eHealth: South African Experience

1. eHealth:South African Experience Dr. KS Chetty Deputy-Director General:Health Service Delivery Department of Health, South Africa eHealth RSA

2. Context • Challenges to SA Health System • NHISSA • Telemedicine, TeleHealth and eHealth • Implementation of Telemedicine in South Africa • Application of technology • Opportunities at various levels of health system • Legal, ethical, confidentiality and security eHealth RSA

3. eHealth • Combined utilization of electronic communication and information technology to generate, capture, transmit, store and retrieve digital data for clinical, educational and administrative purposes. • The purpose of e-Health is to contribute to the improvement the health status of the people of South Africa through optimal use of ICT. eHealth RSA

4. TeleHealth is the management and support of national and international health, by audio, visual and data communications. This includes: - the delivery of health care; - access to repositories of knowledge, applications & literature; - the management of health care institutions; - the education of the public; basic and continuous education; - the surveillance of diseases and services; - health emergencies and hazards; and - research. eHealth RSA

5. Telemedicine, TeleHealth and e-Health are all operational terms that describe some or all of all the following activities: health information exchange, education, consultations, medical practice, health promotion and health commerce through the use of ICTs. Essentially, they would not exist without economical, effective, user-friendly ICT and their infrastructures. eHealth RSA

6. TELEMEDICINE The practice of medical care using audio,visual and data communications; this includes medical care delivery, diagnosis and treatment, as well as education and the transfer of medical data. eHealth RSA

7. THE SOUTH AFRICAN NATIONAL TELEMEDICINE SYSTEM • Objective is to deliver health care services at a distance to South African rural communities. • Provide rural communities access to physicians and specialist expertise through telemedicine technology. • Health promotion to patients • Continuous Professional Development eHealth RSA

8. Clinical services to rural communities • Primary health care • Pre-natal care and sonograms • Skin diseases • Cardiologists and surgeons • Ophthalmology • Mammographic surveillance • Radiology eHealth RSA

9. PHASE 1 APPLICATIONS • Tele-Radiology • Tele-Pathology • Tele-Ophthalmology • Tele-Ultrasound and Antenatal Screening • Telemedicine Research and Training Centre eHealth RSA

10. Current Status • Telemedicine sites have now expanded from 28 to 68 sites • Distance learning is showing huge benefits to health professionals for health education, clinical ward rounds and training. eHealth RSA

11. Tele-Health sites in Eastern Cape eHealth RSA

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13. VC Consultation 52 of 69 cases (75.4%) saved referral eHealth RSA

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18. Primary Health Care Telemedicine Workstation eHealth RSA

19. Closed Health Broadcast Channel eHealth RSA

20. Health Channel • As part of TeleHealth, the Department has in collaboration with Sentech established a Closed Health Broadcast Channel that broadcasts health promotion as well health education content for patients and health workers in hospitals and clinics using satellite. • In 2002, the project was piloted with 30 sites for a period of six months. • The Closed Health Broadcast Channel shows capability of reaching the most rural communities • An important tool for health promotion and education to rural communities • Expanded from initial 30 to 110 sites • Implementation 0f 79 John Snow Funded sites completed in December 2006 • Current total 300 sites eHealth RSA

21. health:overview • Partnership between Mindset Network, Department of Health and Sentech • Launched by the Minister of Health in 2004 • Targets health workers, particularly nurses and counsellors, and the public • Initial focus on HIV and AIDS • Sources and creates content: • in video, computer based multimedia and print • In multiple local languages: currently isiZulu, isiXhosa, SeSotho, English, Afrikaans • covers other important health issues including child and maternal health eHealth RSA

22. health:receiving platform at sites Mindset Health Workers “On Demand” broadcast and computer offering in staff areas I Mindset Health daily public broadcast in waiting rooms: 07h30 – 17h30 Computer interface to access content “On Demand” – in the topic and language of their choice eHealth RSA offline online

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24. Benefits of Telemedicine • Health consumer – Patient • Health provider – the clinician • Business – health department eHealth RSA

25. Critical Success Factors • Clinical needs of clinicians • Health needs of community • Overall direction of health care • Enhance existing current strategies eHealth RSA

26. Integration into practice • Must be seen as part of the clinician’s “toolkit” • Confidence and competence • “Champions” • Evolutionary not revolutionary • Building on staff capabilities eHealth RSA

27. Challenges in implementation of Telemedicine • Technology Adoption • Funding remains a constraint for expansion of Telemedicine infrastructure • Competing health priorities eHealth RSA

28. CONCLUSION • The most critical component of Telemedicine is the end users – the health care providers and the patients. • This is true for any ICT project in Health • It is the people and not the technology that determines the operational success of this collaboration initiative. eHealth RSA

29. Thank you eHealth RSA