Despite emerging evidence about the benefits of telemedicine, there are still many barriers and challenges to its adoption. Its adoption is often cited as a failed project because 75% of them are abandoned or 'failed outright' and this percentage increases to 90% in developing countries. The literature has clarified that there is neither one-size-fit-all framework nor best-practice solution for all ICT innovations or for all countries. Barriers and challenges in adopting and implementing one ICT innovation in a given country/organisation may not be similar - not for the same ICT innovation in another country/organisation nor for another ICT innovation in the same country/organisation. To the best of our knowledge, no comprehensive scientific study has investigated these challenges and barriers in all Healthcare Facilities (HCFs) across the Kingdom of Saudi Arabia (KSA). This research, which is undertaken based on the Saudi Telemedicine Network roadmap and in collaboration with the Saudi Ministry of Health (MOH), is aimed at identifying the principle predictive challenges and barriers in the context of the KSA, and understanding the perspective of the decision makers of each HCF type, sector, and location. Three theories are used to underpin this research: the Unified Theory of Acceptance and Use of Technology (UTAUT), the Technology-Organisation-Environment (TOE) theoretical framework, and the Evaluating Telemedicine Systems Success Model (ETSSM). This study applies a three-sequential-phase approach by using three mixed methods (i.e., literature review, interviews, and questionnaires) in order to utilise the source triangulation and the data comparison analysis technique. The findings of this study show that the top three influential barriers to adopt and implement telemedicine by the HCF decision makers are: (i) the availability of adequate sustainable financial support to implement, operate, and maintain the telemedicine system, (ii) ensuring conformity of telemedicine services with core mission, vision, needs and constraints of the HCF, and (iii) the reimbursement for telemedicine services.

Many boundaries are hindering successful utilisation of e-health in the Kingdom of Saudi Arabia (KSA). We have previously proposed an integrated framework of knowledge management and knowledge discovery to overcome barriers of e-health in KSA. Our proposed framework facilitates diabetes self-management for diabetic citizens in the Kingdom. In this paper, we will investigate and rank the barriers of e-health in KSA from the prospective of three stakeholders. We designed a questionnaire which constituted of items related to eight different e-health barriers and its associated sub-barriers. Citizens participated in 51 items related to six barriers. Healthcare professionals answered 83 items related to eight barriers. IT specialists participated in 74 items related to six barriers. Within each group of respondents, we compared the mean scores for each factor and sub-factor. The highest possible score for the mean was 5.00 and the lowest was 0.00 where the higher the mean score was the more the barrier constituted an obstacle for e-health in KSA. Citizens ranked the connectivity of information system as the top barrier with the mean of 4.0 whereas the least barrier was the cultural barriers with the mean score of 3.1. Healthcare professionals ranked the connectivity of information systems as the top barriers with the mean score of 3.5 whereas the least barrier was the technical expertise and computer skills with the mean score of 2.2. The top ranked barrier from the perspective of IT specialists was the medication safety with the mean score of 3.5 and the least ranked barrier was security and privacy with the mean score of 2.2. The results showed consistency with the literature review. Our proposed framework will contribute to the successful implementation of e-health initiatives and assist citizens in KSA to selfmanage diabetes.

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As English increasingly becomes the international language, many ministerial and educational organisations have identified the need to improve the competence of Thai students in speaking English. While there is significant research devoted to developing software tools to support the teaching of English as a second language, they are mostly concerned with adult learners. This project focuses on addressing the need to improve the teaching of English as a second language to primary school children with hearing impairments. This paper presents the development of an educational software tool referred to as the Total Communication with Animation Dictionary (TCAD), which supports learners in the acquisition and retention of new English lexical knowledge and is based on the theoretical approaches of Total Communication and situated learning. A series of experiments was undertaken to evaluate the effectiveness of the TCAD in improving vocabulary acquisition and retention. Early results are promising with increased learner engagement and performance compared with traditional approaches.

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