Question NW3319 to the Minister of Health

Reply:

1. We are not in a position to provide a list of all (a) hospitals, (b) clinics and (c) other public health facilities that have upgraded to electronic record-keeping per province because each province has a complex set of different solutions. However, we can report on the systems that are installed as follows:

The national department of Health together with provinces implemented the Health Patient Registration System (HPRS) as the first step to the development and implementation of a shared electronic health record. The HPRS records a patient’s visit and categorise the patient’s reason for visit.

A list of facilities where the HPRS has been installed is provided in a separate spreadsheet of 3474 public health facilities.

The following responses were received from the provinces

Eastern Cape

Eastern Cape is in the process of installing the Health Management System Version 2 (HMS2) system in the following 32 facilities and services:

Free State

Only 1 facility (National Hospital) has been upgraded to an electronic record-keeping system in the province.

Limpopo

41 hospitals are using ‘Enterprise Manager’ known in the province as Provincial Health Information System (PHIS). Clinics are using the Health Patient Registration System (HPRS).

Northern Cape

All Facilities are making use of manual record keeping. The province is upgrading the record keeping at facilities (new files, cabinets, etc) first and will then start to look at implementing an electronic version (digitization).

North West

No health facility in North West Province has upgraded to an electronic record keeping system. The province has approved a pilot project to be implemented in three health facilities as proof of concept for digitalization of patient record. The project is ongoing.

Mpumalanga

The Mpumalanga Department of Health appointed a service provider in 2022/23 financial year to scan and archive patient records in the following hospitals: Rob Ferreira Hospital, Themba Hospital, Ermelo Hospital, Witbank Hospital, Mapulaneng Hospital, Tintswalo Hospital, Middelburg Hospital, Bernice Samuel Hospital and Tonga Hospital.

Western Cape

The Western Cape Department of Health (WCDOH) has embarked on a journey to upgrade from paper record-keeping to electronic record-keeping which is a complex, medium to long term programme.

Patient Administration systems: Clinicom Patient Administration system in 53 hospitals. Primary Healthcare Information system (PHCIS) in all 308 primary healthcare facilities in the province. The PREHMIS primary care system in 95 of the City of Cape Town (CoCT) clinics.

Clinical investigations: The Trakcare laboratory system, can be accessed by all facilities. The RIS PACS is a digital imaging system in 13 Facilities.

The NDOH has not yet received an update from KwaZulu Natal (KZN) and Gauteng

2. Regarding the situation with public health facilities’ (a) telephones, (b) computers and/or laptops, (c) access to the internet and/or WiFi and (d) any other information and communications technology infrastructure.

A summary of Communication and ICT Infrastructure at PHC facilities is provided in tables and are provided in an Excel document. Data has been collected through self-assessment by facilities during the Ideal Clinic Assessment in 2023.

Tot # PHC Facilities:	3474
Tot # PHC Facilities that didn't conduct a self-assessment:	46
Number/Percentage of facilities that have a functional telephone/computer and internet access
Province	# Facilities conducted a self-assessment	# Facilities with Telephone	% of Facilities with Telephone	# Facilities with Computer	% of Facilities with Computer	# Facilities with Internet	% of Facilities with Internet
EC	773	564	73%	760	98%	661	86%
FS	212	205	97%	210	99%	210	99%
GP	364	332	91%	362	99%	345	95%
KZN	602	581	97%	598	99%	532	88%
LIMP	477	439	92%	471	99%	380	80%
MPU	291	266	91%	288	99%	167	57%
NW	305	292	96%	303	99%	293	96%
NC	159	147	92%	156	98%	141	89%
WC	245	241	98%	245	100%	243	99%
South Africa	3428	3067	89%	3393	99%	2972	87%

361 PHC Facilities indicated not to have telephones.

20 PHC Facilities indicated not to have computers.

452 PHC Facilities indicated no access to internet connectivity.

All hospitals have Telephones, Computers and Internet Connectivity

3. There are several factors that need to be considered that include the general communication infrastructure of the geography of where facilities are situated to ensure appropriate ICT infrastructure. Provinces reported that where facilities do not have access to fix line telephones they are provided with mobile telephones. The National Department of Health is working with the Department of Communication and Digital Technology through the SA Connect project for the provision of appropriate broadband connectivity at Health Facilities.

4. Because of the complexities involved the full costing of the upgrade of health facilities to appropriate ICT Infrastructure with specific reference to broadband connectivity to enable the digital health transformation, will be completed by September 2024.The estimated amount based on preliminary costing is R 500 million for infrastructure and annual recurring cost of approximately R 7 million.

END.