Interviews’ approach

As discussed in Chapter 1, the interviews were conducted in the form of semi-structured interviews with open-ended questions. This approach allows flexibility in asking additional spontaneous questions during the interview. It also requires predetermined questions to be asked, for directing the discussions and ensuring that all specific topics are covered and that the required information has been extracted from the participants during the interview (Patton, 2015; DiCicco & Crabtree, 2006).

Therefore, the final outcome of the First Phase (i.e., the initial version of JoinSTNassistant Framework) has been used as a basis for designing the semi-structured interviews and developing in advance the initial questions.

Chapter 4

The initial set of interview questions was then reviewed by the Faculty Research Ethics Committee at Staffordshire University and by the Regional Research Ethics Committee at MOH (as shown in Appendices A and B), to ensure that it is purposive, succinct, unambiguous, and that it covered appropriately all the intended and specific topics in a neutral and unbiased way, whilst also ensuring its compatibility with the Code of Ethics and Standards of the MOH and Staffordshire University. Consequently, modifications were made to form the final approved set of the interviews’ questions.

In order to cover sufficiently the large number of intended specific topics, and their corresponding initial questions, the interviews were designed to be conducted through seven-consecutive sessions, as shown in Figure 4.1.

Figure 4.1 The Main Topic/Theme and Aim(s) of the Seven-Consecutive Interview Sessions

 The 1^st interview session

The main topic/theme of the first interview session was ‘a pre-interview briefing on telemedicine, the STN project, and the JoinSTNassistant Framework’. This session was a knowledge dissemination (i.e., awareness) session, and aimed at informing the participants about telemedicine, the STN project, its challenges, the JoinSTNassistant Framework, and the aims of this study ‘s interviews. Therefore, a presentation and leaflets were provided to the participants in this session, which contained information about the following four subjects:

i. The main concepts of telemedicine and facts regarding its future, ii. A summary of the STN project, its roadmap, and the challenges and

barriers to its implementation,

Chapter 4

iii. A summary of the JoinSTNassistant Framework (this research), the findings of the First Phase,

iv. the aims of the interviews, and the guidelines for the interviews’

questions.

 The 2^nd, 3^rd, 4^th, 5^th, and 6^th interview sessions

The main topic/theme of each interview session of these five of the seven-consecutive interview sessions (from the 2^nd to the 6^th) was based around one of the five pillars of the initial version of the JoinSTNassistant Framework (i.e., human, organisational, technological, environmental, business-financial). Each of these interview sessions aimed at the following:

i. Discussing, evaluating, and nominating the barriers of each related pillar with the participants in order to identify their perspectives, and to develop an understanding of the differences and similarities between them regarding these barriers.

ii. Determining a measurable and tangible parameter/metric for each barrier and a suitable decision assistance technique to be utilised by the JoinSTNassistant Framework.

Each one of these five of the seven-consecutive interview sessions was comprised of the following questions:

 Do you expect this barrier could potentially influence your HCF’s decision to join the STN?

 How do you think this barrier could be measured? And what is its tangible metric?

 Are there any other important barriers within this dimension/pillar that have NOT been identified?

 Can you share anything else that could be important and that we have not discussed?

 The 7^th interview session

The main topic/theme of the seventh interview session was the ‘Decision-making process and the types of information usually required’. Therefore, it was aimed at understanding the normal decision-making process of the HCFs and the types of information that are usually required in order to implement a new ICT innovation.

Chapter 4

Furthermore, it aimed at reaching a consensus on determining key features that should be incorporated/considered into the JoinSTNassistant Framework.

The seventh interview session was comprised of the following questions:

 What is the normal decision-making process of the HCF in order to decide to implement a new ICT system?

 What do you think about the decision-making process of the HCF in order to decide to join the STN?

 What do you think about key features that should be incorporated/considered into the JoinSTNassistant Framework for facilitating, enhancing, and assisting the HCF’s decision to join the STN, to increase productivity and effectiveness? And what types of information are required/needed?

 What do you think about a suitable decision assist technique(s) to be utilised by the JoinSTNassistant Framework for facilitating, enhancing and assisting the HCFs decision to join the STN productively and effectively? And what kinds of reports are required/needed?

In addition, based on the participants’ responses, additional appropriate questions were also asked within all seven-consecutive interview sessions, to gain in-depth understanding and cover the specific topics, or to permit other important aspects to emerge from the participants.

The seven-consecutive interview sessions were conducted via a videoconferencing system (WebEx) because the participants represent all 22-diverse categories of HCFs across the KSA, which are scattered all over the large geographical area of the KSA, with vast distances between them. Furthermore, the participants are usually busy and it is hard and costly to find adequate time and physical places for the interviews.

The duration of each interview session was scheduled to be four hours, on Saturdays (a weekend day), and to be conducted in English and Arabic languages.

During each interview session, notes were taken, and then, these were carefully transcribed, cleaned, and checked. Also, second coding was undertaken to compensate for the lack of quotations and maintain anonymity of the participants which was a

Chapter 4

requirement of the ethical approval of the MOH. Afterward, they were emailed to the participants for approval.

In the interview sessions, the moderator (i.e., the researcher) was attempting to be unbiased about the discussed topics, and to encourage conflicting, non-normative and contentious views to be raised, as advocated by Rubin (2011).