National Department of Health: Patient Information System Assessment Programme

Introduction

The Patient Information System Assessment programme, funded by the National Department of Health (NDoH), spanned three years, and aimed to establish a foundation for transitioning South Africa towards nationalised healthcare. A strategic partnership was formed between the NDoH and the CSIR to assess the technical landscape and readiness of all nine provinces for a standardised model of exchanging patient information across primary, secondary, and tertiary healthcare institutions.

Challenge

South Africa's healthcare system faced significant challenges at all governmental levels, with funding abuses and inadequate technical consultation adversely affecting healthcare delivery. These issues particularly impacted disadvantaged and rural citizens who required medical attention. The proliferation of multiple, ill-suited healthcare platforms further complicated service delivery.

Objectives

The initiative's key objectives were to define a national standard for the secure exchange of patient health information owned by the government and to evaluate all healthcare platforms currently in use across provinces. The evaluation focused on each platform's compliance with the national technical blueprint, its functionality in supporting healthcare services, and its capability for secure information sharing that preserves patient confidentiality and privacy.

Implementation

Implementing the programme involved defining a national assessment framework segmented by province. This required extensive data gathering from government health databases and the use of evaluation questionnaires with inputs from a diverse range of stakeholders, including government officials and platform vendors. The programme team conducted site visits to validate responses and interviews with personnel. A comprehensive data analysis was then performed to present an AS-IS view of the healthcare landscape, alongside an examination of the technical capabilities of each platform and a total cost of ownership exercise.

Importantly, change management practices were applied throughout this process to facilitate the transition for health departments. This involved engaging with stakeholders at all levels to communicate the vision for change, addressing concerns, and ensuring that staff were adequately trained and supported during the implementation. The emphasis on transparent communication and active participation helped to foster a culture of acceptance and readiness for the reforms.

In addition, extensive workshops were conducted with select healthcare workers to help define the healthcare delivery processes and identify gaps or efficiency improvements that technical innovation or automation could address. These workshops facilitated valuable discussions that informed both the assessment framework and the potential solutions to enhance healthcare delivery.

Insights were ultimately reported to the National Health Council to guide the journey toward National Health Insurance for the country.

Results and Benefits

The programme revealed that over 100 healthcare platforms existed across the country, resulting in wasteful expenditure. It showed that approximately 20% of these platforms could satisfy all objectives for national health insurance and support standardised patient information exchange. After ratification at the national level, actions would be tailored to provincial and local governments to provide necessary support for the new mandate, incorporating ongoing change management strategies to ensure effective implementation.

Additional benefits included the development of proof-of-concept pilot projects showcasing national patient information exchange and the establishment of innovation labs for vendor platform certification.

Conclusion

The programme represented a significant achievement in becoming a true partner to the government in enhancing the lives of South African citizens for generations to come. It also demonstrated the effective development and application of technologies within the South African context, paving the way for a more integrated, efficient, and patient-centred healthcare system. The successful application of change management principles, along with the proactive engagement of healthcare workers, further ensured that staff and departments were prepared for the transformations necessary to implement a nationalised healthcare model.