News & Views
“I dream of a better health system”
 “Forgive
me for dreaming – My dream for all our kids is that there will
be a better South Africa one day. A South Africa where infant
mortality will be a thing of the past.”
With these words Dr. Shaheen Khotu, Chief Information Officer
(CIO) of the Department of Health, set the tone for South
Africa’s eHealth strategy. The secret he said, to saving the 55
000 South African children destined to die this year in terms of
infant mortality statistics is information and education. This
includes information about the patients and education on growth
monitoring and immunisation.
“If we implement an 80% successful immunisation programme,” said
Khotu, “then I want to know the names of the children in the
other 20%, their mothers’ names and their ID numbers, so they
can be traced on entry into school and immunised.” This is the
eHealth vision that Dr. Khotu carries.
Khotu said that since the advent of democracy, a number of
health care improvements have been implemented. This includes
free primary health care, and that the paradigms have shifted
from curative to preventative, and from hospital-based to
community-based.
“But it’s not enough,” he said, “we have a mandate from the
government to implement an electronic health care system that
begins at local level and feeds into district, provincial and
national levels,” said Khotu.
Dr. Lincoln Moura, president of Zilics Health Care Systems,
spoke earlier about the Sao Paulo model and how some
South-to-South collaboration could benefit South Africa.
“In a city of over 12 million inhabitants,” he said, “we used
open source java technology on a completely independent
web-based platform to eliminate more than 150 silo-driven
organisations.”
Dr. Moura outlined how the SIGA Saude eHealth programme in Sao
Paulo is able to uniquely identify all individuals. This is
regardless of whether these are patients, health care
professionals or service providers. Using thin client
technology, the information is entered once at the point of
care, using simple machines. “All updates, new programmes and
functionalities can be rolled out easily as the complexity
resides in the data centre,” he said.
Between January 2005 and March 2007, electronic authorisations
for specialised procedures increased by 66%. Asked how the
project handled change management, Dr Moura responded that the
electronic systems were modelled to be identical to the paper
systems. This is to ensure that there was no new methodology to
be learned.
“Offer staff an easier way to work and perform better, and they
will use it,” he said.
Moura also confirmed that the Sao Paulo model is available free
of charge to other health care agencies if they wish to use it.
However, he emphasised that the focus of the SIGA Saude project
is improved health care, not billing.
“Far too many countries implement an electronic system
specifically for billing purposes,” he said, “but what we wanted
for Sao Paulo was a system that can actually provide better
information about the patient and where they can get the best
possible treatment.”
Wise words and ones that Dr Khotu will most surely be able to
identify with in his quest for an electronic system in South
Africa.
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