COVID-19 specialized diabetes clinic model for excellence in diabetes care: scientific perspective

While diabetes centers are well established by the Ministry of Health, there is no separate specialized diabetes clinics for COVID-19 patients (SDCs). There are several clinical diabetes centers throughout the Kingdom of Saudi Arabia, several of which have been developed through philanthropy funding; nevertheless, it is not obvious what distinguishes SDCs from a therapeutic viewpoint and what the potential would be for such centers. Through this context, we suggest a structure to direct the progress of SDCs. Defining protocols for wider adoption of SDCs as a means to enhance public safety and COVID-19 patient care efficiency (including consistency and satisfaction) and minimize health care expenses becomes increasingly essential when moving towards value-based sales and reimbursements away from service charges. It is wise to introduce innovative financial mechanisms to pay for diabetes that cannot be covered by fiscally limited private and university medical centers. We foresee potential clinical SDCs to be made up of a well-defined framework and six areas or foundations that act as basic guiding principles for the advancement of diabetes treatment skills that can be easily illustrated by stakeholders, including insurance facilities, consumers, payers and government departments

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

The potential of voice recognition technology in medical record documentation: Review

Background: Electronic health records (EHRs) have become an integral part of healthcare, providing a digital representation of patient medical histories. However, the transition from paper-based to electronic records has raised concerns about the security and privacy of sensitive health data. Aim of Work: This study aims to provide valuable insights to stakeholders in the healthcare system on the need for implementing, selecting, developing, and using electronic health records that improve the privacy and security of patients. Methods: The review explores the potential of voice recognition technology in medical record documentation, examining the key security and privacy considerations surrounding electronic health records. Results: The study highlights the importance of ensuring the confidentiality, integrity, and availability of health data stored in electronic systems. It also discusses the impact of emerging technologies, such as cloud computing and mobile devices, on the security and privacy of electronic health records. Conclusion: Securing electronic health records is crucial to safeguarding patient privacy and maintaining trust in the healthcare system. The study emphasizes the need for a multidisciplinary approach involving experts in communications, instrumentation, and computer science to facilitate the secure exchange of medical data and enhance the overall quality of healthcare services

The first survey of the Saudi Acute Myocardial Infarction Registry Program: Main results and long-term outcomes (STARS-1 Program).

BACKGROUND:Prior acute coronary syndrome (ACS) registries in Saudi Arabia might not have accurately described the true demographics and cardiac care of patients with ACS. We aimed to evaluate the clinical characteristics, management, and outcomes of a representative sample of patients with acute myocardial infarction (AMI) in Saudi Arabia. METHODS:We conducted a 1-month snap-shot, prospective, multi-center registry study in 50 hospitals from various health care sectors in Saudi Arabia. We followed patients for 1 month and 1 year after hospital discharge. Patients with AMI included those with or without ST-segment elevation (STEMI or NSTEMI, respectively). This program survey will be repeated every 5 years. RESULTS:Between May 2015 and January 2017, we enrolled 2233 patients with ACS (mean age was 56 [standard deviation = 13] years; 55.6% were Saudi citizens, 85.7% were men, and 65.9% had STEMI). Coronary artery disease risk factors were high; 52.7% had diabetes mellitus and 51.2% had hypertension. Emergency Medical Services (EMS) was utilized in only 5.2% of cases. Revascularization for patients with STEMI included thrombolytic therapy (29%), primary percutaneous coronary intervention (PCI); (42.5%), neither (29%), or a pharmaco-invasive approach (3%). Non-Saudis with STEMI were less likely to undergo primary PCI compared to Saudis (35.8% vs. 48.7%; respectively, p <0.001), and women were less likely than men to achieve a door-to-balloon time of <90 min (42% vs. 65%; respectively, p = 0.003). Around half of the patients with NSTEMI did not undergo a coronary angiogram. All-cause mortality rates were 4%, 5.8%, and 8.1%, in-hospital, at 1 month, and at 1 year, respectively. These rates were significantly higher in women than in men. CONCLUSIONS:There is an urgent need for primary prevention programs, improving the EMS infrastructure and utilization, and establishing organized ACS network programs. AMI care needs further improvement, particularly for women and non-Saudis