Patrick Sello from the Gauteng Department of Health speaks on the overall ICT Strategy and Digital Transformation in Public Healthcare.

1. HEALTHCARE INNOVATION SUMMIT AFRICA
17 NOVEMBER 2022
Patrick Sello 17/11/2022

2. ICT MANDATE (GAUTENG DEPARTMENT OF HEALTH)
Integrated Health Information Systems
- Integrated healthcare at point of
care (eHealth & mHealth)
- 360 view of the patient
- Electronic health records
- Health provider access to
consolidated patient data
irrespective of physical location
1
Modernisation and Digital workspace
- Staff mobility (cloud)
- eDocument management and
collaboration.
- Elimination of paper through use of
digital document submission and
eSignature.
- ePerformance Management
- Management reporting using real-
time data
2 3
ICT Governance
- Ensure alignment of ICT Governance and
Cooperate Governance of ICT.
- Deliver eHealth services aligned with
organizational objectives.
- Utilize sourcing strategies which will
deliver value to the Department.
Patrick Sello 17/11/2022

3. ICT STRATEGIC OVERVIEW (GAUTENG DEPARTMENT OF HEALTH)
6th Administration
Strategic Imperatives
2020-2025
ICT Strategy
7-ICT Goals
Key Drivers
Improved Patient
Experience of Care
Improved Clinical Services
NHI Implementation
Strengthen Governance &
Leadership
Strengthen Public Health
Literacy and Health
Promotion
Integrated interoperable Provincial
Health Information ecosystem
Automate (Digitise) the Gauteng
Provincial health business processes
Employ mHealth to improve Patient
Experience of Care; improve health
literacy and expand health
promotion
To
strengthen
ICT
governance
structures
and
oversight
for
Health
system
digitisation
To
acquire
appropriate
digital
applications
that
improve
health
services
for
patients
and
health
workers.
To augment physical network
infrastructure and broadband
connectivity across all Health
facilities.
Health observatory tracking
population health outcome, health
workforce, health financial
investments.
Repeat Auditor General
Findings (weak system
controls)
Eliminate the technology
risks, associated with
inadequate ICT investments
Transform the ICT ecosystem
to accommodate NHI
objectives
Adopt new and innovative
technology to improve
patient experience of care.
Improve data storage,
collection and dissemination;
reduce paper
2022/11/22
Patrick Sello 17/11/2022

4. Two Approaches
1. Scanning of Paper-
based records
(Digitization)
2. Electronic Records
on Health
Information System
(Automation)
Scanned patient
record
Patient Referral System
(Vendor Neutral Platform)
 Once-off scanning
consolidating paper-based
patient records in digital
format.
 Integration within HIS to
provide continuum of care
(360-view of the patient)
Electronic patient
record
Patient
1. Integrated into the HIS
functions.
2. Single view of the patient.
3. Improved data analysis
Digital
transformation
Approach
Patient
Digital
Record
DIGITAL TRANSFORMATION IN PUBLIC HEALTHCARE (GAUTENG DEPARTMENT OF HEALTH)
Patrick Sello 17/11/2022

5. ELECTRONIC MEDICAL RECORD ADOPTION - EMRAM (GAUTENG DEPARTMENT OF HEALTH)
5
• HIMSS Analytics has defined a strategic roadmap for effective EMR adoption and maturity
that is considered a standard for healthcare providers around the world.
• The eight-stage (0-7) model measures the adoption and utilization of EMR functions
required to achieve a near paperless environment that harnesses technology to support
optimized patient care.
50% Clinical Orders
CPOE
Nursing Care Tasks
Allergies and Risk
Factors
Vital Signs
50% PMD Clinical
Documentation
Integrate test result into
EMR
50% Nursing
documentation
Clinical Outcomes,
discharge summary
Blood Products
Clinical Data Repository
Radiology and
Laboratory systems
Access to Clinical
Decision Support
Pharmacy Information
system
Provided by EMR Provided by 3rd party systems
Drug interactions
Prescription and
Administration (EPMA)
Paper based record
Physician order
Integrated Clinical
Decision Support
Mobility
Data Warehouse, HIE
100% Clinical Orders
CPOE
100% PMD Clinical
Documentation
100% Nursing
documentation
90% Nursing
documentation
Adoption
and
Change
Patrick Sello 17/11/2022

6. DIGITAL TRANSFORMATION IN PUBLIC HEALTHCARE (GAUTENG DEPARTMENT OF HEALTH)
6
Implementation of a single Patient Electronic
Health record / information system with
Patient Administration and Billing
functionality. The system will be integrated
with Pharmacy, National Health Laboratory
Services, Blood Services and Radiology
systems
Integration:
Pharmacy,
NHLS,
SANBS,
Radiology,
HPRS,
Mental
Health,
Transversals
Clinical
Data
Repository
Health Patient Registration System (HPRS)
LAN Infrastructure Upgrade
Picture Archiving & Communications System
Business
Analytics &
Intelligence
(all
facilities)
2022/11/22
Patrick Sello 17/11/2022

7. ENABLING TECHNOLOGY TO ACHIEVE STRATEGIC OBJECTIVES (GAUTENG DEPARTMENT OF HEALTH)
Artificial Intelligence Cloud Computing Internet of Things
(IoT)
Big Data Block Chain &
Security
Goal 1: Integrated interoperable Information ecosystem.
Goal 2 & 6: To automate health systems business processes
& acquire appropriate solutions.
Goal 3: Augment mobile technology (mHealth) to improve
Patient Experience of Care
Goal 4: To strengthen ICT governance structures and oversight
for Health system digitisation
Broadband
Goal 5: Augment mobile technology (mHealth) to improve
Patient Experience of Care
Goal 7: To augment physical network infrastructure and
broadband connectivity across all Health facilities
Goal 8: To develop a Health observatory tracking population
health outcome, health workforce, health financial investments
in both the public and private health sectors
ICT Goals
Technology
Patrick Sello 17/11/2022

8. INTEGRATION HEALTHCARE (GAUTENG DEPARTMENT OF HEALTH)
SOA Platform
Requester
OSB
Oracle Service Bus
Provider
SOA
MFT
Managed File Transfer
Service
Orchestration
SANBS
Fin & HCM
Mngt
BAS
Oher
Systems
Business Systems Integration Touchpoint
HPRS GDOH INTERNAL NETWORKS & SYSTEMS
Hospital Clerk
Mobile
Network
Consumer
Applications
Patient Administration
Web
NDoH, NGO,
Public etc.
HoD, MEC,
etc.
Clinicians,
Nurse etc.
F
5
L
B
R
HIS
Pharmacy
Radiology
IVS NHLS
Mental Health
System
TransUnion
Medikredit VNA
DHIS
Home
Affairs
SAP
e-Receipting
MIRTH
Connector
Patrick Sello 17/11/2022

9. D
A
T
A
P
R
O
D
U
C
E
R
S
DATA
INGEST
ARCHIVAL
STORAGE
DATA
MANAGEMENT
ACCESS
D
A
T
A
C
O
N
S
U
M
E
R
ADMINISTRATOR
ADMINISTRATOR
SIP
DIP
AIP AIP
MANAGEMENT
SIP Submission Information Pack
AIP Archive Information Pack
DIP Dissemination Pack
queries
result sets
orders
LOTAR, 2018
• Reference Model for an Open Archival Information System" (OAIS) published as standard ISO
14721:2003 and developed by the aerospace and defense community.
• We mapped the patient data flow against the open archival information system
• Each stage OAIS is evaluated and assets against exiting regulation on data collection, access and
consumption
OPEN ARCHIVAL INFORMATION SYSTEM (OAIS)
2022/11/22
Patrick Sello 17/11/2022

10. LOTAR, 2018
OPEN ARCHIVAL INFORMATION SYSTEM (OAIS) – OVERVIEW DATA FLOW
Patrick Sello 17/11/2022

11. End
Blood
Service
Triage
Registration
(including Automated
billing)
X-Ray
Pathology
Pharmacy
or
Billing End
Consult
Admissions Discharge
Manual Automated
Semi -
Automated
Patient
Doctor
Nurse
• Digital health data is created at every point of contact with the patient
• The patient data flow is from Charlotte Maxeke Academic Hospital process flow
• Digital health data is created and collected at every point of contact with the patient
• It is collected in high volume, velocity, veracity and variety
• Health Information System is used to create, collect and store the digital health information
• Data created after consultation is stored in multiple system
• X-Ray data stored in Picture Archiving and Communication System
• Blood Services data stored in SANBS systems
• Pathology data stored in LAB track
• Pharmacy data stored in RX solution
OVERVIEW DIGITAL HEALTH DATA FLOW
Patrick Sello 17/11/2022

12. D
A
T
A
P
R
O
D
U
C
E
R
S
Triage
• Condition 1: Accountability,
• Condition 2: Processing limitation
• Condition 3: Purpose specification
• Condition 5: Information quality
• Condition 6 : Openness (Notification to
data subject when collecting personal
information)
• The National Health Act also stipulates
that all information concerning a user,
including information relating to his or
her health status, treatment or stay in a
health establishment, is confidential
(section 14(1))
• The A data controller must have the
express written permission of the data
subject for the collection, collation,
processing or disclosure of any personal
information on that data subject unless
he or she is permitted or required to do
so by law
Process Systems & End-user
Data Generated &
Collected
Health Information System:
Nursing
vital signs
: pulse rate, temperature,
respiration rate, and blood
pressure
Patient Registration
Health Information System:
Administrators & clerks
Patient Administration &
Billing Information:
Demographics,
Socioeconomic Status,
Consultation
Health Information System:
Clinicians, Registrars,
Administrators, Clerks and
Nursing
Clinical Information:
Examination, Diagnosis,
ICD10 code
Regulations
Protection of Personal Information Act, No 4 of 2013 ; Promotion of Administrative Justice Act,
2000 (Act No. 3 of 2000); Promotion of Access to Information Act 2 of 2000 ; National Health
Act, 2003 ; The Medical Schemes Act; Electronic Communications Act 25 of 2002
Guidelines
HPCSA, Guidelines on the Keeping of Patient
Records (2008), paragraph 9 ; South African
Minister of Health, eHealth Strategy ; World
Health Organization on digital health
interventions
DIGITAL HEALTH DATA CREATION, DATA PRODUCERS & REGULATIONS
Patrick Sello 17/11/2022

13. Thank you
Q & A