Electronic health record system in the public health care sector of South Africa: A systematic literature review.

Munyaradzi C Katurura,Liezel Cilliers

doi:10.4102/phcfm.v10i1.1746

Abstract

BackgroundSouth Africa is planning to implement the National Health Insurance (NHI) scheme in the near future. The NHI is intended to improve the accessibility of quality health care services for all South African citizens. For the NHI to achieve this objective, an electronic health record (EHR) system to register and track patients who visit different health care providers will have to be developed.AimTo identify critical success factors for the implementation of EHRs in South Africa’s public health care sector.SettingThis study reviewed studies on EHR implementation in African countries published between 2006 and 2017.MethodsThe study made use of a systematic literature review to identify barriers to the implementation of EHRs in the public health care sector.ResultsFifteen articles were included in the study. The study identified technical, social and environmental barriers to the implementation of EHRs. The barriers could further be broken down into lack of supporting infrastructure; user training and commitment; political influence or strategy; legislation and regulations; and the lack of a framework for implementation and management of EHRs. The study suggests six main recommendations for the successful implementation of EHRs in South Africa’s public health care sector.ConclusionThe study recommended investing in alternative infrastructure facilities, incentivising the health informatics field to attract and retain information and communication technology professionals and to encourage the participation of all stakeholders in the development process to develop context-relevant e-health implementation strategies, legislation and frameworks. Government should also allocate separate budgets for e-health projects.

Highlights

South Africa is planning to implement the National Health Insurance (NHI) scheme in the near future
While the content filtering services (CFSs) for each project may be unique, this study identified factors that are common in electronic health record (EHR) implementation projects in African countries
The need to implement EHRs was identified in the NHI white paper that was presented by the National Department of Health in South Africa

Summary

Introduction

South Africa is planning to implement the National Health Insurance (NHI) scheme in the near future. South Africa is developing many strategies towards improving the quality of public health care services as well as improving the accessibility of these services.[1] One of these strategies is the implementation of National Health Insurance (NHI). The National Department of Health, the Department of Science and Technology and the Council for Scientific and Industrial Research (CSIR) developed a patient registration system that could be used together with an electronic health record (EHR). The goal of this system is to allow patient tracking wherever patients present themselves in South Africa while solving the issues of lack of interoperability, fragmentation and the absence of a National Patient Master Index. The EHR systems allow for the capturing, storing and sharing of a patient’s personal as well as medical information.[4] http://www.phcfm.org

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