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E-Health Approach Toward Diabetes Management

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E-Health Approach Toward Diabetes Management Question: Discuss about the E-Health Approach Toward Diabetes Management.     Answer: Introduction Prevalence of Diabetes in Saudi Arabia is high with an estimate of one in every four citizen suffering. In the previous years of 1970s, diabetes was un heard of as most of the people lived nomadic life. Lifestyle changes have characterised by the Saudis engaging in less exercises and consumption of high density sugars and fat rich foods.  In Gulf Co-operation council, the prevalence has been increasing, with expectation to rise by 96.3% by 2035. In Saudi Arabia the prevalence is 17.6%, (IDF, 2015) higher than the global prevalence rate of 8.8%. The focus of this study is an innovative approach of using technology of e-health utilization in managing diabetes disease. E-Health Innovative Approach In Saudi Arabia, application of e-health innovative approach has been initiated. In the recent years, the research arena has shifted focus on the use of technology towards efficient production process, with focus on the role of mobile based applications towards innovative services in health care provision. In the health care sector, the importance of industrialization play key role in ensuring that economic benefits are achieved, (OECD,2012). E-health care services approach offer quality, safe and timely health care needs to the health challenges of individual’s citizens, (Jung & Berthon, 2009). This e health approach entails a web based mobile application with an education and nursing approach on diabetes. Patients can do self assessments, monitor their blood sugar level effectively, connect to support from the medical and engage them in a more convenient way. It utilises the use of mobile phone and a smart phone as an application which guides the patients on lifestyle tips and glycaemia control levels. Ehealth is being implemented in Saudi Arabia. The adoption of e-health services as a cost effective way of improving health care services has been implemented in public health sector arena. E-health have cutting cost on cost reductions, improving on quality health care services and offering safe medical care to the citizens, (Aanesen, Lothrington & Olsen, 2012).    Need And Rationale Of The Innovation Diabetes in Saudi Arabia is major challenge having far reaching impacts on the health status of the people in general. The high incidences of diabetes have gone higher and this has called for the necessity for the e-health innovative approaches towards health care provision. This has further been compounded with the rise in digital technology especially among the young people. The innovative introduction of e-health technology is essential in ensuring that health is achieved. A study by Altuwaijir (2011) has highlighted the need the national e-health for the wider Saudi Arabia citizens. Studies on innovative use of technology in Saudi Arabia referred to as Mobile Health Effectiveness and Readiness Questionnaire (MHERQ) have shown that people’s health can be effectively be improved through mobile based health innovation and showed that it can significantly lower the rate incidence rate of type 2 diabetes through educative messages and self assessment , (Alenazi et al., 2017). Components Of Critical Care Model The innovative approach is embedded in critical care model which seeks to improve care at population and patient level. It incorporates patient needs and technology system issues on addressing diabetes management using web based mobile e health approach. It involves empowering communities through improved health systems which translate to informed patients acting proactively towards improved outcomes on the diabetes state.    Critical Analysis And Performance Neighbouring Gulf countries face high rates of diabetes and have been rated as among top countries in the world with high prevalence rates. This has seen associations such as the Saudi Arabia association for the health informatics being at the fore front in promoting co-ordination among health professionals. . E-health initiatives in Saudi Arabia have focussed on education approaches, (Househ, Saddik  Al-Dosari, 2011). E health educations programs have been entrenched in the education sector as currently observed with the development of master of health informatics. Initiatives such as the Kuwait Scotland e Health Innovation Network has been undertaking partnerships with key relevant institutions such as the government, industry players and education sector in order to deliver a comprehensive package for the clinical service development. This has seen shift in how informatics systems change in health care especially among children and adults with diabetes. The innovative approach presents partnerships among health education, industry and government players aimed at delivering clinical service package under one comprehensive system. The results of this innovative program provided an overview of clinical and operational data of diabetes patients in the registry system. This showed how users at population level can assess diabetes indicators based on national standards of diabetes, it also provided educational program on diabetes for patients, (Conway et al., 2014). KSeHIN- The Kuwait-Scotland e Health Innovation Network has represented a successful collaboration with various stakeholder on cutting across the different players towards targeting patient outcomes, systems, performance and professional development in ensuring the management of quality diabetes care for the growing population of Kuwait. The collaboration has achieved enrolment of approximately 4000 registered patients who are not able to meet the national clinical targets for diabetes. On education program, over 150 masters students have been enrolled and over 400 projects related to diabetes management have been  accomplished, (Conway et al., 2014). Feasibility studies are being undertaken in Saudi Arabia on development of diabetes management system for social behaviour change for diabetes management tailored specifically to Saudi Arabians is taking center stage. This e health approach seeks to promote monitoring for diabetic patients and increasing the diabetic patients health awareness and obtaining feedback for maintenance of regular blood glucose level, (Alanzi, 2014). This e-Health system was designed on smart mobile platform for use among patients on cognitive behavioural therapy. The assessment of this approach showed a general acceptance of the patients using the system. The end results showed that the SANAD- Saudi Arabia networking for aiding diabetes program, has positive implications on the promotion of knowledge of diabetes and increasing self efficacy among the target groups of the program,(Alanzi, 2014). Challenges And Factors Associated With Success And Poor Performance Kingdom of Saudi Arabia currently faces numerous challenges in the e-health system. The ministry of health has been under pressure to develop quality care and improve e-health services to its residents especially in non communicable disease such as diabetes. There are more many challenges with regard to implementation of telemedicine utilization. These challenges include shortage of medical and engineering experts in the region, lack of good infrastructure, poor mobile technology infrastructure and training models and lack of diabetic specialist nurses and medical personnel on diabetes care (Alotaibi et al., 2016). Challenges have been observed in implementation which entails lack of clear direction and infrastructural framework to support the various initiatives, (Istepanian, et al., 2009). Factors contributing to its success is the widely use of smart phones in Saudi Arabia, making success of the health possible. The population are having smart phones which supporting e-health applications.    Address Towards Health Equity One of the most recognizable efforts of technology based innovative approaches has been the adherence of treatment and achieving healthy lifestyles. Adherence often is accompanied with permanent behavior change which is a long term approach towards health care access, (Reach, 2009). Technology tools of e-health to support behavior change has been widely shared across the board with specificity on diabetes management in offering e-Health solutions in terms of knowledge sharing healthy lifestyle and individual health assessments. The need towards achieving this approach entails understanding the social behavior change of the people. Currently majority of the Saudi Arabians own Smartphones and other mobile devices which this potential can be tapped to ensure that behavior change and diabetes assessment is achieved (Fogg, 2002). In this emerging field of positive technology, the need of utilising innovations in addressing the health equities is of concern. Reaching the larger population has been the primary focus. This has seen in depth studying into aspects of technology which focuses on the innovation associated with behaviour change for the people and the integration of how these features can be integrated into instruments that can impact positively on the lives of the people and to meet the specific needs of the various target groups, (Street et al, 2013). Research focus has shifted attention into how context and situation merge in health care access on diabetes management. The ability of how it would take into account the social and cognitive process of individuals has been on the focus, (Kaptein et al, 2010). These studies have led to focus on the technological devices which have an impact on the behaviour change and how it would be integrated into the systems of health care, (Hallsworth et al., 2015). With view of mobile health devices which include software intensive communication networks and mobile health information, services have been observed as having better chance of achieving support for patients by integrating the doctor patient relation on disease patterns, (Erikson et al., 2014). Implications On Consumers And Health Care Community The e-Health model for diabetes management has had far reaching effects on empowering the patients with increased knowledge about the disease which improves better management of the disease, (Riley et al, 2011). It is essential in providing free short text messages to the patients with the mobile applications, (Erikson et al., 2014). The educational component has been seen to borrow a leaf from the Iraq and Bahrain through collaborations built and following guidelines on diabetes management. This messages have been modified to offer patients with treatment related messages, blood glucose monitoring steps, diabetes complications awareness and encouraging the patients to improve clinic attendance and diet, (Alotaibi, Istepanian & Philip, 2016). e-Health application in the medical set up have important benefits on health care, which entail positive efficiency of health care, utilization of effectiveness of health care, reduction of error rates and reduction of health care costs. These innovative approaches have been observed to offer sigh of relieve to the burdening impact of the health care system, (Stellefson, Dipnarine & Stopka, 2013). The implementation of e-Health platform in Saudi Arabia, further has had far reaching positive consequences. The web based applications have been found to provide educational specialists with important medical information on every individual patient. They also provide relevant information to the patients in the remote regions where health care on diabetic management is limited. If these systems are adopted, they will tremendously improve self monitoring aspects of the disease which eventually reduces the overall burden of mortality rates across Saudi Arabia kingdom, (Silva et al., 2015). Further on health care staff, there have been collaborations on managing diabetes. The ministry of health in Saudi Arabia, has joined forces with other partners like Joslin Diabetes centre associated with Harvard medical school in improving the standard of care in health care centres to achieve international standards. Health workers will be trained latest methods of diabetic management, (Arab News, Online 2016). Limitation E health programs on diabetes management in Saudi Arabia have not been published making it challenge for successful analysis review. Many programs being undertaken have not been published yet thus making it a challenge for long term studies to assess their effectiveness. Thus the gap in literature needs to be reduced so as to indentify and utilise effective programs on diabetes management. Recommendations  Towards overcoming the exhibited challenges there is need to identify a clear e-health framework which provides solutions to major medical challenges in the overall address towards prevention of prevalence of diabetes. There is need to increase the awareness of mobile based health technologies among the community members, inclusion of m-health as part of medical educational programs in medical curriculum and improving on public awareness on mobile health among diabetic patients in Saudi Arabia kingdom. For effective management of diabetes there is need for implementations which have been successful in other countries and are applicable in Saudi Arabia. Lifestyle interventions have proofed to be a cost effective approach. They have the ability to delay the progression of diabetes to more complex stages. With appropriate management of lifestyle type 2 diabetes complications such as heart attack, blindness, kidney failure and limb amputations can be reduces, (Gillies et al, 2007).    Opportunities The ministry of health has implemented prevention, treatment and rehabilitation programs in its facilities in an aim for ensuring inclusive health for all. This further supplements the efforts of national executive plan for diabetes for 10 years starting from 2010-2020, aiming at helping the Saudi community from disease incidence, (MoH, 2013). This opportunity can be utilized as leverage for other intervention programs. Available opportunities to be utilized are the establishment of initiatives based in the community through collaborative process and engagement of all stakeholders. The programs to be facilitated include public health education, screening programs, lifestyle medication to promote prevention and management support for chronic disease prevention. Utilizing these opportunities will be beneficial in public health arena through reduction of disease burden in the community and minimizing impact on the health care network. Conclusion The core strengths of health care technology in Saudi Arabia are actionable health information, care management, consumer involvement, health care insurance and financial facilitation. The availability of these assets is paramount in improving health care for the citizens. There is need for partnership approach among the health care professionals and other concerns stakeholders, which leads to reduction of diabetes prevalence. Implementing these, Saudi Arabia will be a model for learning how innovative approaches such as e-health as an innovative model able to treat and prevent diabetes towards achieving critical part of Saudi vision 2030.    References Aanesen, M., Lotherington, A.T. and Olsen, F., 2011. Smarter elder care? A cost-effectiveness analysis of implementing technology in elder care. Health Informatics Journal, 17(3), pp.161-172. Alanzi, T 2014, ‘Mobile diabetes management system for Saudi Arabia embedding social networking and cognitive behavioral therapy modules’, British Library EThOS, EBSCOhost, viewed 22 January 2018. Alenazi, H., Alghamdi, M., Alradhi, S., Househ, M. and Zakaria, N., 2017. A Study on Saudi Diabetic Patients’ Readiness to Use Mobile Health. Studies in health technology and informatics, 245, pp.1210-1210. Alotaibi, M.M., Istepanian, R. and Philip, N., 2016. A mobile diabetes management and educational system for type-2 diabetics in Saudi Arabia (SAED). mHealth, 2. Altuwaijri, M.M., Bahanshal, A. and Almehaid, M., 2011. Implementation of computerized physician order entry in National Guard Hospitals: assessment of critical success factors. Journal of Family and Community Medicine, 18(3), p.143. Conway, N.T., Al Wotayan, R., Alkuzam, A., Al-Refaei, F.F., Badawi, D., Barake, R., Bell, A., Boyle, G., Chisholm, S., Connell, J. and Emslie-Smith, A., 2014. The Kuwait–Scotland eHealth Innovation Network (KSeHIN): a sustainable approach to quality improvement in healthcare. Quality in primary care, 22(1), pp.43-51. Eriksén, S., Georgsson, M., Hofflander, M., Nilsson, L. and Lundberg, J., 2014, August. Health in hand: Putting mHealth design in context. In Usability and Accessibility Focused Requirements Engineering (UsARE), 2014 IEEE 2nd International Workshop on (pp. 36-39). IEEE. Fogg, B.J., 2002. Persuasive technology: using computers to change what we think and do. Ubiquity, 2002(December), p.5. Hallsworth, M., Berry, D., Sanders, M., Sallis, A., King, D., Vlaev, I. and Darzi, A., 2015. Correction: stating appointment costs in SMS reminders reduces missed hospital appointments: findings from two randomised controlled trials. PloS one, 10(10), p.e0141461. Househ, M.S., Saddik, B. and Al-Dosari, B., 2011, February. Development of a graduate level course in e-Health and Emerging Technology in Saudi Arabia. In ITCH (pp. 69-73). International Diabetes Federation. (2015). IDF Diabetes Atlas. Retrieved Seventh Edition Istepanian, R.S., Zitouni, K., Harry, D., Moutosammy, N., Sungoor, A., Tang, B. and Earle, K.A., 2009. Evaluation of a mobile phone telemonitoring system for glycaemic control in patients with diabetes. Jung, M.L. and Berthon, P., 2009. Fulfilling the promise: A model for delivering successful online health care. Journal of Medical Marketing, 9(3), pp.243-254. Kaptein, M.C., Markopoulos, P., de Ruyter, B. and Aarts, E., 2010. Persuasion in ambient intelligence. Journal of Ambient Intelligence and Humanized Computing, 1(1), pp.43-56. Media Report on the MOH Efforts of Educating on Diabetes, Accessed on 23/01/2018. http Oh, H., Rizo, C., Enkin, M. and Jadad, A., 2005. What is eHealth?: a systematic review of published definitions. World Hosp Health Serv, 41(1), pp.32-40. Reach, G., 2009. Can technology improve adherence to long-term therapies?. Journal of diabetes science and technology, 3(3), pp.492-499. Riley, W.T., Rivera, D.E., Atienza, A.A., Nilsen, W., Allison, S.M. and Mermelstein, R., 2011. Health behavior models in the age of mobile interventions: are our theories up to the task?. Translational behavioral medicine, 1(1), pp.53-71. Rubin, R.R., Fujimoto, W.Y., Marrero, D.G., Brenneman, T., Charleston, J.B., Edelstein, S.L., Fisher, E.B., Jordan, R., Knowler, W.C., Lichterman, L.C. and Prince, M., 2002. The Diabetes Prevention Program: recruitment methods and results. Controlled clinical trials, 23(2), pp.157-171. Saudi Arabia and Harvard join forces to fight diabetes Mohammed Rasooldeen Published — Thursday 15 December 2016 Silva, B.M., Rodrigues, J.J., de la Torre Díez, I., López-Coronado, M. and Saleem, K., 2015. Mobile-health: A review of current state in 2015. Journal of biomedical informatics, 56, pp.265-272. Stellefson, M., Dipnarine, K. and Stopka, C., 2013. Peer reviewed: The chronic care model and diabetes management in US primary care settings: A systematic review. Preventing chronic disease, 10. Street, R.L., Gold, W.R. and Manning, T.R. eds., 2013. Health promotion and interactive technology: Theoretical applications and future directions. Routledge.

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