Digital health is an emerging term that is being used frequently with health information technology nowadays that includes all forms of computerised and digital operations in healthcare and medicine. Digital healthcare relates to any kind of electronic healthcare provided through technology-based channels, including informative, educational, and even commercial content, as well as services that are provided by medical facilities, specialists, and individuals themselves.
Digital health systems use information and communication technologies (ICT) to deal with health issues that people experience. These methods include telemedicine, web-based analysis, email, applications for mobile phones, messages via text, and clinic or remote surveillance sensors, as well as hardware and software solutions and services.
The scope of digital healthcare in Saudi Arabia
In view of the most recent and increasing interest in digital health programs and initiatives in the Kingdom of Saudi Arabia, researchers, clinicians, and policymakers must improve their understanding of current electronic health record programs, policies, and activities.
Over the last three decades, the Saudi government has invested billions of Riyals to establish, improve, and extend healthcare coverage. As a result, the number of government and private sector hospitals and medical institutions has risen.
Related: Growth opportunities in specialised sectors of Saudi Arabia
Rise of telemedicine
The Ministry of Health in Saudi Arabia urged all healthcare companies to offer distant communication treatments via telehealth programs during the COVID-19 pandemic owing to unforeseen conditions like lockdowns and social distance limitations. Around 10 Saudi teleradiology businesses compete with contractor radiologists for customers. Most of these firms were licensed in 2018. MOH licensing requirements include applying to regional and governorate health directorates and the support agency for growing health investment in the ministry. The radiology facility is assessed every two years.
According to the 2030 Vision, the MOH priorities teleradiology in PPPs. However, the government, hospitals, and commercial health institutions are wary of teleradiology providers. All Saudi private teleradiology firms struggle with a dearth of full-time radiologists.
Most sub-specialised radiologists in Saudi Arabia work for the government or private hospitals. The Saudi health system prohibits dual employment. The private teleradiology sector also faces deficiencies in subspecialty coverage, on-call coverage, government outsourcing of teleradiology to private companies, and low financial compensation due to the current financial module and prices.
Digital health investment in private sector
In Saudi Arabia, the number of studies and information on digital health is still inadequate. Data is confined to some facilities and may not accurately represent the range and complexity of existing and potential electronic healthcare use across the region’s healthcare organisations.
Five major health authorities serve a majority of the population. The Ministry of Health (MOH) supervises 60 per cent of Saudi Arabia’s hospitals, while the other four authorities in conjunction deal with around 20 per cent, with the other 20 per cent controlled by the private sector.
The Ministry of Health serves Saudi natives and registered foreigners and is working on integrating its hospitals and developing a national digital health strategy. Some of these hospitals’ health information systems are from separate manufacturers and are not yet interlinked.
Saudi citizens are served by the King Faisal Specialist Hospital and Research Center (KFSH&RC). The hospital is now part of the KFSH&RC telemedicine network, together with more than 12 Ministry of Health facilities. Administrative work is being eased up in secondary departments, giving them more time to deliver better services and enhance regulatory compliance techniques.
Pharmacists and nurses are currently spending considerably less time processing orders and significantly giving more time to providing medical assistance. The time spent on making calls to physicians for inquiries about and checking prescriptions will be significantly reduced via e-health services.
Emerging telehealth companies in the Kingdom
The Ministry of Health in Saudi Arabia is growing nationwide telemedicine capabilities by utilising innovative technologies in healthcare services. As a result, Seha, a digital health app, was developed in 2018 to allow users to have live audiovisual medical consultations with their physicians on their cell phones.
Users may sign on to the app, speak directly with a professional, and have their medical conditions diagnosed via the app, which has been designed to facilitate audiovisual interactions. As a result, an expert responds to individuals’ queries, provides the necessary medical consultation, and performs the needed clinical procedures.
In 2018, consultations through Seha app accounted for two per cent of medical visits in Saudi Arabia. In the first half of 2020, the Seha app was used to perform 1,877,440 online consultations. Patients that utilised the app were largely pleased with their experience.
Recent surveys, however, revealed that the general population in Saudi Arabia still has inadequate expertise with the Seha application and is hesitant to use it because of a lack of confidence in digital health software.
According to research, a significant number of the participants (70 per cent) recognised the prospective advantages of telemedicine and expressed their interest in employing this approach for healthcare. However, 52 per cent of them never utilised the Seha application. Approximately 51 per cent stated to have never obtained medical advice via smartphone.
Significant differences were observed in views, preferences, and utilisation of telemedicine that were identified throughout people’s age, gender, area of residence, country, and occupation. A considerable number of the respondents were reticent to try out telemedicine for two reasons, 29 per cent was due to a lack of faith in this technology and 30 per cent had doubts because they do not know the doctor on an interpersonal level.
Investments in telemedicine
In 2018, the Saudi government dedicated SAR 146.5 billion (US$1 = SAR 3.75) to healthcare and social improvement, accounting for 15 per cent of total government budgeted investment.
The World Health Organization (WHO) placed the Kingdom of Saudi Arabia’s healthcare system 26th out of 191 different countries, ahead of most of its surrounding Arabian Gulf states, including the United Arab Emirates (27th), Qatar (44th), and Kuwait (45th). It also placed higher than several other developed-country healthcare systems, including Canada (30th), Australia (32nd), and the United States (37th).
The healthcare industry is a primary priority for the Saudi Arabian government, which is why the country spends 60 per cent of all GCC healthcare money. It plans to spend US$36.8 billion (14.4 per cent of its budget) for healthcare and social development in 2022.
More than US$65 billion will be spent on Saudi Arabia’s healthcare system as part of Vision 2030. It also seeks to privatise 290 hospitals and 2,300 primary health facilities, raising the private sector’s participation from 40 per cent to 65 per cent. The Saudi Ministry of Health (MOH) wants to introduce “health clusters” servicing around one million people each to increase access to the service to promote preventative and integrated care.
There are also extensive initiatives in place for digital health expansion in Saudi Arabia. These include spending an additional US$1.5 billion on health IT, digital transformation, and expanding the use of telemedicine. The government’s dedication to healthcare and social development is shown in the 2023 budget, which allotted more than SAR180 billion for these purposes.
With the region’s fastest-growing population, the healthcare system in the Kingdom of Saudi Arabia is in dire need of reform, and a 2015 study from the McKinsey Global Institute (MGI) also urged the country to overhaul its economy.
Therefore, in 2016, the Kingdom developed a new strategic plan called Vision 2030. According to the MGI analysis, the GDP of Saudi Arabia may be doubled by 2030, and as many as six million new employments might be created for Saudi citizens. Eight industries were highlighted in the analysis, with the health industry having the ability to create almost 60 per cent of the development opportunities. To ensure a smooth transition, the government has set aside SAR6 billion to fund healthcare reform.
Improvements in governance in the healthcare system through accountability mechanisms; addressing quality of patient safety issues; and improving the infrastructure and safety standards were all part of the NTP 2020’s plans. Other goals include increasing the private sector’s involvement in healthcare through alternative financing and supervision, making better use of existing resources, and embracing information technology and digital transformation.
Related: Milestone initiatives of value-based healthcare in Saudi Arabia
Challenges faced by the digital healthcare system
Given the healthcare complex structure system in KSA, a research paper has also highlighted several limitations and expected problems in the deployment of telemedicine there. Healthcare facilities are organised into three sectors and controlled by distinct regional zones and directorates in Saudi Arabia.
Moreover, most of them operate independently, and each healthcare facility has its unique business strategy and financial incentives. Although the Saudi government has allocated a huge budget for telehealth care in the country, a lot of barriers like cost, legal, cultural, infrastructure, police, priorities, standards, knowledge, and expertise are just some of the other obstacles highlighted by WHO that are also important considerations for Saudi Arabia.
Future prediction of digital health in KSA
Consumers in Saudi Arabia are beginning to see the value of digital health technologies in the context of comprehensive disease management. Eighty-four per cent of consumers agree that technology plays an important role in health management.
To take care of themselves, 44 per cent utilise the internet, 40 per cent use mobile apps and 41 per cent use social media to track their health. Remote health management strategies include the use of remote consultation (24 per cent of users) and remote health monitoring (12 per cent of users).
In addition, consumers overwhelmingly favor fitness (46 per cent) and diet/nutrition (54 per cent). Approximately 81 per cent of patients reported receiving better treatment when their providers accessed and utilised EHR. Saudi consumers are keen to use digital technologies for health tracking and to share the data they collect with their healthcare providers (HCPs).
After all, Saudi Arabia is the region’s biggest ICT investor, spending an estimated US$35 billion on technology in 2015 and US$39 billion in 2019. While the Ministry of Health’s goal of providing access to quality healthcare has resulted in the proliferation of public hospitals around the kingdom, private facilities have been more active in adopting and making use of the e-health solutions insight.
When compared to civilian hospitals, military facilities provide a comparable number of e-health services. Hospitals linked with governmental entities and other institutions are on the rise in KSA with the Ministry of Health having many affiliated hospitals. There is a discrepancy between the predicted rate of e-health adoption and the actual number of MOH hospitals.
The Communications, Space, and Technology Commission (CST) released the Saudi Internet Report 2022 which presents precise data on the Internet system and its utilisation in the Kingdom of Saudi Arabia. The report also assesses the level of infrastructure development to improve digital services for both the public and private sectors, attracting technical investments, and fostering the growth of a prosperous digital economy.
The study also included information about the Kingdom’s increasing proportion of Internet use, which reached 98.6 per cent of its population. According to the report’s findings, the Tawakkalna Services application was the most downloaded e-government application this year. In the category of educational apps, Madrasati scored top, while Nusuk was the most downloaded program for travel.
There are still obstacles to e-health’s widespread adoption, despite the many positive outcomes that may result from its implementation. Barriers to adopting large-scale IT systems, such as e-health, may be broken down into four distinct types of information: project/economic, technical, organisational, and behavioural. Several obstacles to innovation have been identified by different studies.
The capacity of an organisation to reduce or eliminate the different knowledge barriers affects the adoption and execution of a complicated IT solution.
Dr. Abdullah Alotaibi is the Medical Director and Head of Telehealth Department at MHCS, Manzil Healthcare Services in Saudi Arabia. He is an experienced Assistant Consultant of Family Medicine with a strong track record of comprehensive patient care in diverse healthcare centres in Saudi Arabia. He is also certified in Healthcare Management from Yale School of Management, a Fellow of The International Society for Quality in Healthcare (ISQua), PMP® Certified, and an MBA candidate at Hult Business School in London, UK.
