Patients’ and caregivers’ satisfaction with virtual wound care services in Saudi Arabia

We have read the paper by Cheryl Modica et al on Advancing Virtual at-Home Care for Community Health Center Patients Using Patient Self-Care Tools, Technology, and Education. 1 We congratulate all authors who provide interesting information regarding health services that use virtual models that integrate self-care tools and technologies. This is interesting because since the beginning of the COVID-19 pandemic, health centers have switched to a virtual service delivery model. Providing efficient, coordinated and high-quality services is important for the prevention and management of chronic disease conditions in patients. Virtual health services that use self-care tools and technology are an important model for increasing access to care for hard-to-reach patients. 2 The study conducted by Cheryl Modica et al aimed to explore the use of virtual care models, implemented using a systems approach and patient-driven tools and technologies, on clinical measurement performance and patient experience. 1 However, there are several obstacles that have arisen that can be caused by virtual care, including communities whose connectivity and access to technology is still limited and also concerns about primary health services, where there is a focus on relational continuity of services based on relationships between patients and health workers due to the widespread use of virtual services. 3 Therefore we must pay attention to several things before using a virtual care model including (1) the guiding principles needed for measuring virtual care; (2) best practices implemented to measure the quality of virtual services aligned with face-to-face frameworks; (3) Increasing the implementation of virtual services which have an impact on patient access and experience as well as the scale of measurement; (4) constraints and barriers faced by organizations in developing a quality virtual service framework; and (5) Application of virtual services in various patient cases. 4 The results of Cheryl Modica et al's study showed a statistically significant improvement in patients who completed the initial 4 virtual visits and reported decreased depression and increased satisfaction with virtual care visits compared to inperson visits. 1 However, healthcare professionals also need to evaluate the use of virtual visit platforms in primary care, examine patient and physician preferences for virtual communication methods, and report on visit characteristics and patient experience of care. Although there are concerns that virtual visits will be overused by patients, many virtual visits appear to be replacing in-person visits. This approach can improve access and continuity of primary health services. 5 In conclusion we agree that primary healthcare services that implement virtual care models with patient self-care tools, technology, and education, experience improvements in chronic condition prevention and patient recovery. 1 However, it is important to review how the use of virtual health services has evolved and ensure patients have access to the platform for a longer period of time. Therefore, further research is needed which must also focus on the use of administrative data to track the impact of virtual services on the use of face-to-face primary health services, emergency department visits and hospitalizations, as well as exploring how the use of virtual care impacts. 5

<h3>Context:</h3> The COVID-19 pandemic spurred the rapid implementation of virtual care – which can include video visits, telephone calls, remote monitoring, and asynchronous services – within primary care settings. Little is known about how virtual care will transform primary care delivery beyond the pandemic. <h3>Objective:</h3> Characterize future roles for virtual primary care. <h3>Study Design:</h3> Qualitative study using interviews with health care administrators. <h3>Setting:</h3> National sample of health care systems and primary care practices. <h3>Population studied:</h3> Administrators at 17 diverse health care systems and primary care practices. <h3>Outcome Measures:</h3> Future plans for virtual primary care. <h3>Results:</h3> Administrators discussed three broad areas for the future of virtual primary care. <h3>Optimizing services:</h3> Administrators realized that many medical services were appropriate for virtual primary care including care of some acute and chronic conditions as well as preventive health. For example, e-visits (where patients complete questionnaires and clinicians respond electronically) enable primary care teams to address common issues, such as urinary tract infections, in ways that reduce effort for both clinicians and patients. Several administrators thought that behavioral health visits are ideal for virtual primary care. <h3>Care coordination:</h3> Administrators were considering how virtual care can enhance coordination between primary care and specialists. For example, one primary care clinician reported attending specialist visits with patients. Other administrators described use virtual care for chronic care management and follow-up processes. <h3>Engaging patients:</h3> Administrators reported that virtual care could engage new patients and sustain existing relationships. Administrators hoped that virtual care would engage younger, healthier patients in preventive care. They also considered the Medicare Annual Wellness Visit as ideal for virtual visits, in part, because they enable clinicians to assess risks within the home. <h3>Barriers:</h3> Administrators expressed concerns about virtual care reimbursement and external competition. Sustained pay parity between virtual and in-person visits is needed to ensure financial viability of virtual care. Some worried how virtual care services provided by payers and technology companies could impact their revenue. <h3>Conclusions:</h3> Administrators are actively exploring ways to improve virtual primary care services.

The COVID-19 pandemic resulted in unprecedented adoption and implementation of virtual primary care services, and little is known about whether and how virtual care services will be provided after the pandemic ends. We aim to identify how administrators at health care organizations perceive the future of virtual primary care services. In March-April of 2021, we conducted semistructured qualitative phone interviews with administrators at 17 health care organizations that ranged from multi-state nonfederal delivery systems to single-site primary care practices. Organizations differed in size, structure, ownership, and geography. We explore how health care administrators anticipate their organization will offer virtual primary care services after the COVID-19 pandemic subsides. All interviewed administrators expected virtual primary care services to persist after the pandemic. We categorize expected impact of future virtual services as limited (n = 4); targeted to a narrow set of clinical encounters (n = 5); and a major shift in primary care delivery (n = 8). The underlying motivation expressed by administrators for providing virtual care services was to remain financially stable and competitive. This motivation can be seen in the 3 main goals described for their anticipated use of virtual services: (1) optimizing medical services; (2) enhancing the patient experience; and (3) increasing loyalty among patients. Health care organizations are considering how virtual primary care services can be used to improve patient outcomes, access to care, and convenience of care. To implement and sustain virtual primary care services, health care organizations will need long-term support from regulators and payers.

The COVID-19 pandemic prompted an abrupt shift in the delivery of community-based child and youth mental health services as virtual care was rapidly adopted. The objective of this study was to evaluate the sector-wide transition to virtual care across Ontario, with a focus on implementation facilitators and barriers. We used a multi-level mixed-methods design where agency leaders, service providers, and clients shared their experiences planning, implementing, and accessing virtual care. In total, 97 agency leaders, and 192 youth and family members responded to the surveys; 13 agency leaders, and 11 service providers participated in interviews or focus groups. Most agencies undertook a similar journey to implement virtual care. Stakeholders described common facilitators such as staff engagement, leadership support, and training activities. Barriers included internet connection issues, lack of resources, and privacy concerns. Service providers innovated as they implemented by partnering with agencies to meet clients' needs, using multiple platforms to engage clients, and altering session duration to reduce fatigue. Clients found virtual care easy to use, felt confident using it, and intend to continue accessing virtual care. Implementation of virtual care during the pandemic was complex and the evaluation involved obtaining perspectives at multiple levels. This research provides a blueprint for evaluations of the implementation of virtual mental health services, particularly in a child/youth context. Virtual care is a viable way to deliver mental health services, however, equity, accessibility, and appropriateness need to be addressed to ensure services are effective for children, youth, and their families. Academic literature suggests that using technology to deliver child and youth mental health services is a promising way to enhance access to care and improve engagement for many children and youth. Despite this, the provision of virtual child and youth mental health services in Ontario prior to the COVID-19 pandemic was limited. Efforts that did exist were largely focused on providing care to those in rural and remote areas. The COVID-19 pandemic prompted a rapid shift to virtual care, as most in-person mental health services were suspended. This paper presents new insight into how virtual mental health services were quickly established and used across Ontario from the perspectives of senior leaders, service providers, and clients. Results from this evaluation showed that agencies followed similar steps to prepare to use virtual services. Staff engagement, support from leadership, and opportunities for staff training supported the implementation of virtual care while internet connections issues, lack of resources (like computers or phones), and privacy and safety concerns hindered the implementation. Most youth and family members found virtual services easy to use and intend to continue using them. Most agencies intend to continue to offer virtual services post-pandemic but noted that it was not appropriate or accessible for all clients. This study provides a foundation for additional research to examine situations and conditions that are most conducive to virtual care delivery to address child and youth mental health concerns. These results may encourage agencies to rely more confidently on virtual services as another means to meet clients' needs and preferences.

Since the outbreak of COVID-19, the attention has now shifted towards universal vaccination to gracefully lift strict COVID-19 restrictions previously imposed to contain the spread of the disease. Sub-Saharan Africa is experiencing an exponential increase of infections and deaths coupled with vaccines shortages, personal protective equipment, weak health systems and COVID-19 emerging variants. Some developed countries integrated telemedicine to reduce the impacts of the shortage of healthcare professionals and potentially reduce the risk of exposure, ensuring easy delivery of quality health services while limiting regular physical contact and direct hospitalization. However, the adoption of telemedicine and telehealth is still nascent in many sub-Saharan Africa countries. Therefore, this study reflects on progress made towards the use of telemedicine, virtual health care services, challenges encountered, and proffers ways to address them. We conducted a systematic literature review to synthesise literature on telemedicine in sub-Saharan Africa. The study revealed that telemedicine provides unprecedented benefits such as improving efficiency, effective utilization of healthcare resources, forward triaging, prevention of medical personnel infection, aiding medical students' clinical observation and participation, and assurance of social support for patients. However, the absence of policy on virtual care and political will, cost of sustenance of virtual health care services, inadequate funding, technological and infrastructural barriers, patient and healthcare personnel bias on virtual care and cultural barriers are identified as limiting factors to the adoption of virtual health care in many African health systems. To alleviate some of these barriers, we recommend the development of robust policies and frameworks for virtual health care, the inclusion of virtual care in the medical school curriculum, supporting virtual care research and development, increasing health funding, removing monopolisation of telecommunication services, developing of virtual health solutions that address eccentricities of African health systems.

Background: The purpose of this scoping review was to map the challenges, strategies, and lessons learned from high-income countries that can be mobilized to inform decision-makers on how to best implement virtual primary care services during and after the COVID-19 pandemic. Findings of our scoping review identified the barriers and strategies within the Quadruple Aim components, which may prove to be an effective implementation strategy for virtual care adoption in primary care settings. Materials and Methods:The two concepts of virtual care and COVID-19 were searched in MEDLINE, EMBASE, and CINAHL on August 10, 2020, and Scopus was searched on August 15, 2020. The database searches returned 10,549 citations and an additional 766 citations were retrieved from searching the citations from the reference lists of articles that met all inclusion criteria. A total of 1,260 full-text articles were reviewed of which 38 articles met the eligibility criteria for inclusion in the review. Results: Seven key barriers and strategies were identified for the implementation of virtual primary care. Of the 38 articles included, the key barriers identified were equitable access to care (n = 20; 53%), lack of funding for virtual care (n = 14; 37%), negative patient and clinician perception (n = 11, 29%), lack of regulatory policies (n = 10, 26%), inadequate clinical workflows (n = 9, 21), lack of virtual care infrastructure (n = 8, 21%), and insufficient virtual care training and education (n = 5, 13%). Strategies included the following: increased funding (n = 15, 39%), improving clinical workflows (n = 13, 34%), appropriate education and training (n = 11, 29%), improving virtual care infrastructure and patient equity (n = 7, 18%), establishing regulatory policies (n = 5, 13%), and improving patient and clinician perceptions (n = 3, 7%). Conclusions: As many countries enter potential subsequent waves of the COVID-19 pandemic, applying early lessons learned to mitigate implementation barriers can help with the transition to equitable and appropriate virtual primary care services.

BackgroundThe rapid virtualization of health services during the COVID-19 pandemic has drawn increasing attention to the impact of virtual care technologies on health equity. In some circumstances, virtual care initiatives have been shown to increase health disparities, as individuals from underserved communities are less likely to benefit from such initiatives.ObjectiveThe purpose of this paper is to describe a protocol for a scoping review of reviews that aims to map review-level evidence that describes challenges and strategies for promoting effective engagement with virtual care technologies among underserved communities.MethodsOur methodology was adapted from seminal scoping review guidelines provided by Arksey and O’Malley, Levac at al, Colquhoun et al, and the Joanna Briggs Institute. Our search strategy was developed for the following databases: MEDLINE (on Ovid), EMBASE (on Ovid), CINAHL (on EBSCO), Scopus, and Epistemonikos. Supplementary searches will include the use of Google Scholar and reference tracking. Each citation will be independently screened by 2 researchers at the title and abstract level, and full-text screening will be performed in accordance with our eligibility criteria. The eligibility criteria focused on the inclusion of methods-driven reviews (ie, systematic reviews, scoping reviews, meta-analyses, realist reviews, and critical interpretative syntheses) to enhance rigor and quality. Other inclusion criteria included a focus on virtual care services that facilitate bidirectional patient-provider communication (ie, video, telephone, and asynchronous messaging visits) for underserved populations (ie, those who experience social disadvantage due to race, age, income, and other factors related to the social determinants of health).ResultsThis scoping review of reviews will provide a broad overview of identified challenges associated with the accessibility of virtual health care services among underserved communities. In addition, strategies for improving the access to, uptake of, and engagement with virtual care technologies among underserved communities will be identified. The knowledge synthesized from this review will aid in developing and implementing virtual services that acknowledge the unique needs of populations who experience barriers to care and disproportionately worse health outcomes. The results will also inform gaps in current research.ConclusionsThe rapid shift toward virtual health services has highlighted the urgent need to critically examine the intersection of virtual care and health equity. Although technology-driven innovations in health care generally aim to improve access, quality, and health outcomes, it is also possible for these innovations to produce intervention-generated inequities. Assessing current review-level evidence on the key challenges and strategies for improving the application of virtual care in underserved communities is imperative for ensuring that virtual care benefits all populations.International Registered Report Identifier (IRRID)PRR1-10.2196/22847

To understand patients' and carers' experiences of virtual medical care delivered into rural and remote hospitals. Qualitative study using semi-structured interviews. Interviews were conducted between 7 June 2022 and 21 February 2023. Participants were people who had received a virtual medical service from the Virtual Rural Generalist Service (VRGS), and their carers, in rural and remote hospitals within the Western NSW Local Health District. Acceptability of, access to, quality of and appropriateness of care provided by the VRGS. We interviewed 43 patients and carers about their experiences of VRGS services received in an emergency department or inpatient setting. About half of our participants thought that virtual medical care (supported by in-person nursing staff) was highly acceptable and equivalent to in-person care. For the remaining participants, virtual care was seen as being an acceptable alternative if in-person care was not available. Patients reported that the model met their immediate needs, even if the virtual delivery mode was not their preference. VRGS doctors were generally seen as skilled and personable, and acceptability of virtual care increased with more experience of it. A key perceived benefit of virtual care was increased access to medical care without the need to travel long distances. Hospital-based virtual care was not considered less appropriate for older adults or children. Virtual care in a rural hospital setting, such as that delivered by the VRGS, is broadly acceptable to patients and carers. While most would prefer to have a doctor physically present, patients and carers are accepting of the need for virtual care to supplement in-person care in rural and remote areas. Patients and carers who experience hospital-based virtual care perceive that it can provide good quality medical care and meet many of their needs.

Virtual pharmacist interventions on abuse of over-the-counter medications during COVID-19 versus traditional pharmacist interventions

Virtual care in Canada rapidly expanded during the COVID-19 pandemic in a low-rules environment in response to pressing needs for ongoing access to care amid public health restrictions. Emergency medicine specialists now face the challenge of advising on which virtual urgent care services ought to remain as part of comprehensive emergency care. Consideration must be given to safe, quality, and appropriate care as well as issues of equitable access, public demand, and sustainability (financial and otherwise). The aim of this project was to summarize current literature and expert opinion and formulate recommendations on the path forward for virtual care in emergency medicine. We formed a working group of emergency medicine physicians from across Canada working in a variety of practice settings. The virtual care working group conducted a scoping review of the literature and met monthly to discuss themes and develop recommendations. The final recommendations were circulated to stakeholders for input and subsequently presented at the 2023 Canadian Association of Emergency Physicians (CAEP) Academic Symposium for discussion, feedback, and refinement. The working group developed and reached unanimity on nine recommendations addressing the themes of system design, equity and accessibility, quality and patient safety, education and curriculum, financial models, and sustainability of virtual urgent care services in Canada. Virtual urgent care has become an established service in the Canadian health care system. Emergency medicine specialists are uniquely suited to provide leadership and guidance on the optimal delivery of these services to enhance and complement emergency care in Canada.

BackgroundIn response to the COVID-19 pandemic, older adults worldwide have increasingly received health care virtually, and health care organizations and professional bodies have indicated that virtual care is “here to stay.” As older adults are the highest users of the health care system, virtual care implementation can have a significant impact on them and may pose a need for additional support.ObjectiveThis research aims to understand older adults’ perspectives and experiences of virtual care during the pandemic.MethodsAs part of a larger study on older adults’ technology use during the pandemic, we conducted semistructured interviews with 20 diverse older Canadians (mean age 76.9 years, SD 6.5) at 2 points: summer of 2020 and winter/early spring of 2021. Participants were asked about their technology skills, experiences with virtual appointments, and perspectives on this type of care delivery. Interviews were digitally recorded and transcribed. A combination of team-based and framework analyses was used to interpret the data.ResultsParticipants described their experiences with both in-person and virtual care during the pandemic, including issues with accessing care and long gaps between appointments. Overall, participants were generally satisfied with the virtual care they received during the pandemic. Participants described the benefits of virtual care (eg, increased convenience, efficiency, and safety), the limitations of virtual care (eg, need for physical examination and touch, lack of nonverbal communication, difficulties using technology, and systemic barriers in access), and their perspectives on the future of virtual care. Half of our participants preferred a return to in-person care after the COVID-19 pandemic, while the other half preferred a combination of in-person and virtual services. Many participants who preferred to access in-person services were not opposed to virtual care options, as needed; however, they wanted virtual care as an option alongside in-person care. Participants emphasized a need for training and support to be meaningfully implemented to support both older adults and providers in using virtual care.ConclusionsOverall, our research identified both perceived benefits and perceived limitations of virtual care, and older adult participants emphasized their wish for a hybrid model of virtual care, in which virtual care is viewed as an addendum, not a replacement for in-person care. We recognize the limitations of our sample (small, not representative of all older Canadians, and more likely to use technology); this body of literature would greatly benefit from more research with older adults who do not/cannot use technology to receive care. Findings from this study can be mobilized as part of broader efforts to support older patients and providers engaged in virtual and in-person care, particularly post–COVID-19.

Background: Saudi Arabia has accelerated its comprehensive digital health transformation plan since 2021. Understanding physicians&amp;apos; exposure to telemedicine and their experiences is crucial. Objectives: This study aimed to explore the knowledge, attitude, perception, and satisfaction of physicians who have participated in telemedicine versus those without experience. Methods: This analytic cross-sectional study included physicians from both governmental and private healthcare institutions in Saudi Arabia, with and without previous exposure to telemedicine. Data was collected through a self-administered, electronically distributed coded questionnaire. Results: Among 402 physicians, only 150 [37.3%] were engaged in virtual care, predominantly from the government sector [76% vs. 24%, p &amp;lt; 0.001]. Physicians with virtual clinic experience demonstrated greater knowledge [70% vs. 41.23%; p &amp;lt; 0.001], a more positive attitude [57.33% vs. 35.71%; p &amp;lt; 0.001], a stronger inclination to recommend telemedicine [70.6% vs. 0%; p &amp;lt; 0.001], and fewer concerns about challenges and social unacceptability [72% vs. 60.32%; p = 0.002]. However, they expressed increased concerns regarding reduced personal interaction [36% vs. 26.2%; p = 0.038] and session recordings [36% vs. 26.2%; p = 0.038]. Overall, 65.33% of physicians were satisfied with virtual clinic services. Conclusion: Physician participation in virtual care in Saudi Arabia is limited, especially in the private sector. While exposure to telemedicine enhances confidence and acceptance, it does not fully alleviate concerns about confidentiality. Our findings suggest that further education and practice in telemedicine can improve acceptance and address challenges. More research is needed to explore long-term benefits and optimize telemedicine in Saudi Arabia.

COVID-19 dramatically changed the landscape, demanding an immediate widescale shift in how healthcare is provided. (State of New South Wales (NSW Agency for Clinical Innovation) 2021). This created an unparalleled opportunity to deliver improved outcomes and experiences for patients and the community through a Virtual Care service. The rapid onset and need for programs to be stood up quickly opened the door for an integrated and inclusive leadership model. Stepping away from traditional leadership structures of hierarchical medical and nursing models to an integrated leadership team inclusive of nursing, medical, social work, allied health, pharmacy, administrative and data teams has driven the success of the Virtual Care program and positively impacted patient outcomes. All members of the leadership team were at the centre of design, implementation, reviews &amp; adaptations, having a valued and meaningful seat at the table. Having an interdisciplinary lens for a complex health crisis led to advocating for patients and families to create an awareness of the psychosocial factors, issues and challenges that come with care delivered in a Virtual Care environment This integrated leadership team provided contemporary and agile patient centred care for all Tasmanians ensuring equitable health access across the State especially for those in rural and remote areas. The Virtual Care leadership team is a multidisciplinary team that values teamwork, engagement, and education, with a focus on developing a person-centred culture that integrates evidence based- care and involves all stakeholders. The team respects the different experiences and strengths of each team member, which enhances the service. The team have embraced virtual health care and are strong change champions, adapting to the needs of the community and can pivot and adapt to change without any restrictions. Integrating allied health leaders into previously medical and nursing dominated structures allows for improved innovation and integration. Stakeholder engagement within the primary care setting has been essential for success, as well as Government, Health Executive, Primary Care Networks, Acute Hospital &amp; Community Health support. Virtual Care continues to be successful in achieving desired outcomes. Patient Satisfaction survey results demonstrate consistently high scores since commencement. Demonstrating the service’s strength primarily lie in the way staff members interacts with patients. By enabling the Allied Health leads to have equal leadership within the team it allows a more cohesive and patient centred approach. Providing efficient and patient centred health services across Tasmania with equal accessibility no matter the location with a virtual integrated care team inclusive of allied health, pharmacy, medical and nursing teams. The Tasmanian Virtual Care program’s COVID@homeplus is a real-world example of how virtual care programs can respond seamlessly and agilely to new challenges whilst sustaining the satisfaction of its end users and community. The learnings from this are now being used in further expansion with shared leadership model and consumer engagement at the core of effective design.

IntroductionAs part of the COVID-19 pandemic response, the Ontario Ministry of Health funded a virtual care pilot program intended to support emergency department (ED) diversion of patients with low acuity complaints and reduce the need for face-to-face contact. The objective was to describe the demographic characteristics, outcomes and experience of patients using the provincial pilot program.MethodsThis was a prospective cohort study of patients using virtual care services provided by 14 ED-led pilot sites from December 2020 to September 2021. Patients who completed a virtual visit were invited by email to complete a standardized, 25-item online survey, which included questions related to satisfaction and patient-reported outcome measures.ResultsThere were 22,278 virtual visits. When patients were asked why they contacted virtual urgent care, of the 82.7% patients who had a primary care provider, 31.0% said they could not make a timely appointment with their family physician. Rash, fever, abdominal pain, and COVID-19 vaccine queries represented 30% of the presenting complaints. Of 19,613 patients with a known disposition, 12,910 (65.8%) were discharged home and 3,179 (16.2%) were referred to the ED. Of the 2,177 survey responses, 94% rated their overall experience as 8/10 or greater. More than 80% said they had answers to all the questions they had related to their health concern, believed they were able to manage the issue, had a plan they could follow, and knew what to do if the issue got worse or came back.ConclusionsMany presenting complaints were low acuity, and most patients had a primary care provider, but timely access was not available. Future work should focus on health equity to ensure virtual care is accessible to underserved populations. We question if virtual urgent care can be safely and more economically provided by non-emergency physicians.Supplementary InformationThe online version contains supplementary material available at 10.1007/s43678-022-00407-9.

Health care providers can use these virtual platforms for delivering medical advice and prescriptions to patients. This study was aimed to explore the patients' experiences and level of satisfaction regarding virtual health care received during the coronavirus disease-19 (COVID-19) pandemic. This study also assessed the before and during lockdown sleep quality in these participants. The current study included 522 participants from Saudi Arabia. Virtual health care satisfaction questionnaire was implemented to record the data on patient experience toward the virtual health care during COVID-19 pandemic. Patients expressed a high level of satisfaction with virtual health care services during the COVID-19 pandemic, as indicated by a mean score of 4.15 on a five-point Likert scale, which translates to an 83% satisfaction rate. Most participants felt they could communicate effectively with their doctors, appreciated the good picture and sound quality of their virtual appointments, and felt that their privacy was respected. Additionally, they reported comfort during history taking and examinations, and felt that doctors adequately explained solutions, including prescriptions and advice. Interestingly, the study found no significant association between the type of specialty or patient demographic factors and the level of satisfaction. In terms of sleep quality, a comparison of subjective sleep parameters before and during the lockdown revealed significant changes. The results from a t test indicated that mean scores for various sleep components: such as sleep duration, sleep disturbances, sleep latency, daytime dysfunction, habitual sleep efficiency, and subjective sleep quality, showed significant differences (P < .001) between the 2 assessment periods. Overall, the mean scores for these components increased, indicating a deterioration in sleep quality during the lockdown period. The study found that most participants were satisfied with the virtual health care system, noting its benefits in reducing overcrowding, care delays, and unnecessary in-person visits during pandemics. This increased accessibility could enhance patient satisfaction and lower costs, though it may not completely replace traditional hospital visits. The researchers recommend further studies with a larger, more diverse group to better understand patient experiences and improve telehealth services in Saudi Arabia. Overall, while the virtual system shows promise, more research is needed to optimize its use.