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      Challenges of Telemedicine Implementation in Patients with Cardiovascular Diseases: Insight from a Single Center during COVID-19 Lockdown


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          Telemedicine is a desirable option for healthcare in Saudi Arabia. The challenges of telemedicine in cardiovascular care in Saudi Arabia are not known. The COVID-19 pandemic offered an unprecedented opportunity to identify real-life challenges of telemedicine in Saudi Arabia. We sought to identify the challenges of telemedicine among patients with cardiovascular diseases using the experience of the COVID-19 pandemic.


          This is a cross-sectional survey-based study through a self-filled questionnaire. The questionnaire included demographic data, type of cardiovascular disease, and difficulties faced by the patients during the COVID-19 lockdown.


          394 (60% male, mean age 51.4 ± 19.3 years) participated in the study. 30.3% had valve diseases, 26.4% had heart failure, and 24.1% had coronary artery disease. 45.6% reported difficulty with telemedicine during COVID-19 lockdown. Among those who have difficulties, almost half of the participants had difficulty with the cancellation of telemedicine appointments, and 15.5% had difficulty in getting medications.


          Cancellation of telemedicine appointments and getting the medications were cardiovascular patients' main challenges during the COVID-19 lockdown. Telemedicine is a feasible option for the follow-up of chronic cardiovascular diseases. Therefore, it should be implemented to increase the availability of specialized cardiovascular care over a wide geographical area.

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          Most cited references11

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          Virtually Perfect? Telemedicine for Covid-19

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            Rapid Response to COVID-19: Health Informatics Support for Outbreak Management in an Academic Health System

            ABSTRACT Objective To describe the implementation of technological support important for optimizing clinical management of the COVID-19 pandemic. Materials and Methods Our health system has confirmed prior and current cases of COVID-19. An Incident Command Center was established early in the crisis and helped identify electronic health record (EHR) based tools to support clinical care. Results We outline the design and implementation of EHR based rapid screening processes, laboratory testing, clinical decision support, reporting tools, and patient-facing technology related to COVID-19. Discussion The EHR is a useful tool to enable rapid deployment of standardized processes. UC San Diego Health built multiple COVID-19-specific tools to support outbreak management, including scripted triaging, electronic check-in, standard ordering and documentation, secure messaging, real-time data analytics, and telemedicine capabilities. Challenges included the need to frequently adjust build to meet rapidly evolving requirements, communication and adoption, and coordinating the needs of multiple stakeholders while maintaining high-quality, pre-pandemic medical care. Conclusion The EHR is an essential tool in supporting the clinical needs of a health system managing the COVID-19 pandemic.
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              Telemedicine Practice: Review of the Current Ethical and Legal Challenges

              Background: Telemedicine involves medical practice and information and communications technology. It has been proven to be very effective for remote health care, especially in areas with poor provision of health facilities. However, implementation of these technologies is often hampered by various issues. Among these, ethical and legal concerns are some of the more complex and diverse ones. In this study, an analysis of scientific literature was carried out to identify the ethical and legal challenges of telemedicine. Materials and Methods: English literature, published between 2010 and 2019, was searched on PubMed, Scopus, and Web of Science by using keywords, including “Telemedicine,” “Ethics,” “Malpractice,” “Telemedicine and Ethics,” “Telemedicine and Informed consent,” and “telemedicine and malpractice.” Different types of articles were analyzed, including research articles, review articles, and qualitative studies. The abstracts were evaluated according to the selection criteria, using the Newcastle–Ottawa Scale criteria, and the final analysis led to the inclusion of 22 articles. Discussion: From the aforementioned sample, we analyzed elements that may be indicative of the efficacy of telemedicine in an adequate time frame. Ethical aspects such as informed consent, protection data, confidentiality, physician's malpractice, and liability and telemedicine regulations were considered. Conclusions: Our objective was to highlight the current status and identify what still needs to be implemented in telemedicine with respect to ethical and legal standards. Gaps emerged between current legislation, legislators, service providers, different medical services, and most importantly patient interaction with his/her data and the use of that data.

                Author and article information

                Saudi Journal of Health Systems Research
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                14 March 2023
                14 March 2023
                : 1-5
                [1] aKing Abdulaziz Cardiac Center, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
                [2] bCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
                [3] cKing Abdullah International Medical Research Center, Riyadh, Saudi Arabia
                [4] dCollege of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
                Author notes
                Copyright © 2023 by The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.

                : 7 November 2022
                : 18 January 2023
                Page count
                Figures: 2, Tables: 1, References: 13, Pages: 5
                This study received no specific grant from any official funding agencies.
                Research Article

                telemedicine,cardiovascular disease,covid-19,lockdown,obstacles


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