Blockchain in Healthcare: A Decentralized Platform for Digital Health Passport of COVID-19 Based on Vaccination and Immunity Certificates.

COVID-19 has become a very transmissible disease that has had a worldwide impact, resulting in a huge number of infections and fatalities. Testing is critical to the pandemic's successful response because it helps detect illnesses and so attenuate (isolate/cure) them and now vaccination is a life-safer innovation against the pandemic which helps to make the immunity system stronger and fight against this infection. Patient-sensitive information, on the other hand, is now held in a centralized or third-party storage paradigm, according to COVID-19. One of the most difficult aspects of using a centralized storage strategy is maintaining patient privacy and system transparency. The application of blockchain technology to support health initiatives that can minimize the spread of COVID-19 infections in the context of accessibility of the system and for verification of digital passports. Only by combining blockchain technology with advanced cryptographic algorithms can a secure and privacy-preserving solution to COVID-19 be provided. In this article, we investigate the issue and propose a blockchain-based solution incorporating conscience identity, encryption, and decentralized storage via interplanetary file systems (IPFS). For COVID-19 test takers and vaccination takers, our solution includes digital health passports (DHP) as a certification of test or vaccination. We explain smart contracts constructed and tested with Ethereum to preserve a DHP for test and vaccine takers, allowing for a prompt and trustworthy response from the necessary medical authorities. We use an immutable trustworthy blockchain to minimize medical facility response times, relieve the transmission of incorrect information, and stop the illness from spreading via DHP. We give a detailed explanation of the proposed solution's system model, development, and assessment in terms of cost and security. Finally, we put the suggested framework to the test by deploying a smart contract prototype on the Ethereum TESTNET network in a Windows environment. The study's findings revealed that the suggested method is effective and feasible.

Decentralized Patient-Centric Report and Medical Image Management System Based on Blockchain Technology and the Inter-Planetary File System.

Several academicians have been actively contributing to establishing a practical solution to storing and distributing medical images and test reports in the research domain of health care in recent years. Current procedures mainly rely on cloud-assisted centralized data centers, which raise maintenance expenditure, necessitate a large amount of storage space, and raise privacy concerns when exchanging data across a network. As a result, it is critically essential to provide a framework that allows for the efficient exchange and storage of large amounts of medical data in a secure setting. In this research, we describe a unique proof-of-concept architecture for a distributed patient-centric test report and image management (PCRIM) system that aims to facilitate patient privacy and control without the need for a centralized infrastructure. We used an Ethereum blockchain and a distributed file system technology called the Inter-Planetary File System in this system (IPFS). Then, to secure a distributed and trustworthy access control policy, we designed an Ethereum smart contract termed the patient-centric access control protocol. The IPFS allows for the decentralized storage of medical metadata, such as images, with worldwide accessibility. We demonstrate how the PCRIM system design enables hospitals, patients, and image requestors to obtain patient-centric data in a distributed and secure manner. Finally, we tested the proposed framework in the Windows environment by deploying a smart contract prototype on an Ethereum TESTNET blockchain. The findings of the study indicate that the proposed strategy is both efficient and practicable.

Sustaining blended and online learning during the normal and new normal conditions in a Saudi higher education institution: health science students' perspectives.

Background: Higher education institutions (HEIs) shifted from in-person attendance to blended and online learning due to the COVID-19 lockdowns. Objective: This study investigated the students' perception of satisfaction, convenience, engagement, and learning towards blended and online courses conducted before, during, and after the COVID-19 lockdowns. Methods: A longitudinal study design was adopted to examine the students' perception of online and blended learning courses before, during, and after the COVID-19 lockdowns. The subjects consist of Health science students (N = 130) belonging to two different colleges of a public university and the study period includes three academic years (i.e., six semesters) (2018-2021). A survey tool was developed to collect data from students studying the computer fundamentals course through blended and online learning modes from 2018 to 2021. Results: Over 95% of students have been satisfied with the course offered through various blended learning formats since 2018. The blended 0.50-course format is the most preferred one for the students; however, the Blended 0.75-course format is highly rated by the students regarding their satisfaction and engagement than other learning formats during the COVID-19 lockdowns. Following adaption after COVID-19, the students reported a high perception of learning towards the course when delivered through 100% online learning mode. Conclusion: Students' achievement is significantly associated with the learning modes, exam modes, and various student batches. The blended 0.75-course format group shows a higher achievement than the other three-course format groups. Likewise, those students who appeared in their exams online showed higher achievement than those who appeared physically. Further, the students felt equally convenient with Blended 0.75 and 100% online learning course formats. These findings would also help HEIs choose appropriate learning and examination modes while designing courses.

Factors Affecting Utilization of the E-Health "Seha" Interactive Application for Online Medical Consultation in Saudi Arabia.

Purpose: Telehealth, Internet interventions, or digital apps provide healthcare to isolated regions and can span borders. The purpose of this research was to assess the use of the Seha application, public perceptions toward the application, and factors that affect its utilization. Methods: The cross-sectional method was used to analyze the quantitative data. Grounded Theory was used to analyze the qualitative data. This study was conducted from December 1, 2018, to January 31, 2019. A total of 419 participants were surveyed online, and semi-structured interviews were conducted for 20 participants. The participants were chosen based on convenience sampling techniques. The survey contained two sections. The first section consisted of demographic data and the second section included eight questions, each covering one main aspect. For the qualitative approach, participants were chosen using a theoretical sampling technique. Researchers acted as the primary data collection instrument. Results: Out of the total, 88.5% of the participants did not use "Seha" application. Among users, the main perceived benefit from the application was the ability to contact a general practitioner anytime. Among non-users, the greatest barrier to use was the lack of awareness about it, while the ability to contact a general practitioner any time (25%) and reducing visits to the doctor (23%) were the top motivations. A conceptual framework was developed to define the different aspects affecting the use of the online medical consultation application. These aspects included awareness and education, technical issues, access, and consultation information. Conclusion: Public awareness and education about the application, as well as the integration of its functions with other healthcare systems were the main recommendations suggested. Implementing these recommendations is encouraged to deliver value to e-health initiatives in Saudi Arabia.

A survey assessing the health science students' perception towards online learning at a Saudi Higher Education Institution during COVID-19 pandemic.

As the COVID-19 pandemic pushed universities worldwide to shift from traditional to online learning, there is a need to capture the students' perception of online learning using an appropriate tool. Hence, this study explores the appropriateness of the online learning assessment survey (OLAS) model for assessing the students' perception of online learning during the COVID-19 pandemic. It included the undergraduate students (N = 2523) of the selected four health science colleges at Imam Abdulrahman Bin Faisal University (IAU) during 2020-2021. The data was obtained through OLAS using "Google Docs" from 728 students. The structural equation modeling (SEM) analysis revealed that each item showed a significant positive relationship with its respective variable of OLAS. The proposed OLAS model with five variables showed a good fit to assess the students' perception of online learning during the COVID-19 pandemic. Those variables enable the university policy planners to evaluate the students' perception of online learning during the pandemic, thereby supporting them in framing appropriate strategies to improve the quality and success of online learning. Further research is necessary to include all students of various programs offered at Saudi universities to generalize the outcomes. OLAS can include a global item assessing overall students' satisfaction with online learning, and the influence of OLAS variables on the overall students' satisfaction can be evaluated in future studies.

Digital health transformation in Saudi Arabia: A cross-sectional analysis using Healthcare Information and Management Systems Society' digital health indicators.

Background: The digital revolution has had a huge impact on healthcare around the world. Digital technology could dramatically improve the accuracy of diagnosis, treatment, health outcomes, efficiency of care, and workflow of healthcare operations. Using health information technology will bring major improvements in patient outcomes. Purpose: This study aims to measure the readiness for digital health transformation at different hospitals in the Eastern Province, Saudi Arabia in relation to Saudi Vision 2030 based on the four dimensions adopted by the Healthcare Information and Management Systems Society: person-enabled health, predictive analytics, governance and workforce, and interoperability. Methods: The study was conducted with a cross-sectional design using data collected through an online questionnaire from 10 healthcare settings, the questionnaire consists of the four digital health indicators. The survey was developed by Healthcare Information and Management Systems Society for the purpose of assessing the level of digital maturity in healthcare settings. Results: Ten healthcare facilities in the Eastern Province, both private and governmental, were included in the study. The highest total scores for digital health transformation were reported in private healthcare facilities (median score for private facilities = 77, public facilities = 71). The 'governance and workforce' was the most implemented dimension among the healthcare facilities in the study (median = 80), while the dimension that was least frequently implemented was predictive analytics (median score = 70). In addition, tertiary hospitals scored the least in digital transformation readiness (median = 74) compared to primary and secondary healthcare facilities in the study. Conclusion: The results of the study show that private healthcare facilities scored higher in digital health transformation indicators. These results will be useful for promoting policymakers' understanding of the level of digital health transformation in the Eastern Province and for the creation of a strategic action plan.

Sociodemographic and Occupational Factors Associated With Burnout: A Study Among Frontline Healthcare Workers During the COVID-19 Pandemic.

Purpose: To describe the prevalence of burnout among frontline healthcare workers (HCWs) during the COVID-19 pandemic and the associated sociodemographic and occupational factors. Methods: A cross sectional survey study was carried out to study HCWs burnout using the 19-item Full Copenhagen Burnout Inventory (CBI) that includes personal, work, and patient-related burnout subscales. Bivariate analysis was used to test for associations and p < 0.05 was considered statistically significant. Results: A total of 207 responses received; where the mean score of personal burnout was 67.23, the mean of work-related burnout was 61.38, and the mean of patient-related burnout was 54.55. Significant associations were found; where female HCWs, those working in rotating day-and-night shifts, working more than 55-h per week, and who had their shift time and hours changed during the pandemic, had higher levels of personal and work-related burnout (P < 0.05). Patient-related burnout was higher among those who were single (divorced or separated), nurses, non-Citizens, those with fewer years of experience, and who were infected by COVID-19 and have been quarantined (P < 0.05). Age was not a significant factor of burnout in any of the CBI subscales. Conclusions: There is a prevalent level of burnout among frontline HCWs during the COVID-19 pandemic. Findings highlight key sociodemographic and occupational factors affecting burnout; which can help planning for psychological support strategies. Furthermore, effective administrative control is important to institute policies and mechanisms to identify, and freely report burnout symptoms among HCWs to promote their wellbeing.

Clinicians' Perceptions of Picture Archiving and Communication System (PACS) Use in Patient Care in Eastern Province Hospitals in Saudi Arabia.

PURPOSE: The picture archiving and communication system (PACS) is one of the most important tools used in patient care in many hospitals worldwide. It allows clinicians to remotely communicate and consult with other clinicians on patient cases and view diagnostic images from different angles, thus facilitating patient diagnosis and treatment. Several studies have been conducted in Saudi Arabia to evaluate different aspects of PACS use; however, no comprehensive study has been conducted in its Eastern Province. This study aimed to investigate clinicians' perceptions of the advantages and disadvantages of the use of PACS in Eastern Province hospitals in Saudi Arabia and identify the factors that affect their perceptions and its use. In addition, it aimed to gather recommendations of clinicians for improving the system and its implementation. METHODS: A qualitative approach with grounded theory method was employed. A sample of 18 residents, radiologists, and consultants from three Eastern Province hospitals in Saudi Arabia participated in the study. Data were collected using semi-structured interviews over a period of 7 months. RESULTS: The perceived advantages of PACS included providing quality images and the ability to manipulate their resolution, whereas the perceived barriers included low-speed internet connections and technical problems. Participants recommended providing clinicians remote access to the system and implementing a mobile PACS application. The theory that emerged from the analysis revealed that demographic, system-related, and hospital-related factors affected participants' perspectives of PACS and its use. CONCLUSION: The results of this study and its theoretical model can help identify areas of improvement and inform policy and strategic planning for the effective implementation of PACS in patient care in Saudi Arabia.

Mobile Ambulatory Application Asafny and Traditional Phone Request 997: A Comparative Cross-Sectional Study.

PURPOSE: This study aimed to determine whether there was a time difference between the ambulatory application Asafny and traditional type 997 in reaching people in need and interacting appropriately. MATERIALS AND METHODS: This study was conducted using retrospective cross-sectional study. A total of 2120 ambulance requests was extracted from Saudi Red Crescent Authority servers in Eastern Province, Kingdom of Saudi Arabia. The requests were extracted between 2017 and 2019. RESULTS: There were no significant differences between the two methods of request. In 2019, the shortest times for all phases of requests were recorded. "Ordinary patient" was the most common cause for requests. CONCLUSION: Over the years, efforts by the Saudi Red Crescent Authority facilitated improvements in ambulatory services by adapting new technology and services. This has helped reduce times for all phases of emergency requests.

Annual survey on the level and extent of usage of electronic health records in government-related hospitals in Eastern Province, Saudi Arabia.

This study aims to determine the level and extent of usage of electronic health records (EHRs) in government-related hospitals in Eastern Province, Saudi Arabia. Another aim is to develop a Web site to serve as a forum of exchange on the development of EHRs in Saudi Arabia. All government hospitals (n = 19) in the province were included. The information technology (IT) managers in those hospitals made up the target population. An online questionnaire was developed, and the IT managers in all 19 government hospitals were invited to participate in the survey. The responses from the online survey were downloaded and analyzed using descriptive statistics. Of the 19 hospitals, only three (15.8 percent) use EHRs. These hospitals were established in 1984, 1995, and 2005. All three of these hospitals have implemented the same EHR software and were using it successfully, and all three were using the three core features of laboratory, radiology, and pharmacy electronic modules. Some modules were present in the EHR system but were underutilized. Some of the main challenges faced by the IT managers in implementing EHRs in their hospitals were related to the uncooperative attitudes of some physicians and nurses toward EHRs. In fulfillment of the second aim of the study, a Web site, http://ehr2011.weebly.com, was developed to serve as a forum for exchange of information on the development of EHRs in Saudi Arabia. The government of Saudi Arabia has prioritized the development of eHealth (health information technology) and allocated committed funding for it during 2008-2011. During this period, some sectors of government made highly commendable efforts in developing eHealth services. Along these lines, we had hoped to see higher uptake of EHRs than the 15.8 percent found in this study. The rate of implementing EHRs in government hospitals should be accelerated. The aim should be on achieving some basic EHR functionality in these hospitals, and once this has been achieved, additional functionality can be pursued in stages.