The South African healthcare arena will never realise the true benefits of information and communications technology without a major unified initiative from within its own ranks, both public and private, to hammer out the definition of a strategic IT solution for the industry as a whole.
Until such time, individual IT service providers will continue to create fanfares around their proposed healthcare solutions, be they network backbones, portals or databases, without any real progress or sign of a real solution on the ground. This is the view of Richard Firth chairman of MIP Holdings, a leading systems provider in the healthcare arena.
Firth argues that the South African healthcare arena is too fragmented and unbalanced right now to focus on the interests of the country as a whole. "The healthcare industry is decentralised at a hospital level, pharmacy level, drug processing level and medical fund level. Small groups of healthcare service providers look no further than their own patients and profits when considering their IT infrastructure. IT service providers mirror their behaviour by presenting limited scenario solutions," he says.
In the meantime an equally unbalanced and fragmented customer base demands delivery. On the one hand there is the majority of South Africans still trapped in the third world environment, awaiting the benefits promised by reformed medical legislation," says Firth. "On the other there is the small previously-advantaged group who take medical aid schemes for granted and expect first world medical care on demand.
"With even the best intentions healthcare service providers are struggling to find creative ways to deliver to these expectations in a financially challenging climate. Meanwhile the IT industry does nothing to allay the pressure, but rather adds to the problem by sitting on the sidelines and watching for profitable opportunities.
"At the end of the day, a solution cannot be imposed on the industry. Healthcare will have to buy into any broad spectrum IT solution proposed from outside," says Firth. "Even if a service provider were to come up with a brilliant solution, healthcare would need to consider whose interests would be served if a single IT service provider were to take ownership of the total healthcare arena. Far better for healthcare to sit down around a table and hammer out its own solution to be chopped up and outsourced across a variety of service providers.
"Many argue that healthcare delivery stands and falls on the availability of funds. A forum would find an appropriate IT solution to provide cost-effective healthcare delivery across the board. Surely, if a truly visionary solution were to come out of such a forum, creative funding solutions could be found to make it a reality?"
Firth argues that healthcare is in exactly the same boat as education from the point of view that you get what you give. That just as SA`s true potential cannot be realised without a well-educated population, it cannot be reached without a healthy population. "Does it really have to be spelt out that we are facing a crisis in the health arena as well?" asks Firth.
"It is incumbent upon the government to spearhead consultation and participation by the various interest groups and stakeholders in healthcare to put together a strategy which would include the dynamic use of information and communication technology to streamline processes and realise delivery. Strong leadership from within healthcare would also be needed to bind all the disparate parties into an agreement. "Right now there is an impasse, partly because of the lack of an electronic data exchange (EDE) standard and partly because private enterprise is nibbling only at the bits its considers profitable.
"While the calendar heralds the beginning of a new millennium, the birth of the Internet and the convergence of technologies promise consequences we cannot yet predict.
"One thing is clear, technological innovations that came painfully slowly to us over the past two thousand years, and then started to speed up rapidly in the past centuries, have been the underlying cause of the rebirth of democracy. Democratisation has in turn fed technological growth by delivering educated people and funds for more research and development. In other words the rate of development and progress is now directly influenced by the quality of the democratic structures behind it. This principle applies in South Africa as much as anywhere else.
"So by not considering a total democratic solution in regard to a specific service area, such as healthcare, you weaken the entire healthcare structure and the country`s long-term potential," says Firth.
"We also need to take cognisance of the threat of globalisation. Will the international service providers take on the guise of Mother Theresa when they enter the fray here or will they cherry pick and deliver the final blow to the delicate fragment of our present healthcare system? A unified system would offer the ultimate protection. The jumble of non-profitable, ineffectual, wasteful operations we have now can change with the right initiative and the right leadership."
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