Implementing E-Healthcare in Saudi Arabia: Opportunities and Challenges - Literature review Example

? Implementing E-Healthcare in Saudi Arabia: Opportunities and Challenges Prepared for Dr Dale Mackrell Supervisor and Lecturer in Charge Faculty of Information Sciences and Engineering Information Sciences Extension Studies 2 PG (7866) Prepared by Yousef Mohammed Yousef Almohandis u3031577 LITERATURE REVIEW Overview of e-Healthcare Health and healthcare are crucial services of eminent importance (Haux 2006). The cost to maintain public health has been rising disproportionately over the last decades in virtually all civilised countries and particularly the Kingdom of Saudi Arabia (KSA). This has escalated to reach levels that arouse questions regarding unrestricted public access to healthcare services even in well developed nations (WHO 2011). E-Health includes the delivery of clinical information, care and services through Information Communication Technology (ICT). With the global development of the e-technology, it has turned out to be crucial to incorporate the ICT tools in every field of service delivery. The technology of internet services not to mention the mobile telephony is growing considerably; this has proved a good leverage to health care delivery through a number of innovative solutions via mobile devices, which is basically referred to as m-Health (Mechael 2009). E-Healthcare has been termed as e-health, e-medicine; with Eysenbach (2001, p.21) referring to it as the emerging field in the connection of medical informatics, public health and commerce; with respect to health services and information availed or enhanced via the ICT. According to the University of La Trobe as cited in Du et al (n.d., p. 391); e-Healthcare is defined as a means of delivering and accomplishing improved health outcomes via valuable and innovative use of health information. It can also be defined as the means of providing high quality health care to all health consumers. DeLuca & Enmark (2000) define e-health as the nascent convergence of wide-reaching technologies like the internet, computer telephony/interactive tone response, wireless communications, and unswerving access to healthcare givers, care management, education and wellness. According to World Health Organisation standard definition, it is “the use, in the health system, of digital data-transmitted, stored and retrieved electronically in support of health care, both at the local and at distant level’ (WHO 2011, p. 117). The concept regarding e-healthcare is broad and prompted Abdallah and Albadri to give out a detailed explanation through citation of several of its examples (2010, p. 177-178). First, it refers to tools that are effective in describing the application of information and communications. They further described it as the electronic patient administration system, laboratory and radiology information systems, electronic messaging systems, telemedicine, tele-pathology and tele-dermatology. Lastly, they termed it as the use of computer systems by the common practitioners and pharmacists for patient supervision, medical files and prescription handling. Another aspect to note in this context is the m-health and mobile health. Mobile health can be termed as a sub-set of e-health and the use of mobile devices in the delivery of health services to the customers (Mechael 2008). This can be clearly established as the use application of mobile telecommunication and multimedia technologies in mobile and health care delivery systems. In broader terms, it relates to the use of wireless technologies to transmit and enable diverse data contents and services that are easily accessible by the health workers via mobile devices such as mobile devices like mobile phones, smart phones, PDAs, laptops, and Table PCs (UN foundation and Vodafone Foundation 2009). The essence behind critical emphasis on the mobile health is the growing population of individuals owning phones. With this focus, m-health can be termed as personalised and interactive provision whose key goal is to offer ubiquitous and collective access to medical advice and information to any customer over the mobile device. E-Healthcare in the Kingdom of Saudi Arabia Transformation of organisational systems globally through ICT in the 21st century has been ongoing; this drives and evolves systemic goals. The introduction of ICT in healthcare has provided avenues for the transformation of healthcare delivery by making it more accessible, affordable and effective across the contemporary world (Altuwaijri 2010). In 2000, the Saudi government established a health reform committee that highlighted the lack of proper informatics as a major challenge facing the Saudi health sector (Altuwaijri 2008). This prompted the strategic move to promotion of IT in healthcare provision and builds a national electronic health record. According to Altuwaijri the following recommendations were critical for implementation. First was the building of cadres specialised in the field of health informatics. Secondly, was to establish an association or society for health informatics in KSA, as well as centres for excellence. Further, a design for the specifications of the electronic health records and expansion of tele-medicine network in the country was crucial. The volume and intensity of the literature regarding e-healthcare is expansive. This contextual analysis narrows down to tackle the specific case of Saudi Arabia e-healthcare and ascertain the opportunities and challenges therein. Currently, there is a dearth of literature with respect to e-healthcare in Saudi Arabia as it is at the helm of development. According to Altuwaijiri (2010), the Saudi Arabia health sector has progressed considerably in the past decades to the point of a number of hospitals receiving international credit. Nevertheless, the situation has not been accompanied by development in the sector health informatics that are crucial in the achievement of given objectives in hospitals like the enhancement of health care quality and reduction of time and cost of the healthcare delivery. Health informatics is a new science prompted by the need for ICT use in health care and is a socio-technical discipline incorporating ICT use in support of the delivery of health care. Alshehri and Grew (2010) clearly ascertains the logic behind the inclusion of ICT; they term it as the most important aspect in the current world and in every new development changes every level of our lives. The evolution of ICT has brought immense change to the citizens in the areas of public and private service delivery; and the level of interaction has been enhanced to a large extent. In the past four decades, the Saudi Arabia government has spent billions of dollars in its mission to progress the quality of health care and in expanding the scope coverage throughout the country. In 2009, the Saudi’s total health expenditure totalled to $US16.7 billion which is a 26.5% increase from 2008 (Almariki et al. 2011). This clearly shows the magnitude of the escalation of the budget regarding healthcare provision. Altuwaijri (2010, p.120) states that 60% of the health care services are presented by the Ministry of Health while the remainder by other bodies like the National Guard, the Ministry of Defence and Aviation, the Ministry of Interior and University Hospitals, as well as the rapidly growing private sector. The number of public and private hospitals in Saudi Arabia in 2010 stood at 400 and is projected to rise close to 500 by 2013 (Guo 2010). In clear statistics, the MOH is the major government heath care provide and financier, with a total of 244 hospitals having 33, 277 beds and an approximately 2037 primary health care (PHC) centres (Almaralki et al. 2011). Further, the government bodies operate 39 hospitals wit a bed capacity of 10, 822 and the private sector contribution mainly in cities and large towns with a total of 125 hospitals having 11, 833 beds and 2218 dispensaries and clinics (Almaralki et al. 2011). In this context, it is clear to note that the government of Saudi has a great role in the enhancement of measures towards the improvement of health care. The variation in health service provision results into diverse ways in the approach in which health care facilities are administered and managed with significant variations in the kind of information used (Haux 2006). Patients’ history is critical information in healthcare service delivery; therefore, the scattering of the information as evidenced in Saudi Arabia centres without one provider having the complete record is very insignificant. This negative impact can be eased by use of ICT to manage patients’ records, which can be accessed from a central point managed by the central authorities within the Ministry of Health (Almariki et al. 2011). Implementation of e-Healthcare in Saudi Arabia With an annual population, growth rate of 2.4%, which stands higher than that of global average growth rate of 1.17%, Saudi Arabia in under intense pressure to heighten its healthcare services (Alshehri and Drew 2010)? The use of ICT in the health sector calls for a central governing body within the Ministry of Health that will deal with the registry of all patients’ records. This is in the quest towards effective handling of patients’ record and enhanced monitoring of patients. According to Guo (2010), in order for the Saudi Arabia’s e-healthcare plans to succeed, there in crucial need to comprehend the other nations failures with respect to e-health implementation. According to Ministry of Health Portal news (2011), the e-health National strategy is based upon four main pillars involving improvement of health services to provide better patient care. Secondly, is to establish effective connection between all MOH hospitals by linking them to the national database. The third pillar incorporates facilitating patient referrals and lastly the Performance Measurement Program. Through the sensitisation of the essence of the e-health incorporation, the public will be made to understand the importance attached to it rather than the fear of privacy intrusion. This can be achieved through measures by the Saudi Health Information Management Association elaborating on the effectiveness of e-health and how the records of patients would be safeguarded. This calls for strategic moves in the laying a firm foundation towards the effective implementation of this project. This could be realised via programs to promote e-health and sensitizer the public on its advantage and eventual sustainability. According to Altuwaijri (2008), with incorporation of enhanced technological channels, information movement within organisations is instant, making the whole process of service delivery efficient. Challenges and Limitations of e-Healthcare in KSA Challenges associated with health care provision are considerable. Further, when it comes to health care Information Technology Industry, there are a number of challenging aspects that hinder full realisation of the treasured success with respect to this. According to Eysenbach (2001), there are three challenges that face the general implementation of e-health care. They include; the capability of consumers to interact with their systems online (business to consumer), secondly is the improved possibilities for institution-to-institution transmission of data (business to business) and finally, new possibilities for peer-to-peer communication of consumers (consumer to consumer). According to Deluca and Enmark (2000), with a societal perspective, there are technological, organisational, managerial and ethical insinuations that are connected with e-health propagation. Cognitive, social and cultural barriers may pose a challenge towards the implementation of this mission and lead to the subjects affected heavily by this the least to benefit from e-health. The barriers may be literacy, cultural differences, access to technology and educational deficiencies and these can be resolved with conscious efforts to address these barriers leading to e-health initiatives expansion to meet a broad range of society’s needs. The specificity of the Saudi case with respect to e-health care can be associated to its effectual challenges in the health segment. The lack of technological knowledge among the practitioners and expansive population may pose a great challenge towards the implementation of e-health. According to Alshehri and Drew (2010, p. 1055), lack of IT professionals and necessary computer training is a major issues towards implementation of electronic service delivery. Further, the variable service availability and support across the Kingdom is one great challenge that hinders the implementation of the e-health strategy. This is in regard to the consolidation of patients records. Consequently, there exists various levels of e-Health maturity that could seem to complex for full implementation; though, this calls for intense consideration and scrutiny with patience for consistency purposes in the realisation of the whole process. The lack of standardisation or the consistency in the technology investment currently poses a major challenge which calls upon the government of the KSA to effectively look into the correction of this challenge. The connectivity that has existed between the primary health care centres and hospitals has been minimal. This has been enhanced by the population growth and calls for intense intervention towards the effective realisation of solutions towards e-health effectiveness. The security and privacy of patients information is very critical and poses a challenge with respect to e-healthcare delivery. The fact that information will be shared online through websites, many individuals have viewed the scenario as not safe. Owing to open architecture of the internet, there is a need for a guarantee towards the privacy and integrity of e-health systems; this can be achieved through organisational policies and procedures. The policies ought to focus on the data security and other ethical issues regarding to e-health. Therefore, the government has the obligation of ascertaining the security of the private data to enhance confidence to the public with respect to this venture. Potentiality of e-Healthcare in Saudi Arabia and future Development The health services are often inadequate in developing countries as they are neither accessible nor affordable; thus, they are frequently dysfunctional, low in quality and impassive to the requirements of the clients (Mechael 2009). Thus, the e-health technology has emerged as a feasible solution towards the pressing of healthcare requirements through its high reach and low cost means by making health care more accessible, affordable and efficient across the developing world. The inclusion of internet in the healthcare enhancement of transmission of information, globally connect physicians to collaborate on services like tele-surgery and the provision of access to physicians and persons once perceived unattainable (UNF and VF 2009). With the inclusion of e-healthcare in KSA, significant opportunities for health care providers, to offer effective services enhanced by technology to their consumers and provide consumers with alternative methods for accessing relevant information regarding healthcare. The Kingdom of Saudi Arabia has the capacity to foster the technology for e-health in the country. With respect to the full implementation of the venture, there is a critical need towards meeting the challenges in the current Saudi health sector. With a clear vision, aimed at enhancing care for the patients, connect providers at the primary care level and hospital level, monitor and measure what has been achieved and finally transform the whole health system. This will see the healthcare sector grow a notch higher with respect to health care delivery and enhancement. This calls for a survey of relevant routes towards the realisation of the e-health system at the national level and establish a board with experience to implement the e-health to review the progress of the process implementation. Further, full potential of e-health will be realised via greater investment in telecommunications equipment and supporting ICT. On the same note, a team of esteemed international specialists to advice at greater detail on the development strategy is critical with this context. Notable fields that are being enhanced by the use of e-healthcare technology include the imaging system with respect to the field of Radiology that is critical in internal organs observation. Among a collective venture, that would see the effective realisation of the e-health would be the m-healthcare, virtually every household in Saudi has access to mobile telephony. This will thereby act as a critical aspect towards the realisation of these services to the whole population in KSA. In conclusion, amid the various challenges that are faced with respect to the inclusion of e-health in the KSA, it is crucial to note that, with enhanced perspective and effortless measures, the results are very robust. The government of the KSA has the capacity to uphold and support the project; it only requires availing a taskforce to look into the carrying out of the whole process and its effectual implementation. The e-healthcare will enhance the quality by increasing efficiency; this is through the allowance for comparison between diverse providers of healthcare. This is in respect to inclusion of consumers as additional force for quality assurance, and directing patient streams to the best quality providers. Consequently, the patients will be empowered in the sense that they are enlightened based on medicine and personal electronic records availed over the internet. Inherently, this study has not exhausted all the probable channels that can be utilised by the KSA towards achieving a successful and efficient e-healthcare. This is with respect to the fact that technology is progressing and new methods of electronic information delivery changing with time. Therefore, this lays a foundation towards extensive research work pertaining to the method of e-health technology that will be effective and efficient to all the patients in all parts of Saudi Arabia. Reference List Abdallah, S. and Albadri, F, 2010. ICT Acceptance, Investment and Organization: Cultural Almariki, M., Fitsgerald, G. and Clark, M., 2011. Health Care System in Saudi Arabia: An Overview. Eastern Mediterranean Health Journal, Vol. 17(10), p. 784-793. Alshehri, M & Drew, S, 2010, 'Challenges of e-Government Services Adoption in Saudi Arabia; from an e-Ready Citizen Perspective'. World Academy of Science, Engineering and Technology, vol.66, pp.1053 -1059. Altuwaijiri, M., 2010. Supporting the Saudi e-Health Initiative: The Master of Health Informatics Programme at KSAU-HS. Eastern Mediterranean Health Journal, Vol. 16(1), p. 116-124. Altuwaijri, M., 2008. Electronic in Saudi Arabia: Just Around the Corner? Saudi Med. Journal, Vol. 29(2), p. 171-178. Deluca, J. and Enmark, R., 2000. E-health: The Changing Model of Healthcare. Front Health Ser Manage, Vol. 17(1), p. 3-15. Du, H., Bradford, B., Assadi-Shehni, R. and Gandhi, V., (n.d.). E-HealthCare: What is E- HealthCare? Eysenbach, G., 2001. What is e-health? Journal of Medical Internet Research. Guo, X., 2010. Saudi Arabian e-Health to Learn from Others’ Mistakes. [Accessed March 31, 2012]. Haux, R. 2006. Health Information Systems-Past, Present, Future. Int. J Med Info. Vol. 75, p. 268-281. Mechael, P., 2009. The case for m-Health in Developing Countries, Innovations: Technology, Governance, Globalisation. MIT Press Journal [online] Vol. 4(1), p. 103-118. Ministry of Health Portal, 2011. E-Health Changes in Health Technology: Ministry News. [Accessed March 31, 2012]. Practices and Values in the Arab World. Hershey, PA: IGI Global. United Nations Foundation and Vodafone Foundation, 2009. M-Health for Development: The Opportunity of Mobile Technology for Healthcare in the Developing World. [Accessed on March 31, 2012]. World Health Organization (WHO), 2011. A System of Health Accounts, 2011 Edition, OECD Publishing, Paris. Read More