eHealthALIVE, Opinion, South Africa

Matthew Chetty: On Achieving National Interoperability

Matthew Chetty will be part of an expert panel leading a two-part Interoperability Masterclass at eHealthALIVE2016.

Matthew Chetty - EHN

Competency Area Manager: Integrative systems, platforms and technologies at the CSIR Meraka Institute, Matthew Chetty, talks about the CSIR’s role in facilitating interoperability in South Africa.

Matthew Chetty will be part of an expert panel leading a two-part Interoperability Masterclass at eHealthALIVE2016 to give delegates the practical tools they need to develop and implement strong interoperability strategies. Get your ticket now and be part of this transformational event.

Tell us about your background and your function and role at the CSIR.

My educational background is in Electronic Engineering, particularly telecommunications. I first started working for the CSIR as early as 1998, initially in network planning, and then onto programme management. I moved on to work for the New Partnership for Africa’s Development (NEPAD) where I managed the NEPAD eSchool Initiative, then to Advanced Micro Devices (AMD) where I led AMD’s 50×15 Foundation. In 2011 I returned to the CSIR and took on the job that I still hold today, Competency Area Manager of integrated systems, platforms and technologies. I’m involved in building IT solutions for our customers, which are typically government departments, who require solutions in the space of education, health, rural development and indigenous knowledge systems.

Let’s talk about the role of the CSIR in facilitating interoperability. 

Over the last five years we’ve been working closely with the National Department of Health (NDoH) to facilitate interoperability. One of the problems that the Minister of Health highlighted in the eHealth Strategy was the fragmentation of eHealth systems; even where we have automation of our systems they are still fragmented and don’t speak to each other. Therefore some of the work that we’ve been doing with the NDoH has been around trying to address this issue of fragmented eHealth systems.

The first piece of work that we did, on behalf of the NDoH, to address this situation was to establish a set of standards for eHealth systems in terms of the way that they transfer information. That was published in April 2014 as the Health Normative Standards Framework (HNSF), which we believe is a major milestone towards eHealth interoperability in the country. The HNSF includes a set of technical standards which cut across a number of different categories, from content standards to messaging standards to coding standards to information security standards. There are even some general IT standards that eHealth systems should comply with. In theory, even if we have different systems deployed across the country, if they are compliant to those standards then you have a foundation against which information can be shared and interoperability can be achieved. Of course it’s not the only thing that needs to be in place, but it’s a very important first step at a technical level of interoperability to have those standards in place.

We are also working with the NDoH to see how the already deployed national eHealth systems can become interoperable with each other. We were involved in the first step assessment of the systems already deployed in the primary healthcare environment to determine to what extent they comply with the HNSF. We completed that evaluation last year and soon after the results were presented to the National Health Council.

The resounding consensus throughout industry is that the HNSF document is useful, a high quality document and has been well received. What is the next step in helping organisations actively use the document to guide their interoperability strategies?  

There are plans underway at the CSIR to establish an “interoperability lab” where people can actually physically test whether their systems interact or interoperate with each other. The lab will include some testing tools that will be able to help us understand to what extent, at a technical level, these systems comply with the standards and where changes or improvements need to be made. We’re aiming to have that facility up and running by the end of 2016.

What are some of the other benefits to interoperability outside of the ability to share healthcare data and as a result, improve the quality and continuity of care?

Interoperability has financial benefits for the health system. We want to get out of the situation where we are, for example, doing multiple tests at different institutions. Duplication is costly and wasteful and is a result of not being able to share information.

Another benefit is that it will address fragmentation. If we can overcome that hurdle then we will probably see greater automation of the health system, which will lead to numerous benefits and efficiencies within the health system for patients, healthcare workers, management and government.

Over and above the technical level of interoperability, what are some of the other obstacles we have to overcome to achieve interoperability?

For one, we need IT infrastructure to be in place in order to enable the orchestration of information and the exchange of information. We also need to look at interoperability from many levels, including from an organisational level, at a regulatory level, as well as a policy level. Once we do that, we can address what will encourage or incentivise vendors to share health information stored in their systems.

Another big issue that still needs to be tackled is how we are going to deal with all of this health information in a way that respects the privacy of the patient. In other words, defining what the information could be used for; what it should be used for; what it shouldn’t be used for; and what kind of permissions do you need from the patient to share their information. Understanding these critical factors is part of our work at the CSIR and I look forward to sharing more with attendees at ehealthALIVE2016.

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