Progress and challenges in the implementation of Electronic Medical Records in Saudi Arabia : a systematic review

Electronic Medical Record (EMR) systems are being implemented increasingly worldwide. Saudi Arabia is one of the developing countries that commenced implementing such systems in 1988. Whilst EMR uptake has been low in Saudi Arabia until now, a number of hospitals have implemented EMR systems successfully. This paper analyses available studies (n = 28) in the literature regarding EMR implementation in Saudi Arabia to identify the progress of EMR implementation to date and to identify the facilitators and barriers to implementation.

Person-Centred Approaches to Private Housing for People with Disability : Impediments, Difficulties and Opportunities

Objective The main objective of the project was to explore the barriers and obstacles impeding a person-centred approach to planning and private housing for people with disability. Method Methodologically, the project involved explanation building using a multiple case study approach supported by a contextual study. It focussed initially on three organisations and their attempts to integrate innovative and what they regarded as person-centred models of housing into the private housing market for people with disability. It also included a fourth case highlighting the experiences of individuals with disability in accessing suitable and affordable housing. Results Using an ecological framework, the project found that: • Challenges exist within systems (such as the macro cultural, economic, regulatory systems through to local community, family and intra personal systems) as well as with interaction between systems • Reaching across systems is a key role for organisations and individuals but is very challenging with distance from the individual as well as from the policy/funding/service systems being a key aspect of the nature and extent by which they are challenged • In the case of housing for people with disability a ‘disability space’ is assumed and maintained disparately within each system and is separate from the ‘mainstream space’ with the established policy, legal, funding structures making it difficult to move between the two spaces. Conclusions Based on these findings, the project makes recommendations for government, community organisations, the housing industry, people with disability and their families and support networks, as well as for future research. An overarching recommendation is the need to address housing stock availability and suitability by adopting a mainstream approach rather than a disability-first/disability-specific approach.

An examination of Saudi high school teachers' ICT knowledge and implementation

This study investigated Saudi high school teachers' implementation of ICT in schools. The study also explored the relationship between the teachers' level of TPACK and their implementation of ICT. In the first phase of the study, more than 250 Saudi teachers from Al-Madinah administrative area filled in a four-part self reported questionnaire while in the second, 12 teachers completed semi-structured interviews. Findings from both phases of the study revealed that Saudi high school teachers demonstrated low level of effectiveness of ICT implementation. Among a number of barriers, Teachers' TPACK knowledge was found as the best predictor of the effectiveness of ICT implementation.

Reshaping housing : the role of prefabricated systems

Prefabricated housing innovations have the potential to reduce the environmental impact of construction through improving efficiency and quality. The current paper systematically summarises the published evidence since 1990 that describes the barriers and drivers affecting the uptake of prefabricated housing innovations. These are discussed in relation to a ‘Project-Based Product Framework’ which considers multiple stakeholders including builders and other intermediaries, suppliers, end-users, the broader policy context and technical issues. The framework facilitated identification of central issues such as the prevalent business and cultural resistance associated with process changes; the potential for efficiency and quality improvements and cost savings; the simultaneous risks and benefits of close supplier-builder relationships, and negative user perceptions towards prefabricated houses. Though there is a lack of evidence regarding the effects of regulations and government policies on prefabrication uptake, there are indications of the positive potential of financial and social incentives. Directions for further research include understanding how to: manage the industry’s transition to prefabricated houses; appropriately compare prefabricated housing to traditional housing on cost, efficiency and quality measures; reconcile the differing perspectives of various stakeholders; quantify and identify the perspectives of the potential end-user population, and manage the interface between the emerging industry and information technology improvements.

Barriers to entering affordable home ownership for young people: A preliminary study from university students’ perspectives

Over the last two decades, housing affordability has been a problem for young people, and identified as factor leading to youth homelessness. The National Youth Commission Inquiry into Youth Homelessness developed a roadmap for preventing this problem (National Youth Commission, 2008). The roadmap recommends increasing the supply of affordable housing for young people as an important strategy to reduce the risk of homelessness problems. In addition, understanding the barriers and the needs of young people is a significant part of the development of a national affordable housing strategy. This paper explores issues encountered by young people when they enter the housing market as first home buyers. A short survey was conducted to review the barriers to entry, classified by income levels, housing cost and availability of affordable housing. In the current competitive job market, young people have minimal work experience, relatively low job security and low income. In addition to these barriers, participants also suggested other barriers towards the purchase of their first home, such as lack of knowledge of legal issues and lack of government funding. This study suggests the need for both government and educational support for young people around housing choices and the development of financial strategies to manage barriers towards owning their first home.

Electronic medical record systems in Saudi Arabia: Knowledge and preferences of healthcare professionals

Background The use of Electronic Medical Record (EMR) systems is increasing internationally, though developing countries, such as Saudi Arabia, have tended to lag behind in the adoption and implementation of EMR systems due to several barriers. The literature shows that the main barriers to EMR in Saudi Arabia are lack of knowledge or experience using EMR systems and staff resistance to using the implemented EMR system. Methods A quantitative methodology was used to examine health personnel knowledge and acceptance of and preference for EMR systems in seven Saudi public hospitals in Jeddah, Makkah and Taif cities. Results Both English literacy and education levels were significantly correlated with computer literacy and EMR literacy. Participants whose first language was not Arabic were more likely to prefer using an EMR system compared to those whose first language was Arabic. Conclusion This study suggests that as computer literacy levels increase, so too do staff preferences for using EMR systems. Thus, it would be beneficial for hospitals to assess English language proficiency and computer literacy levels of staff prior to implementing an EMR system. It is recommended that hospitals need to offer training and targeted educational programs to the potential users of the EMR system. This would help to increase English language proficiency and computer literacy levels of staff as well as staff acceptance of the system.

Identifying the financial barriers to deliberative, affordable apartment development in Australia

Purpose The purpose of this paper is to identify the financial barriers to the supply of affordable apartments in Australia and examine whether demand aggregation and ‘deliberative development’ (self-build) can form a new affordable housing ‘structure of provision’. Design/methodology/approach Market design, an offshoot of game theory, is used to analyse the existing apartment development model, with ‘deliberative development’ proposed as an innovative alternative. Semi-structured interviews with residential development financiers are used to evaluate whether deliberative development could obtain the requisite development finance. Findings Our investigation into the financial barriers of a deliberative development model suggest that while there are hurdles, these can be addressed if key risks in the exchange process can be mitigated. Hence, affordability can be enhanced by ‘deliberative development’ replacing the existing speculative development model. Research implications Market design is a new innovative theoretical approach to understanding the supply of housing, offering practical solutions to affordable apartment supply in Australia. Originality/value This research identifies financial barriers to the supply of affordable apartments; introduces theoretical understandings gained from market design as an innovative solution; provides evidence that a new structure of building provision based on ‘deliberative development’ could become a key means of achieving more affordable and better designed apartments.

Can evidence-based healthy housing interventions be put into practice in the UK's private housing sector?

The UK’s public health agenda has encouraged enhanced housing and health interventions. The private housing sector (privately rented and owner occupied) is the favoured and majority UK tenure, but is it seen as a primarily health promoting environment, or a commercial asset? There has been a growing interest in integrating health and housing policy in recent years. However, housing and public health fall under separate government departments and funding regimes. Partnership working has sought to overcome silo working and encourage evidence-based practice, yet is particularly challenging for interventions in the private housing sector, with an increased emphasis on ‘personal responsibility’ for conditions. Strategic public health frameworks are in place, but barriers remain and there is pressure for organisations to revert to core activities. An accessible, continually updated evidence base specific to private sector housing is recommended, to help estimate health gain arising from interventions to prioritise activities and address inequalities.

Accelerating innovation in the social housing sector in UK

The UK government has been promoting innovation in the construction sector to improve the sustainability of the built environment. It has the potential and strength in developing construction research in design and engineering, but the impact of these processes seems to be slow in reaching the residential sector. While funding remains a major constraint research show that a number of detrimental issues including; organisation, risk, mind sets of the stakeholders, planning constraints,reluctance to accept change and the unexploited markets are major contributing factors. Most of these barriers can be overcome with research, development and information and knowledge transfer techniques. Educating all stakeholders can act as an accelerator for innovation. Given the large stock of existing dwellings, the situation is compounded, by issues related to climate change, to the point that this problem can no longer be ignored and requires an urgent response from all sectors involved. This paper attempts to highlight some of the key issues that are important in accelerating innovation in the housing sector. It briefly looks at the process of innovation in housing and presents lessons learnt from two research projects. The drivers and barriers and the role played by the government are examined in relation to the housing context.

A Community Hub Approach to Older People’s Housing

Purpose. This paper explores the potential of housing with care schemes to act as community hubs. The analysis highlights a range of benefits, barriers and facilitators. Design/methodology/approach. Data is presented from the ASSET project (Adult Social Services Environments and Settings) which used a mixed methods approach including a review of the literature, surveys and in-depth case study interviews. Findings. Most housing with care schemes have a restaurant or café, communal lounge, garden, hairdresser, activity room and laundrette, while many also have a library, gym, computer access and a shop. Many of these facilities are open not just to residents but also to the wider community, reflecting a more integrated approach to community health and adult social care, by sharing access to primary health care and social services between people living in the scheme and those living nearby. Potential benefits of this approach include the integration of older people’s housing, reduced isolation and increased cost effectiveness of local services through economies of scale and by maximising preventative approaches to health and wellbeing. Successful implementation of the model depends on a range of criteria including being located within or close to a residential area and having on-site facilities that are accessible to the public. Originality and Value. This paper is part of a very new literature on community hub models of housing with care in the UK. In the light of new requirements under the Care Act to better coordinate community services, it provides insights into how this approach can work and offers an analysis of the benefits and challenges that will be of interest to commissioners and providers as well as planners. This was a small scale research project based on four case studies. Caution should be taken when considering the findings in different settings.

Housing trajectories of individuals found not criminally responsible on account of mental disorder.

Au Canada, les Commissions d'Examen des Troubles Mentaux de chaque province ont la responsabilité de déterminer les conditions de prise en charge des personnes déclarées Non Criminellement Responsables pour cause de Troubles Mentaux (NCRTM) et de rendre, sur une base annuelle une des trois décisions suivantes: a) détention dans un hôpital, b) libération conditionnelle, ou c) libération absolue. Pour favoriser la réinsertion sociale, la libération conditionnelle peut être ordonnée avec la condition de vivre dans une ressource d’hébergement dans la communauté. Parmi les personnes vivant avec une maladie mentale, l’accès aux ressources d’hébergement a été associé à une plus grande stabilité résidentielle, une réduction de nombre et de la durée de séjours d'hospitalisation ainsi qu’une réduction des contacts avec le système judiciaire. Toutefois, l’accès aux ressources d’hébergement pour les personnes trouvées NCRTM est limité, en partie lié à la stigmatisation qui entoure cette population. Il existe peu d’études qui traitent du placement en ressources d’hébergement en psychiatrie légale. Pour répondre à cette question, cette thèse comporte trois volets qui seront présentés dans le cadre de deux manuscrits: 1) évaluer le rôle du placement en ressources d’hébergement sur la réhospitalisation et la récidive chez les personnes trouvées NCRTM; 2) décrire les trajectoires de disposition et de placement en ressources d’hébergement, et 3) mieux comprendre les facteurs associés à ces trajectoires. Les données de la province du Québec du Projet National de Trajectoires d’individus trouvés NCRTM ont été utilisées. Un total de 934 personnes trouvées NCRTM entre le 1er mai 2000 et le 30 avril 2005 compose cet échantillon. Dans le premier manuscrit, l’analyse de survie démontre que les individus placés dans un logement indépendant suite à une libération conditionnelle de la Commission d’Examen sont plus susceptibles de commettre une nouvelle infraction et d’être ré-hospitalisés que les personnes en ressources d’hébergement. Dans le deuxième article, l'analyse de données séquentielle a généré quatre modèles statistiquement stables de trajectoires de disposition et de placement résidentiel pour les 36 mois suivant un verdict de NCRTM: 1) libération conditionnelle dans une ressource d’hébergement (11%), 2) libération conditionnelle dans un logement autonome (32%), 3) détention (43%), et 4) libération absolue (14%). Une régression logistique multinomiale révèle que la probabilité d'un placement en ressource supervisée comparé au maintien en détention est significativement réduite pour les personnes traitées dans un hôpital spécialisé en psychiatrie légale, ainsi que pour ceux ayant commis un délit sévère. D'autre part, la probabilité d’être soumis à des dispositions moins restrictives (soit le logement indépendant et la libération absolue) est fortement associée à des facteurs cliniques tels qu’un nombre réduit d'hospitalisations psychiatriques antérieures, un diagnostic de trouble de l'humeur et une absence de diagnostic de trouble de la personnalité. Les résultats de ce projet doctoral soulignent la valeur protectrice des ressources en hébergement pour les personnes trouvées NCRTM, en plus d’apporter des arguments solides pour une gestion de risque chez les personnes trouvées NCRTM qui incorpore des éléments contextuels de prévention du risque, tel que l’accès à des ressources d’hébergement.

Overcoming barriers: black African chartered accountants in 1990s South Africa

This paper examines the experiences of black Africans in South Africa who became Chartered Accountants in the 1990s. Building on previous work on marginalized groups within the accounting profession, the study relies on interviews with 22 of those who overcame steep educational, economic, racial, cultural, and political obstacles to join a profession that had fewer than 1% black Africans as members. The interviews indicate that those black Africans who did manage to become CAs in the 1990s shared many common characteristics and experiences. They and their families placed a high value on education and made tremendous sacrifices to meet the requirements to earn the CA certification. Many overcame extreme poverty in their childhoods and attended poorly equipped schools. All were exceptionally accomplished academically, most qualifying for scholarships offered only to the very top black African students in the country. Most faced educational disruptions due to boycotts and political protests that shut down schools and many black universities in the years immediately prior to the bringing down of the apartheid regime. All faced racial discrimination in housing and education. Few had ever met a chartered accountant before enrolling in university; many had never heard of the certification until that point. In the 1990s when they entered some of the major firms to meet their training requirements, they were typically not given the same opportunities as their white peers. Now that they have become Chartered Accountants, and the government has changed and instituted affirmative action policies, most find that they are often offered jobs outside of public accounting. Still only composing about one percent of all chartered accountants, in a country that is 75% black African, most believed that the main road towards overcoming this disparity is through radical efforts to equalize educational opportunities in South Africa across racial lines. Most make professional decisions based at least in part on the opportunities a given position offers towards contributing to the black community.

Evaluating the triple bottom line in the implementation of photovoltaic systems in UK social housing

The Intergovernmental Panel on Climate Change warnings regarding the detrimental effects of carbon dioxide emissions and global warming have gained acceptance amongst many governments (IPCC 2001). The UK government has agreed to reduce emissions, implement a package of enabling measures (UKCCP 2000) and issued an Energy White Paper (HMSO 2003) calling for a diversification of energy supply policies which will include renewable sources.

Housing accounts for approximately 25% of UK CO2 emissions and as providers of social housing, Registered Social Landlords (RSLs) and their tenants are major contributors. RSLs are deliverers of national policy in several areas and contribute to the attainment of governmental environmental, social and economic targets and impact upon the wider demands of housing policy, healthcare, education and law & order (DETR 1999, Cole and Shayer 1998).

Photovoltaic (PV) electricity generation could deliver “free” electricity to the low income households historically housed by RSLs. PV helps address such issues as fuel poverty and could be used as a stimulus for creating interest in areas of low demand for social housing.

RSLs provide housing solutions which cross traditional economic, social and environmental divides and this lends their modus operandi to the concept of the triple bottom line. The triple bottom line enables social and environmental aspects to be considered alongside economic considerations within decision-making frameworks (Elkington 1999, Andreason 1995).

Using a qualitative research methodology, this paper assesses current commercial viability of PV installations on RSL developments and identifies key barriers to implementation. The paper also investigates whether the application of the triple bottom line can liberate RSLs from viewing PV as a non-viable option by enabling a greater emphasis to be placed on the social & environmental aspects of PV. The paper considers whether a framework for RSLs to improve their decision-making processes by embracing social & environmental factors is feasible.

Perceptions of representatives of public, private, and community sector institutions of the barriers and enablers for physically active transport

Active transport bridges many shared concerns in the public health and transport sectors. To positively affect opportunities for active transport, public health and transport professionals are engaging with other sectors, including urban planning, housing, recreation, retail, education, and employer groups. A first step in such inter-sectoral collaboration is to understand the perceptions of key players in all of these sectors. This paper describes the results of structured interviews with senior and middle-level administrators from public, private, and community groups in a rapidly developing region in Queensland, Australia, to assess the perceived barriers and enablers to active transport. Key themes emerged relating to infrastructure delivery, public transport services, walk- and cycle-friendly community attributes, political leadership and government coordination, and societal travel norms and culture. There were also themes relating to limits due to resources and limited relevant technical expertise, institutional and practitioner cultures, and agencies not identifying with their roles in active transport. Policies and cross-government initiatives were seen to hold promise, including economic incentives and built environment guidelines, campaigns targeting public attitudes and opinions, and community participation in policy-making. These elements are potential keys to positively promoting comprehensive active transport initiatives among gatekeepers and leaders across different sectors.