The development of an integrated Health Information System (HIS) is key to the implementation of the National Health Insurance (NHI) scheme, says the Department of Health.
Deputy health minister Molefi Sefularo says the department will prioritise its ICT projects as a means of achieving its service delivery goals.
"The successful implementation of the NHI will need a very strong ICT infrastructure. It is, therefore, paramount that an Integrated National Health Information System, which will cater for all service providers, public and private, is developed as part of an e-health strategy," he says.
SA has embarked on a process of developing a national Electronic Health Record (EHR) for all patients in public hospitals. An electronic health record is a database of patient health information, which will include demographics, vital signs, medical history, medications, procedures, laboratory data and radiology reports.
The State IT Agency and the department will establish the requirements for implementing an EHR.
Sefularo noted the current fragmented HIS sub-systems would be integrated into a single, national HIS. The department would focus on establishing an integrated national data warehouse for all data sources and tracking of human resources, equipment, physical status of facilities and expenditure.
"We have prioritised the improvement of service delivery in our hospitals. Along with this increased attention to technology, there shall be emphasis on the appropriate maintenance training. We shall collaborate with other role players, including academic, research, donor and non-governmental organisations in this regard," he adds.
Ownership issues
The Presidential National Commission on Information Society and Development says it is crucial to consider the privacy and confidentiality of individuals` health records, before embarking on the implementation of the EHR system. The body notes that, to share patient data across different systems, the system requires approved standards by a recognised body that provides rules and guidelines.
"One should make sure that all the necessary legislative requirements are in place to avoid any litigation. The issue of ownership of the health record must also be clearly stated," it notes.
The commission adds it is important to ensure there is adequate infrastructure to transmit medical information across the health network.
"The challenge in the Department of Health is that all hospitals are connected with minimum bandwidth of 64k to carry out administrative functions like BAS, Logis and Persal. This bandwidth is inadequate to carry clinical data," it states.
Computer access is also required to use an electronic health record system, and a sufficient number of workstations, laptops or other mobile computers must be available, said the commission. EHR software should also be capable of interfacing with the transversal systems.
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