E-health framework completed

Johannesburg, 28 Aug 2007

The bones of the e-health record system have been set up.

The national health department says it has developed a framework electronic health record system for SA, and it is now up to the individual provinces to enter patient data into the medical database.

The system is part of government's e-health strategy and seeks to capture citizens' medical information from birth to death.

National Health Information System (NHIS) director Dr Shaheen Khotu says the framework is complete and ready for use. "There is no need for proof of concept of anything; we've demonstrated that it works."

Khotu says the data of more than a million patients from the Western Cape has already been fed into the database.

"It is now up to the national health department to facilitate the establishment, implementation and maintenance of the record by provincial departments, district health councils, municipalities and the private health sector." Provinces must also establish committees to implement the record transfer, he adds.

Khotu says e-health initiatives enjoy the enthusiastic support of hospital information system teams (Clinicom) and managers.

The custom-built software is also closely tuned to user needs. As a result, there is strong support for the record, he says, which will move hospitals away from paper-based systems that are prone to loss and other problems associated with non-IT systems.

Political sacking

Khotu's comments come after a health ministry spokesman said former deputy health minister Nozizwe Madlala-Routledge was sacked in part for her alleged failure to produce a health IT policy.

Sibani Mngadi, health minister Manto Tshabalala-Msimang's spokesman, told the Sunday Times earlier this month that Madlala-Routledge was assigned to deal with health technologies, laboratories and government mortuaries, but showed slow progress in these fields.

Democratic Alliance health spokesman Mike Waters said in response that the fault, if any, could probably not be laid at Madlala-Routledge's door. "The claim that the deputy minister had not performed in relation to the implementation of the NHIS is hard to substantiate, given that the deputy minister's position is not mentioned at all in relation to this programme on the health department's Web site," Waters said.

"One can only presume that this is yet another effort to pin a tag of non-performance onto the deputy minister to justify what was clearly a politically-motivated sacking," he added at the time.

Linking private, public sectors

The NHIS is intended to provide the country with an overall patient information system, linking the private and public sector at local, district, provincial and national level. The public sector alone includes 369 general and 54 specialised hospitals, as well as 3 143 clinics and a number of support institutions such as medical laboratories.

The project was conceived about a decade ago, following what was billed as a "major review" of the then-existing systems for handling health information. The review recommended that priority be given to information systems related to disease surveillance and facility management.

The NHIS was developed with a view to introducing technological innovations in various aspects of healthcare, including:

* A registration system for information on births, deaths and diseases.
* A telemedicine system for hospitals (involving the use of technology to give assistance to doctors and nurses in inaccessible areas).
* A system for recording regional variations in disease management and disease-occurrence.