Day two of the eStrategies event kicked off with a lively roundtable discussion focusing on the development and roll out of eHealth in South Africa.
The session was opened by British Deputy High Commissioner and Chairman of the Newton Fund, Peter Boxer, on the importance of investment in healthcare to realise equity and prosperity throughout South African society.
The roundtable was chaired by Director of CHIRAD, Professor Graham Wright, and included a panel consisting of representatives from Accenture, InterSystems, HST, the Western Cape Department of Health (WC DoH), the Free State DoH, the Kwazulu-Natal (KZN DoH) and Datacentrix.
The overriding theme of the open discussion was the need for a patient centric approach to ensure effective eHealth implementation in SA and the importance of developing public private partnerships (PPPs) to deliver on the objectives outlined by government. “The NDoH has burnt their fingers on pilots that have failed, it’s up to the private sector to invest in working relationships with government to help them understand the value versus the cost and to ensure projects are successful,” said ECM Public Sector at Datacentrix, Trish Dicks.
Director Information Management at the WC DoH, Ian de Vega, outlined the success the WC DoH has had with eHealth implementation that he credits to having clear strategic guidelines in place to reach a predefined goal that aligns with a number of plans, such as Healthcare 2030 and the National Development Plan (NDP). “ICT is the number two strategic objective in the WC DoH after human resources; with no skills resource achieving an effective ICT roll out won’t be possible,” said de Vega.
“To enable eHealth the DoH has to focus on forming a strategy that will work for them. It’s not only about ticking all the boxes, you have to plan thoroughly, strive towards milestones by seeing through activities, sticking to budgets and involving stakeholders from the beginning,” continued de Vega.
De Vega concluded by listing the eHealth success stories of the province, such as how it’s the only province with a single Health Information System (HIS) and Patient Master Index (PMI). “By 2016 all clinics and healthcare facilities in the province will have broadband of a minimum speed of 10MB,” said de Vega.
Executive Director of HST, Gerrit Henning, highlighted that the published eHealth Strategy and more recent eHealth Standards Framework for Interoperability are positive steps towards implementing eHealth. “As stated in the Framework, the NDoH must have a budget to establish and maintain shared health infrastructure, health information exchange and clinical repositories,” said Henning. “Now it’s about how we’re going to do it, not what are we going to do.”
Henning then raised a few questions regarding the strategic documents: What will happen if vendors don’t comply? How will the standards affect the private sector? How and when will it be enforced? How will it be legislated? How will it roll out? And lastly, what independent body will regulate it? All these questions are yet to be answered by the NDoH.
Executive Health at Accenture, David Christie, noted that it was imperative to look at international examples of eHealth implementation, specifically Australia and Brazil, to realise SA’s goal as opposed to “trying to reinvent the wheel.” Christie added that we should make the shift from “patient centric to citizen centric and promote the wellness of individuals instead of only engaging them about their health when we are treating them at our clinics and hospitals.”
Acting DDG: Specialised Health Services at the KZN DoH, Dr Mandla Mazizi, said that for an eHealth system to work it needs to be “accessible, efficient and equitable,” and added that “without an HIS there will be no NHI.”
Professor Wright concluded the roundtable by raising the question of how to make the Framework a reality in terms of organising Connectathons to test interoperability. The overall consensus was that the first step was for the NDoH to demonstrate leadership and appoint an independent body to test compliance and to establish mutually beneficial relationships through PPPs or more appropriately termed “multi-sectorial partnerships.”