Telemedicine Practice in Saudi Arabia During the COVID-19 Pandemic

Barriers and Facilitators of Telemedicine Among Physicians at a University Hospital

Background and aims This study explored the perceived barriers and facilitators to the implementation of telemedicine among physicians and estimated and compared the prevalence of telemedicine use among physicians before and during coronavirus disease 2019 (COVID-19). Methods This cross-sectional study was conducted at King Saud University in Riyadh. A convenience sample of 163 physicians working at King Khalid University Hospital (KKUH) completed an online survey. Demographic data, patterns of use, and perceived barriers and facilitators of telemedicine were collected using a 5-point Likert scale. Results Our research showed that 61.3% (n = 100) of the physicians surveyed had used telemedicine in their careers. The prevalence of telemedicine before the onset of COVID-19 was 18.4%, whereas during COVID-19, it increased to 59.5%, which is an increase of 330% (P < .001). Most of the respondents (50.9%; n = 83) used it weekly (27%) or occasionally (23.9%). The most prevalent perceived barrier was technical difficulties (68.7%; n = 112), and the most prevalent perceived facilitator was that telemedicine can reduce unnecessary face-to-face appointments (86.5%; n = 141). Conclusion The use of telemedicine to provide health care is on the rise, especially in the case of emergencies. Different specialties face different facilitators and barriers, and the potential of telemedicine implementation depends on the work environment and the needs of the specialty. Several obstacles need to be overcome before telemedicine becomes a consistently used method for providing health care.

Impact of COVID-19 on pediatric emergency fellowship training in Saudi Arabia

OBJECTIVES

To assess the impact of the COVID-19 pandemic on the academic and clinical processes of pediatric emergency medicine (PEM) fellowship training held by the Saudi Commission for Health Specialties (SCHS).

METHODS

A cross-sectional, nationwide, survey-based study was conducted between June and December 2020. PEM program directors as well as fellowship trainees were eligible. The collected data were under the following domains: (1) sociodemographic and work-related characteristics; (2) impact of the COVID-19 pandemic on patient flow and PEM procedures; (3) impact on emergency skills and competence; (4) impact on academic performance; and (5) attitudes toward PEM practice and potential solutions. Monthly reports of PEM visits and procedures were also collected from program directors.

RESULTS

A total of 11 PEM program directors and 42 fellows responded. During the pandemic, the number of total ED visits decreased by 70.1%, ED inpatient admissions fell by 57.3%, and the number of intraosseous need insertion and lumbar puncture procedures fell by 76.7% and 62.3%, respectively; the temporal differences in the median frequencies were statistically significant. The pandemic has influenced the knowledge acquisition and leadership skills of one-third of program directors (36.4% and 27.3%, respectively) and the skills and competence of fellows (31.0%). The majority of directors and fellows showed that online classes/webinars were useful (100% and 95.2%, respectively), and there was no need to extend the current fellowship training to compensate for learning deficits (62.7% and 78.6%, respectively). The importance of dedicated modalities to fill in the training gap increased by 62.5% of program directors and 35.7% of fellows.

CONCLUSION

The COVID-19 pandemic had significant effects on clinical procedures and academic activities in the PEM fellowship program. The impact was consistently perceived across PEM program directors and fellows. Technology-driven solutions are warranted to mitigate the expected learning and clinical deficits due to reduced clinical exposure.

Perceived Knowledge, Attitudes, and Barriers Toward the Adoption of Telemedicine Services in the Kingdom of Saudi Arabia: Cross-Sectional Study

BACKGROUND

The adoption of telemedicine has facilitated the opportunity to offer the best health care services. Nevertheless, there is a mismatch between the presence of telemedicine programs in the Kingdom of Saudi Arabia and poor acceptance by the end-user patients.

OBJECTIVE

This study aimed to gain a holistic understanding of the knowledge, attitudes, and barriers of the end-user patients (ie, research participants) toward the utility of telemedicine services in the Kingdom of Saudi Arabia.

METHODS

A cross-sectional, survey-based study was conducted from June 1 to July 31, 2022, in the Kingdom of Saudi Arabia. The questionnaire was developed based on a literature review and was examined for validity and reliability. Knowledge questions used a yes-or-no format, whereas attitude and barrier questions used a 5-point Likert-scale format. Data were reported descriptively and analyzed using SPSS (IBM Corp) software. To evaluate the differences in mean scores and identify sociodemographic factors associated with knowledge and attitudes toward the adoption of telemedicine, the data were analyzed using univariate and multivariable regression analyses, respectively.

RESULTS

Overall, 1024 participants participated in the survey. The percentages of participants who attended a telemedicine service before, during, and after COVID-19 were 49.61% (508/1024), 61.91% (634/1024), and 50.1% (513/1024), respectively. The mean score for knowledge was 3.52 (SD 1.486; range 0-5), reflecting a high level of knowledge. The mean score for attitudes was 37.08 (SD 8.526; range 11-55), reflecting optimistic (positive) attitudes. Regarding barriers, the participants voiced some concerns regarding patient and physician resistance and attributed some cultural and technology-related limitations as potential hindrances to the full adoption of telemedicine services. The place of residence (rural vs nonrural) had a significant impact on the scores of knowledge, attitudes, and barriers, whereas gender had no significant impact. The multivariable regression analysis showed that several sociodemographic factors significantly correlated with knowledge and attitudes toward the adoption of telemedicine services.

CONCLUSIONS

The participants showed good knowledge and positive attitudes toward telemedicine services. The perceived barriers were in line with the published literature. This research calls for the need to strengthen the positive attitudes and rectify the barriers, so that the utility of telemedicine services can be maximized in the community.

Utilization of Telemedicine during COVID-19 in Saudi Arabia: A Multicenter Study

BACKGROUND

The outbreak of the novel Coronavirus disease 2019 (COVID-19) has influenced all aspects of life and significantly impacted healthcare services. It has collectively necessitated the use of telemedicine in providing healthcare. Through this study, we aim to report the statistics on telemedicine utilization and satisfaction across the Kingdom of Saudi Arabia during COVID-19.

METHODS

This is a cross-sectional study to report the utilization and patient satisfaction with telemedicine services across Saudi Arabia. The data was collected retrospectively from March 2020 to July 2020 on 22,620 patients who used telemedicine services for consultations, medicine refills, and home healthcare visits during COVID-19.

RESULTS

The patients received a quick response to their calls within a mean (± SD) waiting time of 2.54 (± 6.8) minutes corresponding to a median (IQR) of 0 (0-1) minutes. Home healthcare services were presented within a median (IQR) time of 20.16 (4.64 - 42.28) hours, and patients received medication at home with a median (IQR) time of 18.8 (12.15 - 36.1) hours. Conversations over the phone varied for a median (IQR) time of 5 (3-7) minutes. The highest number of telemedicine calls were for family medicine consultations, i.e., 6729 (29.7%), and the lowest was for infectious diseases 04 (0.1%), followed by cardiology consultations, i.e., 635 (2.8%). A total of 13,154 (58.15) rated their overall satisfaction, of which 11,684 (88.82%) found telemedicine services satisfactory.

CONCLUSION

The utilization of telemedicine across Saudi Arabia results have shown telemedicine to be a satisfactory service for convenient and safe communication between patients and their healthcare providers. It can thus be established as a smart and indissoluble service across the kingdom. However, there is a need to raise awareness of insurance coverage for such services to make them more feasible and accessible to the public.

Perception of Saudi undergraduate medical students on telemedicine training and its implementation

BACKGROUND

The use of telemedicine has increased considerably in healthcare delivery, especially during this time of the coronavirus disease 2019 (COVID-19) pandemic. It has, therefore, become necessary to train medical students to better equip them for this new means of healthcare delivery. The aim of the present study was to assess the perception of undergraduate medical students on telemedicine training.

MATERIALS AND METHODS

A cross-sectional study was conducted on a total of 521 undergraduate medical students studying in the Eastern Region of Saudi Arabia. Data were collected via a self-administered pretested questionnaire comprising two main sections: demographics and knowledge and opinions regarding telemedicine training.

RESULTS

About 73% students think that the use of telemedicine for patient care will increase in the future, and 59.3% think that the medical students should be trained in telemedicine. Majority of the students (78%) opined that telemedicine training should be optional and 58% said it should be taught during the clinical phase of the undergraduate curriculum. The best telemedicine training course learning objectives medical students opined to be included were: telemedicine practical skills (70.2%), legal aspects of telemedicine practice (68.3%), and potential positive and/or negative use of telemedicine tools and methods (67.6%). Telemedicine skills students would like to learn how to effectively engage patients, knowledge about telemedicine regulations and the consequences of breaching them.

CONCLUSION

Medical students are aware of the importance of incorporating telemedicine training into the medical curriculum. Training these students is vital to ensure their competence as physicians in their future clinical careers, that is make them a digitally health-literate future workforce.

Telemedicine Acceptability Among Patients of Primary Health Care Clinics in the Western Region, Saudi Arabia

Background Telemedicine has become increasingly important during recent years. Investigating the acceptability of telemedicine among patients is an important first step in adapting and maintaining the use of telemedicine and gaining the advantages of technologies in daily practice. Objective To measure the acceptability of telemedicine among the patients of primary health care centers (PHCC) using the Service User Technology Acceptability Questionnaire (SUTAQ) at King Abdulaziz Medical City (KAMC), Jeddah, Saudi Arabia. Methods This cross-sectional study utilized a validated questionnaire in phone call interviews with patients of PHCC clinics. All patients who had a telemedicine visit at PHCC within the past month of data collection were eligible for inclusion. The SUTAQ tool was used to measure the acceptability of telemedicine technology. Results Out of 365 people selected for participation, 73.9% responded. The study found that the median age was 40 years old with an interquartile range of 30-52. The majority of participants were female (61.1%) and married (86.7%). The median total SUTAQ score was 4.3, out of a maximum score of 6. The medians for SUTAQ subscales were as follows: the perceived benefits score was 5.4, the privacy and discomfort score was 2.1, the health care personnel concerns score was 3, the satisfaction score was 5.7, and the kit as substitution score was 4.3. Patients who had not previously experienced telemedicine visits showed a higher score in "health care personnel concerns" (P-value=0.009), while first-time patients had a higher score in "kit as substitution" (P-value=0.006). Conclusion This study provided positive evidence that telemedicine is an acceptable service among PHCC patients. However, PHCC providers should prioritize patient education and awareness about telemedicine to improve utilization. Addressing privacy, discomfort, and personnel concerns could increase patient satisfaction. Future studies investigating telemedicine utilization can help in understanding its impact on clinical outcome.

Health care professionals' knowledge and attitudes toward telemedicine

Background

The utilization of modern communication technology in the healthcare field is known as telemedicine, and it represents an advancement in the healthcare industry. For effective implementation of these technologies, healthcare professionals must possess the appropriate knowledge and hold a positive perspective toward the implementation of telemedicine. The current study aims to evaluate the knowledge and perspective of healthcare professionals in King Fahad Medical City, Saudi Arabia toward telemedicine.

Methods

This study was carried out in a diverse hospital, King Fahad Medical City, Saudi Arabia and it was a cross-sectional study. The study took place from June 2019 until February 2020, during which 370 healthcare professionals, including physicians, nurses, and other healthcare professionals participated. The data was gathered by using a structured self-administered questionnaire.

Results

The analysis of the data revealed that the majority of the healthcare professionals who participated in the study, 237 (63.7%), had limited knowledge of telemedicine. About 41 (11%) participants had a good understanding of the technology, and 94 participants (25.3%) had extensive knowledge. The overall attitude of the participants toward telemedicine was positive, with a mean score of 3.26. The mean attitude scores varied significantly (P < 0.001) among the different professions, with physicians scoring 3.69, allied healthcare professionals scoring 3.31, and nurses scoring 3.07. The coefficient of determination (R2) was used to evaluate the variation in attitude toward telemedicine and it was found that education (12.4%) and nationality (4.7%) had the least impact on the attitude toward telemedicine.

Conclusion

Healthcare professionals are crucial to the successful implementation and continuity of telemedicine. However, despite their positive attitude toward telemedicine, most of the healthcare professionals who participated in the study had limited knowledge of it. There were differences in attitude among different groups of healthcare professionals. As a result, it is necessary to create specialized educational programs for healthcare professionals to guarantee the proper implementation and continuation of telemedicine.

Perception of Healthcare Providers during the COVID-19 Pandemic: A Mixed Method Survey in an Integrated Healthcare Delivery System in Saudi Arabia

During the COVID-19 pandemic, telemedicine was broadly adopted for patient care. Considering this experience, it is crucial to understand the perceptions of teleclinic healthcare professionals. In Saudi Arabia, telemedicine literature was restricted to physicians working in government and private hospitals. This study examined perceptions in relation to telemedicine among physicians and other healthcare professionals practicing in Saudi Arabian military hospitals in the Taif region. During COVID-19, telemedicine was implemented in military hospitals; consequently, this study assists in evaluating introduced practices and the perceptions of health professionals regarding these new practices. A quantitative, descriptive, correlational, and cross-sectional study was undertaken on healthcare professionals (N = 153). Twenty (20) items based on standardized measures were used to collect data using an online questionnaire. The measures contained three subscales: perceived usefulness, perceived ease, and behavioral intention. It was hypothesized that the perception of teleclinic usefulness and ease score by healthcare providers would be significantly correlated with behavioral intention. Descriptive statistics for mean, frequency, and standard deviation, as well as a Pearson correlation coefficient and regression analysis, were conducted to assess the relationship and predictive association between variables. In addition, a focus group discussion was organized to collect information directly from healthcare professionals. Most of the participants were approximately 40 years of age, Saudi Nationals (63%), medical specialists (62%), and were involved in teleclinic practices before the COVID-19 pandemic (60%). The reliability of all three scales was determined to be acceptable (α = 0.75-0.91). Perceived usefulness and perceived ease were shown to be significantly correlated with behavioral intention (r = 0.877, p = 0.05). In addition, the regression analysis indicated that perceived usefulness and perceived ease are predictors of the behavioral intention (R² = 0.777, F (2,152) = 261.76, p = 0.001) of teleclinic practices among healthcare professionals. The positive perception of telemedicine integration in healthcare systems revealed by this study is a major catalyst for continuous adoption. On the other hand, certified telemedicine platforms, on-the-job training, Internet of things, and a flexible approach are required to find opportunities and enhancements in telemedicine interactions.

Physicians’ Perspective of Telemedicine Regulating Guidelines and Ethical Aspects: A Saudi Experience

Methods

This was an observational cross-sectional study conducted among physicians working at the College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), and its affiliated academic tertiary hospital, King Fahad Hospital of the University (KFHU), Eastern province-KSA. Data were collected between August 2019 and March 2020 via a structured, pretested, self-administered questionnaire distributed to 220 eligible physicians at KFHU. A final sample of 101 physicians completed our survey. Collected data was coded and analysed using SPSS, and the results presented as frequencies, percentages, and summary statistics.

Results

Among our respondents, 62 (61.4%) were males, 46 (45.5%) were in the age group of 35 to 44 years, and 62 (61.3%) were Saudi. Two-thirds of physicians (58 (57.4%)) use smart devices in healthcare delivery, and 51 (50.5%) are satisfied with this use. A minority (21 (20.8%)) knew about telemedicine guidelines, 8 (7.9%) had encountered legal issues related to telemedicine use, and 52 (51.5%) were doubtful about patients' readiness for virtual care. Regarding physicians' awareness of the ethical aspects regulating the use of social media and medical apps in patient care, only 44 (45.3%) were aware of the proper reporting system if they found accounts sharing unreliable information. Nevertheless, the majority (91 (92.9%)) agreed it is essential for healthcare providers to report such accounts. Concerning physicians' awareness of the rules and regulations of online self-promotion, the majority of our respondents were unsure or unaware of such regulations (46 (45.6%) and 18 (17.8%)), respectively. Nonetheless, 67 (66.3%) of the physicians would not pay SM influencers to advertise for them.

Conclusion

Two-thirds of our physicians use smart devices in healthcare delivery, with 1 in 13 having encountered related legal issues. Nonetheless, only a minority was aware of telemedicine use regulating guidelines, including physicians' online self-promotion regulations. These results highlight the necessity of targeted physicians' training on telemedicine use related guidelines, thereby ensuring the safety of both patients and healthcare professionals and the optimum utilization of online health-related interactions.

Healthcare Providers’ Perception and Barriers Concerning the Use of Telehealth Applications in Saudi Arabia: A Cross-Sectional Study

Background: Telehealth services are widely used in Saudi Arabia. Despite this, neither the use rate nor the attitudes, perceptions, and barriers concerning telehealth applications have been evaluated nationally from the perspective of healthcare providers (HCPs). Aim: This study aims to explore the use rate of telehealth, as well as the attitudes, perceptions, and barriers concerning telehealth use in Saudi Arabia from the perspective of HCPs. Methods and design: A cross-sectional survey was conducted and distributed to all HCPs between 16 November 2021 and 16 March 2022, through an online platform (Survey Monkey). Results: Overall, 1034 HCPs completed the online survey, of which 65.0% (n = 677) were male. Physicians accounted for 22.34%, while nurses and respiratory therapists accounted for 22.34% and 21.47%, respectively. Only 491 HCPs (47%) have used telehealth applications, the majority for less than a year (21.47%) or from one to three years (14.51%). Around 44% of HCPs perceived telehealth as being useful in quality and care delivery. Around 43% of HCPs felt comfortable using telehealth, and 45.45% perceived telehealth as being useful for patients with transportation difficulties. Additionally, 38% believed that telehealth provides a confidential way of protecting patients’ information, and 36% would like to receive more training in telehealth. Speech-language therapists and public health professionals were the highest HCP users (98% and 95%, respectively), while general physicians and dentists were the lowest users (44% and 55%, respectively). Lack of time or a busy schedule was the most common barrier to not using telehealth among all HCPs (38%). Conclusion: The use of telehealth was perceived as being positive as well as valuable and confidential in monitoring and providing care. However, challenges such as the lack of time or a busy schedule impeded the use of telehealth among HCPs in Saudi Arabia.

Efficacy of Telemedicine Utilization for Cardiac Outpatients’ Care during the Pandemic of COVID-19: A Large Center Experience in the Wave of the Pandemic

Introduction

Synchronous telemedicine using teleconferencing may play a role in clinical care. In a tertiary care center, video conferencing-enhanced virtual clinics were established via a new application platform. They were introduced during COVID-19 pandemic to connect patients to trained health-care providers via a secured line. While maintaining patients' privacy, they were theorized to offer effective communications and continuous clinical care. In this cross-sectional cohort study, we ought to examine the impact of service and the assistance they may offer to cardiac patients in the outpatient setup.

Methods

A prospective cohort study looking at all video-conferencing virtual clinics' visits during the pandemic with primary focus on cardiac outpatient clinic, addressing primary endpoints of need for admission or emergency visits from cardiac demises during the pandemic and secondary endpoint of patient satisfaction based on patients' experiences.

Results

A total of 6000 live care video-based chats were made over 10 months period from March 10^th, 2020, to January 30^th, 2021, among which 277 patients were evaluated in the virtual cardiac clinic, of these 193 (69.7%) were males, with mean age of 48 ± 15.60 (22.3%), patients were requested to present to clinic for further evaluation and testing, 20 (7.2%) patients were asked to visit the emergency room, of whom 8 (2.8%) patients were hospitalized. All 8 were admitted for high-risk findings that require immediate medical attention, 4/8 underwent cardiac catheterization, mean duration of admission was 2 ± 1 days. When compared to regular walk-in care, there was a statistical difference in admission rate and emergency visits p = 0.001 and p = 0.0001, respectively, both were statistically higher in the virtual clinic. The satisfaction rate in a 5-scale grading system was 97% of 4 and above recommending the continuation of the service beyond pandemic time.

Conclusions

Video-enhanced virtual cardiology clinic works safely and efficiently during COVID-19 pandemic with a difference in admission rate and ER visits when compared to walk-in clinic. It can be used during nonpandemic time to reduce load on hospital and clinic crowdedness. It also decreases the chances of COVID-19 transmission indirectly by reenforcing physical distance.

The worldwide impact of telemedicine during COVID-19: current evidence and recommendations for the future

During the COVID-19 pandemic, telemedicine has emerged worldwide as an indispensable resource to improve the surveillance of patients, curb the spread of disease, facilitate timely identification and management of ill people, but, most importantly, guarantee the continuity of care of frail patients with multiple chronic diseases. Although during COVID-19 telemedicine has thrived, and its adoption has moved forward in many countries, important gaps still remain. Major issues to be addressed to enable large scale implementation of telemedicine include: (1) establishing adequate policies to legislate telemedicine, license healthcare operators, protect patients' privacy, and implement reimbursement plans; (2) creating and disseminating practical guidelines for the routine clinical use of telemedicine in different contexts; (3) increasing in the level of integration of telemedicine with traditional healthcare services; (4) improving healthcare professionals' and patients' awareness of and willingness to use telemedicine; and (5) overcoming inequalities among countries and population subgroups due to technological, infrastructural, and economic barriers. If all these requirements are met in the near future, remote management of patients will become an indispensable resource for the healthcare systems worldwide and will ultimately improve the management of patients and the quality of care.

The role of the COVID-19 pandemic in expediting digital health-care transformation: Saudi Arabia's experience

A comprehensive literature review of Research engines was conducted up to March 2022 to retrieve the articles. We considered all published data, press briefings, and announcements by the Ministry of Health of Saudi Arabia (MOH). The search included both sources in English and Arabic. Thus, this paper aims to give a comprehensive overview of the evolution and role of telemedicine and E-health represented in multiple informatics mobile applications during the COVID-19 pandemic in Saudi Arabia. As a component of its subjective drives, the MOH has launched and developed a total of 12 mobile applications from 2012 to 2019, three apps of which were developed during the COVID-19 pandemic. My health "Sehhaty" was the cornerstone of telemedicine services provided by the MOH in Saudi Arabia during the COVID-19 pandemic. Virtually booked physician appointments exceeded 3.8 million. Appointment "Mawid" app number of users sprinted from 4 million to 25 million users and the number of appointments booked in the same app went from 8 million to 100 million appointments in pre-COVID-19 compared to the post-COVID-19 period. Furthermore, the Health 937 hotline numbers grew to 24.6 million calls. The Health "Seha" app provided 2 million remote medical consultations with an almost 8-fold increase compared to pre-COVID-19 times.

Public Perceptions around mHealth Applications during COVID-19 Pandemic: A Network and Sentiment Analysis of Tweets in Saudi Arabia

A series of mitigation efforts were implemented in response to the COVID-19 pandemic in Saudi Arabia, including the development of mobile health applications (mHealth apps) for the public. Assessing the acceptability of mHealth apps among the public is crucial. This study aimed to use Twitter to understand public perceptions around the use of six Saudi mHealth apps used during COVID-19: “Sehha”, “Mawid”, “Sehhaty”, “Tetamman”, “Tawakkalna”, and “Tabaud”. We used two methodological approaches: network and sentiment analysis. We retrieved Twitter data using specific mHealth apps-related keywords. After including relevant tweets, our final mHealth app networks consisted of a total of 4995 Twitter users and 8666 conversational relationships. The largest networks in size (i.e., the number of users) and volume (i.e., the conversational relationships) among all were “Tawakkalna” followed by “Tabaud”, and their conversations were led by diverse governmental accounts. In contrast, the four remaining mHealth networks were mainly led by the health sector and media. Our sentiment analysis approach included five classes and showed that most conversations were neutral, which included facts or information pieces and general inquires. For the automated sentiment classifier, we used Support Vector Machine with AraVec embeddings as it outperformed the other tested classifiers. The sentiment classifier showed an accuracy, precision, recall, and F1-score of 85%. Future studies can use social media and real-time analytics to improve mHealth apps’ services and user experience, especially during health crises.

Perspectives on Telemedicine during the Era of COVID-19; What Can Saudi Arabia Do?

The coronavirus disease 2019 (COVID-19) pandemic has represented a challenge to medical practice in Saudi Arabia and worldwide. In contrary to the increasing numbers of COVID-19 patients, there was a limitation in the capacity of medical practices and access to healthcare. A growing body of evidence from healthcare settings in Saudi Arabia and worldwide has suggested a possible role for telemedicine in responding to this evolving need. Telemedicine can be used for triage, direct care, follow-up, and consultation. It could be delivered through synchronous, asynchronous, and mixed approaches. While telemedicine has several advantages, such as accessibility and cost-effectiveness, its diagnostic reliability should be further investigated. The Saudi Vision (2030) has drawn up a roadmap to invest in digital healthcare during the coming decade; however, some barriers related to using telemedicine in Saudi healthcare settings, including cultural issues and technical difficulties, should be openly discussed. In addition, before putting telemedicine in practice on a wide scale in Saudi Arabia, more efforts should be carried out to issue updated legislation and regulations, discuss and respond to ethical concerns, and ensure data security.

Teledermatology During COVID-19: An Updated Review

The coronavirus disease 2019 (COVID-19) pandemic has fundamentally transformed the landscape of providing dermatologic care. In an age of lockdowns and social distancing, teledermatology (TD) has emerged as a powerful tool to deliver remote care. Here, we review literature on TD use during the pandemic to evaluate the positives and negatives of TD implementation. We especially consider the reception of TD in underserved communities and the developing world as well as the ethico-legal challenges wrought by the burgeoning utilization of this new paradigm of care. The potential of TD to occupy a more prominent role in dermatologic care in a post-COVID-19 world is also discussed.

Real Time Telephone Application Use for Consultation in Emergency Medical Services

BACKGROUND: Emergency medical services (EMS) are an operation that requires speed and prompt decision-making to provide patients treatment and rescue them from crisis. A telephone application was created to be a communication channel. However, the effectiveness of EMS consulting via telephone application has not been well studied. AIM: The aim of this study was to describe the use of real-time telephone application use for consultation in EMS. METHODS: A cross-sectional, single EMS centered study at Srinagarind Hospital in Thailand. Data were gathered from LINE® Application under the name of “Current training EMKKU” and the EMS database throughout 2020-2021. RESULTS: A total of 11550 messages with 6221 general text; messages were not involved in patients’ consultant (53.86%). The consultation mostly took place during the afternoon shifts (4PM to 0AM) accounted for 45.11%. We found that Thursday (19.63%) was the day with most frequent consulting services, followed by Tuesday (16.05%) and Friday (16.03%) regarding the consultation. There were 45 active users in the LINE® Application under the name of “Current training EMKKU”. The mean age of the participants was 32.10±5.60 years, and 51.11% (n = 23) of them was female. CONCLUSIONS: The real-time telephone application is used for consultation related to patients' symptoms during EMS operations and ER patient care was most commonly in the afternoon and on Thursdays and Tuesdays.