Document Type



Doctor of Philosophy (PhD)


Public Health

First Advisor's Name

Timothy Page

First Advisor's Committee Title

Committee chair

Second Advisor's Name

Alejandro Arrieta

Second Advisor's Committee Title

committee member

Third Advisor's Name

Jessica Adler

Third Advisor's Committee Title

committee member

Fourth Advisor's Name

Tala Mirzaei

Fourth Advisor's Committee Title

committee member


public health, health services research

Date of Defense



The Ministry of Health (MOH) in the Kingdom of Saudi Arabia introduced E-health system reform in 2011. The national E-health plan has already been in action; the MOH expects to implement the system throughout the country by 2021. The MOH manages about 60% of the hospitals in Saudi Arabia. In 2016, the government of Saudi Arabia introduced vision 2030. One of the main objectives of the reform is to accelerate the implementation of primary and digital infrastructure projects. This research aims to evaluate the effectiveness of the E-health system reform in Saudi Arabia.

This research utilized a questionnaire to collect data from physicians who work at the Ministry of Health in Saudi Arabia to evaluate the outcome of the E-health system reform. The total responses used for the study were 188. An Ordinary Least Squares (OLS) regression was used to measure physicians' perception of E-health effect on MOH, patient referrals, and cost of care. The analysis included services provided by MOH to measure the effect of E-health. Collectively these measures affect the patient's experience. Quality and consistency, efficiencies, speed of patient's admission and examination, accuracy, and completeness of filling out reports were significantly impacted by electronic services. The analysis outcomes suggest that E-health improved patients' services and helped create a better environment for their visits and treatment.

The analysis investigated the effect of E-health on physician perceptions of patient referrals and waiting time. The outcomes indicate a significant enhancement in inpatient referrals in speed, accuracy and completeness, bed availability, viewing patient's medical history, and remote diagnosis. The E-health reform in Saudi Arabia has significantly enhanced patient referrals between the MOH primary care centers and hospitals, reduced the waiting time, and increased the number of referrals.

Physician perceptions on the cost of care were also included in the analysis. The analysis included accuracy, viewing patient's history, electronic services cost reduction, overall cost, and electronic training. The outcomes indicate no significant impact on the cost of care after introducing the E-health reform in Saudi Arabia except for remote training. The analysis shows that online training is affected significantly with E-health, which led to a cost reduction. the cost of care in Saudi Arabia has not been significantly impacted by the introduction of the E-health reform in Saudi Arabia. However, training can be effective for accuracy to contribute to cost reduction, and electronic services affect remote training, and E-health can reduce the cost of training.





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