Table 1

- Major challenges hindering the successful implementation of telemedicine programs and virtual neurology clinics in Saudi Arabia

Some patients live in rural areas with no or limited access to the internet or mobile devices, which makes communication difficult and almost impossible in some cases
Due to cultural reasons, some female patients do not accept virtual neurology clinics and prefer face-to-face in-person clinic visits in the presence of their relatives
Some patients, whether men or women, are not willing to be treated with telemedicine for various personal reasons
Some patients may have cognitive, visual, or hearing impairments, which may hinder direct-to-patient telehealth encounters
Other challenges include a lack of regulations, approved strategies, and plans for implementing telemedicine as well as a lack of availability of adequate experts to operate and maintain telemedicine programs
Some stakeholders may be unwilling to make the required modifications to healthcare processes and bylaws beyond the COVID-19 crisis
Healthcare personnel cannot access electronic medical records from areas outside the hospital for unconvincing reasons such as patient confidentiality. Thus, patient history, laboratory work, and radiology are inaccessible at night during medical consultations, and the patient cannot be interviewed for emergency conditions
Telemedicine is not part of any policy, mission, vision, or needs in most Saudi hospitals. Ensuring the conformity of these aspects with telemedicine is mandatory
Some Saudi hospitals are not equipped with advanced health informatics including electronic medical records, which hinders the application of telemedicine
There are limitations regarding neurological examination and difficulties in performing specific examination maneuvers that require on-site assistance or special equipment
Telemedicine is not part of the undergraduate medical college curriculum or postgraduate residency training programs