The thesis follows and adheres to Staffordshire University’s code of ethics during all research phases. Several ethics principles were utilised to ensure that ethical considerations were covered; these principles are explained as follows:
• Governance
The researcher submitted the appropriate ethics form to the Research Degree Sub-Committee of Staffordshire University to gain approval before conducting the research activities. The researcher also made it clear to all the participants that Staffordshire University’s code of ethics would be followed during all the phases of this research. A formal request by the researcher to conduct this research was approved by the Regional Research Ethics Committee in Saudi Arabia.
• Informed consent
The researcher provided written information for all the participants that explained the research aim and objectives. The developed consent form stated clearly that participation in this research study is completely voluntary and the participants have the right to withdraw from participation at any time without stating a reason for their withdrawal (Runeson & Höst, 2009).
• Anonymity
Anonymity is maintained during the research since no personal details are required and hence individuals will be non-identifiable (Saunders et al., 2009).
• Confidentiality
Data collection was collected in an anonymous and confidential manner and used for research purposes only. The results of the research will be published only in academic publications without providing the names of the individuals and organisations, and, to ensure confidentiality, no sensitive information to be published or leaked outside the organisations (Runeson & Höst, 2009).
1.9 Thesis Outline
The thesis structure follows the “Lead in, Core, Lead out” format suggested by Dunleavy
(2003), as shown in Figure 1.6, and the thesis contains nine chapters as follows:
Chapter 1 Introduction: The purpose of this chapter is to introduce the context of the investigation by discussing the background and motivation of the research. It also provides information about healthcare in Saudi Arabia, which is selected as the research case study. The chapter presents the aim and objectives of the research and identifies the contributions to knowledge it provides. The chapter explains the research processes followed during the study, the validation and evaluation of the developed framework, and any ethical implications. It concludes by outlining the thesis structure.
Chapter 2 Cloud Computing: The aim of the chapter is to explore many aspects of Cloud Computing such as its characteristics, different Cloud Computing deployment models and services models. The chapter also includes a critical review of the benefits and challenges of implementing Cloud Computing solutions, and the current frameworks and models of Cloud Computing decision-making.
Chapter 3 From E-health to E-health Cloud: This chapter discusses the challenges of traditional healthcare systems and the benefits of e-health solutions. It also describes the challenges of current e-health practices and the movement towards Cloud Computing in healthcare organisations. The chapter then focuses mainly on Saudi Arabia by discussing e-
health status in Saudi Arabia and how Cloud Computing can benefit Saudi healthcare organisations.
Chapter 4 The Development of an Holistic Approach Framework for Cloud Computing Strategic Decision-Making in the Healthcare Sector (HAF-CCS): This chapter describes the development process of the Holistic Approach Framework for Cloud Computing Strategic Decision-Making in the Healthcare Sector (HAF-CCS). The chapter begins by introducing the theoretical basis of the framework since the framework is built based on three theoretical frameworks: TOE, IS strategy triangle and HOT-fit. Five perspectives (i.e. Business, Technology, Organisation, Environment, Human) and their sub-factors are reviewed based on the literature to explain their relation to the decision about Cloud Computing adoption.
Chapter 5 Understanding the Determinants of Cloud Computing Adoption in Saudi Healthcare Organisations: This chapter presents the study conducted to understand the factors affecting Cloud Computing adoption in healthcare organisations in Saudi Arabia by using a questionnaire. The chapter also contains the analysis of the collected data using various statistical tests such as Cronbach’s alpha, Confirmatory Factor Analysis, KMO test and ANOVA. The results from the study are used to refine the framework.
Chapter 6 Decision-Makers’ Views of Factors Affecting Cloud Computing Adoption in Saudi Healthcare Organisations: This chapter describes the investigation conducted among decision-makers in Saudi healthcare organisations in order to identify their views about Cloud Computing using semi-structured interviews. Framework analysis is implemented to analyse the results, which are tested against the developed framework.
Chapter 7 Validating the Framework using Two Healthcare Case Studies: This chapter describes the validation of the framework by means of workshops. It provides a description of real-world-based scenario case studies that are used to validate the framework. The application of the HAF-CCS in two healthcare organisations is explained to ensure that the framework can be applied in a real-world context and that its results supported the Cloud Computing decision- making.
Chapter 8 Evaluation of the HAF-CCS Framework: This chapter presents the evaluation of the developed framework using a panel of experts. The framework is tested against specific criteria to confirm its accessibility by the decision-makers in healthcare organisations.
Chapter 9 Conclusion and Future Work: This chapter draws the thesis to a conclusion by summarising the research findings and contributions. It also outlines the limitations of the research and potential areas for future work.
Figure 1.6 Thesis structure Chapter 1: Introduction
Chapter 2: Cloud Computing
Chapter 3: From E-health to E-health Cloud
Chapter 4: The Development of an Holistic Approach Framework for Cloud Computing Strategic Decision-Making in the Healthcare
Sector (HAF-CCS)
Chapter 5: Understanding the Determinants of Cloud Computing Adoption in Saudi Healthcare Organisations
Chapter 6: Decision-Makers’ Views of Factors Affecting Cloud Computing Adoption in Saudi Healthcare Organisations
Chapter 7: Validating the Framework using Two Healthcare Case Studies
Chapter 8: Evaluation of the HAF-CCS Framework Sector
Chapter 9: Conclusion and Future Work
Lead In: Introducing the topic and current literature Core: Main materials of the research Lead out: Research summary
1.10 Conclusion
This chapter has introduced the thesis by presenting the background of the research and the motivations for conducting this research. This was followed by stating the aim and objectives of the research and the contribution to the knowledge it offers. Then, the research philosophies, approaches, strategies, tools and process were explained and the choice of each concept was discussed and justified. The chapter also described the validation and evaluation approaches for the research and explained the ethical implication of the research. Finally, the chapter presented an outline of the thesis and a brief summary of each chapter. The following chapter will discuss the context of this research, which is Cloud Computing.
2 Cloud Computing
2.1 Introduction
This chapter provides a literature review of Cloud Computing to provide the technical basis for the study’s investigation. This chapter starts by briefly exploring the evolution of Information and Communication Technologies that has led to Cloud Computing. A definition of Cloud Computing and its main characteristics is discussed along with the enabling technologies that help in understanding Cloud Computing phenomenon. A critical investigation of different Cloud Computing service models and deployment models is conducted and the benefits and concerns of each are discussed, followed by a comparison. Additionally, the advantages that drive Cloud Computing adoption and the concerns that may affect adoption are identified. Its relationship to existing information system topics such as Service-Oriented Architecture (SOA) and outsourcing is also described. Finally, current cloud adoption decision-making frameworks are analysed and the need to develop a strategic framework for Cloud Computing decision- making processes which emphases a multidisciplinary holistic approach is identified.
2.2 A Brief History
The continuous revolution and evolution of Information and Communication Technologies (ICT) have affected the way that organisations conduct their business. The ICT industry has moved through many stages, beginning with mainframe computing and moving to Cloud Computing. Although Cloud Computing is an emerging paradigm which is transforming the IT industry, the idea behind it goes back to the 1960s. In 1961 John McCarthy proposed the following:
If computers of the kind I have advocated become the computers of the future, then computing may someday be organized as a public utility just as the telephone system is a public utility… The computer utility could become the basis of a new and important industry. (McCarthy, 1961, quoted in Erl et al., 2013, p.26)
Cloud Computing could be seen as a paradigm that has evolved from previous computing paradigms. Voas and Zhang (2009) suggested that there are six distinct phases for computing development, as shown in Figure 2.1. The first phase is mainframe computing, where multiple users share a CPU via a number of terminals. The second phase is stand-alone personal computers, where every user works alone. In phase 3, personal computers are connected to each other; this is called networking. The Internet or network of networks is the fourth phase
of the computing movement. The fifth phase is grid computing, where many computing resources cooperate to achieve specific goals. Cloud Computing, which is an evolution of grid computing, is the sixth, current and emerging, phase of computing (Azeemi et al., 2013; Durao et al., 2014).
Figure 2.1 Computing paradigm shift