Explain how health laws regarding medical privacy have influenced the adoption of telemedicine.
Telemedicine is the use of communication technologies to deliver healthcare services outside of the conventional health institution. Telemedicine serves to provide improved medical self-care to the society since patients can have access to medical professionals in the comfort of their homes (Hale & Kvedar, 2014). It also serves to improve healthcare access in the community since medical professionals can reach more people at a time. While telemedicine has the potential to solve many healthcare related problems, there remains to be concerns on how telemedicine may infringe the medical privacy of the patients.
Privacy is an essential component of the patient-doctor relationship and serves to build trust. Telemedicine, however, may infringe on patient privacy which threatens this relationship. Telemedicine devices may collect more information than necessary which will threaten patient privacy (Hale & Kvedar, 2014). Body sensors, for example, designed to collect information on patient falls or vitals may collect other private information such as substance abuse tendencies. These devices could also collect information on the patient’s whereabouts which is a huge infringement on the patient’s privacy.
The main concern on privacy is the unauthorized access to patient information. The communication devices used in telemedicine are prone to attacks and may lead to unauthorized access to patient information (Hale & Kvedar, 2014). Furthermore, the manufacturers of these devices can access patient data and sell it to third parties or advertising firms (Hale & Kvedar, 2014). The devices are also susceptible to hacking or malware which will lead to unauthorized access to patient data.
Privacy laws have been put in place to protect patient privacy and confidentiality. However, these laws do not safeguard the patient using telemedicine services. They only cover the health worker and institution but do not cover the patient privacy outside this context (Hale & Kvedar, 2014). This loophole could potentially put patient data at risk on unauthorized access.
Research the barriers and challenges in adopting telemedicine in Saudi Arabia.
There are a number of challenges identified by Alaboudi et. al, (2016) that plague the implementation of telemedicine in Saudi Arabia. One of the challenges is the lack of adequately trained medical personnel to operate the telemedicine services (Alaboudi et. al, 2016). This barrier is more prominent in the rural areas than urban areas. The number of medical specialists in the urban areas is much higher than that in the rural areas. This means that the rural areas would experience shortage in medical personnel, making the implementation of telemedicine difficult. Furthermore, the burden of providing telemedicine services to the KSA by a few numbers of specialists would be impractical.
The second challenge is the lack of basic infrastructure to support the telemedicine initiative (Alaboudi et. al, 2016). Telemedicine requires access to ICT and constant electricity supply to work efficiently. While these services are readily available in the military and in urban areas where private health care facilities are located, rural areas lack the basic infrastructure to support the telemedicine services (Alaboudi et. al, 2016). The military receives support from the government to establish the basic ICT infrastructure for telemedicine and the private health care facilities in urban areas have a budget to support the ICT infrastructure and accessibility. Government hospitals and rural areas are not well equipped with the infrastructure, limiting the adoption of telemedicine in those areas.
The economic feasibility and sustainability of the telemedicine services is also another drawback to implementing telemedicine in KSA (Alaboudi et. al, 2016). Private healthcare facilities are at the forefront of providing telemedicine services since they have access to the required infrastructure, personnel and financial muscle. They are, however, for profit organizations and have to look at their bottom line (Alaboudi et. al, 2016). The sustainability of the telemedicine services depends on the client acceptance of the service. The public is yet to embrace the telemedicine services, which limits its economic feasibility and adoption by the private healthcare centers.
Explain the current KSA laws that protect patient information and provide for the ethical treatment of Saudi patients.
Article 21 of the Law of Healthcare Professionals dictate that the healthcare professional is responsible for maintaining the privacy of the patient data they acquire while on the job and should only disclose the information when mandated by the law (Elgujja & Arimoro, 2019). The exceptions include disclosing information on an endemic disease, crime-related death, testimony on court or a legal order to disclose information to another individual (Elgujja & Arimoro, 2019). The healthcare practitioner can therefore be forced to testify and expose their patient’s data during court proceedings. Failure to comply with the law attracts a fine or suspension from practice. The law places the sole responsibility of maintaining patient confidentiality to the medical practitioner. The Saudi Arabian laws also allow the patient to consent to have their information disclosed to other members (Elgujja & Arimoro, 2019). The patient is therefore allowed at will to forego their right to privacy and have the medical practitioner disclose their health information to other parties.
There are however some major drawbacks on the patient privacy laws. The laws do not regulate the data controllers on their use of the patient’s sensitive data (Elgujja & Arimoro, 2019). There are also no rules controlling the access, use and destruction of sensitive data by data handlers (Elgujja & Arimoro, 2019). The Ministry of Health is at sole discretion to determine the arbitrary access of patient sensitive data, which cannot be accounted for precisely enough to avoid abuse of power (Elgujja & Arimoro, 2019). All these factors could potentially lead to disclosure of this data to unauthorized personnel, putting the patient’s sensitive data at risk.
Analyze the role of informed consent and the requirements needed for participation in a telemedicine network.
Informed consent is mandatory to the telemedicine network. Obtaining informed consent allows the medical practitioner to explain what the patient should expect from the telemedicine services. The patient is notified of their right to stop using the service at any time, the limitations of their service and their responsibilities in ensuring the services are a success (Rheuban & Krupinski, 2018). The patient is also notified of the policies regarding the use of videos and photos to maintain their privacy. It is also during this time that the patient is advised to notify their primary healthcare provider of their intentions to seek out telehealth services. Obtaining the informed consent therefore sets a precedence of the patient-doctor relationship and its intricacies. It is the first step the medical practitioner should take in the telemedicine services.
Telemedicine can only be used in certain situations. Telemedicine can only be used for general wellness, counselling, prescriptions, test result discussion and managing chronic conditions. It cannot be used for patients who may require a procedure done on them or diagnosing a disease that will require physical examination (Rheuban & Krupinski, 2018). It is the responsibility of the medical professional to highlight these challenges to the patient at the beginning of the session. Since the session is conducted online, it is important to have uninterrupted internet connection and a clear videocam to allow efficient communication between the patient and the health provider.
What legal and ethical challenges do you see in adopting telemedicine in Saudi Arabia?
There is a glaring lack of patient data protection laws in the country. The country only has few provisions that protect patient privacy. Furthermore, there are no laws that protect the patient’s electronic health records (Elgujja & Arimoro, 2019). The laws do not mandate organizations to be responsible for securing the privacy of the client data acquired online, which may lead to data breaching with no consequence for the organization (Elgujja & Arimoro, 2019). The laws also do not have legal definitions of important terms such as personal data which can be used as a loophole in court and potentially put the patient’s private information at risk (Elgujja & Arimoro, 2019). The Saudi Arabian population is very conservative (Al-Hazmi, Sheerah & Arafa 2021). Telemedicine requires the patient to share photos of their lesions with their medical practitioner. The public may shy away from sending such private content on the internet (Al-Hazmi, Sheerah & Arafa 2021), especially with the feeble data protection laws in the country. The lack of proper patient data protection creates an ethical concern since it infringes on the patient’s right to privacy. This major drawback should be addressed to allow telemedicine implementation in the KSA.
The other ethical consideration is the quality of healthcare service the patient receives while using this service, specifically the accuracy of diagnosis of the service. Studies have shown that the diagnosis accuracy using telemedicine is comparable to face-to-face diagnosis (Al-Hazmi, Sheerah & Arafa 2021). However, the accuracy has been related to the quality of audio and video during these consultations. This means that there is a potential for misdiagnosis for patients with unstable internet connections and poor audio and video quality, which may infringe on their basic right to access quality healthcare.
Propose what you see as a solution to those challenges
The implementation of data protection regulations for patient sensitive data will serve to resolve the major challenge of patient privacy. Regulations should be implemented to mandate organizations to safeguard patient data obtained online and their electronic health records (Elgujja & Arimoro, 2019). There should also be regulations on the access and utilization of the patient sensitive information. The Saudi Health Information Exchange Purpose of Use Policy has regulations on the utilization of confidential patient information and is an excellent first step in managing patient confidentiality (Elgujja & Arimoro, 2019). The document however has no legal hold and thus cannot be used as a legislation. It could however be used as a guide to creating legislations that protect patient data.
It is also important to create a regulatory body to monitor the use of telemedicine services, particularly the compliance of the health practitioners to maintaining patient privacy (Elgujja & Arimoro, 2019). The body can regulate the access and use of patient data. This will safeguard the patient data from misuse and abuse and help safeguard their right to privacy.
