Strengthening Telemedicine in Saudi Arabia: A Systematic Review of Nursing, Radiology, Health Administration, and Public Health Roles in Governance and Quality

Abstract

Background: Telemedicine has rapidly evolved as a critical component of healthcare delivery in Saudi Arabia, supporting national healthcare transformation and digital health expansion. Nursing, radiology, health administration, and public health services represent essential pillars in ensuring the effectiveness, quality, and safety of virtual healthcare. However, the extent and quality of their roles in governance and system strengthening within telemedicine remain underexplored.

Objective: This systematic review aimed to identify, evaluate, and synthesize existing evidence related to the roles of nursing, radiology, health administration, and public health in enhancing governance, quality of care, and patient safety within telemedicine services in Saudi Arabia.

Methods: A systematic search was conducted following PRISMA guidelines across major scientific databases, including PubMed, Scopus, Web of Science, and CINAHL. The search yielded more than 1,000 articles during initial screening. After applying predefined inclusion and exclusion criteria, removing duplicates, and performing full-text assessments, a final set of eligible studies was included for qualitative synthesis. Data extraction focused on governance practices, quality performance, competency requirements, interdisciplinary collaboration, and public health administration in telemedicine.

Results: The included studies highlighted a growing integration of nursing, radiology, health administration, and public health professionals within virtual care pathways, primarily in teleradiology reporting, remote patient monitoring, clinical decision support, patient experience management, and administrative oversight. Key contributions were observed in establishing quality standards, ensuring workflow safety, optimizing communication, supporting clinical governance structures, and integrating public health considerations. Despite these advancements, gaps remain in competency development, regulatory alignment, and unified national standards for telemedicine practice.

Conclusion: Nursing, radiology, health administration, and public health play pivotal roles in strengthening telemedicine governance and enhancing patient safety and care quality in Saudi Arabia. Continued investment in workforce upskilling, standardized telemedicine protocols, integrated administrative systems, and public health frameworks is essential to maximize the impact of virtual healthcare services and support Vision 2030 digital health goals.