This paper details the process involved in developing the theoretical framework of factors for a major study entitled “Factors influencing the implementation of ICD-10 in Saudi public hospitals”. An original systematic review strategy, together with specific features of Endnote bibliographic manager software, were used to classify the global literature, separating it into the categories of developed nations and developing nations and, again, nationally according to the national modifications of ICD-10. Finally, the separated literature was examined under three categories, namely Health information, Organization, and National, in order to cast light on how such a process could be implemented in Saudi public hospitals. The issue has not been previously discussed in the Saudi literature. Saudi Arabia is attempting to implement ICD-10 from scratch without the background of a history of earlier ICD version usage. The results of the systematic review indicate a combination of barriers facing healthcare organizations in implementing ICD-10, including a lack of training, specialists, awareness, technology, resources, and some administration barriers. However, in terms of the reality of developing nations, more applicable practical advice was found in the healthcare literature of Thailand, rather than in that of the OECD nations. As ICD-10 is a new phenomenon in Saudi public hospitals and, based on the findings of this paper, it is possible that implementation may best be underpinned by Rogers’ Theory of Diffusion of Innovations, although certain factors that are essential for its success illustrate that an organizational application Maslow’s Triangle applies in dealing with these factors first.