Introduction
E-health engulfs all forms of electronic and digital processes that take place in healthcare and provided through information and communication technology (ICT) channels. In Saudi Arabia, e-health is relatively a recent term where healthcare is being offered in a more efficient and sufficient way, allowing professionals and patients to interact in ways that were otherwise deemed impossible. The COVID-19 pandemic has presented a new set of challenges, with more people demanding access to health services. Travel restrictions and social distancing practices have created the necessity for e-health and telemedicine. Analyzing how these technologies are impacting healthcare in Saudi Arabia, both within and beyond the pandemic is a crucial endeavor.
E-health in Saudi Arabia
The ministry of health (MOH) in Saudi Arabia has been encouraging people to use available mobile applications to seek medical care instead of visiting care providers during the outbreak. Currently, telemedicine adoption is approximately 70% in the country. Similarly, 34% of young physicians are using smart approaches such as the use of artificial intelligence (AI) to offer services (Hassounah et al., 2020). The government of Saudi Arabia has also invested heavily in digital and IT transformation in hospitals. In 2018, the government launched a mobile and web-based application ‘Mawid’ whose purpose was to ease the processes of appointment in health delivery (Hassounah et al., 2020). Afterward, the country has witnessed a growth in digital health applications such as Sehha, Wasfaty, Cura, Labayh, and 80/20 Lifestyle apps. The Health Electronic Surveillance Network (HESN) has been a reliable source for COVID-19 laboratory test data in Saudi Arabia.
How the Data Will Be Analyzed
The data will first be analyzed using R statistical software which will allow the researchers to visualize and model the data. Descriptive statistics will be used to summarize the data collected and synthesize the information (Hassounah, Raheel, & Alhefzi, 2020). Independent variables will be compared based on COVID-19 and pre-COVID-19 periods using paired t-test. For categorical values, data will be represented in form of percentages and frequencies (Ramaswamy et al., 2020). On the other hand, standard deviation, proportion, and mean will be used to describe data for the continuous variables (Tashkandi et al., 2020). Multivariable linear regression will be fit with the study co-variables. To measure the level of association between some of the variables used in the study, the chi-square test will be performed (Fisk, Livingstone, & Pit, 2020). The test will enable the researcher to compare expected and observed frequencies objectively.
Statistically, significant differences will be considered at P<0.05. The Kruskal-Wallis H test will be used to establish the value of P (Parisien et al., 2020). Microsoft Excel will be used to perform less-complex data analysis, such as response yield, and proportion of participants
Study Variables and Regression
The dependent variable in the study will be the impact of e-health and telemedicine in Saudi Arabia as indicated by the number of services offered through ICT applications (Y). On the other hand, the dependent variables in the study will be perceived usefulness (p) and economic impact (e). Following these variables, the following regression will be tested.
Y= β (p+e)
Where; β = Accessibility of E-health services
Data will be obtained through questionnaires and interviews. Interested healthcare professionals working in the study settings will be included. Similarly, healthcare facilities adopting telemedicine will be included in the study. Patients will only be included in the study if they conform to the set ethical standards as per the research protocol.
What Kind of Results Will Confirm or Disconfirm the Hypothesis?
The nonparametric Wilcoxon-Mann-Whitney test will be used to test the study hypothesis. To test the impact of using telemedicine and e-health within and beyond the COVID-19 pandemic in Saudi Arabia, two major hypotheses formulated during the study will be tested. Results whose P-value is less than or equal to the alpha (α) level will lead to the null hypothesis being rejected, hence confirmation of the alternative hypothesis (Sultan, Mashrei, & Washer, 2020). On the other hand, a P value greater than α will result in the disconfirmation of the hypothesis, leading to the adoption of the null hypothesis.
Hypothesis 1
The first hypothesis will test the economic impact of telemedicine and e-health in Saudi Arabia, both within and beyond the COVID-19 pandemic. Economic variables used to determine the effect of TM on healthcare will include the cost of care and associated expenses, such as the opportunity cost of visiting hospitals.
H0: Telemedicine and e-health does not have any economic impact on healthcare during and beyond the COVID-19 pandemic in Saudi Arabia
H1: Telemedicine and e-health have a positive economic impact on healthcare during and beyond the COVID-19 pandemic in Saudi Arabia
For the first hypothesis, the researcher expects a P-value that is less than α. As a result, it is expected that the null hypothesis will be rejected. It will be concluded, therefore, that telemedicine and e-health pose significant economic effects on healthcare in Saudi Arabia.
Hypothesis 2
The second hypothesis will test whether patients perceive the use of telemedicine and e-health as generally beneficial during and beyond the COVID-19 pandemic. As such, the relative advantage (RAD) of using telemedicine will be tested (Blandford et al., 2020). For the purposes of this study, for TM and e-health to be considered beneficial, they must be associated with improved efficiency in care delivery.
H0: Telemedicine and e-health are not beneficial during the COVID-19 pandemic
H1: Telemedicine and e-health are deemed beneficial during the COVID-19 pandemic
The researcher expects a P value that is less than α for this hypothesis. Therefore, it will be concluded that patients and healthcare professionals deem the use of telemedicine and e-health as beneficial during the outbreak.
Significance and Conclusion
The novel COVID-19 continues to pose a major challenge to healthcare systems, not only in Saudi Arabia but across the globe as well. Hospital congestions, the fear of contracting the disease, challenges in transportation, and restrained resources have made telemedicine and e-health a preferred approach in delivering healthcare in Saudi Arabia (Cory & Stevens, 2020). It is expected that the post-COVID-19 period will witnesses an increased investment in telemedicine by healthcare systems (Mishra, 2020). The potential benefits of telemedicine include; reduced healthcare costs, increased access to information, provision of healthcare not previously deliverable, and increased access to services (Hong et al., 2020). Considering the impacts that adopting telemedicine and e-health present, evaluating the impact of these technologies on healthcare delivery is a noble task.
Different interest groups, such as healthcare organizations, government health agencies, and educators would benefit immensely from this research. It is, therefore, expected that they would be willing to finance and publish the article upon request. This research will lead to significant improvements over original studies by incorporating two major aspects, which are deemed critical in making investment decisions on TM and e-health. First, the study analyses the economic impact from the perspective of both the patients and healthcare providers. Secondly, the study uses data that stretches both during and beyond the COVID-19 outbreak. Using such data allows the researcher to have a clear visualization of the actual impact of the adoption of telemedicine in healthcare delivery in Saudi Arabia.
The significance of using telemedicine and e-health conforms to the general guidelines issued by the World Health Organization (WHO) on minimizing the risk of spreading COVID-19. Notably, a majority of people continue seeking to decrease personal presence, as well as maintaining social distancing. As a result, it is expected that a large number of health organizations in Saudi Arabia will continue to replace their on-site services with virtual care services.
References
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