Service Level Agreements (SLA) in Saudi Arabia, Research Paper Example
Definition of Terms
Abbreviation | Term |
AIDS | Acquired Immunodeficiency Syndrome |
CT | Computed Tomography |
E-Health | Electronic Healthcare Services |
EHR | Electronic Health Record |
GDP | Gross Domestic Product |
GHIs | Gross Health Initiatives |
HealthEd | mHealth Education |
HI | Health Informatics |
HIT | Health Information Technology |
HIV | Human Immunodeficiency Virus |
ICT | Information Communication Technology |
IP | Internet Protocol |
IT | Information Technology |
IXP | Internet Exchange Point |
KSA | Kingdom of Saudi Arabia |
Mb | Megabyte |
MDGs | Millennium Development Goals |
mHealth | Mobile Health |
MIB | Medical Information Bus |
MOH | Ministry of Health |
PCs | Personal Computers |
SLA | Service Level Agreement |
SMS | Short Message Service |
UN | United Nations |
UNDP | United Nations Development Programme |
WHO | World Health Organization |
Research Topic
The Kingdom of Saudi Arabia (KSA), shown in Figure 1 is the largest of the Arab states in Western Asia based on its land area so it constitutes the majority of the Arabian Peninsula, but is the second largest state in the Arab world geographically (CIA World Factbook, 2015). Founded in the in the year 1932, the Kingdom of Saudi Arabia has an estimated population of 26 million residents with an annual growth rate of 2.2%, making it one of the world’s fastest growing economies since they control approximately 16% of global petroleum reserves, ranking the country as the largest exporter of petroleum (CIA World Factbook, 2015).
Figure 1: Map of Saudi Arabia
This accounts for about 80% of all budget revenues, 45% of the gross domestic product (GDP), and 90% of national export earnings (CIA World Factbook, 2015). The Kingdom of Saudi Arabia is presently ruled by King Salman bin Abd al-Aziz as of 2015, acting as both the head of state as well as the prime minister and governs through Shariah Law, which is part of the Islamic religion (CIA World Factbook, 2015).
The Ministry of Health (MOH) is the primary organization responsible for managing the healthcare network within the KSA and currently operates 62% of the hospitals in addition to 53% of the clinics and healthcare centers (MOH, 2013). The World Health Organization (WHO) has defined the parameters of technological inclusion in the provisioning of health services, coining the term ‘E-health’ (Electronic Health) to describe the amalgamated usage of information communication technology (ICT) or information technology (IT) and electronic communications in the health sector (MOH, 2013).
The Service Level Agreement (SLA) is a contract established with the intent of providing clarification or guarantees in regards to the quality level of the service aspects to be expected during the interaction between a healthcare service provider and a consumer (AlYazidi & Emam, 2013/2014). Contracting services through a SLA provides a benchmark that the MOH can use to clarify and assess the quality level of assistance provided through the healthcare system as well as the rights and duties of applicable beneficiaries (MOH, 2013).
The nature of the SLA permits the clear and unambiguous presentation of the agreement regulating the relationship between the MOH, the provider, and the recipient of services, irrespective of their knowledge of the contexts of the SLA (Weyns & Host, 2013). Patients receiving treatment through ICT healthcare services are covered under all provisions of any existing SLA through implicit and explicit consent without exclusion even if they are not aware of the existence of the applicable agreement (MOH, 2013).
Previous Studies (Literature Review)
This section will present an in-depth analysis regarding the current state of the healthcare system in Saudi Arabia and the use of a SLA in conjunction with mobile technology in health education through an evaluation of the recent relative literature on the current implementation of e-Health services, mobile technology, telemedicine, and mHealth practices effectively in play globally as well as in the focus area. Through this literature review, a conceptual framework will be created to evaluate current programs implemented that provide the use of mobile technologies in health education and the treatment of patients in developed countries like the United States to evaluate the provisions that are currently being used in Saudi Arabia.
This will set the foundation for establishing that Saudi Arabia is experiencing tremendous growth in the provisioning of healthcare services including mobile health educational services, telemedicine, mHealth, and e-Health to substantiate the feasibility of this solution through examples from empirical studies and existing research. This literature review will first examine the current situation that serves as an obstacle in Saudi Arabia regarding access to healthcare services according to the SLA and preventative factors to the implementation of mobile technologies through exploration of the following details:
- Various aspects regarding how including mobile ICT and IT into the healthcare sector improves overall quality,
- The benefits of integrating SLAs into the contexts of healthcare delivery,
- Acquisition of healthcare services in remote regions of Saudi Arabia,
- Learning innovations using mobile technology,
- How the presence of information technology affects healthcare solutions,
- A global perspective of how telemedicine and e-Health have affected the delivery and availability of medical treatment,
- Demonstrate how telemedicine and e-Health have affected medical care in Saudi Arabia
The expansion of mobile technology within the previous decades has generally resulted in the dissemination of mobile telephones that have become more affordable and accessible. Furthermore, promoting modernization was specifically designed to meet local requirements to support the establishment of economical advancements and occupation resources (Kelly, Mulas, Raja, Qiang, & Williams, 2010). As of 2008, broadband service was available in 182 international markets and mobile networks exceeded one billion by the start of 2009, but more than half of the world’s nations still do not have an Internet exchange point (IXP) (Vo, Brooks, Farr, & Raimer, 2011). The IXP serves as the primary location where traffic can be transmitted and many remote users pay exorbitant charges, as much as $2,000-$5,000 USD per megabyte (Mb) per month to transmit digital information over an IXP (Kelly, Mulas, Raja, Qiang, & Williams, 2010).
Globally, numerous nations have adopted electronic health systems order to upgrade healthcare services by providing e-health services centered on delivering a clinical value that supports the needs of providers as well as consumers (Blumenthal, 2009). The MOH has a number of objectives and initiatives which can be achieved through the e-health that involves working on implementing a highly ambitious program in order to achieve its innovative vision for e-health that constructs a “safe, efficient health system, based on the care centered on a patient, standard-oriented, and supported by the e-health” (MOH, 2013).
This permits the MOH to achieve tangible progress on the e-health field through innovative strategies launched within a relatively short timeframe to permit the development of an extensive five year plan to achieve great strides towards the perpetuation of telemedicine in diverse communities (MOH, 2013). This strategy provides a roadmap for planning e-Health service programs designed to cope with the scope of the demands and needs of all citizens by mobilizing providers and staff to collaborate towards the realization of this vision (Callan, Miller, Sithole, Daggett, & Altman, 2011). The comprehensiveness of the e-Health program integrated in KSA must entail a distinct perspective relative to the extent of provider liability in the SLA that distinguishes specific benefits for both the MOH and the people of the KSA (MOH, 2013).
Health Concerns in Saudi Arabia
The Millennium Development Goals (MDGs) are eight objectives identified by the United Nations and the United Nations Development Programme (UNDP) is the specialized agency entrusted with focusing on helping underdeveloped or developing nations work towards achievement of these goals by the end of 2015 (UNDP, 2014). These eight MDGs are to:
- “Eradicate extreme poverty and hunger
- Achieve universal primary education
- Promote gender equality and empower women
- Reduce child mortality
- Improve maternal health
- Combat human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), malaria, and other diseases
- Ensure environmental sustainability
- Develop a global partnership for development”(UNDP, 2014)
Even with international agreements to provide effective, efficient healthcare that is maintainable by adapting MDGs in 2000, access to comprehensive health coverage is still unacceptably low in many countries, with some countries achieving less than 50% of the margin necessary to obtain the goals set in the MDG for 2015 (Thomson & Mossialos, 2010). Collaborative initiatives involving formal organizational alliances, agencies, and groups have planned strategies to decrease the risk of chronic diseases and improve overall health (Atkinson & Gold, 2002). While these gross health initiatives (GHIs) have resulted in large increases in funding for specific diseases such as HIV/AIDS, malaria, and tuberculosis, due to inadequate infrastructures, GHIs have also added a strain on some countries’ health planning and management systems (Baum, Kendall, Muenchberger, Gudes, & Yigitcanlar, 2010).
In many smaller countries, the poor governing systems, shortages of trained personnel, poor delivery structure, unreliable supply chains, and lack of proper patient health histories lead to the large differences in health status between smaller, underdeveloped nations and larger, wealthier nations (Asiri, 2014). Efforts to create positive synergies between health systems and GHIs have been launched through the WHO, especially in countries with populations that are vulnerable to illness due to poor diets and poor quality drinking water (WHO, 2011). With financial support from the government, these efforts are helping countries to identify solid solutions to build new knowledge and bring clarity to the issues preventing the establishment of continuous interactions between GHIs and national health systems (WHO, 2014).
In recognizing various cultural dichotomies, holistic medicinal practices have begun to grow in numerous markets worldwide. The primary health care scenery with integrated ITC knowledge has previously been accessible as an instrument for management rather than as an implementation tool for assisting, improving, and creating additional efficient specialized examinations involving medication (Carroll, et al., 2010). Computer-based patient education is becoming of increasing significance to the primary care practitioner. From a duty-of-care deliberation, it is useful to have a documented synopsis of the instructive resources dispersed to the consumer (Shahriyar, Bari, Kundu, Ahamed, & Akbar, 2009). Moreover, prearranged patient edification has been exposed to advance customer contentment or gratification without addition to the discussion period.
Mobile technologies are becoming more entrenched, omnipresent, and networked, with increased possibilities for prosperous societal communications through a reliable internet connection (Baum, Kendall, Muenchberger, Gudes, & Yigitcanlar, 2010). Such expertise can have an immense influence on the provisioning of healthcare services, but the challenge will be to recognize how to utilize mobile technologies to convert knowledge into a flawless section of everyday life (Blumenthal, 2009).
Healthcare in Distant Areas
Public health information systems have reformed only progressively in the previous thirty years through integration of health informatics (HI), which refers to “applied research and practice of informatics across the clinical and public health domains” (Asiri, 2014, p. 26). In most major city hospitals, there have been telephones on the counters of numerous medical wins for many years (Donner, 2004). Conceivably, the emergence of personal computers (PCs) as common household items over the past few decades has changed the operational capabilities of even remote healthcare centers, enabling distant communication to occur between personnel in diverse locations (Blumenthal, 2009). These difficulties place the provincial hospitals within larger cities as the only source of modern medical treatment, especially for those with complex health conditions.
However, the acquisition of ITC equipment such as photocopiers and printers is as well as document and toner is extremely difficult to obtain in many remote areas of the KSA, making the presence of widespread systems of information an unrealistic venture (Atkinson & Gold, 2002). Primarily in the pastoral communities, communication tools such as mobile devices was tenuously established, allowing the data to steadily progress connecting the center and the periphery, and infrequently relating the remote sections of the local health program (Telmesani, Zaini, & Ghazi, 2011). Particularly each institution receives benefits of not only the exceptionally observable wireless and transportable equipment, but also less observable improvements designed to inform associations transmitting data.
However, pioneering attempts to resolve these situations that address various insufficiencies in the connectivity and information-processing capabilities of the integrated ITC intended to improve local health programs are stagnated by the by the availability of the relevant upgrades (Cutler & Lleras-Muny, 2007). Telemedicine serves as an incomplete solution to the dilemmas of contributing medical care to isolated cities or to limited areas underserved by physicians or healthcare specialists (Vo, Brooks, Farr, & Raimer, 2011).
Telemedicine has also been integrated in inner-city healthcare delivery in diverse locations in the KSA in an attempt to meet the increasing demand for healthcare services (Istepanian, Woodward, & Richards, 2001). Medical expertise, such as radiology, psychiatry, dermatology, and language therapy have exercised telecommunications effectively (Tsai, et al., 2014). Numerous studies have identified a wide diversity of clinical missions that can be significantly achieved using various ITC devices (Weyns & Host, 2013).
The demand for telemedicine is remarkable in the presence of major obstructions to establish a high standard of healthcare (Smith, et al., 2013). The unequal geographic distribution of healthcare workers and resources remains a problem that interferes with the ability of healthcare providers to keep up with a rapidly changing body of knowledge (Naismith, Lonsdale, & Sharples, 2003). Additionally, it is not fiscally possible to provide medical specialists, the highest-technology equipment, and major information supplies in each infirmary and clinic department (Varshney, 2007). One particular limited resolution to these problems is to increase healthcare contributor availability to experts and information via telecommunications at the time they demand assistance.
Benefits of Mobile Technology
Although technologies have traditionally been used in the health sector, it is proposed that the integration of mobile technology into the infrastructure of the healthcare system will help facilitate success in the KSA similar to the positive results experienced in developed countries like the United States (Jha, et al., 2009). The Internet is playing an increasingly vital role in health education, as is illustrated through the statistics that 86% of adults with Internet access have utilized it to research health-related information and health queries that represent 37% of their total Internet usage (Harrison & Lee, 2006).
Further evidence regarding the value of ICT in the delivery of health information is presented through analysis of the benefits associated with using SMS (short message service) messaging to send reminders to patients to improve follow-up attendance rates (Downer, Meara, & Costa, 2005). Additional support explores the use of IT for interactive health communication and the effects of this use on patient behaviors (Atkinson & Gold, 2002). These examples demonstrate that provisioning of the right policies, organizational resources, and institutions that can help ICTs and other forms of mobile technology prevent, diagnose, and treat illnesses to increase the capabilities of those working to improve health (Carroll, et al., 2010).
The numerous technological advances have enabled medical professionals to more accurately assess individual health risks and provided an in-depth understanding of basic physiologic and pathologic processes through revolutionary imaging and diagnostic scanning technologies (Cao, Krebs, Toubekis, & Makram, 2007). The implementation of other novel technologies like the Medical Information Bus (MIB) illustrates the application of innovative forms of ICT (Martinez, et al., 2008).
Inclusion of the dynamics of e-Health or telemedicine within healthcare practices provide a standard method to connect with critical care medical programs that includes patient monitors, infusion pumps, ventilators, pulse oximeters, and other devices used in operating rooms, intensive care units, and hospital emergency rooms on host computers (Kun, 2001). However, while there are countless benefits to amalgamation of mobile technologies into the field of healthcare and health education, there are also several challenges identified that must be conquered to achieve integration, which include:
- the absolute need to guarantee patient, user and equipment safety;
- the need for complete standardized plug and play operation with no user intervention;
- the need to provide a framework for an expandable data language; and of the need to provide open system interoperability to hospital wide information systems(Chaudhry, et al., 2006)
These amendments also influence device availability, network ability, and connections that have developed innovations that promise to work where other such developments have been unsuccessful (Atkinson & Gold, 2002). It is generally obvious that the local health information programs in the KSA are in a time of hasty modernization and experimentation. In addition to the complex technologies used within medical practices, mobile telephones, e-mail, and videoconferencing all offer additional options for sharing paramount health information (Istepanian, Woodward, & Richards, 2001).
Policy attempts to amalgamate ICT into healthcare forums in the KSA must consider the overall health determinants that affect people’s environments, which include health related objectives and account for the social, economic, environmental, and gender-related variables that have impact individual well-being (Asiri, 2014). Connecting patients to providers through ICT in the provisioning of healthcare allows medical professionals to use existing airtime and sophisticated applications on existing platforms with the explicit intention of sustaining or changing one or more health outcome (Kaplan, 2006). Similar to the MIB, the Electronic Health Record (EHR) was expected to facilitate major and quantifiable developments to improve overall health outcomes in the KSA populace through an alternative healthcare delivery system (Telmesani, Zaini, & Ghazi, 2011).
The ultimate vision is one in which all patients are fully engaged in their healthcare and providers have real-time to access all medical records in addition to tools that help ensure patients receive safe, quality care that also affords improved access that nullifies healthcare disparities (Labrique, Vasudevan, Kochi, Fabricant, & Mehl, 2013). In achieving such a vision, millions of people globally would benefit from the improvements in health education, how they receive healthcare services, and the access to such care (Smith, et al., 2013). Health information technology (HIT) provides a service that enables the comprehensive management of medical information and its secure exchange between healthcare consumers and providers (Asiri, 2014).
Difference between Telemedicine and health
In the provisioning of mobile health services, telemedicine and mHealth are two commonly used forms of ICT that have improved healthcare (Callan, Miller, Sithole, Daggett, & Altman, 2011). However, there are differentiations in the two forms of information transfer.
Telemedicine is defined as the deliverance and distribution of medical information relative to healthcare over a distance that incorporates telecommunications to connect professionals with patients in isolated areas for diagnosis, consultation, treatment, conveyance of medical records, and education (Vo, Brooks, Farr, & Raimer, 2011). This version of ICT also provides many different communication treatments by integrating various forms of technology that ranges from implementing closed-circuit television to conveying medical care to patients miles away or using satellites to supply medical guidance and instruction to healthcare professionals in various countries (Istepanian, Woodward, & Richards, 2001).
The technologies used in telemedicine also include healthcare specialists as well as other medical professionals transmit computed tomography (CT) images through a computer-assisted or web-based provider-patient communication system (Kaplan, 2006). Although various uses of telephones have added to this inventory of telemedicine, the principal method relies on telephone lines in conjunction with computer-automation, phone follow-ups, counseling, memos, collaborative ICT systems, late night telephone access, and telephone examination (Asiri, 2014).
There is a growing concern from health educational forums, clinicians, and rule makers regarding the worth of these intercessions to advance health outcomes as well as patient quality of life (Cutler & Lleras-Muny, 2007). At the same time, most recent developments relative to telemedicine, the expression e-Health, which was initially used as an industry and marketing term, has infiltrated scientific literature and may be replacing ‘telemedicine’ as the newest expression for an extremely dynamic subject matter (Kaplan, 2006). Within this context, e-Health can be defined as “both a structure and a way of thinking about the integration within health services and information using the Internet and related technologies” (Kaplan, 2006, p. 2).
The term mHealth is characteristically exercised in reference to the implementation of portable technological programs with the capacity to create, store, retrieve, and transmit information between end users and real time in order to enhance patient protection and quality of care (Mechael & Sloninsky, 2008). Portable hardware with software applications enables the transition of mobile health information and patient data across wireless networks (Cao, Krebs, Toubekis, & Makram, 2007). Mobile healthcare allows medical access to a wide range of key software applications pertinent to patient care and consequently helps clinicians to reach mobility and gain ease of access to vital information, regardless of location (Thompson & Brailer, 2004).
For instance, a healthcare professional may use a transportable piece of equipment to write and send out prescriptions to a pharmacy, access patient EHRs, interrelate with patient management plans, correspond with public health data, request analytical tests, evaluate labs, or access medical references (Shahriyar, Bari, Kundu, Ahamed, & Akbar, 2009). Data transmission is recognized by technologies that appear in normal everyday life including cell phones and blue tooth technology, Wi-Fi, infra-red, and wired technologies, all of which operate as part of each network (Blount, et al., 2007).
Transportable devices can be useful in the healthcare, communicating very important information promptly during a severe public health disaster or being used for on-going requirements such as education and training (Telmesani, Zaini, & Ghazi, 2011). When being utilized for patient care, mobile devices are credited with improving patient safety by eliminating errors commonly associated with paper-based medical records and expanding the continuation of healthcare (Blumenthal, 2009).
In addition to improved patient results, workflow and administrative efficiencies from the use of mobile devices can produce cost savings for the consumer organization through the use of mHealth Education or ‘HealthEd’ which represents an emerging new set of applications of mobile devices that consist of training, testing, support and supervision of healthcare workers, as well as applications that provide health information to individuals (Labrique, Vasudevan, Kochi, Fabricant, & Mehl, 2013). Enhanced medical care through e-Health, mHealth, or HealthEd options is civilizing the condition of care and levels of knowledge to increase satisfaction amongst patients and reduce attrition for practitioners (Zheng, 2005).
The contemporary applications for healthcare recruits primarily include providing additional assistance that aid in the regulation of the possibility for portable applications to decrease prices by proposing advancements for educating and for disseminating health information (Telmesani, Zaini, & Ghazi, 2011). The complete possibility of mHealth education will demand integration of relevant submissions by administrations as tools to facilitate price efficient implementation of their nationwide health approaches and fitness-care employment establishment tactics (Carroll, et al., 2010). The healthcare management breach in developing countries identifies a principal challenge to enhancing physical conditions and overall progression in advancing nations as the deficiency of educated healthcare personals (Cao, Krebs, Toubekis, & Makram, 2007).
Expansion of medical services to include ICT capabilities is expensive due to the superior assessments placed into discovering, choosing, and teaching communal health employees, and it interrupts permanence in associations with the community (Nesbitt, 2007). While burnout is the biggest driver of attrition among healthcare employees, lack of occupational improvement opportunities and deficiencies of continuing instruction also contribute to dissatisfaction (Henry & Henry, 2004; Keidel, 2002).
Community physical condition recruits were originally intended to be an indispensable element of individual healthcare income for developing countries (Callan, Miller, Sithole, Daggett, & Altman, 2011). Such workers can take on some duties traditionally performed by doctors and nurses at a much lower cost; they also demand less training than professional healthcare workers; and in many cases they also experience lower rates of attrition (Callan, Miller, Sithole, Daggett, & Altman, 2011). Using professional supporters as substitute medical doctors and community health workers frequently offers a more realistic path to strengthening rapidly the healthcare workforces in low-income countries.
SLAs and Healthcare in the KSA
The unique aspects of Shariah Law that governs the KSA necessitate explicit identification of the contextual dynamics of the healthcare services available to Saudi citizens. Specification of which IT services should be provided through the SLA as well as the associated costs, availability, and other details need to be explicitly agreed upon (Weyns & Host, 2013). This written contract between the organization using the IT system and the IT management organization is documented in the SLA, which can also exist as an agreement between different administrations that outsource their IT management to an external contractor or interdepartmentally between the organizations own IT department and the rest of the company (AlYazidi & Emam, 2013/2014).
The purpose of the SLA is to facilitate communication between the various partners, especially concerning the responsibilities and the scope of the IT services offered by the IT department (Weyns & Host, 2013). an SLA concerns technical characteristics of a service. A service level agreement is an agreement regarding the guarantees of a web service. It defines mutual understandings and expectations of a service between the service provider and service consumers. The service guarantees are about what transactions need to be executed and how well they should be executed. SLA concerns agreements on the availability degree of a Web service (AlYazidi & Emam, 2013/2014).
Research Goals/Objectives
The goals and objectives of this thesis is to provide an overview about the use and importance of mobile technologies in the public health sector in developing countries using Saudi Arabia as a model, with primary emphasis being made to the influence of the SLA on service provisioning through mobile technologies and various ICT integrations. This thesis will evaluate the efficacy of providing medical treatment and health education via the use of mobile technologies in the KSA. In order to achieve the MDGs for Saudi Arabia, these issues must be overcome to stop the unnecessary spread of preventable or treatable diseases and illnesses.
The information delivered is a preferred basis on the individual client requirements. The consumer can request explicit subject knowledge through a professional to increase the information they have regarding their health situation. This characteristic contributes a response to the dilemma of connecting data that is legitimate, dependable, detailed, and personal. The customer can also create individual remarks for their healthcare professional. Use of e-Health and other ICT based services can facilitate persuade both self-sufficient and collaborative knowledge experiences. The specifications of the SLA detail what services the patient is entitled to, which identifies the opportunities available through the indicated service provisions.
Hypotheses and Research Questions
In order to establish foundation for the effectiveness of online academic programs, literature linked to conventional academic programs must be reviewed to establish a quality threshold by which students perceive online programs. To comprehensively satisfy the research aim and objectives, the following research questions and hypotheses will be adopted as the primary focus of this study.
Research Questions
The goal of this research study is to gain an understanding of the impact integration of ICT measures that include SLA has on the delivery of healthcare services in the KSA. The main intent of this research is to evaluate the relevance of the SLA in the specific context of ICT integration for healthcare services within the KSA and examination of this topic will be guided by the following research questions:
- How does ICT that includes SLAs influence the delivery of public health services across Saudi Arabia?
- How has the integration of ICT tools and the accompanying SLAs changed the service delivery paradigms?
- What are the cultural barriers to comprehensive integration of healthcare services using ICT and other mobile technologies?
These research questions will aid in the development of the conceptual framework that will be used to design the research instruments and will also provide a benchmark that can be used to measure the veracity of the hypotheses.
Research Hypotheses
The researcher will be aiming at finding out whether and how organizations should invest in ICT in addition to the contextual nature of the accompanying SLA, which details the included provisions that will underlie the applicable healthcare services. Examination of the topic according to the research questions will attempt to test the following hypotheses:
- Saudi Arabia has experienced significant growth, but there is no telecommunication infrastructure in remote areas. Therefore, the first hypothesis is that it would be extremely difficult to promote the use of mobile technologies in the public sector that will improve the delivery of healthcare services in the KSA.
- Due to the high illiteracy, unemployment, and poverty rate prevalent in some areas of Saudi Arabia, it would not be possible for the majority of citizens to purchase or gain access to expensive mobile technologies such as PDAs and IPhones. The second hypothesis is that it would be more beneficial for citizens to become familiar with and use the relatively cheaper audio and video tools associated with telemedicine, which includes unique SLAs based on the delivery paradigms.
- Numerous cultural and societal barriers currently exist in Saudi Arabia, as this is an Islamic nation. The third hypothesis is that cultural norms would not permit healthcare and medical professional personnel to freely and effectively communicate with women through mobile technologies or enhance awareness and importance of family planning, medical tests, and routine check-ups.
Assessment of this research topic based on the designated questions and hypotheses will provide a unique perspective that will aid in understanding the interactions between ICT, SLAs, and the provisioning and consumption of healthcare services in the KSA. This will form a basis for academics who intend to study the impact of ICT engagement in the design and development of healthcare programs globally and especially in the KSA context.
Research Methodology and Methods
The research methodology used for this thesis will entail mixed qualitative and quantitative methods (Thomas, 2003). The data obtained from both primary and secondary research methods can then be evaluated together according to how they relate to testing the hypotheses (Creswell, 2009). Theories should not be included for the sake of having a theory if the included details will not enhance the study, provide clarification of a concept, or add relevancy to an idea proposed or being tested within the context of the study.
Research methods are the tool used during the process of conducting scientific analysis in order to assess various situations through both first-person observation and secondary research of academic published materials (Thomas, 2003). The included research methods like secondary qualitative research and primary quantitative research approaches assist in development of hypotheses to prove or disprove various theories related to a specific subject (Creswell, 2009). Provision of a theoretical or conceptual framework to guide a research study helps the researcher to maintain focus on the ideas or principles of practice being examined and provides a basis for activity and selection of methods used within the study.
Evaluative inspection is explored to deduce the impression of a specific social intervention or system expected to resolve a social dilemma (Babbie, 2007). The research can then be appraised into informed assertions according to presumed hypotheses to prove or disprove their foundations so that development of practical conclusions and recommendations for improvement can be proposed (Creswell, 2009).
Quantitative methods are exploited within research backgrounds to convert information to a mathematical diagram that is simple to analyze (Babbie, 2007). The use of quantitative methods rely less on interviews, observations, questionnaires, focus groups, subjective reports, and case studies, but remain focused on the collection and analysis of numerical and statistical data (Neuman, 2006). Determinations made though quantitative research can be supportive of or against the hypotheses being tested and use deductive reasoning to determine if the hypotheses are proven or disproved (Render, Stair Jr., & Hanna, 2011).
Qualitative research collects and analyzes data to gain an in-depth comprehension on how people behave in specific situational contexts (Creswell, 2009). The main objective of qualitative research is to conduct appropriate assessments of human actions to determine the reasons governing their behavior and the underlying meanings related to why they respond to certain situations in specific ways (Babbie, 2007). Qualitative research methods focus on an inductive reasoning process where the hypotheses are tested against suppositions from the research analysis to determine if they were correct in their assumptions or not (Neuman, 2006).
The strengths in each of these examination progressions is that they help to organize a comprehensive investigation regarding the efficiency of using ICT with SLAs in health education to accomplish MDGs in Saudi Arabia based on the intensity of such achievement in other improved countries, developing nations, and obtainable programs already implemented in Saudi Arabia with special emphasis on how these methods are influenced by the SLAs. Evaluation of available empirical discovery will allow determinants that will cause a reaction to the principle research inquiry and confirm or invalidate the speculations through supporting specifics established within the existing literature.
A literature examination for relevant academic journalism will distribute a referential establishment that will be generated to show the applicable particulars concerning the operation of mobile technology for health education in Saudi Arabia and this information will be quantitatively analyzed by regulating the details with numeric representations that will authorize statistical investigation. This examination will consistently connect the research inquiries and viewpoints that describe resolution in the exploration.
Internet-based and library documents seek for intervention studies (as illustrated above) in developing countries was commenced operating the following conditions: “telemedicine”, “Saudi Arabia”, “MDGs”, “e-Health”, “mHealth”, “telecommunications”, “wireless”, in various combinations with “healthcare”, “physical condition”, Searches included MEDLINE, CINAHL, (nursing and allied health), Google Scholar, Proquest, Project Muse, IEEE, and JStor.
The study will primarily engage in archival research as a means of collecting relevant data for examination. Archival research involves drawing conclusions by analyzing existing sources of data, including both public and private records. The key thing you should note right away is that most of this process involves making decisions ahead of time so that the process of data collection is smooth, simple, and systematic (Newman, 2011). Archival research provides a test of the hypothesis by examining existing data and, thereby, avoids most of the ethical and practical problems of other research designs. Related to this point, archival research also neatly sidesteps issues of participant reactivity, or the tendency of people to behave differently when they are aware of being observed.
Expected Thesis Organization
- Title Page
- Abstract-Comprehensive summary of thesis
- Definition of Terms-defines acronyms used in the thesis
- Introduction- Introduce the topic; present the aims, research question, and hypotheses.
- Literature Review- Provide literature review that provides a conceptual framework and thoroughly examines current research regarding the healthcare system in Saudi Araba, the use of e-Health services, and how the SLA influences service provision
- Research Methodology- Explain the methodology used to conduct the research and explain why the method was chosen
- Results- Present the outcome of this research through the use of charts, graphs, and narrative account and
- Discussion- Provide an analysis of the findings
- Conclusion- Present the conclusions gathered from the research and indicate areas for further research
- References
Research Timetable
Once the official proposal is approved, the entire research will be conducted within the span of ten to twelve months, as outlined in Table 1. The first 2 phases of the work will be spent reviewing and collecting the survey results and literatures using on line data bases to gather educational reviews, inter-library services, and personal contacts with colleagues in the field to expand the literature review during the third phase.
Phase # | Description | Period |
Prepare & Submit Proposal | May, 2015 | |
#2. | Development of Data Collection Tool | June, 2015 |
Expansion of Literature Review | July, 2015 | |
Collection of Research Data | August, 2015 | |
Analysis of Data | October, 2015 | |
Completion of Research | February, 2016 |
Table 1: Research Timetable
The search and analysis will be used to sort out the useful results of our research. This may take approximately two additional months. Known and new results ascertained through the study will provide the utilities of work and this process may take approximately four months. During the final stages, empirical data will be presented to give a realistic perspective, which may require 2 months for phases four and five. Transcribing the material and composing the thesis may take 2 months for the final composition of the thesis during phase six. Additional time is integrated into the plan to serve as a cushion to ensure that all segments of the study remain within their allotted timeframes.
References
AlYazidi, S. A., & Emam, A. Z. (2013/2014, December-February). Monitoring SOA based applications according to business level agreement. International Journal of Software and Web Sciences (IJSWS), 7(1), 4-7.
Asiri, H. A. (2014). Challenges of the health informatics education in the Kingdom of Saudi Arabia: What stands in our way? Journal of Health Informatics in Developing Countries, 8(1), 26-35.
Atkinson, N., & Gold, R. (2002). The promise and challenge of eHealth interventions. American Journal of Health Behaviour, 26(6), 494-503.
Babbie, E. (2007). The Practice of Social Research (11th ed.). Belmont, CA: The Thomas Wadsworth Corporation.
Baum, S., Kendall, E., Muenchberger, H., Gudes, O., & Yigitcanlar, T. (2010). Professional practice and innovation: Geographical information systems: An effective planning and decision-making platform for community health coalitions in Australia. Health Information Management Journa, 39(3), 28-33.
Blount, M., Batra, V. M., Capella, A. N., Ebling, M. R., Jerome, W. F., Martin, S. M., . . . Wright, S. P. (2007). Remote health-care monitoring using Personal Care Connect. IBM Systems Journal, 46(1), 95-113. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.122.426&rep=rep1&type=pdf
Blumenthal, D. (2009, April 9). Stimulating the adoption of health information technology. The New England Journal of Medicine, 360(15), 1477-1479.
Callan, P., Miller, R., Sithole, R., Daggett, M., & Altman, D. (2011). mHealth education: Harnessing the mobile revolution to bridge the health education and training gap in developing countries. Report for mHealthEd 2011 at the Mobile Health Summit (pp. 1-44). Cork, Ireland: iheed Institute. Retrieved from http://openlmis.hingx.org/Share/Attachment/1445/iheedreport_2011.pdf
Cao, Y., Krebs, M., Toubekis, G., & Makram, S. (2007). Mobile community information systems on wireless mesh networks: An opportunity for developing countries and rural areas. 5th International Workshop on Ubiquitous Mobile Information and Collaboration Systems (UMICS 2007), CAiSE ’07 workshop, (pp. 483-497). Retrieved March 1, 2014, from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.70.5215&rep=rep1&type=pdf
Carroll, M., James, J. A., Lardiere, M. R., Proser, M., Rhee, K., Sayre, M. H., . . . Ternullo, J. (2010, January/February). Innovation networks for improving access and quality across the healthcare ecosystem. Telemedicine and e-Health, 16(1), 107-111.
Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E., . . . Shekelle, P. G. (2006). Systematic review: Impact of health information technology on quality, efficiency, and costs of medical care. Annals of Internal Medicine, 144(10), 742-752. Retrieved from http://annals.org/article.aspx?articleid=723406
CIA World Factbook. (2015). The World Factbook- Middle East: Saudi Arabia. Retrieved from CIA World Factbook: https://www.cia.gov/library/publications/the-world-factbook/geos/sa.html
Creswell, J. (2009). Research design: Qualitative, quantitative, and mixed methods approaches (3rd ed.). Thousand Oaks, CA: Sage Publications.
Cutler, D., & Lleras-Muny, A. (2007). Education and health. National Poverty Centre, 9, 1-4.
Donner, J. (2004). Innovations in mobile-based public health information systems in the developing world: An example from Rwanda. Mobile Technologies and Health: Benefits and Risks (pp. 1-12). Udine, Italy: The Earth Institute at Columbia University. Retrieved from http://jonathandonner.com/donner-mobhealth.pdf
Downer, S., Meara, J., & Costa, A. (2005). Use of SMS text messaging to improve outpatient attendance. Medical Journal of Australia, 183(7), 366-368.
Draugalis, J. R., Coons, S. J., & Plaza, C. M. (2008). Best practices for survey research reports: A synopsis for authors and reviewers. American Journal of Pharmaceutical Education, 72(1), 1-6.
Harrison, J., & Lee, A. (2006). The role of e-health in the changing health care environment. Nursing Economics, 24(6), 283-289.
Henry, J. D., & Henry, L. S. (2004). The self-caring nurse: Strategies for avoiding compassion fatigue and burnout. Oklahoma Nurse, 49(1), 9.
Istepanian, R., Woodward, B., & Richards, C. (2001). Advances in telemedicine using mobile communications. Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 4, pp. 3556-3558. Istanbul, Turkey: Department of Electronic and Computer Engineering.
Jackson, S. (2014). Research methods: A modular approach. California: Cengage Learning.
Jha, A. K., DesRoches, C. M., Campbell, E. G., Donelan, K., Rao, S. R., Ferris, T. G., . . . Blumenthal, D. (2009, April 16). Use of electronic health records in U.S. hospitals. The New England Journal of Medicine, 360(16), 1628-1638.
Kaplan, W. (2006). Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries? Globalization and Health, 2(9), 1-14.
Keidel, G. C. (2002). Burnout and compassion fatigue among hospice caregivers. American Journal of Hospice & Palliative Care, 19(3), 200-205, 216.
Kelly, T., Mulas, V., Raja, S., Qiang, C. Z.-W., & Williams, M. (2010). What role should governments play in broadband development? ICTs for Development: Improving Policy Coherence- The Development Dimension (pp. 1-10). Paris: OECD Publishing, World Bank. doi:10.1787/9789264077409-en
Kun, L. G. (2001). Telehealth and the global health network in the 21st century. From homecare to public health informatics. Computer Methods and Programs in Biomedicine, 64, 155-167.
Labrique, A. B., Vasudevan, L., Kochi, E., Fabricant, R., & Mehl, G. (2013). mHealth innovations as health system strengthening tools: 12 common applications and a visual framework. Global Health: Science and Practice, 1(2), 160-171.
Martinez, I., Fernandez, J., Galarraga, M., Serrano, L., de Toledo, P., Jimenez-Fernandez, S., . . . Garcia, J. (2008, February). Implementation of an end-to-end standard-based patient monitoring solution. IET Communications, 2(2), 181-191.
Mechael, P. N., & Sloninsky, D. (2008). Towards the development of an mHealth strategy:. New York, NY: The World Health Organization/The Millennium Villages Project.
MOH. (2013, March 6). National e-Health Strategy. Retrieved from Ministry of Health (MOH): http://www.moh.gov.sa/en/Ministry/nehs/Pages/Ehealth.aspx
Naismith, L., Lonsdale, P., & Sharples, M. (2003). Literature review in mobile technologies and learning. Retrieved from Nesta Future Lab: http://www2.futurelab.org.uk/resources/documents/lit_reviews/Mobile_Review.pdf
Nesbitt, T. S. (2007, September). Meeting the health care needs of California’s children: The role of telemedicine. Digital Opportunity for Youth Issue Brief, 3, 1-16. Retrieved from https://www.aucd.org/docs/resources/Childrensdoc.pdf
Neuman, W. L. (2006). Social research methods: Qualitative and quantitative approaches (6th ed.). Boston: Allyn and Bacon.
Onwuegbuzie, A., & Leech, N. (2005). On becoming a pragmatic researcher: The importance of combining quantitative and qualitative research methodologies. International Journal of Social Research Methodology, 8(5), 375–387.
Render, B., Stair Jr., R. M., & Hanna, M. E. (2011). Quantitative analysis for management (11th ed.). Upper Saddle River, New Jersey: Pearson Education, Inc.
Shahriyar, R., Bari, F., Kundu, G., Ahamed, I., & Akbar, M. (2009, September ). Intelligent mobile health monitoring system (IMHMS). International Journal of Control and Automation, 2(3), 13-27.
Smith, C. W., Graedon, T., Graedon, J., Greene, A., Grohol, J., & Sands, D. (2013, May 16). A model for the future of health care. Journal of Participatory Medicine, 5, e20. Retrieved from http://www.jopm.org/opinion/commentary/2013/05/16/amodelforthefutureofhealthcare/
Telmesani, A., Zaini, R. G., & Ghazi, H. O. (2011). Medical education in Saudi Arabia: A review of recent developments and future challenges. Eastern Mediterranean Health Journal, 17(8), 703-707.
Thomas, R. (2003). Blending qualitative and quantitative research in thesis and dissertations. Thousand Oaks: Sage.
Thompson, T., & Brailer, D. (2004). The decade of health information technology: Delivering consumer-centric and information-rich health care. Washington, D.C.: Department of Health and Human Services, Office of the Secretary National Coordinator for Health Information Technology. Retrieved from http://www.providersedge.com/ehdocs/ehr_articles/The_Decade_of_HIT-Delivering_Customer-centric_and_Info-rich_HC.pdf
Thomson, S., & Mossialos, E. (2010). Chapter 10: Private health insurance and the internal market. In E. Mossialos, G. Permanand, R. Baeten, & T. K. Hervey (Eds.), Health systems governance in Europe: The role of EU law and policy (pp. 419-460). Cambridge, UK: Cambridge University Press. Retrieved from World Health Organization (WHO).
Tsai, K.-L., Leu, F.-Y., Wu, T.-H., Chiou, S.-s., Liu, Y.-W., & Liu, H.-Y. (2014). A secure ECC-based electronic medical record system. Journal of Internet Services and Information Security (JISIS), 4(1), 47-57.
UNDP. (2014). The Millennium Development Goals: Eight Goals for 2015 . Retrieved from United Nations Development Programme (UNDP): http://www.undp.org/content/undp/en/home/mdgoverview.html
Varshney, U. (2007, July 12). Pervasive healthcare and wireless health monitoring. Mobile Network Applications, 12, 113-127. doi:10.1007/s11036-007-0017-1
Vo, A., Brooks, G. B., Farr, R., & Raimer, B. (2011). Benefits of telemedicine in remote communities & use of mobile and wireless platforms in healthcare. University of Texas Medical Branch/ Internet Innovation Alliance. Retrieved from http://telehealth.utmb.edu/presentations/Benefits_Of_Telemedicine.pdf
Weyns, K., & Host, M. (2013). Service level agreements for municipal IT dependability management. Research Challenges in Information Science (RCIS), 2013 IEEE Seventh International Conference (pp. 1-9). Lund, Sweden: Deptartment of Computer Science, Lund University.
WHO. (2011). Initial summary conclusions: Maximizing positive synergies between health systems and Global Health Initiatives. Retrieved March 3, 2014, from World Health Organization (WHO): http://www.who.int/healthsystems/New-approach-leaflet-ENv2-p4p.pdf?ua=1
WHO. (2014). About health systems. Retrieved March 3, 2014, from World Health Organization (WHO): http://www.who.int/healthsystems/about/en/
Zheng, Y. (2005). Information culture and development: Chinese experience of e-Health. Proceedings of the 38th Hawaii International Conference on System Sciences. Hawaii: IEEE.
Time is precious
don’t waste it!
Plagiarism-free
guarantee
Privacy
guarantee
Secure
checkout
Money back
guarantee