Browsing by Author "Alomar, Dalia"

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Patient access to electronic health records (EHRs) and EHRs-based telehealth to improve healthcare engagement in Riyadh, Saudi Arabia
(Saudi Digital Library, 2026) Alomar, Dalia; Ainsworth, John; Whelan, Pauline; Eleftheriou, Iliada
Abstract Background: Patient access to electronic health records (EHRs) and EHR-integrated telehealth is a significant innovation in modern healthcare systems, allowing individuals to actively participate in their care while improving engagement, communication, and health outcomes. Notwithstanding extensive global research, not much empirical data is available on the impact of such technologies on patient healthcare involvement in non-Western and fast-emerging healthcare facilities of countries like Saudi Arabia. This thesis was built to investigate the impact of patient access to EHR and EHR-based telehealth on healthcare involvement in Riyadh’s healthcare centres using the Technology Acceptance Model (TAM) and the framework of patient-centred care. Four consecutive studies were conducted to create a cumulative image of engagement mechanisms and contextual determinants. Methods: A systematic review is adopted which initially combined world evidence regarding the relationship between patient access to EHRs and healthcare engagement. MEDLINE, Embase, PsycINFO, and CINAHL (2010–2023) searches provided 1,737 records and 10 further references; 18 studies were included. In the second phase, the cross-sectional survey of Riyadh hospitals, questionnaires were completed by 380 patients and 190 HCPs to evaluate the factors affecting patients’ healthcare engagement through accessing their EHRs in Riyadh’s hospitals. Descriptive statistics, correlation, and multivariate regression were used to analyse the data. The third phase, qualitative study, assessed perceived usability, perceived benefits, and barriers of EHRs-integrated telehealth through semi-structured interviews by 20 patients and 10 HCPs, thematically coded using NVivo 14. Finally, a longitudinal pre–post study analysed anonymised system log data from Dr. Sulaiman Al Habib Medical Group (2023–2024) to assess changes in engagement behaviours using t-tests and regression analyses. Results: The systematic review found consistent positive associations between EHR access and healthcare participation on six dimensions: treatment adherence and self-management, patient involvement and empowerment, healthcare communication and relationship, patient satisfaction and health outcomes, utilization of healthcare resources, and usability concerns and barriers. The cross-sectional study discovered that factors of usability, accessibility, trust, and awareness all significantly predicted healthcare engagement, however socio-demographic characteristics had no significant effect. The qualitative analysis found substantial patient and provider support for EHR- integrated telehealth due to convenience, reduced visits, and enhanced continuity, but also identified constraints such as technological challenges, a lack of insurance integration, and limited provider choice. The longitudinal study identified large increases in EHR use measures (+187%), logins (+71%), and appointment scheduling (+166%) with female patients showing higher sustained access compared to men. Conclusions: Collectively, the results affirm that EHR and telehealth access facilitate patient healthcare engagement through usability promotion, trust enhancement, and institutional facilitation. The thesis shows how organizational and sociocultural factors enhance digital engagement by applying TAM and patient-centred care frameworks to the Saudi setting. These observations guide future health informatics practice, research, and policy with the goal of transforming healthcare in a way that is patient-centred, sustainable, and equitable. Keywords: Patient access to EHR, Telehealth, EHRs-based telehealth, Healthcare engagement, Riyadh, Saudi Arabia
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