Ethical and Legal Aspects of Telerehabilitation in Saudi Arabia.

Organizations have their own policies and procedures to govern operational aspects of health care facilities. With the advent of telemedicine, there has been a growing trend in providing telehealth practices without formally exploring the ethical and legislative aspects. The potential use of electronic and digital services in telerehabilitation can influence various ethical and legal factors, such as confidentiality, consent. and negligence. Thus, establishing clear strategies in this regard is necessary. Ethical and legal aspects of healthcare are influenced by cultural, religious, and legislative rulings of a state. At the same time, the multidimensional scope of rehabilitation in a health system has its own challenges. This narrative review intends to highlight the importance of incorporating the ethical and legislative framework in the telerehabilitation process in Saudi Arabia. A summary of various aspects in-line with unique local attributes is included, which can also help to facilitate regional telerehabilitation services in the Arab World.

Telerehabilitation Guidelines in Saudi Arabia.

Rehabilitation needs are increasing globally due to population growth, aging population, high survival rates for people with disability, and severe health conditions. In the past few years, new telecommunication-based practices, including various forms of e-rehabilitation have gained attention all over the world, including the Kingdom of Saudi Arabia (KSA). Telerehabilitation is an alternative way of delivering rehabilitation services in which information and communication technologies are used to expedite communication between the health care professional and the patient at a distant location. It can be beneficial to people in rural areas, especially individuals in isolated communities. At present, the COVID-19 pandemic has forced speedy adoption of telerehabilitation due to restricted traditional in-person visits all over the world, including KSA; however, no telerehabilitation guidelines are available in the country. Since specialized rehabilitation services are limited to main cities of the country, the provision of care by reaching out the underserved areas using telemedicine technology is deemed important. These guidelines were established collaboratively by panel of various rehabilitation experts with input from other practitioners in the field and strategic stakeholders. It will facilitate rehabilitation clinicians practicing in KSA providing consultation, counseling, education, assessment, monitoring, therapy, or follow-up to a patient remotely using telemedicine communication technologies. This document includes administrative, clinical, and technical guidelines, which are aimed to standardize telerehabilitation practice across the country. The core principles are based on standards set forth by American Telemedicine Association and are guided by telemedicine policy in KSA. Additionally, ethical considerations of telerehabilitation practice pertinent to Saudi culture and health care system are elaborated as well. This document serves as a general guide for the provision of telerehabilitation services and do not describe a specialty-specific clinical practice guideline.

Long-term compliance with bladder management in patients with spinal cord injury: A Saudi-Arabian perspective.

Objective: To examine long-term compliance with bladder management in patients with spinal cord injury (SCI) at a tertiary care rehabilitation facility in Saudi Arabia.Design: Cross-sectional survey.Setting: Tertiary care rehabilitation facility in Saudi Arabia.Participants: A self-administered questionnaire was distributed to patients with SCI during their clinic visits. 50 patients (41 males and nine females) participated in the survey. Data documentation included demographic characteristics, type and level of injury, compliance with bladder management and barriers in compliance.Main outcome measures: The type of bladder management employed at first follow-up visit was compared with that employed at discharge.Results: Eleven out of 41 patients who were discharged on clean intermittent catheterization (CIC) stopped it within 3 months of discharge, mainly due to lack of accessibility and financial support to buy catheters. Of the total sample, 23% reported that they did not know the difference between catheter types and their advantages, and 49% stated that they did not receive proper health education regarding bladder management.Conclusion: CIC was the most commonly used bladder management technique in patients with SCI following up at a tertiary care rehabilitation facility in Saudi Arabia. Compliance with CIC may be improved by ensuring access to catheters post-discharge and by providing appropriate education about bladder management during inpatient rehabilitation.