathaami, Alshahrani, Kojan, Al-Jumah, Alamry, & El-Metwally (2015), there is low acceptability of health information systems in Saudi Arabia due to cultural inclination to protect personal privacy (p. 27).

The difference in socio-economic status couples the high costs for calls and messaging that reduces the propensity of some of the patients to use cell phones. Skaria (2013) notes that many of the available mobile technology are applicable to phones with 2G/3G system such as the renowned smartphones that people of lower socio-economic status cannot afford (p. 27). The socio-economic disparity is escalated by the prominent gender inequality in Saudi Arabia. Mobaraki and Soderfeldt (2010) opine that Saudi Arabia is a male dominated society whereby women are even forced to marry their relatives (p. 115). Therefore, women would be more concerned about trust on the use of mobile technology. Additionally, such gender inequity can subject the Saudi Arabian women to hindrance from using such technology. The language diversity in Saudi Arabia aforementioned would also affect the ability of patients from different language backgrounds to use one national language. Therefore, cellphone designers should ensure that the language mode of the phones can be easily adjusted to suit the needs of different patients.

The designs of cellphones can hinder mobile technology usage among patients in Saudi Arabia. Cellphones have similar characters with computers with the properties of storage and computation of data. However, they have relatively smaller screens compared to computers or laptops that patients can use for similar reasons of accessing healthcare information. Skaria (2013) asserts that the small screens of cellphones propels users to use the navigation keys to scroll up and down to access entire message content and this might prove difficult to the elderly patients and commoners (p. 28). According to Almalki, FitzGerald, and Clark (2011), Saudi Arabia has a population of 27.1 million with 5.2% of the total population being over 6o years of age (p. 785). Therefore, based on the difficulties the elderly face in using cellphones with small screens, the 5.2% of the Saudi Arabian population might not get sufficient services from mobile technology in healthcare.

The patients also have inadequate knowledge on the existence of mobile technology usage in healthcare systems. Khalifa (2013) asserts in the results of the Saudi Arabian case study that the human barriers to usage of information technologies in healthcare include lack of awareness of the importance and benefits of using electronic medical records, lack of knowledge and experience for using electronic medical records (p. 338). Therefore, the patients would be reluctant to use electronic platforms to satisfy their health needs due to lack of awareness and inexperience. Healthcare IT professionals should, therefore, ensure that patients receive adequate training on mobile technology usage prior to the launch of its implementation.

Mobile technology usage is also discouraging due to the lack of a single consistent and standard language used for communication in the information systems. Patients get confused of the terms used in the internet or across the data sharing applications in their cellphones. Bahkali, Almaiman, Almadani, Househ, & El Metwally (2014) posit that inconsistency of terminology is common in coding health events reported to the systems at MOH and the NGHA rendering health data difficult to comprehend (p. 263). The consequence of this language confusion would be misinterpretation of patient information leading to misdiagnoses of healthcare cases. It is also significant to note that patients have an opportunity of visiting physicians to seek clarification for the confusing terminologies and this opportunity would lead to a dependence on physicians and limit mobile technology usage. Therefore, a multi-lingual state such as Saudi Arabia should develop a standardized controlled terminology for use in medicine to avoid information confusion among the patients.

From the perspective of physicians

There are also barriers to mobile technology use on the physician and care providers’ view in Saudi Arabia. Physicians and other healthcare team members are prone to resist new technology. The negative attitudes towards mobile technology usage among physicians emanate from the fear of the unknown.  Khalifa (2013) asserts that the marked resistance of physicians and other healthcare providers to embrace and use health information systems and electronic medical records is certainly one of the major barriers that delayed the adoption and successful implementation of such systems in Saudi Arabia (p. 336). Therefore, mobile technology designers should involve healthcare providers in decisions regarding mobile designs. Additionally, integration of mobile technology in a healthcare setting should involve a change process implemented by a change manager to enable physicians actively imbibe the new technological advancements.

The cost of maintaining patient alerts using mobile technology is also high. Youssef (2014) asserts in his research in clinics in Saudi Arabia that telephone reminders are costly and repeated calls may be needed to reach the patient (p. 318). Proper integration of a new technology into healthcare settings requires that all the resources necessary for its use are available. However, technology adoption slackens when the cost of its usage rises exponentially. Therefore, the Saudi Arabian government should provide financial incentives to enable physicians use mobile technologies efficiently to improve patient outcomes. Depatie and Bigbee (2015) posit that a perception of increased workload is a potential barrier to the usage of mobile technology (p. 162). Mobile technology usage in healthcare increases the professional responsibilities of physicians and other healthcare professionals because they have to enter patient data into the mobile networks every time the patient experiences a new health condition. Therefore, physicians would have an increased workload of alerting patients using cellphones and ensuring the integrity of the mobile technology.

Physicians also face the challenge of language confusion due to the inconsistency in the terminologies used to transmit data across different clinical settings. Bahkali, Almaiman, Almadani, Househ, & El Metwally (2014) posit that lack of procedures and health policies that define a clear technique for communicating and documenting health information compounds terminology inconsistency in hindering the use of information systems in Saudi Arabia (p. 263). Language standardization is a key step for ensuring that healthcare professionals communicate effectively. However, data transmission using mobile technology is threatened by the common usage of different languages and documentation skills of various healthcare providers. Therefore, mobile technology designers should succinctly provide measurable strategies for incorporating single terminologies such as the American Association of Nurses or the NANDA classification system in identification of patients’ conditions.

There are also physician concerns on privacy and security of patient given data. Data sharing through mobile technology lacks surety of remaining confidential within the confines of the care provider and the patient. Depatie and Bigbee (2015) assert in their concept map that perceived loss of privacy deters implementation of mobile technology (p. 162). The loss of patient privacy is always foreshadowed due to the global threat by hackers to unlawful access patient information from various mobile technologies. The physicians risk by posting useful patient information in the internet where there is potential data security threats and remarked hacking possibilities. Almoajel (2012) opines that most bills of rights such as the Saudi are concerned with autonomy, informed consent, confidentiality, and privacy of patients and therefore medical professionals are expected to respect all the rights of patients (p. 330). Physicians, therefore, would be reluctant to air healthcare information of patients in mobile networks due to fear of persecution in case of any unauthorized access. The physicians will also experience an increased workload of manually entering patients’ data into the software so that they can access the information via the smartphones. Therefore, physicians and other care providers should receive adequate support from the Saudi Arabian government to enable for incorporation of mobile technology into healthcare system.

Physicians can also develop attitudes that might hinder their usage of mobile technology. . Khalifa, M. (2013) posits that the negative beliefs, behaviors and attitudes of healthcare professionals towards mobile technology might act as barriers to the effective use of such systems (p. 336). Physicians might have negative beliefs about the new technology due to the low perception of its usefulness. The introduction of mobile technology to medicine is a spontaneous change that affects an array of care providers. Workforce of most organizations is usually resistant to change due to perceived threats such as increased workload. Similarly, physicians are resistance to the usage of mobile technology due to the perception of future threats. Altuwaijri (2008) notes that the behavioral barriers to mobile technology usage in the perspective of physicians entail resistance to change among individuals affected by the implementation and includes concern for the physician usage (p. 173). Therefore, policymakers in healthcare should involve healthcare professionals in the implementation of mobile technology. Additionally, the implementation of new mobile technology should be treated as a change project that is carried out stepwise.

Additional human factors can also hinder physicians from using mobile technology. Khalifa (2013) asserts that the human barriers to technology usage among care providers include ability to learn over time, computer knowledge and typing proficiency, understanding HIS and EMR systems, motivation and personal initiative to explore the systems and user-developed strategies to solve problems (p. 336). Physicians usually have a lot of information and data to learn and integrate because evidence-based practice is data intensive. This time constrain reduces the capacity of physicians and other healthcare providers to learn new applications in cellphones that are used to transmit healthcare information to patients. The low personal motivations to understand the mobile technological systems emanate from the previous reliance on paper-based work. Therefore, physicians would perceive mobile technology usage as a new task implemented by the administration.

There is also physician concern for the use of mobile technology in the management of emergency cases. The use of cellphones to compose and transmit short messages is not spontaneous and emergency medicine requires markedly short period for the healthcare team to respond. According to Alajmi, Khalifa, Jamal, Zakaria, Alomran, El-Metwally, & Househ (2015), 44.9% of physicians disagree that telemedicine can be used in emergency situations where timely responses are mandatory but rather agreed that telemedicine can be used in preventive medicine (p. 300). Therefore, healthcare IT designers should enable the use of faster application or conduct adequate training to physicians and other healthcare professionals. The training would enable them to use mobile technology applications faster.

The physicians and nurses further experience interoperability challenges due to the diversity of the healthcare workforce. It is necessary that all the healthcare providers and sectors be able to communicate with each other and the patients effectively to enable smooth flow of health information. The diversity extends to language that differs to the Arabic language that is the official language in the Kingdom of Saudi Arabia (Ur Rahman & Alhaisoni, 2013 p. 113). Therefore, the non-Muslim medical expatriates will experience a challenge in addressing critical issues by using mobile technology that is tuned to English language. Almutairi, McCarthy, & Gardner (2014) opine on their abstract that in Saudi Arabia, the healthcare workforce mainly comprises of expatriate nurses from different linguistic and cultural backgrounds (p. 1). Therefore, the healthcare workforce will have difficulty communicating with other healthcare professionals from different linguistic backgrounds. This challenge is aggravated by the fact there is no standardized terminology in healthcare in Saudi Arabia. The cellphone applications also have limited language use and therefore, the physicians will experience total confusion if they use mobile technology where translation is impossible. Therefore, mobile technology designers should ensure that they include the necessary language translation tools in their cellphone applications.

A knowledge gap exists on the technological competencies and skills on how to use mobile technology. The existence of knowledge gap compounds other challenges such as perceived threat of loss of confidentiality of patients. The challenge of inadequate skills and competence has led slow integration of e-health in Saudi Arabia. Altuwaijri (2008) opines that despite the array of the Saudi Arabian’s government initiatives to improve e-health such as the 2006 conference, the integration is still slow due to the challenges the program faces in its implementation (p. 178). Physicians and other healthcare professionals face the challenge of sparing time to learn new applications of cellphones. The time becomes a factor because healthcare professionals are usually very busy in evaluation of patients’ health information and other co-activities such as giving prescriptions and bedside patient care. The knowledge gap calls for initiatives that are aimed at enhancing the skills and health informatics competencies of healthcare professionals. The Saudi Arabian government should stick to the medical professional development requirements and offer healthcare professionals additional training to enable them manage mobile technology effectively. Therefore, the government should empower Health Informatics designers to establish a nationwide e-health program.

The physicians might also lack the infrastructure to interrogate and evaluate patient health data transmitted via mobile technology applications. Altuwaijri (2008) posits that most of the MOH hospitals in Saudi Arabia lack information and communication infrastructure (p. 175). The poor communication infrastructure acts as a disincentive for the physicians to accept mobile technology usage due to the fear of disappointing patients. For instance, cellphones cannot store progressively longer messages due to limited internal space and therefore, physicians should get access to additional devices for storing the messages. Khalifa (2013) also asserts that one of the technical barriers for health information technologies is that the communication networks used in Saudi Arabian governmental hospitals are old and slow (p. 340). The slow pace of the communication networks can frustrate both patients, physicians, as well as other healthcare providers. Additionally, in cases facilities for storing these messages are obsolete or unavailable, healthcare providers will be demotivated and concerned about the absence of the complementary tools. Therefore, healthcare information systems designers and the government should ensure that the complementary services such as data storage devices are available to all physicians before implementation of mobile technology.

In the perspective of non-clinicians

The non-clinicians in healthcare include the stakeholders and the government because they are influential in making healthcare policies. The first barrier the government experiences is breaching the gap between the poor and the rich in the society to ensure that everyone can afford smartphones whose applications are used to in mhealth. Mobile subscriptions are low in Arab countries and the government should ensure that all the citizens can afford mobile subscriptions. Skaria (2013) argues that India added 142 million mobile subscriptions in 2011 that is more than in all Arab states (p. 26). The technological illiteracy would prompt the government to seek for other means of data management such as the paper-based system. The government and other stakeholders are also faced with the challenge of ensuring that patient data do not leak to third parties illegally. As such, security systems such as strict passwords should be encouraged in Saudi Arabia. There are also few health informatics experts in Saudi Arabia and therefore, the government relies on expatriates from other countries.

Healthcare stakeholders also face the challenge of integrating mobile technology in the much diversified healthcare system. Healthcare consists of various subsectors that should be coordinated for the country to realize a holistic approach to patient care using the mobile technology. According to Altuwaijri (2008), health stakeholders have untiringly relied on advanced information and communication systems (p. 175). However, it is unfortunate that there is no unified national network and repertoire for the health records (Altuwaijri, 2008 p. 175). The consequence of the incoordination is the emergence of independent health information and communication systems that are not connected to each other especially in big healthcare institutions. There are also no channels that link different healthcare providers and this makes patients to receive segmented care rather than the ethically accepted holistic care. Almalki, FitzGerald, & Clark (2011) assert that despite the multiplicity of healthcare providers there is no coordination or clear communication channels among them and this leads to underutilization of resources and duplication of efforts (p. 786). The inability to link different care providers in various clinical settings leads to interoperability challenges in using mobile technology. Therefore, the healthcare stakeholders should work together with the Saudi Arabian government to ensure all the information systems including mobile technology are coordinated and connected to each other.

The adoption of health data standards is slow in Saudi Arabia and this translates to the slow implementation of mhealth. Alkraiji, Jackson, & Murray (2013) opine that the core barriers to the establishment of health data standards in Saudi Arabia consist of lack of a national regulator and a data exchange plan, inadequate policy regarding healthcare IT systems and information management, and national healthcare system as well as technical barriers and financial costs (p. 1). The lack of a national regulator and a data exchange plan would limit the usage of healthcare information at the local levels. Therefore, consumers of the mobile technology services are unlikely to get standardized information from the national government. It is a renowned fact that standardization is indispensable for ensuring equity in distribution of healthcare services in a vast country such as Saudi Arabia. However, with the lack of national regulator and data exchange programs, the local variations are likely to escalate and this can further bring disparity in healthcare delivery. The healthcare stakeholders are, therefore, reluctant to uphold mobile technology that lacks a national regulator due to the perception of an escalated disparity.

The existing facilitators to mobile technology usage across patients, physicians and other providers (Medical, Non-Medical, Government) in the context of Saudi Arabia

In the perspective of the patients

There are factors that have immensely enhanced mobile technology usage by the Saudi Arabians to improve their health. The features of mobile phones used for calls, short messages service and on-line retrieval of data of high usability as long as the user is literate. According to the knoema world literacy reports (2015), the adult literacy rate was at 82.9% by 2004. The rise in literacy rates in Saudi Arabia is compounded by the current fight for democracy and rights of women to education in the Arab countries. Saudi Arabia has high literacy rates and this means that a good proportion of its population can read and write as well as understand and comprehend simple facts. This analysis skill enables people to use mobile technology in texting messages, evaluating their healthcare information, and giving clear and timely responses to their care providers. The second facilitator of mobile technology in Saudi Arabia is the ease of accessibility to cellphones. Cellphones are currently readily available in Saudi Arabia and most citizens possess cellphones for personal communication functions. According to Youssef (2014), Saudi Arabia is one of the fastest growing economies for cellphone use among the Middle Eastern countries with a penetration rate resting at 198% (p. 318). It is further evident that most people in Saudi Arabia have high disposable income that they can access to access various devices used in establishing usage of mobile technology. Almalki, FitzGerald, and Clark (2011) opine that Saudi Arabia is one of the richest and the fastest growing nations in the Middle East due to the vast production of petroleum (p. 785). Therefore, patients in Saudi Arabia can access phones and this promotes mobile technology use in healthcare provision.

The advantages of using cellphones to share health data between healthcare providers and patients include convenience, affordability, and targeted sharing of information. Youssef (2014) argue in his research on use of reminders in a Saudi Arabian clinic that mobile phone messaging have the advantage of being inexpensive, convenient, and able to reach to the intended individual immediately (p. 318). The convenience of using cellphones encourages patients to use mobile technology to satisfy their healthcare needs. Additionally, the property of messages reaching the intended person immediately limits the chances for a breach of confidentiality and this improve the trust of the public in usage of mobile technology. Katib, Rao, Rao, & Williams (2013) assert that smartphones are remarkably cheap in Saudi Arabia with application such as Jeev helping patients to track vaccination records (p. 115). Cellphones are remarkably portable and the mobile technology services can be used in any place as long as network system is available to support the applications. Alajmi, Khalifa, Jamal, Zakaria, Alomran, El-Metwally, & Househ (2015) opine that telemedicine services can be used everywhere especially the areas with shortage of physicians or healthcare specialists (p. 294). Therefore, with the negligible challenge of socio-economic status difference, Saudi Arabians can perfectly manage to use cellphones to satisfy their healthcare needs.

Cellphones have low capacity to store charges and consequently, cellphone users frequently recharge their phones to avoid inconveniencies. The rate of recharging cellphones depends on the applications usage and involvement in internet technology. Consequently, a reliable source of electricity is indispensable for convenient usage of cellphone applications in any economy. The applications that patients use in mobile technology are largely dependent on internet server connections and therefore, consume more electric power. Therefore, patients should have access to constant electric power supplies. However, Abdul-Majeed, Al-Hadhrami, Al-Soufi, Ahmad, & Rehman, (2013) posit that the Kingdom of Saudi Arabia has remarkably restructured its power sector to meet the rising electricity supply needs of its population (p. 379). The electric supply in Saudi Arab that is noted as one of the richest Middle Eastern countries as aforementioned is very stable. The patients will not have problems recharging their cellphones and this would enable them to use mobile technology without fear of electric power blackouts. Therefore, the Saudi Arabian government should ensure that it maintains its power supplies to enable the citizens use cellphones sufficiently.

The co-existence of data application tools with other cellphone application such as the pervasive games encourages people to use mobile technology in Saudi Arabia. Gavalas, Kasapakis, & Guo (2015) assert that current mobile device platforms use sensor technologies to ensure real world experience of the clients during gaming activities and this has remarkably encouraged people to get engaged in mobile technology usage (p. 493). Therefore, the pervasive games would attract patients to use mobile technology to access their healthcare data alongside the games.

In the perspective of physicians

Physicians find mobile technology usage convenient due to the enabling characteristics of the features and applications in cellphones. According to Youssef (2014), mobile phone messages have the properties of being inexpensive, convenient, and able to reach the intended person faster (p. 318). These properties of cellphone messages enable healthcare providers to use cellphones to communicate to patients. The communications could be better in instances such as when ensuring strict adherence to medication by using reminders. It is also easy to access cellphones and install the desired applications that can be used to monitor patient data and respond to the queries of different patients. Youssef (2014) posits that cellphones with text messaging characteristics are nowadays very common in Saudi Arabia and the countries experiences growth of cellphone markets faster than other Middle Eastern nations (p. 318). The ease of access to cellphones corroborates their affordability. Therefore, healthcare providers would have a high propensity to use cellphones due to the perceived ease of possession.

Physicians and other healthcare providers can use mobile technology conveniently for surveillance of the state of health in the country. There is a current urge in the public health sector to keep persistent surveillance of the health of the public to monitor emerging infectious diseases such as Ebola and Influenza. Bahkali, Almaiman, Almadani, Househ & El Metwally (2014) argue that a project between the CDC and MOH provided a mobile computing technology used for the surveillance of the population health during the Hajj season (p. 262). The applicability of mobile technology in the public health sector enables healthcare providers to use cellphones to promote public health.

The constant electric power supply in Saudi Arabia also motivates physicians to use mobile technology to enhance patient outcomes. Physicians and other healthcare professionals need to recharge their mobile technology devices too. According to Abdul-Majeed, Al-Hadhrami, Al-Soufi, Ahmad, & Rehman (2013), the Saudi Arabian government has consistently ensured adequate electric power supply to serve the rising needs of the citizens (p. 379). The countrywide electric power supply reaches governmental institutions such as hospitals, schools, and marketplaces as well as various residential centers. Therefore, healthcare providers will have ample time recharging their cellphones and this motivates them to adopt mobile technology.

There is adequate fund to facilitate research on mobile technology that encourages physicians to come up with the most effective approaches to mobile technology usage. Saqlain & Mahmood (2013) opine that the Saudi Arabian government allocates a large sum of money for research activities (p. 106). Therefore, the physicians and other healthcare providers have the privilege of conducting research that are aimed at resolving the key issues in health informatics that challenge the implementation of mobile technology.  Mobile technology also enables physicians to communicate with other healthcare providers and patients effectively. The doctor-patient relationship will be enhanced because of the role of mobile technology in educating patients to develop appropriate medical language that can help them describe their medical conditions. Saqlain & Mahmood (2013) assert that mobile technologies offer manifold use of language learning among students (p. 107). It is evident that there is no marked difference between the students and patients that physicians offer healthcare services. Therefore, the same principles apply to patients who can learn medical language through cellphone applications to ease their communication with healthcare providers. Consequently, physicians and other healthcare providers opt to use mobile technology to facilitate their communication skills.

In the perspective of non-clinicians

The non-clinicians are mobilized to use mobile technology in healthcare. According to Almalki, FitzGerald, and Clark (2011), the Saudi Association for Health Information holds several e-health conferences to emphasize the significance of e-health in improving patient outcome (p. 792). Such conferences provide insights to other healthcare stakeholders and the Saudi Arabian government on the importance of mobile technology. The demand for healthcare reforms in Saudi Arabia also facilitates transformation to mobile technology usage. Almalki, FitzGerald, and Clark (2011) posit that The Saudi healthcare system is challenged by the shortage of local healthcare professionals, such as nurses, physicians, and pharmacists (p. 789). The scarcity of the care providers prompts the Saudi Arabian government to encourage people to use cellphones to keep in touch with different healthcare professionals.

There is an unequal distribution of healthcare services in Saudi Arabia and people can use mobile phones to get health tips and information regarding health issues of concern instead of the long waiting hours. Almalki, FitzGerald, and Clark (2011) point out that the current MOH statistics show that there is a maldistribution of healthcare professionals and healthcare services across geographical areas (p. 791). The government of Saudi Arabia is also facing challenges that threat the achievement of the national healthcare standards goal and these threats are principal facilitators to the adoption of mobile technology. According to Alajmi, Khalifa, Jamal, Zakaria, Alomran, El-Metwally, & Househ (2015), implementation of telemedicine is more effective in Saudi Arabia due to the medical services challenges such as lack of adequate resources, financial needs, and lack of enough healthcare professionals (p. 295). These constraints facilitate mobile technology usage and the government works towards developing initiatives that would encourage mobile technology usage to accomplish its healthcare policies amidst the vast array of challenges. Therefore, non-clinicians opt to use cellphone technology to bridge this gap.

The communications systems can also be used to transmit patient data and information regarding to treatment options due to the large geographical area of Saudi Arabia. Altuwaijri (2008) asserts that the use of telemedicine and electronic communication devices can be greatly utilized in the Kingdom of Saudi Arabia because of the vastness of the country as well as the large number of its villages (p. 174). The country is large and this can lead to unnecessary travels to meet healthcare providers of choice. Therefore, the government provides incentives to encourage the use of mobile technology to reduce the cost of securing healthcare services.

There are also distinct initiatives in Saudi Arabia that are aimed at increasing the coverage of mobile technology in healthcare. The first initiative that helps healthcare stakeholders manage information properly is the establishment of the Health Informatics Master Program at King Saud bin Abdulaziz University for Health Sciences in 2004. Altuwaijri (2008) argues that the mission of the program for the masters is to advance the efficiency and quality of healthcare system in Saudi Arabia through improvement of information management (p. 176). The master’s program is beneficial to healthcare stakeholders opting to embark on mobile technology because more health information experts would be available to strategize cellphone features and designs that ensure optimal use of the technology. The next enabler of mobile technology in Saudi Arabia is the Saudi Association for Health Informatics, (SAHI). According to Altuwaijri (2008), SAHI has significantly contributed to the development and promotion of scientific thinking in health informatics by holding seminars, symposia, and informatics courses as well as the additionally role of creating ethical standards in health informatics (p. 176). The involvement of SAHI in health informatics ensures that stakeholders use professional standards to deliver mobile technology services for communication. Consequently, healthcare stakeholders would get to trust cellphone technologies usage for the dissemination of healthcare information of patients. Altuwaijri (2008) also asserts that SAHI act as an umbrella for healthcare stakeholders to make optimal use of the nursing informatics applications in the research and clinical aspects (p. 176). Therefore, healthcare stakeholders get the necessary guidance on how to ensure mobile technology is used with the consideration of patient safety.

The last initiative to facilitate mobile technology usage is the Saudi e-health conference of 2006 in Riyadh, Saudi Arabia. According to Altuwaijri (2008), the conference encouraged expansion of telemedicine services and establishment of centers of excellence for health informatics as well as national registries for epidemics and common diseases (p. 176). The use of nationwide registries would promote communication between care providers, and care providers and patients. Therefore, health informatics experts should emphasize the points raised in the conference to strengthen the application of mobile technology in Saudi Arabia.

The government of Saudi Arabia has also undertaken steps that are aimed at facilitating use of mobile technologies within Saudi Arabia to reduce regional disparities in healthcare. Almalki, FitzGerald, & Clark (2011) posit that the Saudi Arabian government, through the Ministry of Health, allocated a budget of SR 4 billion to run a 4-year development program aimed at developing e-health services in the public sector (p. 792). The financial initiative aforementioned indicates the willingness of the Saudi Arabian government to support programs that enhance mobile technology usage. Initiatives that are strongly upheld by the government usually succeed and the usage of mobile technology in Saudi Arabia is destined to success due to the formidable support by the government. Saudi Arabian hospitals have also promoted an enhanced contact with patients even after discharged. Khan and Alam (2014) assert that hospitals in Saudi Arabia have created tele-care systems that enable follow up of patients with chronic diseases to attract medical tourism (p. 261). The urge to remain in touch with patients after discharge has prompted the hospitals to adopt information systems such as the use of cellphones that would ensure they follow their patients sufficiently.

Conclusion

The Kingdom of Saudi Arabia is adequately prepared to address its healthcare provision challenges using mobile technology. The challenges experienced by patients and healthcare providers should be addressed to ensure full implementation of mhealth in Saudi Arabia. The key areas of concern include privacy and security issues, acceptability of mobile technology, and the knowledge and skills required to use the mobile technology application in the sharing and transmission of patient health information. The electric power supplies are excellently stable in Saudi Arabia and the country has enough income per capita to at least enable its people to acquire cellphones. Most of the health information systems researchers agree that Saudi Arabia is a stable country in the Middle East with an emerging urge for democratic developments. Therefore, the government works towards ensuring that all the rights of patients to privacy and confidentiality are protected. Consequently, physicians and healthcare providers become concerned with the potential risk of on-line data sharing to hacking that can lead to lawsuits by affected patients. Another challenge is the potential risk for neglected the elderly patients while using mobile technology in health care because some cellphones have small screens difficult for use.

The Saudi Arabian population comprises of people from different socio-economic background. Furthermore, the medical expatriates are from different countries that speak different languages. The language diversity in Saudi Arabia posts interoperability challenge especially in mobile technology usage where there is no involvement of medical translators. Therefore, the government of Saudi Arabia has also taken steps to encourage mobile technology usage by allocating adequate funds for research and acquisition of communication resources. A recommendation for future study would be to evaluate the effectiveness of the involvement of the patients in making decisions concerning mobile technological designs. It is also recommendable for future researcher to investigate the relationship between development and mobile technology usage in a developing country such as Saudi Arabia.