Head of CSC in SA`s healthcare vertical, Lorna Powe, explains why an electronic patient record (EPR) will save South African hospitals money - and lives - and why the South African government should introduce a national electronic health record (EHR).
Medical and IT professionals attending a CSC/Oracle Healthcare Open Session held in Cape Town and Johannesburg recently believe SA`s healthcare institutions could benefit from the introduction of an EPR.
Healthcare is one of SA`s largest and most important industries - both in terms of market size and growth. It`s a sector that is undergoing significant changes, facing increasing consumer demands and spiralling costs.
Powe believes the future health of the industry requires stronger partnerships between healthcare companies, regulators and product and service companies and the public health system.
"SA has a progressive healthcare industry. Several South African private healthcare companies are already providing their services to areas such as the Middle East, Africa and the UK, and others have international healthcare aspirations. The Competition Board is currently investigating the private industry because of price fixing via the Board of Healthcare Funders` (BHF) tariff setting. This will mean that private hospitals will have to be able to understand their cost base in order to negotiate with the medical schemes as this activity can no longer be undertaken via the BHF."
South Africans are early adopters of technology which makes SA an ideal market for the introduction of a national, centrally-held EHR, particularly in light of the changes taking place at the national and public level and with the legislation for Social Health Insurance, the new government medical scheme.
"An EHR would enable the government to better control the expenditure within the public sector, which is becoming increasingly important if government is to provide healthcare to all South Africans," says Powe.
"An EHR can prevent medical errors, enforce standards, improve staff efficiency, simplify record keeping, improve knowledge sharing and financial control and improve patient care. It is a system that puts together pieces of information about a patient in a unified and clinical way and then provides decision support from this information. It does this from the clinical process and not from the administrative process - this is a paradigm shift in the way of thinking for the healthcare industry. By capturing data at the clinical level, you are ensuring that the data is correct at the time of treatment by those who know what has happened."
EPRs installed in overseas hospitals have been found to save time, money and lives, and Powe hopes SA will follow the example of major hospitals and governments around the world that have installed sophisticated EPR and EHR systems. Danish hospital authorities have gone so far as to insist that all hospitals have an EPR by 2005.
Powe believes that in future, doctors, nurses and other clinicians will take on a more active advisory role, with the EPR providing information. Doctors will be able to provide the patient with better insight into the course of his or her own illness and the information will, in turn, allow the patient to assume more responsibility in the management of his/her illness. One of the benefits of this is the reduction of medical costs.
The EPR will have multiple, simultaneous users who investigate, decide, plan, prescribe, order and reason on the basis of the available data; it will be integrated with many other systems and will be able to record from equipment and humans.
Powe says the popularity of EPR is growing worldwide, largely thanks to the growth in need for better patient information and treatment. The Internet or World Wide Web is playing a part as it makes access to information easier and cheaper.
"Internet technologies not only allow us to link disparate IT systems but doctors and nurses, who are crucial to the success of any EPR, are familiar with this technology. The user-friendliness and convenience of this technology - plus technologies such as voice recognition and touch-screen technology -will go a long way towards encouraging medical staff to support and use an EPR. Even in SA, kiosks could be provided in rural areas or PCs installed in libraries to facilitate access to information."
The healthcare industry is also faced with an increase in consumer participation, a trend which is accommodated by the EPR and the Internet. "Patients can be encouraged to enter their details into a central health portal. This will save time and do away with the frustration of having to provide medical information each time they visit a new healthcare provider. For security and privacy reasons, access to information will be restricted, eg the patient will give permission for his or her details to be made available."
A central EPR, accessible via the Internet, will have the added benefit of improving communication between doctor and patient, says Powe. " For example, parents of a hospitalised child will be able to access their child`s medical records via the Internet, allowing the parents to monitor the child`s progress while at work."
So what will the healthcare service of the future look like? "We envisage a healthcare service of the future that is linked through communication and service-oriented IT systems which, by means of common standards and well-developed and reliable communication channels, enable exchange and retrieval of patient-related information anytime and anywhere, as required.
"An important aspect of the EPR is the necessity and ability to manage the data in order to produce information with which to manage the hospital as a business in the private sector and in the public sector to provide the information to be able to monitor and prevent illness."
Just what the doctor ordered!
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