RIYADH, 10 March — It is known throughout the Kingdom that Prince Sultan ibn Abdulaziz, second deputy premier and minister of defense and aviation, maintains a sincere interest in providing for the less fortunate in Saudi society. This group includes the sick, the elderly, the handicapped, and children in need of special care in early childhood. In order to provide a tangible and meaningful way of assisting these people, the Sultan bin Abdulaziz Humanitarian City was established by Royal Decree on Sept. 15, 1996.
Construction of the Humanitarian City is now complete and the facility is accepting patients.
Prince Sultan will formally open the Humanitarian City at the end of April. Occupying an area of over 200,000 square meters, the City is located thirty kilometers north of Riyadh, in the small community of Binban. Built at a cost of over one billion riyals, the Humanitarian City will provide health care and rehabilitative services at the highest level of professionalism to all in need, regardless of their ability to pay.
The Humanitarian City encompasses both in-patient and outpatient facilities. An extensive range of rehabilitation programs is available including services for pediatric, neurological, brain injury and spinal cord injury. A Child Development Center will provide an integrated educational and therapeutic program for 150 children who have special educational needs due to physical handicaps, developmental disabilities or complex health problems. The Humanitarian City’s outpatient clinics encompass 13 clinics with 55 examination rooms and eight operating rooms. Important features of the outpatient clinics are the Day Surgery Center and the Cranio-Facial Surgery Center. The capacity of the outpatient clinics is nearly 260,000 patient visits per year in addition to 7,000 surgeries. The outpatient clinics are serviced by their own laboratories, pharmacy and radiology department. A conference hall, sports hall, staff housing and an administration building, supplement the City’s medical facilities.
The Humanitarian City is just one of the programs of the Sultan Bin Abdulaziz Al-Saud Foundation. Since its beginning on Jan. 21, 1995, the Foundation has worked to promote humanitarian, educational, social and cultural services in Saudi Arabia and around the world. The Foundation has interests in a variety of fields including medicine, science & technology, communications and education. The activities of the Foundation are made possible through the generous support and continued directions of Prince Sultan. The Foundation’s Secretary-General, Prince Faisal ibn Sultan, oversees the management of its various branches.
In all its activities the Foundation uses the latest technologies available. In that regard, Sultan Bin Abdulaziz Al-Saud Foundation created the Sultan Bin Abdulaziz Medical and Educational Telecommunications Program (MeduNet). Led by its Director, Dr. Abdullah Al-Salamah, MeduNet provides advanced technological solutions such as telemedicine and distance learning, which initially will benefit hospitals in the Kingdom, but eventually will reach out throughout the Arab World.
MeduNet is chartered to establish a state-of-the-art Health Information Network (HealthNet) for unrestricted delivery of Telemedicine, Health Information Systems, Distance Learning and Medical Content, providing services throughout Saudi Arabia and the Arab world for the coming decade.
MeduNet designed the overall network and supervised the project implementation for the $2 million network infrastructure contracted from NCR Corporation for the Humanitarian City. The core network infrastructure at the City is based on Asynchronous Transfer Mode (ATM) technology from Marconi.
“The Humanitarian City network will enable very demanding applications including low-definition video conferencing for simple meetings, high-definition video conferencing for telemedicine, as well as rapid transfer of high-resolution medical images with an absolute requirement for the security of the data,” explained Al-Salamah. “Being a hub of HealthNet will allow the City to have high-speed Internet access and will give doctors and medical technicians access to a wide range of medical data.”
But MeduNet’s telemedicine network is not focused only on Riyadh. Since 1998 MeduNet has expanded the network nationwide. MeduNet is able to provide health care delivery and distance medical education services virtually anywhere. The expanding network carries significant implications for how medicine will be practiced in Saudi Arabia in the future and furnishes available critical resources to health care professionals throughout the Kingdom. MeduNet, is dedicated to the continued development of a telemedicine network that provides the following medical and clinical advantages:
*Diminished necessity to relocate or transfer patients, *More efficient use of skilled specialists by connecting health care professionals together,
*Diminished hospital length of stay,
*Expediting patient referrals and hospital transfer, *Diminished requirement for physicians in the remote regions,
*International consultation,
*Training and continuing medical and nursing education programs,
*Providing Internet access to information concerning the latest treatments and techniques all available through www.health.net.sa.,
*In crisis and disaster management — immediate response capability, immediate access to disease control information, immediate medication guidance, and immediate access to specialists throughout the world.
MeduNet has already completed arrangements with specialized major medical centers abroad to provide consultancies through HealthNet. At the MeduNet offices in Riyadh, training facilities are being equipped, staffed and made ready to educate medical professionals in the use of the specialized tools required for telemedicine and hospital information systems.
What is telemedicine? According to Al-Salamah:
“Telemedicine is the delivery of health care services, where distance is a critical factor. This is done by health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries. In addition, telemedicine may be used for the continuing education of heath care providers as well as research and evaluation, all in the interests of advancing the health of individuals and their communities.”
The possibilities for telemedicine are vast. Digital x-rays and other images can be sent for diagnostic review and second opinion over the HealthNet. Special stethoscopes can transmit the digitized sounds of a patient’s heartbeat to a cardiologist anywhere in the world. Using a microscope connected to the network, a pathologist in a specialized laboratory can examine tissue or fluids on slides for abnormalities. Through HealthNet, doctors in distant medical centers are able to both see and communicate with patients. Physician-to-physician consultations are enabled as well.
“The rising population in Saudi Arabia and the high cost of advanced medical technologies coupled with a serious shortage of local medical personnel are creating a widening gap between demand for medical services and available health care resources,” said Al-Salamah. “If current trends and policies continue, quality health care will be unsustainable and unaffordable. We must find ways to utilize our health care resources effectively and efficiently and the use of new information technologies will be important in achieving that goal.”
Health care in the Kingdom is heavily dependent on the recruitment of foreign physicians, nurses and allied health personnel. This dependence will continue to grow as the Saudi population increases in excess of 3.5 percent yearly. The Ministry of Health has itself stated that this massive and increasing dependence on a diminished availability of health care funding is leading to a crisis. Currently only about 400 Saudi medical students graduate yearly. The Kingdom is also caught up in the global shortage of nurses. Of the estimated 61,214 nurses in the Kingdom as of 1416H, 83 percent, or 51,114 were foreign.
Studies have found that the quality of foreign physicians is at best variable and their average length of stay is less than one and a half years. With their departure, no Saudi gain is recorded and no Saudi legacy has been established. During the Gulf War, the Kingdom experienced first hand its vulnerabilities in the use of foreign medical staff when thousands of these professionals left Saudi Arabia and the government was forced to shut down many hospitals and clinics Kingdomwide.
In 1996, Saudi Arabia spent $4 billion on foreign physicians, nurses and allied health personnel. This represented almost 10 percent of the Kingdom’s annual budget for that year. If current patterns persist, by the year 2015, the annual expenditure for these foreign health care professionals will reach a minimum of $8 billion, not accounting for inflation or cost of living increases.
While resources urgently need to be focused on enlarging available scientific educational programs and creating new ones, other measures should also be taken to decrease the numbers of physicians required by the Kingdom to maintain quality health care. These measures include innovative computerized distant educational applications utilized in massive education programs for physicians, nurses, nurse practitioners, etc. Extensive medical and educational Kingdomwide telecommunications must be enabled using a high-speed broad bandwidth network to centralize medical specialists in regional “Centers of Medical Excellence.”
“We need to give young Saudis basic skills and also enhance the education of Saudi health care professionals. We must demonstrate to Saudi youth that medical careers are desirable. We can do this by showing them through our level of investment in these professions how highly they are valued. The aim must be for Saudi Arabia to own its health care delivery system rather than lease its medicine,” emphasized Al-Salamah.
“The technologies MeduNet is implementing are new to the Kingdom but they are already in use in other nations,” he continued “In this new millennium knowledge is more than power — it is a necessity for survival. A country unprepared for this information age, with its citizens untrained in the everyday technologies, will be significantly handicapped. The talent of its citizens will go untapped, and the society itself stands to be harmed.”
MeduNet has already jump-started the timely distribution of health information in the Kingdom. It has developed an Internet health site that allows physicians and other health professionals to reach, through one location, up-to-the-minute medical news, e-mail, a job database and medical literature. This portal can be found on the Internet at www.health.net.sa.
In addition to the hospitals connected to Health.Net, more than 12,000 physicians in the Kingdom now have private access to the site’s customized tools and resources. The site features MedLine, a medical database from the National Institutes of Health, which is hosted on MeduNet servers. MeduNet has developed a powerful search engine allowing users quickly and efficiently to search the databases for the most recent articles and information. Registered users can even save their entire search histories, providing a way to run the same search again in the future.
Other useful HealthNet features include:
*Timely medical news stories from Reuters Medical News,
*Weekly news features highlighting new medical developments,
*JobFinder database of career opportunities, such as, job openings at the Sultan Bin Abdulaziz Humanitarian City, *Specialty areas with vital links to medical journals, associations and other information,
*Access to MDConsult, a rich source of medical information for physicians,
*Access to hundreds of CME (Continuing Medical Information) classes,
*Medical Dictionary and Drug Database,
*Personal e-mail accounts.
Future development of HealthNet will provide the ability to link doctors together through interactive chats, message boards and ultimately, real-time “grand rounds” where medical issues are discussed and viewed with videoconferencing over the Internet.
MeduNet is also addressing the shortage of Saudi nurses with advanced degrees. It has developed and is about to introduce a one-of-a-kind online RN to BSN degree program. The courses in the MeduNet nursing program will be led by professors of nursing at George Mason University through the use of video and teleconferencing techniques coupled with online computer classes and Internet tools. Adjunct faculty members will help guide the students in the classroom in Saudi Arabia. With on-going innovations related to distance learning, students are provided with a wealth of information and learning tools, such as:
*English to Arabic glossaries,
*Study guides and tools,
*Sample exams and quizzes,
*Interactive course activities.
“The new wave of e-learning meets and often surpasses the typical expectations of the standard classroom learning environments,” said Al-Salamah. “The instructor involvement, structure of the classes, and the cutting edge technology all contribute to providing the Saudi nursing students with classes identical in content and accreditation to classes they would receive if attending on a typical college campus, without the added stress of leaving their homes and families.”
While MeduNet is actively engaged in the launch of telemedicine, and training and education programs, the organization has ambitious plans for the future.
“Our network can be used for much more than was first envisioned,” said Al-Salamah. “I would like to see every hospital and clinic linked together in business-to-business activities such as online-procurement. I also would like to see the development of a national database of medical records so that any Saudi, anywhere, could allow a physician to have instantaneous access to his medical history. The cost savings to the Ministry of Health through the effective, efficient use of information technology to manage backend operations would be enormous. Those savings could then be used to enhance training and improve medical facilities throughout the Kingdom.”
