eHealth Strategy South Africa 2012 - Department of Health

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National eHealth Strategy, South Africa 2012/13-2016/17 2. Vision, Mission, Aim and Key Principles of this strategy 2.1 Vision eHealth: enabling a long and healthy life for all South Africans. 2.2 Mission To establish eHealth as an integral part of the transformation and improvement of healthcare services in South Africa, especially enabling delivery on the health sector’s Negotiated Service Delivery Agreement 2010-2014. 2.3 Aim The overall aim of this strategy is to provide a single, harmonised and comprehensive eHealth strategy that: a) Supports the medium-term priorities of the public health sector. b) Paves the way for future public sector eHealth requirements. c) Lays the requisite foundations for the future integration and coordination of all eHealth initiatives in the country (both public sector and private sector) 3 . 2.4 Key principles In order to best overcome the challenges listed above, the programme of work that will lead from this strategy will have to be underpinned by certain key principles, i.e. fundamental assumptions that will guide decision-making by the National and Provincial Departments of Health. These principles are: • Get the basics right – infrastructure, connectivity, basic ICT literacy, human resources and affordability planning. • Take an incremental approach – build on what exists already in both the public and private sectors and fill the gaps where necessary. • Look for early wins in implementations and benefits to build the confidence of health professionals, patients and the public in eHealth. • Advocate the benefits of care enabled by eHealth and ensure that these benefits are realised. • Constantly evaluate eHealth initiatives and measure improvements in health outcomes in order to build an evidence base that demonstrates the net benefits over time of eHealth and guides planning and decision-making. • Establish national co-ordination on all initiatives in order to improve the effectiveness of eHealth at all levels. o Enable integration between systems wherever appropriate. o Enforce common standards, norms and systems across the country. 4 o Establish common data standards and terminology across information systems. • Encourage a collaborative approach by leveraging partnerships, e.g. private sector, NGOs, other government departments, other country governments, research organisations. 3 The National Health Act of 2003 empowers the Minister of Health to regulate both the public and private health care sectors. 4 NSDA on Health for period 2010-2014 Sub-output 4.4.8 Strengthening Health Information Systems Page 8
National eHealth Strategy, South Africa 2012/13-2016/17 • Protect information security, confidentiality and patient privacy at all times. • Promote information governance consensus among all stakeholders in order to use information better. • When required, procure cost-effective and re-usable information systems in order to get value for money. • Consider available open source solutions for cost effectiveness. • Build the capacity and the systems to obtain official health statistics from a single official source 5 . • Adhere to the NHIS/SA principles for information management. 6 • Ensure that intellectual property ownership of public sector eHealth initiatives are vested in government. In addition to the above principles, the strategy seeks to provide benefits within the six domains of healthcare quality put forward by the Institute of Medicine (IOM) and the additional imperative of improving access. These six domains are: • Safety: Avoiding harm to patients from the care that is intended to help them. • Effectiveness: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively). • Patient-centeredness: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions. • Timeliness: Reducing waiting times and potentially harmful delays for both those who receive and those who give care. • Efficiency: Avoiding waste, including waste of equipment, supplies, ideas, and energy. • Equitability: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status. 3. Problem statement and challenges The following quotation from the NSDA 2010-2014 sums up the problem statement for this eHealth strategy: “Although large sums of money have been used to procure health ICT and HIS in South Africa in the past, the ICT and HIS within the Health System is not meeting the requirements to support the business processes of the health system thus rendering the healthcare system incapable of adequately producing data and information for management and for monitoring and evaluating the performance of the national health system. This results from the lack of technology regulations and a lack of policy frameworks for all aspects of infrastructure delivery.” 8 The quotation highlights key challenges identified in relation to eHealth. The following are specific challenges identified with respect to eHealth, particularly in the public sector: • No national eHealth strategy and corresponding Enterprise Architecture supporting the national health system. • Limited capacity or capabilities within the public sector to implement a national eHealth strategy. 5 NSDA on Health for period 2010-2014 Sub-output 4.4.8 Strengthening Health Information Systems 6 The strategy also takes into account the key principles adopted by NHIS/SA. • Data to be collected at the point of its generation. • Data collection is to enable service assessment as well as self-assessment. • Service delivery personnel would have responsibility for the collection of data relevant to their specific duties. • Where feasible, the basic analysis of the data would be carried out at the point of collection. • Collection, aggregation and analysis of data would follow the organisational structure of health services, that is national data would comprise of the sum of the provinces, provincial data of the sum of its districts, district data of the sum of its sub-districts. 7 Institute of Medicine (IOM).Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C: National Academy Press; 2001. 8 NSDA on Health for period 2010-2014, page 9. Page 9
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