Question NW2717 to the Minister of Health
15 September 2022 - NW2717
Xaba, Mr N to ask the Minister of Health
What progress has his department made with regard to the transformation of the administration of digitising health records at local clinics and regional hospitals so that the administration is aligned with the commitment of digital transformation?
Reply:
1. The National Department of Health has developed the National Digital Health Strategy which is highlighting the high-level of outcomes towards Digital Health for South Africa. Note: That the implementation of the digital health strategic is delayed by 2 years as a result of the Departments involvement in the management of the COVID 19 Pandemic in the Country.
2. Four levels of technical maturity are defined in health information systems for patient records:
Level 1: Local paper based medical records
Level 2: Local Paper Based records with some IT Support
Level 3: a Centralised shared electronic health record with mixed mode local medical records (both paper based and electronic medical records
Level 4: a Fully integrated national shared Electronic Health record owns by the Patients with local Electronic Medical Records.
3. The aim is to work through a systematic process that would facilitate South Africa to be at the level 4 Maturity. The National Department of Health to date has focused on development and implementation of key building blocks essential for the level 4 maturity namely:
Within the ICT Technology and Hardware component
a) To date the National Department of Health in collaboration with Provincial Departments of Health have purchased and distributed 22 812 Desktop Computers to 3150 public health facilities (3089 PHC facilities and 61 Hospitals)
b) The National Department of Health has established a National Central Health Information Data Centre for the secured Digital Health Solutions and their respective datasets
c) The National Department of has established a Big Data Platform that uses 4IR technology – Artificial Intelligence and Machine Learning to enable the management and matching of different datasets together with the development of data analytics and visualisation products
The following intervention has been focussed on for the development of the Digital Health Enterprise Architecture
d) The National Department of Health in partnership with the CSIR and wide consultation has developed the revised version of the Interoperability Normative Standards framework for Digital Health in South Africa. This framework provides for the set of norms and standards to be used for all Digital Patient Information Systems to allow for the sharing of data and linkages of different patient information solutions with the ultimate aim being the creation of one portable electronic health record.
e) The first phase of the South African Digital Health – Health Information Exchange has been developed. This technology provides a mediator between different software solutions to ultimately provide for the creation of shared and portable Electronic Health Records for the users of the Health System
With regards to software solutions:
f) To date the focus has been on the development and implementation of 2 of the 4 Identity Registry Software Solutions and Platforms required for the development of a shared Electronic Health Record for users of the Health Care System
User Registry:
g) The National Department of Health in partnership with the CSIR developed the Health Patient Registration System (HPRS). The purpose of the system is to standardise patient registration across all health facilities. A National patient registry has been created and will be the source of the NHI Beneficiary registry.
(i)The Health Patient Registration System assigns a unique Master Patient Index (MPI) to everyone registered on the system. This system as at 29 August 2022 has been installed in 3150 public health facilities (3089 PHC Facilities and 61 Hospitals). This solution is the authoritative source of all individual’s’ demographic and personal data. To date the demographic data of 63 241 201 individuals has been registered on the HPRS at the point of care since inception some people will have died and others left the country. The ability to do identity verification at the point of care is important for the authenticity of the data included on the system. During this financial year the department is commencing with the deployment of bio-metric identity verification at the point of care.
h) The Master Patient Index assigned by the HPRS to individuals is used as a catalyst for the development and implementation of the user’s Electronic Health Record, where the information about a patient from different information systems will be linked into one record for the patient. To this effect the HPRS has been linked with the laboratory test results system of NHLS. This functionality is being tested for implementation at PHC facilities in Ugu District in KZN, identified PHC facilities across all districts in Free State and PHC facilities in Gert Sibande district in Mpumalanga. Development has started for the use of the MPI with other systems such as the HIV and TB patient information systems as well as the SYNCH System which is the digital solution of the Chronic Medicine Dispensing and Distribution Programme and an electronic pharmaceutical prescribing and dispensing systems. This initiative forms part of the preparatory work for the implementation of NHI.
An important enabler to ensure maximum impact for this initiative is access to continuous quality broadband connectivity. The department will continue to work with stakeholders in this space namely the Department of Post and Telecommunication services, ICASA, SA Connect and Mobile Telecommunication service providers to develop and implement appropriate solutions.
Health Establishment Registry:
i) NThe National Department of Health has developed the Master Health Facility Registry solution and platform. This registry is the authorative source of data for all health establishments in the country. The registry currently has the details of more than 40 000 health establishments (public and private) registered on the system. This solution assigned a unique identification number to each health establishment. All patient information systems will be required to use this Health Establishment User Identity and forms a non-negotiable component of the development of a share electronic health record.
END.