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The stark reality of creating a National Electronic Patient Record.
Tuesday, 11 July 2006
Problem

Currently South Africa has no national electronic record of patients. Furthermore, the majority of healthcare institutions countrywide have no method of sharing their patient records, electronically or otherwise. This inability to share information is problematic for two reasons. One: records can not be easily accessed when a patient moves between two institutions, and two: it is difficult for government to compile accurate statistics on healthcare in South Africa. The South African government has indicated that by 2010 they intend to have a National Health Information Record (NHIR) in place to collect and share health-related information on a national scale. This would require four technical aspects: network architecture for communication between institutions and external sources of data; a set of communication protocols for transmission and sharing of data; application software for users to use and share data; as well as the maintenance of confidentiality and security of data.

Context
Any distributed network in South Africa will be challenged by lack of infrastructure and differences in organisations. This could include limited or no access to the internet, low bandwidth, computer illiteracy and different healthcare management across the provinces and districts. A further complication is that the capacities, with regards to both infrastructure and personnel, differ greatly.

Because of these factors it may be necessary for the network to cater for different institutions and possibly envelope legacy systems.

Solutions?

There is a great deal of theory for the architecture of a distributed network. Different Computer Science communities advocate different fundamental approaches to sharing data including: distributed databases, peer-to-peer networks, digital libraries, interoperability standards, and web services. The various approaches are appropriate for different sets of user needs and environmental constraints.

In a healthcare network the users specifying these needs will be both those providing healthcare delivery, such as doctors and nurses; as well as those bodies interested in summaries of the data across a set of healthcare institutions. Their various needs will shape how the architecture communicates data.

Outcomes

This project hopes to produce evaluations of the different architectures available for a NHIR in South Africa, based on the needs and capacities of the stakeholders involved. The findings would hopefully prove valuable for any prospective attempts to create a NHIR in South Africa.

Go to the Cell-Life PISYS (Patient Information System) to see our solution.
 
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