Digital health integration and technological advancements in Saudi Arabia’s healthcare system: a comparative analysis of clustered and non-clustered hospitals
Ahmed Abdullah Alshehri, Asaad Abdulrahman AbduljawadAbstract
Background
Digital health is central to Saudi Arabia’s Vision 2030, with hospital clustering introduced to improve efficiency, interoperability, and patient outcomes. However, comparative evidence on digital health adoption between clustered and non-clustered hospitals remains limited.
Objectives
This study evaluates the integration of electronic medical records (EMRs), telemedicine, and mobile health applications in clustered and non-clustered hospitals in Saudi Arabia, assessing their impact on patient-centered care and system performance.
Methods
A convergent mixed-methods observational design was applied. Quantitative hospital-level data (2016–2024) from two clustered and two non-clustered hospitals were analyzed for EMR adoption, telemedicine use, patient satisfaction, and chronic disease management. Logistic regression and ARIMA models assessed adoption patterns. Qualitative data were obtained through semi-structured interviews with 53 participants (30 patients, 23 physicians) purposively sampled from an initial pool of 80; saturation was reached at the 30th patient and 23rd physician. Thematic analysis identified facilitators, barriers, and perceived benefits.
Results
Clustered hospitals consistently outperformed non-clustered hospitals across all digital health indicators. By 2024, clustered hospitals achieved higher Patient-Centered Care Index (95.1% vs. 92.2%) and Chronic Disease Management Scores (96.1% vs. 92.8%). Logistic regression showed clustered hospitals had 1.8-fold higher odds of EMR adoption (95% confidence interval [CI]: 1.3–2.5) and 2.1-fold higher odds of telemedicine use (95% CI: 1.5–2.8). Qualitative findings revealed facilitators (system integration, leadership support), barriers (digital illiteracy, fragmented systems, limited training), and perceived benefits (reduced waiting times, improved follow-up, patient engagement).
Conclusions
Clustering enhances digital health adoption by strengthening interoperability, standardization, and institutional support. Persistent challenges, particularly in non-clustered hospitals, highlight the need for targeted investment in infrastructure, workforce training, and digital literacy to ensure equity in achieving Vision 2030 goals.