Abstract
BACKGROUND:
Numerous preventive measures and regulations including electronic health (e-health) services were implemented during the coronavirus pandemic. Despite their importance, very little is known about their use. Therefore, the aim of this study was to determine the use of e-health application by healthcare providers (HCPs), and assess their awareness, perceptions, and practices of such services.
MATERIALS AND METHODS:
A cross-sectional study was conducted during July to September 2024 using online self-administered questionnaires. Participants were selected using convenient sampling technique supplemented by snowball sampling. The calculated sample size was 218 participants. Data was collected through an online pretested English-language questionnaire. SPSS version 26 was used to analyze data; Chi-square test was used to examine the associations between HCPs’ responses regarding perceived benefits, risks, and needs related to e-health tools.
RESULTS:
Of the 471 survey participants who started filling out the survey, 64% (n=300) reported using e-health services since coronavirus disease and were included in the final analysis. Female HCPs used e-health applications twice as often as males, and a decline in e-health use was seen with increasing age of participants. Most common purpose for using e-health services were treatment (61%), consultations (60%), and follow up with patient (54%). The most used e-health tools were telephones or cell phones (69.0%) and WhatsApp applications (64.0%) followed by Zoom application (50.0%) and Sehhaty application. Technical problems such as poor internet connection and automatic updates of applications were reported by more than half of the users (52%). Participants reported perceived risks regarding privacy and data protection, and clinical risks associated with using e-health tools.
CONCLUSION:
HCPs’ positive experiences with e-health services in Saudi Arabia, valued for their cost-effectiveness and efficiency. However, patient misinterpretation, privacy risks, and clinical errors persist. Growing demand underscores the need for more explicit e-health regulations and broader professional involvement to enhance e-health service.
Keywords: Access to healthcare, e-health, remote consultation, telemedicine, viruses
Introduction
In Saudi Arabia, the Ministry of Health (MOH) confirmed the first case of coronavirus disease 2019 (COVID-19) in March 2020,[1] and later, numerous confirmed cases reported around Saudi Arabia,[2] presented a challenge to the MOH, and impacted on its ability to provide care. However, owing to rapid evolution, numerous precautionary procedures and preventive measures were introduced by the MOH to limit its spread and impact.[3] For example, the MOH instructed people to wear masks in all public venues. Individuals who did not comply with these measures were fined 10,000 Saudi Riyals.[4] In addition, all passengers landing in Saudi Arabia were asked to fill out a health disclaimer form and submit it to health personnel at the airport upon arrival. They had to register on Tataman and Tawakkalna applications, assign a home location within 8 h of arrival, and complete a daily health assessment.[4] All residents had to apply the social-distancing regulations, one of which was to provide care for patients remotely by the healthcare system.[5] Therefore, electronic health (e-health) or telehealth measures, a practice supported by electronic processes and patient communication that allows distance health services, was implemented to reduce patient visits to the healthcare system.[3] Thus, the MOH expanded e-health services to cover all of Saudi Arabia by introducing numerous applications (Apps) for remote patient care, such as Sehha (sending patient prescriptions electronically through SMS text message after physician’s consultation) and Wasfaty (ordering new or repeat prescriptions online).[1,6] All these apps provided virtual and visual medical consultations, allowing all citizens everywhere to have medical consultations with their healthcare providers (HCPs) across Saudi Arabia at a distance.[1] Moreover, these apps were shown to effectively minimize patient healthcare costs and help reduce unnecessary primary or secondary care visits.[7]
Despite the numerous benefits of e-health, a significant gap exists in the literature regarding the prevalence of its use by healthcare practitioners (i.e., physicians and pharmacists) in Saudi Arabia. This study’s aim was to fill this gap by addressing the research question: What is the prevalence of e-health use by HCPs, specifically physicians and pharmacists, in Saudi Arabia, and what are their awareness, perceptions, and practices of e-health?
Materials and Methods
A descriptive cross-sectional survey was conducted over 2 months, from July to September 2024, with physicians and pharmacists recruited through the Saudi Commission for Health Specialties (SCFHS). Participants registered with SCFHS and working in Saudi Arabia were invited through an online questionnaire (QuestionPro). An information page explained the study’s purpose and inclusion criteria, and participants consented by clicking “I agree” before starting the survey. Participants who indicated they had not used e-health services and those who did not complete the study were excluded from the survey. Ethical approval was obtained from the Institutional Review Board vide letter No. IRB-2024-05-514 dated 03/07/2024, and written informed consent was taken from all participants in the study.
The sample size was calculated using a web-based calculator,[8] targeting a 95% confidence interval, 5% alpha error, and 7% precision. The result was 196 participants. After adjusting for a 10% nonresponse rate, the final required sample was 218. A post hoc power calculation confirmed over 90% power.[9]
A pre-existing instrument was adapted from the prior relevant literature to achieve the study objectives.[10] This instrument showed acceptable test–retest reliability and criterion validity Cronbach’s alpha ≥0.7.[10] Questions were tested at the time of their first use. Thus, they seem to have high face validity. A pilot in which all questions reused and pre-tested, was carried out on six randomly chosen HCPs to obtain feedback on the wording and ease of use of the questionnaire. No changes were required. The data collected from the pilot were not included in the final analysis. The pilot also assessed the feasibility of the questionnaire and face validity. An English language questionnaire in four sections was distributed to all participants. The first section involved HCPs’ characteristics. The second, third, and fourth sections had HCPs’ practices, perceptions, and knowledge of e-health services. The perception section was divided into these three subsections: perceived benefits, risks, and needs.
The completed survey was processed and analyzed using the Statistical Package for the Social Sciences software version 26 (SPSS, IBM Corporation, Armonk, NY: USA).
All demographics were reported. The responses to the questionnaire were generated using descriptive statistics. The Chi-square test was used to examine the associations between HCPs’ responses (primary HCPs [PHCP] and secondary HCPs [SHCP]) regarding perceived benefits, risks, and needs related to e-health tools. We assessed whether the two groups’ differences in categorical variables (e.g., levels of agreement, neutrality, and disagreement) were statistically significant.
Results
Four hundred and seventy-one participants were asked if they had used e-health services since COVID-19; 300 said yes, 171 said no, and were removed. Therefore, the prevalence of e-health service use among the participants was about 64%.
The number of females who enrolled in this study was almost twice as many as males (female 61%, male 39%), and 57% were primary healthcare providers. More than two-thirds of the sample (66%) had <1 year of experience working in the health system [Table 1]. The most commonly contacted patients by HCPs had respiratory (53%) and cardiovascular (40%) problems [Table 1].
Table 1.
Characteristics of healthcare providers in Saudi Arabia, 2024 (n=300)
| Variables | N (%) |
|---|---|
| Age | |
| 22-32 | 111 (37.0) |
| 33-43 | 116 (38.7) |
| 44-54 | 45 (15.0) |
| 55-65 | 27 (9.0) |
| >65 | 1 (0.3) |
| Gender | |
| Female | 182 (61.0) |
| Male | 118 (39.0) |
| Profession | |
| A primary care physician or pharmacist (working in primary healthcare sectors such as community pharmacies, clinics, and general practitioner offices) | 117 (57.0) |
| A secondary care physician or pharmacist (working in secondary healthcare sectors such as hospitals) | 129 (43.0) |
| Years of work experience | |
| ≤5 years old | 262 (87.0) |
| >5 years old | 38 (13.0) |
| The characteristics of patients who were contacted by HCPs | |
| The age range of patients who were contacted since the COVID-19 period by HCPs | |
| <18 | 14 (5.0) |
| 28–18 | 40 (13.0) |
| 39–29 | 137 (46.0) |
| 50–40 | 60 (20.0) |
| >50 years old | 49 (16.0) |
| Patients who were contacted using telecommunication tools since COVID-19 period for support | |
| Patients with respiratory problems | 159 (53.0) |
| Patients with cardiovascular problems | 121 (40.0) |
| Patients with GI tract problems | 113 (38.0) |
| Patients with pain problems | 94 (31.0) |
| Patients with endocrine disorders | 87 (29.0) |
| Patients with bone and joint disorders | 71 (24.0) |
| Patients with psychological disorders | 75 (25.0) |
| Patients with skin conditions | 55 (18.0) |
| Patients with dental problems | 15 (5.0) |
GI=Gastrointestinal, COVID-19=Coronavirus disease 2019, HCPs=Healthcare provider
Participants (n = 300) were asked about the age range of their contact patients; almost half of the sample (46%) stated that the patients were between 29 and 39 years old. The HCPs were also asked to specify their patients’ disease conditions from multiple options for all applicable diseases/conditions that patients had previously and for which they had accessed the healthcare system. Participants were asked about the purpose of using e-health tools or services since COVID-19 and who the most commonly contacted patients were. Participants could select multiple options for all applicable conditions in these two questions. Data revealed that almost an equal number of participants had contacted their patients mainly for either treatment (61%) or to provide consultations regarding their conditions or medications (60%). Patient follow-up (54%), either based on their or the HCP’s request, was another reason for using e-health tools [Table 2].
Table 2.
The medical reason for which healthcare providers utilized telecommunication tools, Saudi Arabia, 2024 (n=300)
| Variables | N (%) |
|---|---|
| The medical purpose that you used e-health tools for | |
| Treatment (e.g., new or repeat prescription/refill and medication delivery) | 184 (61.0) |
| Consultation (e.g., consultation on new or previous medicine and answering patient’s questions) | 180 (60.0) |
| Follow up with patients based on the patient’s request or the HCPs request | 161 (54.0) |
| Monitoring (e.g., patient’s clinical conditions or the effects of certain drugs) | 109 (36.0) |
| Examination and diagnosis | 90 (30.0) |
| Sending the results of diagnostic tests | 81 (27.0) |
| Organize the agenda of appointments | 70 (23.0) |
| To make clinical decisions based on information received via e-health services without further patient assessment | 51 (17.0) |
| Send photos or videos to get an evaluation without having a scheduled visit | 42 (14.0) |
| An evaluation before a visit can be done by sending pictures or videos | 41 (14.0) |
| Not applicable | 25 (8.0) |
HCPs were asked about the duration of their use of telecommunication tools before, during, or after the COVID-19 pandemic. Data showed that almost half of respondents (94%) reported using telecommunication tools only during the COVID-19 period, whereas 23% indicated using them for 1–3 years and 18% for more than 6 years [Table 3]. Telephones (69%), followed by WhatsApp (64%) and Zoom applications (50%), were the most commonly used tools to communicate with patients remotely, whereas Skype (5%) and Cisco (3%) were the least used applications to contact participants [Table 3]. This question allowed a multiple response, so each participant selected all the options they preferred. Therefore, in adding up percentages for participants’ answers, more than 100% were obtained because of double-count or triple-count respondents [Table 3]. E-health tools were mainly used, as declared by half of the participants, for medical purposes to contact colleagues (75%) or patients (73%). The number of times the HCPs used e-health daily was between 1 and 3 times daily, mostly during working hours (66%) [Table 3].
Table 3.
Healthcare provider’s practices toward telecommunication, Saudi Arabia, 2024 (n=300)
| Variables | Yes N (%) |
|---|---|
| Have you been using e-health services since COVID-19 to provide patient care? | |
| Yes (n=471) | 300 (64.0) |
| No (n=471) | 171 (36.0) |
| Means of e-health tools used | |
| Telephones or cell phones | 208 (69.0) |
| WhatsApp application | 193 (64.0) |
| Zoom application | 150 (50.0) |
| Sehhaty application | 117 (39.0) |
| Emails | 109 (36.0) |
| Wasfaty application | 75 (25.0) |
| Microsoft team application | 64 (21.0) |
| Skype application | 15 (5.0) |
| Cisco application | 10 (3.0) |
| The duration you have been using telecommunication tools, whether before, during, or after the COVID-19 pandemic | |
| Only during COVID-19 period | 146 (49.0) |
| 1–3 years | 70 (23.0) |
| 4–6 years | 29 (29.0) |
| >6 years | 55 (18.0) |
| The reason(s) for using telecommunication tools | |
| Medical purposes with my colleagues | 225 (75.0) |
| Medical purposes for my patients | 220 (73.0) |
| Other | 21 (7.0) |
| The number of patients you have followed through e-health tools/day | |
| <50 patients | 267 (89.0) |
| Between 50–100 patients | 26 (9.0) |
| >100 patients | 7 (2.0) |
| The number of times you have used e-health/day since that period | |
| Once a day | 71 (24.0) |
| 1–3 times | 102 (34.0) |
| 4–6 times | 42 (14.0) |
| >6 times a day | 85 (28.0) |
| The preferred time of the day you contact your patient through Telecommunication tools since that period | |
| During working hours | 198 (66.0) |
| After working hours | 22 (7.0) |
| Any time | 80 (27.0) |
| Any technical issue experienced while using telecommunication tools when contacting your patient | |
| Yes | 156 (52.0) |
| No | 144 (48.0) |
| Types of technical issues experienced while using e-health tools when contacting your patient | |
| Internet connection problems | 135 (45.0) |
| Not applicable | 117 (39.0) |
| Application automatic updates | 19 (6.3) |
| Losing the patient’s information regarding their cases | 17 (5.7) |
| Losing the contact details | 12 (4.0) |
COVID-19=Coronavirus disease 2019, HCPs=Healthcare provider
When participants were asked about their experiences with e-health tools, it was revealed that approximately half of them (52%) encountered technical issues. These issues included poor internet connection (45%) and automatic updates of applications (6%). Interestingly, the loss of patients’ information (16%) or contact details (4%) were the most minor reported issues, highlighting the need for further research and development in this area [Table 3].
Table 4 illustrates the perceived benefits, risks, and needs related to the use of e-health services by PHCPs and SHCPs. HCPs perceived e-health services as beneficial, most agreeing that they saved time (74%), enhanced the exchange of medical knowledge (73%), reduced healthcare system costs (73%), and confirmed message delivery to patients and colleagues (70%). Despite these benefits, providers acknowledged risks, including clinical risks from undocumented data (58%), privacy and data protection concerns (57%), incorrect clinical evaluations (57%), and patient misunderstanding (53%). Regarding needs, 78% of the participants emphasized the necessity of e-health services in Saudi Arabia, with 69% supporting government investment in the infrastructure. Providers also expressed a need for suitable workspaces (80%) and compensation (69%) for using these tools to engage with patients.
Table 4.
Healthcare provider’s perceived benefits, risks, and needs related to e-health tools used with patients by type of healthcare provider, Saudi Arabia, 2024 (n=300)
| Statement | Agree N (%) | Neutral N (%) | Disagree N (%) | P-value |
|---|---|---|---|---|
| Perceived benefits | ||||
| During COVID-19, I preferred to reduce the possible contact with my colleagues and patients by using e-health services | ||||
| PHCP | 91 (53.0) | 38 (22.0) | 42 (25.0) | 0.996 |
| SHCP | 68 (53.0) | 29 (22.0) | 32 (25.0) | |
| Using e-health services lets me know if patients or colleagues have read the messages | ||||
| PHCP | 114 (67.0) | 50 (29.0) | 7 (4.0) | 0.264 |
| SHCP | 96 (74.0) | 27 (21.0) | 6 (5.0) | |
| I can have a complete picture of a patient case with e-health services | ||||
| PHCP | 54 (32.0) | 67 (39.0) | 50 (29.0) | 0.501 |
| SHCP | 49 (38.0) | 47 (36.0) | 33 (26.0) | |
| Using e-health services for work is time-saving | ||||
| PHCP | 126 (74.0) | 31 (18.0) | 14 (8.0) | 0.880 |
| SHCP | 96 (74.0) | 21 (17.0) | 12 (9.0) | |
| If people use e-health services, there would be a greater exchange of medical knowledge | ||||
| PHCP | 129 (75.0) | 32 (19.0) | 10 (6.0) | 0.495 |
| SHCP | 90 (70.0) | 28 (22.0) | 11 (8.0) | |
| The use of e-health services helps in reducing the costs of the healthcare system | ||||
| PHCP | 130 (76.0) | 36 (21.0) | 5 (3.0) | 0.078 |
| SHCP | 88 (68.0) | 30 (23.0) | 11 (9.0) | |
| E-health services reduce my work productivity due to distractions | ||||
| PHCP | 50 (29.0) | 81 (48.0) | 40 (23.0) | 0.400 |
| SHCP | 43 (33.0) | 51 (40.0) | 35 (27.0) | |
| Telecommunication increases my workload | ||||
| PHCP | 57 (33.0) | 65 (38.0) | 49 (29.0) | 0.642 |
| SHCP | 37 (29.0) | 50 (39.0) | 42 (32.0) | |
| Using e-health services to monitor patient’s conditions increases the likelihood of recovery | ||||
| PHCP | 81 (47.0) | 68 (40.0) | 22 (13.0) | 0.143 |
| SHCP | 47 (36.0) | 59 (46.0) | 23 (18.0) | |
| Using e-health services facilitates my relationship with my patients | ||||
| PHCP | 110 (64.0) | 43 (25.0) | 18 (11.0) | 0.627 |
| SHCP | 76 (59.0) | 38 (29.0) | 15 (12.0) | |
| My patients are satisfied with the use of e-health services | ||||
| PHCP | 87 (51.0) | 69 (40.0) | 15 (9.0) | 0.924 |
| SHCP | 64 (50.0) | 52 (40.0) | 13 (10.0) | |
| I am satisfied with the use of e-health services | ||||
| PHCP | 115 (67.0) | 46 (27.0) | 10 (6.0) | 0.542 |
| SHCP | 81 (63.0) | 42 (32.0) | 6 (5.0) | |
| Perceived risks | ||||
| The use of e-health services involves risks related to privacy and data protection | ||||
| PHCP | 112 (55.0) | 35 (31.0) | 24 (14.0) | 0.486 |
| SHCP | 76 (59.0) | 32 (25.0) | 21 (16.0) | |
| E-health services may involve clinical risks as they are not documented in the medical record | ||||
| PHCP | 95 (56.0) | 47 (27.0) | 29 (17.0) | 0.371 |
| SHCP | 80 (62.0) | 34 (26.0) | 15 (12.0) | |
| The use of e-health services can generate misunderstandings with the patient | ||||
| PHCP | 88 (52.0) | 60 (35.0) | 23 (13.0) | 0.828 |
| SHCP | 71 (55.0) | 42 (33.0) | 16 (12.0) | |
| The use of e-health services may involve the risk of incorrect clinical evaluations and decisions | ||||
| PHCP | 99 (58.0) | 56 (33.0) | 16 (9.0) | 0.786 |
| SHCP | 71 (55.0) | 43 (33.0) | 15 (12.0) | |
| E-health services use is risky because no guidelines or recommendations are available about the safe mode of use and transmission | ||||
| PHCP | 74 (43.0) | 73 (43.0) | 24 (14.0) | 0.110 |
| SHCP | 76 (59.0) | 35 (27.0) | 18 (14.0) | |
| Perceived need | ||||
| E-health services are needed in SA | ||||
| PHCP | 133 (78.0) | 33 (19.0) | 5 (3.0) | 0.947 |
| SHCP | 102 (79.0) | 23 (18.0) | 4 (3.0) | |
| The government should invest more in e-health services | ||||
| PHCP | 122 (71.0) | 41 (24.0) | 8 (5.0) | 0.506 |
| SHCP | 84 (65.0) | 37 (29.0) | 8 (6.0) | |
| As a HCP, I should be compensated for using e-health services | ||||
| PHCP | 99 (58.0) | 55 (32.0) | 17 (10.0) | 0.375 |
| SHCP | 82 (64.0) | 32 (25.0) | 15 (11.0) | |
| As a HCP, I should set a specific time for telecommunication | ||||
| PHCP | 138 (81.0) | 28 (16.0) | 5 (3.0) | 0.605 |
| SHCP | 109 (85.0) | 18 (14.0) | 2 (1.0) | |
| As a HCP, I should be given a suitable place for e-health services | ||||
| PHCP | 135 (79.0) | 30 (17.0) | 6 (4.0) | 0.733 |
| SHCP | 106 (82.0) | 20 (16.0) | 3 (2.0) |
HCP=Healthcare provider, PHCP=Primary HCPs, SHCP=Secondary HCPs, COVID-19=Coronavirus disease 2019, SA=Saudi Arabia
Regarding perceived benefits, both groups demonstrated similar levels of agreement for statements like using e-health services during COVID-19 to reduce contact (53% agreement for both PHCP and SHCP, P = 0.996) and the time-saving nature of e-health services (74% for PHCP and 75% for SHCP, P = 0.880) [Table 4]. However, when examining perceived risks, both groups expressed concerns about privacy and data protection, with 55% of PHCPs and 59% of SHCPs agreeing on the associated risks (P = 0.486) [Table 4]. Notably, the need for e-health services was widely recognized, with 78% of PHCPs and 79% of SHCPs agreeing that these services were essential in Saudi Arabia (P = 0.947). Across all variables, no statistically significant differences were observed between the groups (P > 0.05), indicating a consensus on the benefits, risks, and needs associated with e-health services.
Regarding HCPs’ knowledge of e-health services, there were apparent differences in how much people knew or their level of knowledge of these tools or applications separately for remote patient care. For example, the majority of participants reported that they had a firm understanding of how to use WhatsApp (83%), E-mails (75%), and Zoom applications (57%). However, they also revealed significant gaps in their knowledge, particularly for Cisco (70%), Skype (41%), and Wasfaty (36%) [Table 5]. These gaps highlight the urgent need for educational interventions. About three-quarters of them (74%) had never had any educational training on the use of these applications. Consequently, the majority of participants (86%) stated that they needed educational sessions or training, particularly for Cisco (53%) and Wasfaty (47%), to improve their knowledge and develop the skills and competencies needed [Table 5].
Table 5.
Healthcare provider’s knowledge regarding e-health applications/tools and educational training received on their use, Saudi Arabia, 2024 (n=300)
| Knowledge | ||||
|---|---|---|---|---|
|
| ||||
| E-health applications | Strong N (%) | Moderate N (%) | Weak N (%) | |
| Sehhaty | 115 (38.0) | 118 (40.0) | 67 (22.0) | |
| Wasfaty | 96 (32.0) | 96 (32.0) | 108 (36.0) | |
| 250 (83.0) | 36 (12.0) | 14 (5.0) | ||
| Emails | 225 (75.0) | 58 (19.0) | 17 (6.0) | |
| Zoom | 172 (57.0) | 101 (34.0) | 27 (9.0) | |
| Microsoft teams | 78 (26.0) | 113 (38.0) | 109 (36.0) | |
| Skype | 77 (26.0) | 101 (34.0) | 122 (41.0) | |
| Cisco | 26 (9.0) | 64 (21.0) | 210 (70.0) | |
|
| ||||
| Educational training on E-health applications use | N (%) | |||
|
| ||||
| Have you ever received educational sessions or training on how to use these applications? | ||||
| Yes | 79 (26.0) | |||
| No | 221 (74.0) | |||
| Do you need to upgrade your knowledge and skills in using telecommunication apps to perform your job more effectively? | ||||
| Very much | 130 (44.0) | |||
| A little | 128 (42.0) | |||
| No need | 42 (14.0) | |||
| Which means of telecommunication tools would you like to receive training for? | ||||
| Cisco | 160 (53.0) | |||
| Wasfaty | 139 (46.0) | |||
| Microsoft teams | 137 (46.0) | |||
| Zoom | 105 (35.0) | |||
| Skype | 83 (28.0) | |||
| 52 (17.0) | ||||
| Emails | 45 (15.0) | |||
| Telephones or cell phones | 43 (14.0) | |||
Discussion
As far as we know, this is the first study to measure the prevalence of the use of telehealth services, including telemedicine and telepharmacy, by healthcare practitioners (i.e., physicians and pharmacists) in Saudi Arabia and examine their views, knowledge, and practices in telehealth. In all other previous studies conducted in Saudi Arabia, data were collected from either a single,[11] two,[12] or four sites only,[13] and among physicians only.[11,12,13,14] Some of these studies had a small sample,[11,12] which tends to enhance the margin of error, reduce the power of the study, and render it meaningless.
This study examined the type of care provided for patients by HCPs in primary and secondary care. In contrast, most previous studies (n = 3) conducted in Saudi focused were only on primary care.[11,12,13] Unlike previous studies, this one covered many e-health aspects, such as remote patients’ monitoring and consultation services (i.e., telehealth, telemedicine, and tele-pharmacy). In addition, it involved a broader range of mobile applications used for patient care, ranging from Sehhaty, Wasfaty, WhatsApp, Zoom, Microsoft Teams, Skype, Cisco applications, and other tools such as e-mails and telephones. All previous studies covered a limited range of mobile applications such as WhatsApp,[10,14] Zoom, Microsoft Teams and Sehha App,[14] and e-mails.[13,14]
Another advantage is that this study covered a wide range of HCPs living in Saudi Arabia, as participants were recruited through the SCFHS. In contrast, past studies were conducted only in a specific region: Riyadh[11,13] or Taif City[12] and included a small sample of only 25 physicians.[12]
Data revealed that as healthcare providers get older, their use of e-health services decreases, which aligns with the findings reported in two previous studies.[13,15] Data showed that more than 50% of the HCPs had used their phones, WhatsApp, and Zoom applications to contact their patients since the pandemic, consistent with the results found in four previous studies.[11,12,14] In this study, the most commonly reported medical purposes that HCPs used e-health tools for were telemedicine (e.g., physicians prescribe medications to patients or repeated prescriptions), consultation, and patients’ follow-up, findings which were consistent with five previous studies,[12,13,14,15,16] while one study revealed that research and teaching were the reasons for using e-health services.[15] Data showed that 49% of HCPs used the health services only during COVID-19. This could be because, in Saudi Arabia, the MOH encouraged HCPs to use e-health services more during the outbreak rather than physical visits to ensure patient safety and mitigate the spread of the virus.[7] In this way, patients were exposed to less danger when e-health services were used (e.g., online consultations, monitoring of the progression of chronic conditions, prescription refills, and follow-ups), to avoid unnecessary hospital visits,[7] and promote self-isolation, which the MOH encouraged.
This study has a few limitations, one of which is that although the cross-sectional design, helped the collection of data from a wide demographic, unlike longitudinal studies, it only provided a snapshot at one point in time, which limited our ability to track changes and trends over an extended period. To better understand these dynamics and their long-term effects on healthcare delivery, longitudinal study designs are recommended. Another limitation of this study is recall bias, particularly when HCPs were asked to remember the age range of patients they primarily contacted since COVID-19. Recalling events from 4 years before can be hard and inaccurate unless these details were obtained from electronic records.
Conclusion
This cross-sectional descriptive study offers a detailed insight into the experiences and perceptions of HCPs regarding modern e-health services in Saudi Arabia. The results show that these services were highly appreciated for their perceived benefits, including cost-effectiveness, usefulness, and efficiency in healthcare delivery. However, challenges persist, such as the potential for patient misinterpretation of information, privacy and data security concerns, and the risk of inaccurate clinical evaluations and decisions. The strong demand and willingness to continue using these services underscore their growing acceptance in Saudi health care. Thus, more explicit e-health regulations and enhanced management support are necessary. Regular updates, comprehensive e-health guidelines, integration with e-health systems, and involvement of a broader range of medical professionals could further enhance telehealth services.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
References
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