Other than making healthcare services more affordable for all South African citizens, a key reason behind the impending National Health Insurance (NHI) is to ensure cradle-to-grave continuity of care. This requires interoperable eHealth systems to ensure patient health information can be exchanged seamlessly, with the patient’s consent, between disparate electronic health record systems (EHRs).
Globally there has been a rapid increase in EHR adoption to replace legacy paper-based systems, which are fraught with inconsistencies, duplications and missing or incomplete data entries. However, because EHRs were developed as tools to solely coordinate patient care within a healthcare facility, the majority of systems lack an interoperability layer and are therefore unable to interface with each other or exchange patient health data in an efficient way.
Even though the South African eHealth industry is still in its infancy phase it isn’t immune to interoperability challenges. For NHI to be successful, the South African healthcare industry needs to bridge the gap between data silos in both the public and private sector. To do this, the industry as a whole has to overcome the barriers of technical variations of systems, resistance from vendors to interoperability and lack of incentives to develop interoperability.
The key to achieving interoperability in eHealth systems is through standardisation, which defines the language, structure and data types required for seamless integration. In 2012 the Department of Health (DoH) released the South African eHealth strategy, which highlights the need for standards for interoperability to improve the efficiency of clinical care, produce the indicators required by management and facilitate patient mobility.
Two years later an official follow up document, the National Health Normative Standards Framework (HNSF) for Interoperability in eHealth in South Africa, was released jointly by the DoH and the Council for Scientific and Industrial Research (CSIR). The HNSF prescribes the requirements for the use and exchange of digital data to support healthcare in order to optimise healthcare delivery, research and education.
While the HNSF has received global recognition for its content and overall vision for the way forward, it only addresses a part of the problem of the large, complex issue of interoperability. According to Manager of Architecture and Standards at GE Healthcare and keynote speaker at eHealthALIVE2016, Charles Parisot, the DoH needs to enforce those guidelines outlined in the HNSF and ensure the interoperability specifications can be used to solve real healthcare issues.
“Without a guiding national body, stakeholders feel distanced from the end goal and therefore, not responsible for the overall complexity of delivering interoperability. Stakeholders need to be brought into a collaborative process with the understanding that no one group will drive the process, but rather contribute to the process in an organised way. The government must be the orchestrator and this is critical to making interoperability happen,” said Parisot.
Parisot also believes that African countries would benefit from reusing existing specifications, policies and testing tools not only to achieve interoperability but to reduce the need to invest excessively in their eHealth programme and to reduce overall risk.
The Integrating the Healthcare Enterprise (IHE) integration profiles have been extensively referenced in the HNSF, so it’s essential for South African and other African eHealth organisations to fully understand and engage with the organisation to ensure beneficial collaboration in developing eHealth interoperability standards.
Parisot, who is a representative of IHE, will be hosting a two-part Interoperability Masterclass at eHealthALIVE2016 to give delegates the practical tools they need to develop and implement strong interoperability strategies. The South African Healthcare Informatics Association (SAHIA), a longstanding proponent of the benefits of efficient information management in healthcare and a member of the IHE, as well as an official sponsor of eHealthALIVE2016, will be leading an interactive Q&A session as part of the two-part Interoperability Masterclass where the audience is invited to pose questions about how to best achieve interoperability within the local context.
eHealthALIVE2016 is an inaugural joint initiative between the African Centre for eHealth Excellence (Acfee) and eHealthNews, and will be taking place 6 to 7 September 2016 at the Sandton Convection Centre in Johannesburg.
Tickets are selling fast, so get yours today. For additional information about eHealthALIVE2016, contact firstname.lastname@example.org or visit www.eHealthALIVE.co.za to stay up to date with programme developments.