JoinSTNassistant Framework: An Agile Holistic Framework for Assisting Decision in Healthcare Facilities to Join Saudi Telemedicine Network

In 2011, the Saudi Arabian Ministry of Health (MOH) launched the Saudi
Telemedicine Network (STN) as the first national project for telemedicine in the KSA, which is planned to be completed by 2020. The benefits associated with the STN will only be realised through its successful implementation within the Healthcare Facilities (HCFs) across the Kingdom of Saudi Arabia (KSA). There is a high failure rate of implementation projects of telemedicine within other countries (approximately 75% globally, and 90% in developing countries). Furthermore, there is high failure rate of implementation projects of complex Health Information Technology (HIT) systems within HCFs of the KSA (roughly 80%). These dramatic statistics demonstrate the great need for a suitable framework to assist the STN implementation and increase the likelihood of its successful implementation. Prior studies have asserted that there could
not be a one-size-fits-all framework that could be applicable and used by all countries for assisting the implementation of telemedicine. To the best of our knowledge, there is not any existing framework that has been specifically developed for assisting the STN implementation.
Thus, this research is aimed at developing a novel, agile, holistic framework, referred to as “JoinSTNassistant Framework”, aimed to assist HCFs across the KSA regarding their organisational decision to join the STN. It must be ensured that this JoinSTNassistant Framework is theoretically rigorous, as well as relevant specifically to the context and the needs of the KSA, its HCFs, and the STN roadmap. Therefore, the JoinSTNassistant Framework has been developed through three-sequential phases. The First Phase of development defines and applies the theoretical and philosophical foundations of the JoinSTNassistant Framework. In this First Phase, 56-selected studies from an extensive literature review were analysed. The Second and Third phases of development reflect the practical and pragmatic requirements of the JoinSTNassistant Framework. These two phases must be considered as two stages of validation of the findings of the First Phase, involving as many potential users as possible in the development of the Framework, so as to ensure that it reflects their expectations and meets their needs. The Second Phase of development involved interviews with 81 strategic-level decision makers of HCFs within the KSA. The Third Phase implemented an even higher level of validation, involving as many as 905 potential users, forming a representative sample size of the decision makers of all HCFs across the KSA. In addition, a web-based application (i.e., Portal) for the JoinSTNassistant Framework, referred to as “JoinSTNassistant Portal” was developed for modifying and adjusting the JoinSTNassistant Framework in order to be applicable for each one of HCFs across the KSA, for assisting and guiding them in reaching a decision to join the STN. This research is part of the STN project and is collaborating with the National eHealth Strategy and Change Management Office in the MOH of KSA, and with the STN agency, who is the sponsor and the owner of the STN project.