Strengthening the Saudi Arabian healthcare system: Role of Vision 2030

Key aspects of the Saudi healthcare system reform and the potential impact on the main stakeholders: A qualitative study

Objectives

To explore and understand KSA's fundamental healthcare system reform, the potential changes and challenges, and their impacts on major stakeholders.

Methodology

To gain in-depth insights into healthcare leaders' perspectives regarding healthcare system reform in KSA, a qualitative research approach was used. Ten participants from diverse backgrounds were selected, representing various sectors in KSA: private, public, executive, consulting, and regulatory. This study was conducted between august 2022 and June 2023.

Findings

The findings revealed four key themes that shed light on healthcare system transformation in KSA and its effects: healthcare system reform, the impact of corporatization/privatization on healthcare providers, the impact of corporatization/privatization on health insurance, and the impact of corporatization/privatization on the workforce. Furthermore, the findings indicated that the ongoing transformation of the public sector toward privatization in KSA faces various challenges that affect most, if not all, stakeholders in the sector. However, the private sector possesses several strengths that can aid in addressing the challenges associated with the rapid transformation of the system. These strengths include familiarity with the market, robust financial management, extensive experience in coding and billing payers and insurance companies, efficient decision-making processes, flexibility, and maturity.

Conclusion

The study facilitated comprehensive insights into the transformation of KSA's healthcare system and the public sector's shift toward corporatization/privatization. The sector must enhance its capabilities by establishing specialized units and recruiting talent. Further studies are also needed to gain a deeper understanding of the obstacles hindering the transformation.

Potential Applications of Artificial Intelligence (AI) in Managing Polypharmacy in Saudi Arabia: A Narrative Review

Prescribing medications is a fundamental practice in the management of illnesses that necessitates in-depth knowledge of clinical pharmacology. Polypharmacy, or the concurrent use of multiple medications by individuals with complex health conditions, poses significant challenges, including an increased risk of drug interactions and adverse reactions. The Saudi Vision 2030 prioritises enhancing healthcare quality and safety, including addressing polypharmacy. Artificial intelligence (AI) offers promising tools to optimise medication plans, predict adverse drug reactions and ensure drug safety. This review explores AI's potential to revolutionise polypharmacy management in Saudi Arabia, highlighting practical applications, challenges and the path forward for the integration of AI solutions into healthcare practices.

Perceptions and Knowledge of Undergraduate Dental Students about Artificial Intelligence in Dental Schools: A Cross-sectional Study

OBJECTIVE

This study aims to assess the perceptions and knowledge of undergraduate dental students about artificial intelligence (AI) in dental schools through a cross-sectional study.

MATERIALS AND METHODS

This was a multicenter, cross-sectional study. Participant recruitment was achieved by sending an online questionnaire to the undergraduate students at the assigned universities. The questionnaire consisted of two parts. The first seven questions record general information about participants and their perceptions of AI. The remaining questions are about the knowledge of participants about the applications of AI. The data were analyzed using SPSS version 26.

RESULTS

About 165 undergraduate students from 20 universities related to the dental sciences responded to the questionnaire. And 80.6% of participants found the use of AI in dentistry exciting. I have a basic knowledge of the working principles of AI. About 80.6% of participants believe that applications of AI should be part of undergraduate dental training. And 66.6% of students are aware of the opportunities and threats that AI can create. The results show that 75% of the students indicated that they got their information about AI through social media. Regarding the association of years of studies with AI applications used in periodontics, the knowledge about AI applications in "aggressive periodontics," "compromised teeth," and "success in rate of dental implant" was significantly higher in senior students than junior students (p < 0.05). Concerning applications of AI used in restorative dentistry and prosthodontics, only "computer color matching," "tooth surface losses," and "I do not know" showed statistical significance (p < 0.05) with the year of study of participants. Senior students show significantly better knowledge in "success in retreatment" and "working length determinant."

CONCLUSION

Although undergraduates are enthusiastic about AI and aware of its threats and benefits, their knowledge is limited. In addition, undergraduate programs must exert more effort to prepare students for the era of AI. How to cite this article: Aldowah O, Almakrami A, Alghuwaynim Y, et al. Perceptions and Knowledge of Undergraduate Dental Students about Artificial Intelligence in Dental Schools: A Cross-sectional Study. J Contemp Dent Pract 2024;25(2):148-155.

Public Perceptions Towards Online Health Information: A Mixed-Method Study in Eastern Province of Saudi Arabia

Background

Online health disinformation is one of the key challenges faced globally. Although there are efforts to address this issue, most of the proposed solutions were ineffective or could not address it effectively. One of the key reasons for the ineffective solutions is lack of understanding on how public deal with disinformation and the different areas that could be influenced by health disinformation.

Purpose

This study aims to analyze the public perceptions towards online health information, investigate the impact of online health disinformation, and propose a framework for addressing the issue of online health disinformation.

Methods

A mixed-methods approach design is used in this study which includes a cross-sectional survey design to gather data from public; and a semi-structured interviews approach with healthcare experts to analyze the impact of online health disinformation on the society. A total of 409 Saudi residents were included for survey, and 22 health informatics experts were considered for interviews.

Results

The results revealed low digital literacy levels and poor critical analysis skills among the public resulting in poor management of health disinformation. Age and education can influence the users' perceptions about the use of various online health information evaluation techniques. Thematic analysis of the interviews identified impact in four areas including social, economic, technical, and legal fronts; and various strategies were identified for public, governments, and healthcare institutions for managing the online health disinformation.

Conclusion

The occurrence of online health-related disinformation in Saudi Arabia is high, and there is a need to implement strict regulatory framework for managing disinformation.

The Road Ahead and Challenges of Revenue Cycle Management in Saudi Governmental Hospitals

Healthcare providers use revenue cycle management (RCM) to track patient billing and revenue. The revenue cycle collects data from various systems and compiles it into a single RCM system connected to payers. Effective system integration improves revenue and financial stability. The aim is to assess RCM feasibility in Saudi Arabia's governmental hospitals, examine financial management, and recommend practical implementation. In this study, healthcare leaders were interviewed face-to-face and via audio recording to collect qualitative data in response to semi-structured questions. Key informants from seven main hospitals were interviewed. Respondents understood RCM and identified internal and external challenges in hospital financial management. Government hospitals face accountability obstacles. Two of the seven surveyed hospitals operate business clinics using a fee-for-service model. The billing system is not integrated with the information system. The RCM system faces challenges such as unclear vision, lack of accountability, staff resistance, process redesign, and importance of project management. Despite these challenges, respondents still value RCM and recognize its importance in improving hospital revenue management. Effective implementation of RCM requires significant transformational processes, including vision, governance, accountability, proper training, and effective monitoring and evaluation processes. Communication should also be emphasized, and the patient's perspective must be brought into focus. Involving all stakeholders can create direct and holistic patient benefits; therefore, bringing them on board is crucial. New approaches are required to enhance healthcare in Saudi Arabia, addressing gaps in revenue optimization and RCM. Future research should evaluate the move from government-funded to self-operated hospitals, providing a better understanding of the challenges and opportunities.

Physical accessibility, availability, financial affordability, and acceptability of mobile health clinics in remote areas of Saudi Arabia

Introduction

Access to primary healthcare (PHC) services is a significant concern, especially for those living in remote areas. Mobile health clinics (MHCs) are a model widely used to enhance access to healthcare in rural areas. In Saudi Arabia, the Ministry of Health has launched mobile clinics to facilitate access to PHC and increase access to healthcare. This study aims to assess the accessibility of MHCs in rural areas of Saudi Arabia measuring four dimensions of access from the patient's perspective: physical accessibility, availability, financial affordability, and acceptability.

Methods

A quantitative cross-sectional survey in the form of an interviewer-administered questionnaire was performed on patients who attended mobile clinics between August and October 2020. All these people have been targeted to be interviewed as a nonprobability sample. Data was collected through a survey filled out by the interviewer.

Results

Five hundred participants were interviewed in nine mobile clinics in the nine cities of the Kingdom. The majority were men (82.4%) and from Makkah city (13.6%) and 94.2% of the participants were Saudi nationals. In total, 98.3% of the respondents were satisfied with the overall mobile clinic services and 11.4% of the participants had difficulties with the mobile clinics' work schedules. There was a positive correlation between access to mobile clinics and satisfaction.

Conclusions

The mobile clinics in rural and remote areas in Saudi Arabia during the study period were accessible to the respondents and met patient satisfaction. Most participants accept the work schedule for mobile clinics. However, it requires further improvements to meet all access dimensions of the study.

Professional autonomy among nurses in Saudi Arabian critical care units

BACKGROUND

Professional autonomy is essential in expanding the scope of nursing practice and has been recognized as a top nursing priority.

OBJECTIVE

This study aims to assess Saudi nurses' autonomy level in critical care settings and examine the influence of sociodemographic and clinical characteristics on their autonomy level.

METHODS

A correlational design and a convenience sampling approach were used to recruit 212 staff nurses from five Saudi governmental hospitals in Jouf region of Saudi Arabia. The data were collected through a self-administered questionnaire composed of two sections, including sociodemographic characteristics and the Belgen autonomy scale. The Belgen autonomy scale used in this study measures nurses' autonomy levels and consists of 42 items rated on an ordinal scale. The scale's minimum score of 1 indicates nurses with no authority, while the maximum score of 5 indicates nurses with full authority.

RESULTS

Descriptive statistics revealed that nurses in the sample had a moderate overall work autonomy (M = 3.08), with higher autonomy in patient care decisions (M = 3.25) compared to unit operations decisions (M = 2.91). Nurses had the highest level of autonomy in tasks related to preventing patient falls (M = 3.84), preventing skin breakdown (M = 3.69), and promoting health activities (M = 3.62), while they had the lowest level of autonomy in ordering diagnostic tests (M = 2.27), determining the day of discharge (M = 2.61), and planning the unit's annual budget (M = 2.22). The multiple linear regression model (R2 = 0.32, F (16, 195) = 5.87, p < .001) showed that education level and years of experience in critical care settings were significantly related to nurses' work autonomy.

CONCLUSION

Saudi nurses in acute care settings have moderate professional autonomy, with higher autonomy in making patient care decisions than unit operations decisions. Investing in nurses' education and training could increase their professional autonomy, leading to improved patient care. Policymakers and nursing administrators can use the study's results to develop strategies that promote nurses' professional development and autonomy.

Saudi Arabia Health Systems: Challenging and Future Transformations With Artificial Intelligence

The healthcare system in Saudi Arabia is facing several challenges, including an aging population, an increase in chronic diseases, and a shortage of healthcare professionals. To address these challenges, the government is taking proactive steps, including expanding healthcare infrastructure, promoting the use of technology, improving the quality of healthcare services, and emphasizing the importance of preventive healthcare. In addition, the adoption of artificial intelligence (AI) solutions can play a crucial role in transforming the healthcare system by improving efficiency, reducing costs, and enhancing the quality of care. However, the adoption of AI solutions comes with challenges such as the need for high-quality data and the development of regulations and guidelines. The government needs to continue to invest in healthcare and AI solutions to build a more efficient and effective healthcare system that benefits all citizens.

National and Regional Rates of Chronic Diseases and All-Cause Mortality in Saudi Arabia-Analysis of the 2018 Household Health Survey Data

The disease burden and mortality were estimated in Saudi Arabia between 2010 and 2017 but were unknown in 2018. This study aims to assess the 2018 national and regional rates of chronic diseases and all-cause mortality among the total and Saudi populations. In this descriptive cross-sectional study, we obtained data from 24,012 households from the 2018 household health survey. We included doctor-diagnosed chronic conditions such as diabetes mellitus (DM), hypertension (HTN), cardiovascular diseases (CAD), and cancer (CN). A secondary analysis was performed by the total and Saudi populations. Both citizens and residents comprised the total population. Makkah and Al-Medina had greater rates among the total population; however, Al-Baha and Ha'il had high rates of chronic diseases and related mortality in the Saudi population. Age-adjusted mortality rates were 286 per 100,000 population-year. The age-adjusted mortality rate among those aged 65 and above was 3428 per 100,000 population in the same age group. Men had a rate of 1779 per 100,000 men, which was higher than the rate of 1649 for women. In 2018, most citizens in Ha'il had DM, most Al-Baha had HTN and CAD, and most Al-Qassim had CN. People aged 65 and older had the highest death rate.

Deaths, causes, and their frequency among Saudi citizens: A descriptive analysis of data from the 2017 Population Characteristics Survey

BACKGROUND

The number of deaths, causes, and frequency measures are crucial in determining the health of a country's population.

OBJECTIVE

The current study aimed to estimate deaths, causes of death, and their frequency for Saudi nationals in 2017.

METHODS

In this descriptive study, we used data from the 2017 Population Characteristics Survey (n = 14,215,901) and performed secondary data analysis between November 2021 and February 2022. We used a total number of survey samples to compute the deaths. The cause of death was determined by dividing the total number of fatalities according to sex. We calculated the overall population-, administrative region-, and gender-wise percentages, rates per 1,000 people per year, the ratios for mortality, and their reasons.

RESULTS

There were 58,915 (0.4%) total deaths, including 0.3% and 0.2% deaths among females and males, respectively. The illness was the most frequent cause of mortality (46.5% or 465 per 1,000 population/year), notably in women (52.5% or 525 per 1,000 population/year). The fatality rate was higher due to traffic accidents (a total of five in every female and four males in every female).

CONCLUSION

In 2017, illness-especially in women-was the cause of death. Road car accidents had a high mortality rate, especially among males. Saudi Arabia has lower death rates than other Arab nations and high-, moderate-, and low-income nations.

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.

Patient-Level Cost Estimation for Health Services at Secondary Hospital, Saudi Arabia

Cost information can help to improve the quality of medical care budgeting, and it can also improve the efficient allocation of resources and patient outcomes. The objective of this study was to estimate the inpatient unit cost of healthcare services in a secondary hospital in Saudi Arabia. A cross-sectional retrospective approach was applied to categorize the inpatients discharged from the hospital from January to December 2018. A top-down costing method for cost estimation was used. We found that the overhead cost center holds 40.17% of the total hospital cost, and intermediate and final care cost centers consumed 25.50% and 34.33%, respectively. Among inpatients wards, the Surgical ward had the highest operational cost (39.27%). Human resources consumed the hospital's highest resources (75%) on salaries. The hospital's cost structure was not remarkable and needs revolutionary changes to adopt the new payment mechanism envisioned in the 2030 Saudi vision.

The Use of Artificial Intelligence in Medical Imaging: A Nationwide Pilot Survey of Trainees in Saudi Arabia

Artificial intelligence is dramatically transforming medical imaging. In Saudi Arabia, there are a lack of studies assessing the level of artificial intelligence use and reliably determining the perceived impact of artificial intelligence on the radiology workflow and the profession. We assessed the levels of artificial intelligence use among radiology trainees and correlated the perceived impact of artificial intelligence on the workflow and profession with the behavioral intention to use artificial intelligence. This cross-sectional study enrolled radiology trainees from Saudi Arabia, and a 5-part-structured questionnaire was disseminated. The items concerning the perceived impact of artificial intelligence on the radiology workflow conformed to the six-step standard workflow in radiology, which includes ordering and scheduling, protocoling and acquisition, image interpretation, reporting, communication, and billing. We included 98 participants. Few used artificial intelligence in routine practice (7%). The perceived impact of artificial intelligence on the radiology workflow was at a considerable level in all radiology workflow steps (range, 3.64−3.97 out of 5). Behavioral intention to use artificial intelligence was linearly correlated with the perceptions of its impact on the radiology workflow and on the profession (p < 0.001). Artificial intelligence is used at a low level in radiology. The perceived impact of artificial intelligence on radiology workflow and the profession is correlated to an increase in behavioral intention to use artificial intelligence. Thus, increasing awareness about the positive impact of artificial intelligence can improve its adoption.

Healthcare Transformation in Saudi Arabia: An Overview Since the Launch of Vision 2030

Saudi Arabia’s Vision 2030 has taken a centre stage in the development of its healthcare sector through privatization adopting Public Private Partnerships (PPPs). The objective of this study is to provide an overview of healthcare transformation in Saudi Arabia since the launch of the ambitious Vision 2030, identifying issues those need to be addressed and steps taken towards provision of health systems transformation. Literature review was based on extensive review of published and unpublished articles, where different search engines and databases searched using the key words: ‘Saudi Healthcare’, ‘Healthcare transformation’, ‘Saudi vision: 2030’, ‘Public-Private Partnerships’ and ‘Privatization’, in addition to secondary data as published in government reports, policy, government strategy documents and pertinent press releases. The future of the healthcare like many other developing economies continues to weigh policies for universal coverage while containing costs and the national transformation programme driven by social and economic factors has implemented strategic steps to develop its private healthcare system that includes: establishing health clusters, National Centre for Privatization & PPP – an official enabler for privatization of all government sectors and recently approved Private Sector Participation (PSP) Law involves several legislative enablers designed to enhance investor confidence in the privatization process. Although this study demonstrates systemic legislative progress to facilitate transformation process of healthcare sector, also endorses caution and research in identifying barriers to the implementation of PPPs, Saudi workforce development, implementing effective revenue cycle management function for healthcare reimbursement and ensuring vulnerable population access to good quality and tertiary healthcare. As healthcare of Saudi Arabia embarks on the transformation journey facing daunting challenges, but it appears that the government has laid out a roadmap with the legislative framework; however it is important that there is ongoing monitoring with adjustments as this complex and multifaceted process proceeds.

The Relationship Between Nurses' Quality of Work-Life on Organizational Loyalty and Job Performance in Saudi Arabian Hospitals: A Cross-Sectional Study

Purpose

The purpose of this study is to analyze the relationship between quality of work-life on the organizational loyalty and job performance in Saudi Arabia.

Methods

This study used a cross-sectional design for collecting the data related to the nurses' quality of work-life, organizational loyalty, and job performance from nursing staff in Saudi Arabian hospitals. Three questionnaires were used in this study, which includes Quality of Work Life Scale (QWLS), Organizational Commitment Questionnaire (OCQ), and Individual Work Performance Questionnaire (IWPQ). An online version of the survey questionnaire was generated using the Google survey, to which a link is generated for collecting data. At the end of the survey, 243 responses were received. After removing the incomplete responses, 209 responses were considered for the data analysis. The statistical techniques including t-tests and Pearson's correlation were used in the data analysis.

Results

Nurse managers reflected good quality of life, and high loyalty toward their employers, and also reflected good job performance levels. However, staff nurses reflected poor quality of work-life, organizational loyalty, and job performance. Training and development had strong positive correlation with continuance commitment (r = 0.628, p < 0.01). Job satisfaction and job security held strong positive correlation with task performance (r = 0.601, p < 0.01) and contextual performance (r = 0.601, p < 0.01).

Conclusion

Quality of work-life, organization loyalty, and job performance are positively correlated, and poor quality of work-life can negatively impact job performance and organizational loyalty of nurses.

Leadership Style, Work Engagement and Organizational Commitment Among Nurses in Saudi Arabian Hospitals

Purpose

The purpose of this paper is to examine how nurse managers’ leadership styles, work engagement, and nurses’ organizational commitment are related in Saudi Arabia.

Methods

This study used a cross-sectional design using an online survey instrument targeted at nurse managers and nurses working in Saudi Arabian hospitals. Multi-factor leadership questionnaire (MLQ), organizational commitment questionnaire (OCQ), and Utrecht Work Engagement Scale (UWES) were used in the Questionnaire. The survey link is forwarded to HR administrators of 71 hospitals, which includes public, private, and public–private partnership hospitals. The survey link was active from 27th November 2021 to 18th December 2021, and at the end of the survey, 394 responses were received. After removing the incomplete responses, 390 participant responses are considered for data analysis. t-tests and correlation analysis are used to analyze the data.

Results

Among the participants, 84.4% of the participants were nurses and 15.6% were nurse managers. Significant difference (p < 0.05) of opinions is observed among nurse managers in relation to transformational and transactional leadership styles and engagement. Transformational and transactional leaderships are positively correlated with organizational commitment and nurses’ engagement.

Conclusion

Differences in leadership style perceptions among nurses and nurse managers reflected issues in nursing management, which have to be addressed in light of rapid infrastructural changes owing to Saudi vision 2030.

Prospects of Integrating Gig Economy in the Saudi Arabian Health-care System from the Perspectives of Health-care Decision-makers and Practitioners

Background

Gig economy is an approach in the labor market which is characterized by the prevalence of short-term contracts or freelance work in contrast to permanent jobs. The gig workers are independent workers or temporary contract workers who enter into formal/informal agreements with on-demand companies to provide their services. Rather than employing full-time/permanent employees companies may utilize gig workers as per the demand and work burden, which can minimize the costs incurred in managing permanent employees. However, there is a lack of research on using gig economy in health care, its prospects and the issues involved.

Purpose

The purpose of this study is to identify and evaluate various prospects in integrating gig economy with the Saudi health-care system.

Methods

An online survey questionnaire instrument including 22 prospects under three categories including organizational competitiveness, resource management, and sustainable development was used for collecting data from 712 health-care decision-makers and practitioners in Saudi Arabia. Findings were analyzed using the statistical means and standard deviations for each item in the questionnaire for analyzing the role of each factor in depth, and t-tests were used for comparing the responses between the groups.

Results

T-tests revealed no significant differences among the experts and health-care workers in relation to organizational competitiveness and resource management; however, significant differences in opinions were identified in relation to sustainable development. Individual factors including motivation for Saudization program (mean=4.5, SD=1.15) and creating employment opportunities in rural areas (mean=4.5, SD=1.08), growth in economy (mean=4.4, SD=1.43), increased opportunities for women and disabled (mean=4.4, SD=1.28), and growth in employment (mean=4.3, SD=1.68) were the major prospects identified in relation to the use of gig economy in the Saudi Arabian health-care system.

Conclusion

Gig economy may offer a wide range of benefits in health care, especially sustainable development, effective resource management, and organizational competitiveness.

Using the location-allocation P-median model for optimising locations for health care centres in the city of Jeddah City, Saudi Arabia

Considering spatial accessibility of health services is a critical part in the planning and management of health services. There is evidence that poor geographical locations can obstruct prompt basic health care services to some population sections. We developed a location-allocation P-median model for health centres after analysing their sites, demand location of health services and the road network in Jeddah, Saudi Arabia. This model attempts to optimize health care services network and to put forward location recommendations to maximise service coverage. Our model is shown to be useful as it provides a robust evidence base to urban planners and policymakers responsible for making spatial decisions for the development of the health sector. Besides, it follows the paradigm of new urbanism that encourages decentralisation of essential facilities including basic healthcare in cities, where emphasis is on offering all basic services within walkable distances of 15 min. or less.

Gig Health vs eHealth: Future Prospects in Saudi Arabian Health-Care System

Introduction

The number of gig workers has been rising across the world, reflecting the growing trend toward the gig economy, which is already functioning in various sectors, such as transport(eg, Uber), technology (eg, Appen), and others (eg, Upwork). However, application of gig economy in health care is underresearched, especially in areas of eHealth that can facilitate various online activities and be outsourced.

Purpose

The purpose of this study was to investigate the gig economy and eHealth in terms of prospects for future health care in Saudi Arabia.

Methods

Analysis of data collected using online semistructured interviews with 19 experts, including executives from ministries of health and information and communications, physicians, and health-care administrative managers was conducted and new empirical insights are offered.

Results

A lack of legal and regulatory frameworks and integrating gig culture into the eHealth system were identified to be the major challenges. Improved operational efficiency of health care, reduced costs, and positive societal impact were identified to be the opportunities and benefits of using the gig economy and eHealth in Saudi Arabia. A strategic framework and an effective regulatory framework are essential for integrating the gig economy into the eHealth system in Saudi Arabia and improving future health care by adopting innovative artificial intelligence and machine-learning technologies.

Conclusion

eHealth has major scope for future health-care operations in Saudi Arabia and use of the gig economy in eHealth may lead to effective management of eHealth operations. More studies are required to evaluate the idea of integrating the gig economy and eHealth and analyze its impact.

Policy Discourses: Shifting the Burden of Healthcare from the State to the Market in the Kingdom of Saudi Arabia

Saudi Arabia has modified from a predominantly free, public, and comprehensive system under a welfare model to more of a mixed-economy model of healthcare. The welfare state slowly moved to a liberal model, emphasizing market forces to dominate in the provision of healthcare and the private sector was trusted to provide a better provision of healthcare. The country has to confront enormous problems in the health sector due to population growth, lifestyle changes, the shift of disease patterns, elevated expectations, escalated healthcare costs, limited infrastructure and resources, and poor management practice in the provision of healthcare. Moreover, the government has been emphasizing the need to bring in private sector investment to improve quality and efficiency, development of manpower, and standardization of services. As the current pattern of healthcare is unsustainable, the country is planning to restructure the present healthcare system toward institutionalizing it to meet future challenges. The governments must make an appropriate amount of effort to build their healthcare systems by transforming and modifying the challenges faced by society and its political-economic systems. The government should encourage equity, and fairness in the provision of healthcare.

Current status of telehealth in Saudi Arabia during COVID-19

Since the beginning of the coronavirus disease (COVID-19) pandemic, the responses of countries to emerging infectious diseases have altered dramatically, increasing the demand for health-care practitioners. Telehealth (TH) applications could have an important role in supporting public health precautions and the control of the spread of the COVID-19 pandemic. This review summarizes the existing literature on the current status of TH applications used during COVID-19 in Saudi Arabia and discusses the extent to which TH can support public health measures. TH mobile applications (e.g., Seha, Mawid, Tawakklna, Tabaud, and Tetamman) have found effective tools to facilitate delivering healthcare to persons with COVID-19, and tracking of COVID-19 patients. TH has been essential in the control of the spread of COVID-19 and has helped to flatten the growth curve in Saudi Arabia. Further research is needed to explore the impact of TH applications on the progression of COVID-19 in Saudi Arabia.