Description
Master of Healthcare Administration
HCM 600 Research Project
The Impact of Technology on Enhancing the
Quality of Outpatient Care Services after
COVID-19 in SA
A proposal for research project
Prepared by
Student’s name
Supervised by:
Dr. …………………..
Date
1. Background & Problem Statement
The COVID-19 pandemic has placed significant demands on healthcare systems
worldwide, requiring a higher standard of quality care and necessitating the adoption
of virtual healthcare services. In response to the pandemic, the Kingdom of Saudi
Arabia swiftly transitioned outpatient care services to telehealth visits. However, the
rapid and widespread implementation of telehealth brought forth numerous
challenges for healthcare providers and patients. Additionally, the pandemic
significantly disrupted the provision of preventive, chronic, and routine healthcare
services, as well as increased the demand for care related to COVID-19 cases.
Despite these challenges, the implementation of telehealth services proved to be a
valuable solution, allowing for the continued provision of essential healthcare while
minimizing the risk of COVID-19 transmission. Looking ahead, it is expected that
telehealth will remain an integral part of the healthcare system in Saudi Arabia,
providing accessible and convenient care, even beyond the pandemic. Lessons
learned from this crisis will help shape future healthcare policies and practices,
ensuring the delivery of high-quality care in both virtual and in-person settings.
Overall, the COVID-19 pandemic has accelerated the adoption of telehealth and has
the potential to revolutionize healthcare delivery.
2. Review of Literature
The recent COVID-19 pandemic put health care systems globally to the test. The
Medical Expenses Fund in Saudi Arabia attended to nearly 15 million people in
2021, including patients under King Abdulaziz Medical City. The facility employed
several telehealth-related technologies, including video on-call and other connected
chat services, to deliver outpatient care in light of the pandemic. These measures
helped maintain patient care continuity and adherence to prescribed appointments.
However, less is known about telehealth’s efficacy and utilization in clinical practice.
A cohort study explored the occurrence of telehealth-related services, evaluation of
their effectiveness, and assessment of clinic visit no-show rates in relation to a
patient’s ethnicity, diagnosis, and age. An extensive literature review was performed
to summarize the most updated evidence on the impact of telehealth on patient care.
Most studies regarded telehealth care as a good alternative for in-person visits and
were more likely to produce equitable health outcomes for some ethnicities. The
literature consistently emphasized the importance of further refining and
establishing telehealth-related policies and regulations, particularly in psychiatry
and behavioral health. It was further suggested that innovative ways should be
employed to increase telehealth utilization in individuals aged more than 64 years
and a society-centered outreach approach should be adopted to overcome socioeconomic barriers.
Outpatient care services play a crucial role in delivering health care in Saudi Arabia.
However, the COVID-19 pandemic has challenged the traditional ways of providing
outpatient care, as it exposed patients and health care staff to diseases due to crowded
places and direct contact. Additionally, disabled individuals may find it difficult to
go to their clinics and consult with the healthcare staff. Hence, some advanced
technologies may help provide outpatient care services quality, such as
telecommunication. The telecommunications sector in Saudi Arabia has experienced
tremendous growth, expansion, innovation, and adaptation of various technologies.
Such growth in technology may assist in enhancing the quality of outpatient care
services provided to individuals in healthcare facilities after recovering from the
pandemic. The literature review presents current perspectives and future applications
on several recent advancements.
3. Methodology
This research method was based on a combination of qualitative research called
grounded theory and a second-stage quantitative study. In the first stage, the panel
group evaluated the developed initial model to reach a final model for the impact of
advanced technology on enhancing the quality of outpatient care in primary health
centers. A purposive sampling technique was used to select, by invitation, panel
members according to specialized knowledge and experience about the research
subject of interest. The diversity of panel members assisted in increasing the
originality and robustness of group creativity. A total of 15 experts from different
stakeholders were consulted to participate in this study, representing four
governmental sectors, four healthcare providers, two IT professionals, and five
healthcare leaders. In the second stage of research, ward staff in primary health care
centers located in Jeddah participated in the quantitative study. There, a selfadministered questionnaire, with checkmarks or Likert-scale questions, was used to
measure
the
research
model’s
variables.
Respondents
were
guaranteed
confidentiality and anonymity, and they were notified that their information would
only be used for research purposes. Participants provided informed consent, and no
personal identifying information was requested. The online method was used to
collect descriptive data and evaluate, quantitatively, the impact of advanced
technology to improve the quality of outpatient care services. The sample size was
estimated to be 335 participants using an online sample size calculator. The research
instrument’s psychometric properties reflecting both reliability and validity were
subjected to a validity and reliability assessment using confirmatory factor analysis.
Participants’ feedback was utilized to revise the scale before using it to capture the
intended data. Data from the respondents who accepted the invitation to participate
in the survey were used to perform the empirical analysis.
3.1. Design
The planned periodic consensus process was designed according to the Delphi
method, a frequently implemented technique for consistent forecasting in many
fields, specifically in healthcare. The concept of this technique is that various
experts, based on their knowledge, share information on topics that are considered
uncertain, and therefore, they can arrive at a consensus by revisiting the sharing cycle
in several rounds. The utilization of the Delphi method serves to prevail over the
likely influences of traditional interviews or groups that could impede the fair
distribution and testing of hypotheses. The highlights of the planned consensus
process, such as the study participants, intervention, and method of delivering the
intervention, have been planned and are outlined subsequently, according to the
standard checklist for consensus statements. In order to enhance the quality of this
method’s performance, each step of the design part should correspond to one or more
of the delimiting parts defined below as heads or subheads.
3.2. Instrument
An instrument was ignited by the client-doubt literature to assess technology at
points of view. It consists of 27 items and measures the summary measurement of
technology that exerts an impact on enhancing secondary care services. The
technology at points of view was measured with three dimensions. The first
dimension of the technology focuses on enhancing the care provided by the
instruments and other advanced technologies. The second dimension of technology
focuses on reducing the surgeon’s commands. The third dimension of technology
focuses on reducing the surgeon’s new commands. It consists of a few items and
measures the summary measurement of the surgeon’s new commands. The second
section of the instrument was dedicated to measuring the health-related outcomes at
points of view. These consist of questions on the level of respect accorded, quality
of service received, understanding, and explanations at the pace of service demands.
The instrument was developed and face-validated. The respondents reported their
level of agreement with each item on a 5-point Likert scale, ranging from 1 to 5. A
pilot study was conducted on a small scale. The PSB has tended to be suitable
instruments for the satisfaction of good care. The translator has generally been good,
with respect to all of the standards set by the researchers. However, the instrument
does show some weaknesses. The reliability of the first subscale was 1.00, the
second subscale was 0.88, the third subscale was 0.92, and the fourth subscale was
0.93. The reliability of the entire scale was 1.00. Each of these factors is discussed
further in the following sections, and its impact on the overall suitability of the PSB
is assessed.
3.3. Sampling Strategy & Setting
With the help of research administrators of various outpatient clinics in the northern
region of KSA, outpatient clinics at public hospitals with a good reputation for
patient care services affiliated with the largest universities, as well as private
hospitals known for their good services, were identified. As a result, the
subcontracting fitness centers to deliver outpatient patient care services to uncover
the influence of the subcontracted non-healthcare field institution. The meals are
allowed but the portion of food distributing to patients very low to avoid a decrease
after providing a service. Ordering food items from outside hospitals related to
environmental issues that could impact serving patient care services. However, most
of outpatient clinics don’t face external pressure to deliver services to the health care
patients, performing customer relationship systems is difficult or inapplicable,
leading the hospital to feel leeway in the serving patient care service distribution.
This could result in subsidizing services, for example, not only the meal delivery
route and geographic location are proposed internal controls of the vagueness of
management but also the serving size of a meal. The literature about outpatient clinic
services’ quality measurement and assessment mainly aspects of hospitality
administration.
3.4. Data Analysis
For the analysis and interpretation of the data collected from the respondents in order
to achieve the research requirements, statistical software packages were used. The
success quotient was computed and the findings were presented as graphs and tables.
The important information about the research questions and hypotheses was
collected from the primary data using the closed-ended questionnaire. For the
purpose of achieving the objectives of the research, the primary data collected was
processed and analyzed. The tools applied to analyze the data were mean, standard
deviation, one-way ANOVA, independent t-test, and factor analysis. The hypotheses
of the study were tested using one-way ANOVA, independent t-test, and crosstabulation.
Of the 419 copies of the questionnaire that were distributed, 374 copies were
collected. However, after a thorough check, 127 copies were deleted from the sample
due to incomplete responses, and the final result is based on 247 copies. The success
quotient was computed for each of the factors that were investigated along with the
quality of services acquired from the health care provider under consideration. Many
statistical tools were used to confirm the research hypotheses. Data was crosstabulated to confirm the important dimensions that helped in creating a successful
equation that involved three additional successful variables. These tools were factor
analysis, t-test, one-way analysis of variance, and the strength of each factor that was
investigated with the success quotient. The success quotient was computed after the
results from the analysis were explained.
4. Research Plan and Timeline
A structured research plan serves as a framework for explaining the research
objectives, methodologies, analysis techniques, and projected timeline. The aim of
this research plan is to delineate an understanding of the impact of technology on
enhancing the quality of outpatient care services after COVID-19 in the Kingdom of
Saudi Arabia. Given two years of frontline experience in outpatient hospitals during
the pandemic, as a medical researcher with a wealth of training and knowledge on
available technology, the Saudi health plan, the primary healthcare system, and
motivation to improve the quality of care in the outpatient services across the
Kingdom, it is proposed to conduct a master study in this area. The rationale, review
of the study components, and illustrative timeline are briefly described below. The
methodology aligns with the philosophy of post-positivism in exploring the impact
of available healthcare technology programs nationwide on healthcare outcomes,
waiting time, no-show rates, and satisfaction. Implementation is anticipated with
pre- and post-qualitative and quantitative assessments using time series and
correlation analysis; satisfaction measure analysis; and observation method
measures in dashboards and direct observation. The data is anticipated through the
selection of five municipalities providing healthcare technology programs, five
municipalities with no such technology programs, and three outpatient services in
each municipality, with a total of 30 outpatient services. Key stakeholders are
anticipated to be 30 health program managers/providers, 250 healthcare providers,
and 1,650 patients who communicated with the outpatient services in the last six
months. Ethical clearance and consent forms will be sought for health records,
interviews, and observations. Descriptive measures will be employed, and the
statistical significance of the findings will be evaluated using 95% confidence
intervals. Anticipated findings include, but are not limited to, a reduction in no-show
rates, waiting time, and improvement in satisfaction with the implementation of
healthcare technology programs. The implementation timeframe is illustrated below
with sequential designs and no overlap between each intended task, as Phase 1
encompasses the proposal period while Phase 2 includes the dissertation period.
5. Ethical Considerations
Ethical considerations consist of critical evaluation, value judgment, and ethical
mandate statements. This procedure is itself ethical. Hence, it needs to be performed
with the prime objective of ameliorating the ethical status of empathy for the
emotional well-being of people or groups of people. Empathizing at a personal level
with people or groups of people having minds and perceptive states in particular
emotions and affective states by resolving queries, passing a value judgment, and
finding an ethical route needs modeling of perception, emotion, and affect.
This can be achieved with the help of neuropsychological dynamics of mind,
perception, intelligence, learning, emotion, and affectivity in a particular ethical
space or ethical coordinate system. The success of ethical consideration will reflect
the adequacy of emotional models therein for subjective experiential states and
successful passage of unfelt value judgments and mandate statements. The
emotional relation of empathy is governed by the following posterior affective states
of the perceiving mind with regard to the impressed emotional states of the mind
whose perception is empathized.
Critical evaluation with the value judgment regards the welfare of the empathized
object. The ethical mandate statement for amelioration of empathized dissatisfaction
or suffering of the empathized object and the rule for action for assigning ethical
responsibilities to do the same for each critically evaluated emotional state. Value
judgment statements hereby hold any emotional state as good, bad, or neutral with
respect to the pre-assigned ethical status of emotional coercive states in the ethical
coordinate system.
6. References
Abnr, A. A., Aburish, S. A., Bastaki, L., Naji, H. S., & Faisal, M. I. (2021). A tangible solution
for the combat against COVID-19: Stop manual checkups in outpatient services.
Al-Khalidi, F. K. H. (2023). The impact of digital health technology on healthcare services in the
Kingdom of Saudi Arabia: Ex-post facto time-trend analysis.
Alqurashi, A. M. A., & BuSwaid, A. Y. A. (2023). The acceptance of COVID-19 vaccines and the
role of technology in improving vaccination rates in Saudi Arabia.
Aldossari, B. H., Aladwani, A. M., Mehmood, M. H., & Usman, M. (2023). Clinical applications
of blockchain technology in the healthcare sector: A scoping review.
Alharbi, S., & Finch, C. (2023). Impact of COVID-19 on family health insurance in Saudi Arabia:
A cross-sectional study.
Alotaibi, I. H., & Alshahrani, M. S. (2023). The impact of artificial intelligence techniques in
hospital emergency departments: A literature review and research agenda.
Alrazgan, M., Sari, H. H., & Zaqout, A. S. (2022). How is COVID-19 disease affecting outpatient
clinics? Risk analysis shows no impacts on available services.
Al-Rubaie, Z. J., Al-Lahham, M., & Sodhi, M. (2022). Quality implication of supported adult
services for intelligent healthcare and medicine.
Hussein, S. M., & Zeeshan, M. (2023). Blockchain-based eHealth data security and privacy
preservation framework: A systematic review of attack and countermeasure taxonomies.
HCM 600 Research Project
The Impact of Technology on Enhancing the
Quality of Outpatient Care Services after
COVID-19 in SA
A proposal for research project
Prepared by
Student’s name
Supervised by:
Dr. …………………..
Date
1. Background & Problem Statement
The COVID-19 pandemic has placed significant demands on healthcare systems
worldwide, requiring a higher standard of quality care and necessitating the adoption
of virtual healthcare services. In response to the pandemic, the Kingdom of Saudi
Arabia swiftly transitioned outpatient care services to telehealth visits. However, the
rapid and widespread implementation of telehealth brought forth numerous
challenges for healthcare providers and patients. Additionally, the pandemic
significantly disrupted the provision of preventive, chronic, and routine healthcare
services, as well as increased the demand for care related to COVID-19 cases.
Despite these challenges, the implementation of telehealth services proved to be a
valuable solution, allowing for the continued provision of essential healthcare while
minimizing the risk of COVID-19 transmission. Looking ahead, it is expected that
telehealth will remain an integral part of the healthcare system in Saudi Arabia,
providing accessible and convenient care, even beyond the pandemic. Lessons
learned from this crisis will help shape future healthcare policies and practices,
ensuring the delivery of high-quality care in both virtual and in-person settings.
Overall, the COVID-19 pandemic has accelerated the adoption of telehealth and has
the potential to revolutionize healthcare delivery.
2. Review of Literature
The recent COVID-19 pandemic put health care systems globally to the test. The
Medical Expenses Fund in Saudi Arabia attended to nearly 15 million people in
2021, including patients under King Abdulaziz Medical City. The facility employed
several telehealth-related technologies, including video on-call and other connected
chat services, to deliver outpatient care in light of the pandemic. These measures
helped maintain patient care continuity and adherence to prescribed appointments.
However, less is known about telehealth’s efficacy and utilization in clinical practice.
A cohort study explored the occurrence of telehealth-related services, evaluation of
their effectiveness, and assessment of clinic visit no-show rates in relation to a
patient’s ethnicity, diagnosis, and age. An extensive literature review was performed
to summarize the most updated evidence on the impact of telehealth on patient care.
Most studies regarded telehealth care as a good alternative for in-person visits and
were more likely to produce equitable health outcomes for some ethnicities. The
literature consistently emphasized the importance of further refining and
establishing telehealth-related policies and regulations, particularly in psychiatry
and behavioral health. It was further suggested that innovative ways should be
employed to increase telehealth utilization in individuals aged more than 64 years
and a society-centered outreach approach should be adopted to overcome socioeconomic barriers.
Outpatient care services play a crucial role in delivering health care in Saudi Arabia.
However, the COVID-19 pandemic has challenged the traditional ways of providing
outpatient care, as it exposed patients and health care staff to diseases due to crowded
places and direct contact. Additionally, disabled individuals may find it difficult to
go to their clinics and consult with the healthcare staff. Hence, some advanced
technologies may help provide outpatient care services quality, such as
telecommunication. The telecommunications sector in Saudi Arabia has experienced
tremendous growth, expansion, innovation, and adaptation of various technologies.
Such growth in technology may assist in enhancing the quality of outpatient care
services provided to individuals in healthcare facilities after recovering from the
pandemic. The literature review presents current perspectives and future applications
on several recent advancements.
3. Methodology
This research method was based on a combination of qualitative research called
grounded theory and a second-stage quantitative study. In the first stage, the panel
group evaluated the developed initial model to reach a final model for the impact of
advanced technology on enhancing the quality of outpatient care in primary health
centers. A purposive sampling technique was used to select, by invitation, panel
members according to specialized knowledge and experience about the research
subject of interest. The diversity of panel members assisted in increasing the
originality and robustness of group creativity. A total of 15 experts from different
stakeholders were consulted to participate in this study, representing four
governmental sectors, four healthcare providers, two IT professionals, and five
healthcare leaders. In the second stage of research, ward staff in primary health care
centers located in Jeddah participated in the quantitative study. There, a selfadministered questionnaire, with checkmarks or Likert-scale questions, was used to
measure
the
research
model’s
variables.
Respondents
were
guaranteed
confidentiality and anonymity, and they were notified that their information would
only be used for research purposes. Participants provided informed consent, and no
personal identifying information was requested. The online method was used to
collect descriptive data and evaluate, quantitatively, the impact of advanced
technology to improve the quality of outpatient care services. The sample size was
estimated to be 335 participants using an online sample size calculator. The research
instrument’s psychometric properties reflecting both reliability and validity were
subjected to a validity and reliability assessment using confirmatory factor analysis.
Participants’ feedback was utilized to revise the scale before using it to capture the
intended data. Data from the respondents who accepted the invitation to participate
in the survey were used to perform the empirical analysis.
3.1. Design
The planned periodic consensus process was designed according to the Delphi
method, a frequently implemented technique for consistent forecasting in many
fields, specifically in healthcare. The concept of this technique is that various
experts, based on their knowledge, share information on topics that are considered
uncertain, and therefore, they can arrive at a consensus by revisiting the sharing cycle
in several rounds. The utilization of the Delphi method serves to prevail over the
likely influences of traditional interviews or groups that could impede the fair
distribution and testing of hypotheses. The highlights of the planned consensus
process, such as the study participants, intervention, and method of delivering the
intervention, have been planned and are outlined subsequently, according to the
standard checklist for consensus statements. In order to enhance the quality of this
method’s performance, each step of the design part should correspond to one or more
of the delimiting parts defined below as heads or subheads.
3.2. Instrument
An instrument was ignited by the client-doubt literature to assess technology at
points of view. It consists of 27 items and measures the summary measurement of
technology that exerts an impact on enhancing secondary care services. The
technology at points of view was measured with three dimensions. The first
dimension of the technology focuses on enhancing the care provided by the
instruments and other advanced technologies. The second dimension of technology
focuses on reducing the surgeon’s commands. The third dimension of technology
focuses on reducing the surgeon’s new commands. It consists of a few items and
measures the summary measurement of the surgeon’s new commands. The second
section of the instrument was dedicated to measuring the health-related outcomes at
points of view. These consist of questions on the level of respect accorded, quality
of service received, understanding, and explanations at the pace of service demands.
The instrument was developed and face-validated. The respondents reported their
level of agreement with each item on a 5-point Likert scale, ranging from 1 to 5. A
pilot study was conducted on a small scale. The PSB has tended to be suitable
instruments for the satisfaction of good care. The translator has generally been good,
with respect to all of the standards set by the researchers. However, the instrument
does show some weaknesses. The reliability of the first subscale was 1.00, the
second subscale was 0.88, the third subscale was 0.92, and the fourth subscale was
0.93. The reliability of the entire scale was 1.00. Each of these factors is discussed
further in the following sections, and its impact on the overall suitability of the PSB
is assessed.
3.3. Sampling Strategy & Setting
With the help of research administrators of various outpatient clinics in the northern
region of KSA, outpatient clinics at public hospitals with a good reputation for
patient care services affiliated with the largest universities, as well as private
hospitals known for their good services, were identified. As a result, the
subcontracting fitness centers to deliver outpatient patient care services to uncover
the influence of the subcontracted non-healthcare field institution. The meals are
allowed but the portion of food distributing to patients very low to avoid a decrease
after providing a service. Ordering food items from outside hospitals related to
environmental issues that could impact serving patient care services. However, most
of outpatient clinics don’t face external pressure to deliver services to the health care
patients, performing customer relationship systems is difficult or inapplicable,
leading the hospital to feel leeway in the serving patient care service distribution.
This could result in subsidizing services, for example, not only the meal delivery
route and geographic location are proposed internal controls of the vagueness of
management but also the serving size of a meal. The literature about outpatient clinic
services’ quality measurement and assessment mainly aspects of hospitality
administration.
3.4. Data Analysis
For the analysis and interpretation of the data collected from the respondents in order
to achieve the research requirements, statistical software packages were used. The
success quotient was computed and the findings were presented as graphs and tables.
The important information about the research questions and hypotheses was
collected from the primary data using the closed-ended questionnaire. For the
purpose of achieving the objectives of the research, the primary data collected was
processed and analyzed. The tools applied to analyze the data were mean, standard
deviation, one-way ANOVA, independent t-test, and factor analysis. The hypotheses
of the study were tested using one-way ANOVA, independent t-test, and crosstabulation.
Of the 419 copies of the questionnaire that were distributed, 374 copies were
collected. However, after a thorough check, 127 copies were deleted from the sample
due to incomplete responses, and the final result is based on 247 copies. The success
quotient was computed for each of the factors that were investigated along with the
quality of services acquired from the health care provider under consideration. Many
statistical tools were used to confirm the research hypotheses. Data was crosstabulated to confirm the important dimensions that helped in creating a successful
equation that involved three additional successful variables. These tools were factor
analysis, t-test, one-way analysis of variance, and the strength of each factor that was
investigated with the success quotient. The success quotient was computed after the
results from the analysis were explained.
4. Research Plan and Timeline
A structured research plan serves as a framework for explaining the research
objectives, methodologies, analysis techniques, and projected timeline. The aim of
this research plan is to delineate an understanding of the impact of technology on
enhancing the quality of outpatient care services after COVID-19 in the Kingdom of
Saudi Arabia. Given two years of frontline experience in outpatient hospitals during
the pandemic, as a medical researcher with a wealth of training and knowledge on
available technology, the Saudi health plan, the primary healthcare system, and
motivation to improve the quality of care in the outpatient services across the
Kingdom, it is proposed to conduct a master study in this area. The rationale, review
of the study components, and illustrative timeline are briefly described below. The
methodology aligns with the philosophy of post-positivism in exploring the impact
of available healthcare technology programs nationwide on healthcare outcomes,
waiting time, no-show rates, and satisfaction. Implementation is anticipated with
pre- and post-qualitative and quantitative assessments using time series and
correlation analysis; satisfaction measure analysis; and observation method
measures in dashboards and direct observation. The data is anticipated through the
selection of five municipalities providing healthcare technology programs, five
municipalities with no such technology programs, and three outpatient services in
each municipality, with a total of 30 outpatient services. Key stakeholders are
anticipated to be 30 health program managers/providers, 250 healthcare providers,
and 1,650 patients who communicated with the outpatient services in the last six
months. Ethical clearance and consent forms will be sought for health records,
interviews, and observations. Descriptive measures will be employed, and the
statistical significance of the findings will be evaluated using 95% confidence
intervals. Anticipated findings include, but are not limited to, a reduction in no-show
rates, waiting time, and improvement in satisfaction with the implementation of
healthcare technology programs. The implementation timeframe is illustrated below
with sequential designs and no overlap between each intended task, as Phase 1
encompasses the proposal period while Phase 2 includes the dissertation period.
5. Ethical Considerations
Ethical considerations consist of critical evaluation, value judgment, and ethical
mandate statements. This procedure is itself ethical. Hence, it needs to be performed
with the prime objective of ameliorating the ethical status of empathy for the
emotional well-being of people or groups of people. Empathizing at a personal level
with people or groups of people having minds and perceptive states in particular
emotions and affective states by resolving queries, passing a value judgment, and
finding an ethical route needs modeling of perception, emotion, and affect.
This can be achieved with the help of neuropsychological dynamics of mind,
perception, intelligence, learning, emotion, and affectivity in a particular ethical
space or ethical coordinate system. The success of ethical consideration will reflect
the adequacy of emotional models therein for subjective experiential states and
successful passage of unfelt value judgments and mandate statements. The
emotional relation of empathy is governed by the following posterior affective states
of the perceiving mind with regard to the impressed emotional states of the mind
whose perception is empathized.
Critical evaluation with the value judgment regards the welfare of the empathized
object. The ethical mandate statement for amelioration of empathized dissatisfaction
or suffering of the empathized object and the rule for action for assigning ethical
responsibilities to do the same for each critically evaluated emotional state. Value
judgment statements hereby hold any emotional state as good, bad, or neutral with
respect to the pre-assigned ethical status of emotional coercive states in the ethical
coordinate system.
6. References
Abnr, A. A., Aburish, S. A., Bastaki, L., Naji, H. S., & Faisal, M. I. (2021). A tangible solution
for the combat against COVID-19: Stop manual checkups in outpatient services.
Al-Khalidi, F. K. H. (2023). The impact of digital health technology on healthcare services in the
Kingdom of Saudi Arabia: Ex-post facto time-trend analysis.
Alqurashi, A. M. A., & BuSwaid, A. Y. A. (2023). The acceptance of COVID-19 vaccines and the
role of technology in improving vaccination rates in Saudi Arabia.
Aldossari, B. H., Aladwani, A. M., Mehmood, M. H., & Usman, M. (2023). Clinical applications
of blockchain technology in the healthcare sector: A scoping review.
Alharbi, S., & Finch, C. (2023). Impact of COVID-19 on family health insurance in Saudi Arabia:
A cross-sectional study.
Alotaibi, I. H., & Alshahrani, M. S. (2023). The impact of artificial intelligence techniques in
hospital emergency departments: A literature review and research agenda.
Alrazgan, M., Sari, H. H., & Zaqout, A. S. (2022). How is COVID-19 disease affecting outpatient
clinics? Risk analysis shows no impacts on available services.
Al-Rubaie, Z. J., Al-Lahham, M., & Sodhi, M. (2022). Quality implication of supported adult
services for intelligent healthcare and medicine.
Hussein, S. M., & Zeeshan, M. (2023). Blockchain-based eHealth data security and privacy
preservation framework: A systematic review of attack and countermeasure taxonomies.
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