M. Tech. Business Information Systems / The acceptance of E-health in South African Hospitals and other developing countries is slow and confusing. Healthcare professionals must be fully engaged in the E-health decision making since they are the main users of E-health systems. It is important to note that using E-health to support the daily work of healthcare professionals can improve healthcare provision and so improve citizens' health. However, investing in affordable E-health applications that can help in realising the benefits of technology and minimizing health costs is not easy. Literature shows that much as there are several studies that have been conducted in respect of technology acceptance, adoption and use, little attention has been given to E-health acceptance in South Africa. Therefore, this study sought to design a model for E-health acceptance for South African hospitals.

M. Tech. Business Information Systems / The purpose of the study was to develop a framework that could be used to assess e-health readiness for rural South Africa. Data for the study was collected from Moses Kotane Municipality in the North West Province of South Africa. One state hospital and ten clinics were used for data collection. From related literature, six constructs of; core readiness, structural readiness, engagement readiness, societal readiness, performance and effort expectance were used as pillars for e-health readiness assessment. The attributes that were identified in the literature were validated by healthcare administrators at the regional office of the Northwest province.

Introduction A plethora of health indicators have been added into the District Health Information System (DHIS) since its adoption and implementation as the routine health information for South Africa in 1999. The growing demand for the production and dissemination of routine health information has not been equally matched by improvements in the quality of data. In the health sector the value of monitoring and evaluation is not simply the product of conducting monitoring and evaluation but, rather from discussing and using performance indicators to improve health service delivery. Aim The aim of this study was to classify health care indicators in the national health data sets used for planning, monitoring and evaluation and to review the data management practices of personnel at provincial and district level. Methods An observational, cross sectional study with a descriptive component was conducted, in 2009, using a finite sample population from district and provincial level across eight provinces. The study participants completed a self-administered questionnaire which was e-mailed to them. Results A total of 32 (52%) participants responded to the questionnaire and of this total 21 (65.5%) responses were from district level and 11 (34.4%) from provincial level. The National Indicator Data Set, the key source for primary health care and hospital data, was implemented in 1999 with approximately 60 indicators. In less than 10 years it has grown in size and presently contains 219 performance indicators that are used for monitoring and evaluating service delivery in the public health sector. Whilst both district and provincial level personnel have a high awareness (83%) of the DHIS data sets there is variability in the implementation of these data sets across provinces. The number of indicators collected in the DHIS data sets for management decisions are “enough”, however a need was expressed for the collection of community health services data and district level mortality data. Similarities were noted with other studies that were conducted nationally with respect to data sharing, utilisation and feedback practices. Data utilisation for decision making was perceived by district level personnel to be adequate, whereas provincial level personnel indicated there is inadequate use of data for decision making. Whilst 87.1% of personnel indicated that they produce data analysis reports, 71.9% indicated that they never get feedback on the reports submitted. The top 4 data management constraints include: lack of human resources, lack of trained and competent staff, lack of understanding of data and information collected and the lack of financial and material resources. There was agreement by district and provincial level personnel for the need for additional capacity for data collection at health facility level. Discussion The increasing need for accurate, reliable and relevant health information for planning, monitoring and evaluation has highlighted critical areas where systems need to be developed in order to meet the information and reporting requirements of stakeholders at all levels in the health system Recommendations An overarching national policy for routine health information systems management needs to be developed which considers the following: emerging national and international reporting requirements, human resources requirements for health information and integration of systems for data collection. In the short-term a review of the National Indicator Data Set needs to be conducted. / Thesis (MMed.)-University of KwaZulu-Natal, Durban, 2010.

Research report submitted to the School of Economic and Business Sciences, University of the Witwatersrand in partial fulfilment of the requirements for the degree of Master of Commerce (Information Systems) by coursework and research, 2 November 2017 / Mobile health applications are fast becoming an influential source of information for pregnant women. Studies have shown that pregnant women download 3 such apps on average on their cellphones. These mobile technologies have been shown to help women monitor their progress during their pregnancy and personalise healthcare to suit their needs. To date, llimited research has been directed towards understanding usage behaviours with these apps. Various authors have argued that there is a need to expand the scope of research from simple usage behaviour to deeper levels as technology becomes more sophisticated and easily available. M-health technologies are increasingly becoming more varied and sophisticated and as such this study aims to explore post-adoption usage specifically of mobile health pregnancy applications in the South African context. This study specifically looked at post adoption usage behaviours and used Hsieh and Zmud’s (2006) framework as a basis of understanding these behaviours. The potential influences on these behaviours were sourced from various studies done on pregnant women usage of ICT in general. These influences were then investigated to see whether they were relevant in the context of m-health pregnancy support applications. The primary method of data collection was open ended semi structured interviews with twelve pregnant women. Data analysis was done using the iterative model for qualitative data analysis proposed by Miles and Huberman (1994). The findings revealed that pregnant women displayed post adoption usage behaviours of routine use and IS continuance. With regards to the infusion stage, the study found that pregnant women engaged in the first set of post adoption usage behaviours i.e. extended usage and deep usage. They did not engage in second stage behaviours namely emergent use, feature extension or intention to explore behaviours. The influences identified in the literature were found to be relevant in the context of m-health applications and additional influences such as cost of seeing gynaecologist, number of features on the app and social structures were found to have an influence on usage of the apps. This study provides unique insights into the views of pregnant women’s experiences with m-health apps. Specifically, by using interpretive research it uncovers the subjective meanings around post adoption usage behaviours, understanding how pregnant women engage in these behaviours and subsequently how these behaviours are sustained during their pregnancy. The study recognises m-health pregnancy support apps as important tools in the pregnancy journey. It highlights how pregnant women value these apps and view them as huge information sources, reassurance and comfort during their pregnancy. It is argued that medical professionals cannot distance themselves away from these apps and need to work in conjunction with them to provide robust maternity care to their patients. 5 Theoretically, this study adds to our understanding of post adoption usage behaviours specifically in the context of m-health pregnancy apps. Limited studies have been done in this field specifically in the South African context and the study provides a foundation for further research. Further research can be done to understand how these apps are changing the relationship between pregnant women and medical professionals and furthermore, whether the information received from these apps is reliable and credible. / GR2018

A Dissertation in fulfillment of the requirements for the Degree of Master of Commerce by Research in Information Systems / Electronic Medical Records (EMR) systems aim to provide an integrated solution to a number of hospital processes, including supporting administrative functions such as patient billing, providing clinical guidelines, and allowing clinicians to order and view lab reports. Yet with all these possible benefits, like many other types of information systems and technologies, their impact on hospital performance has been a key area of interest and a source of debate. This study examines the extent to which EMR systems are available across South African hospitals as well as how well they have been integrated into the processes of the said hospitals. The diffusion of EMR systems means they are available in the relevant clinical units whilst their infusion suggests they are comprehensively embedded into the processes that they are meant to support. The most important question answered in this study was whether the diffusion and infusion of these systems had any impact on the performance of hospitals. Answering this question would aid decision makers on whether more effort is indeed needed to ensure their availability across units and their embedding into hospital processes. The study collected data from a number of hospitals in the private and public sector with multiple informants providing data on diffusion and infusion of these systems as well as on hospital performance. Performance measures included the hospitals’ economic efficiency, their clinical effectiveness, patient safety, and patient satisfaction. Key findings were that while there are performance benefits in the diffusion of EMR systems across units, the impacts are not always positive for some hospitals. Large hospitals were less likely to benefit from the diffusion of these systems. However the comprehensive use of these systems provided benefits for all types of hospitals, suggesting that while availability may be important, it is the comprehensive embedding of the EMR system into the hospital’s processes that is more beneficial to all types of hospitals. These results present further opportunity for research into why the impact of EMR systems is not always positive for some hospitals. / MT2017

This research was instigated by testimony of the failure and the subsequent crisis in the South African public healthcare system. Official investigations had brought to light alarming operational deficiencies in institutions under the aegis of the Gauteng Department of Health. The South African public sector and government departments, in general, are currently challenged by a complex transformation process which has a prime objective to ameliorate public accountability, service delivery and budgetary control. They are likewise faced with the equally labyrinthine and demanding task of establishing a public-sector organisation with meaningful and effective operational processes that are, in addition, expected to synchronise with the modern economy. The researcher is unequivocal: the success of the GDH in responding to the challenges of improving organisational performance and healthcare service delivery depends essentially on their knowledge management strategy. Knowledge, across public-sector organisations, is increasingly being acknowledged, not only as a strategic resource but also as a valuable organisational asset. In the context of this research, knowledge is defined as the experience that resides in the minds of people; termed tacit knowledge (as opposed to formal, codified or explicit knowledge). In an analogous manner, research studies abound with evidence that has identified knowledge management as having an influence on operational performance for healthcare service delivery. Yet, a brief inquest indicated that our overall understanding of the existence of the relationship between knowledge management and operational performance for healthcare service delivery in the South African public sector is, at best, exiguous. With these appraisals in mind, the researcher developed a theoretical model that revealed factors that could influence organisational performance and healthcare service delivery. The model focused on knowledge management capabilities and organisational performance. The prime objective was to operationalise the theoretically derived knowledge management capabilities constructs, identify statistically the enhancing or impeding factors that impact on organisational performance and develop a structural equation model to verify this theoretical paradigm. The ambition of this study was similarly to investigate the use of knowledge management by the Gauteng Department of Health for its transformation to achieve improved organisational performance and healthcare service delivery. This study in essence addressed four research questions: Firstly, what was the level of understanding of knowledge management in the Gauteng Department of Health and related healthcare facilities? Secondly, how were knowledge management strategies and practices aligned with the Gauteng Department of Health strategies and operational objectives? Thirdly, how was knowledge management used by the employees in the Gauteng Department of Health? and fourthly, how could the results of the literature review and the empirical data be used to create a knowledge-management culture and a collaborative working environment for the Gauteng Department of Health? The elemental, hypothesised pursuit governing the study was to determine the existence of a relationship between the use of knowledge management and an improvement in organisational performance and healthcare service delivery. Collaterally, what enabling environment would be instituted by the gatekeepers of the institutional praxes to capacitate other staff members specifically so as to include the succession planning conundrum? To accomplish this and after reviewing the literature, the effective factors in knowledge management were identified, namely, knowledge infrastructure proficiencies and knowledge process capabilities. The research followed the parallel mixed-methods approach in gathering and analysing research data. Data was collected using questionnaires with 496 respondents and interviews with 35 interviewees. The sample used in this study comprised employees of the Gauteng Department of Health and its regional healthcare centres. The survey respondents and interview participants were the general staff and executive/senior managers of the Gauteng Department of Health. These individuals were considered to possess the most comprehensive knowledge about their organisation’s characteristics and strategy, which included knowledge management adoption. In order to identify the relationships between the model elements, appropriate tests were initiated using the Statistical Package for Social Sciences. Exploratory and confirmatory factor analyses and structural equation modelling were utilised and the proposed model was then extracted and content analysis was applied in evaluating the resulting qualitative data. The findings of this study furthermore indicated that knowledge management concepts were not universally understood in the Gauteng Department of Health. A structural equation model development strategy, postulated in the factor analysis, also produced a new best-fitting knowledge management capability model based on the new constructs. The structural equation model suggested that significant factors influencing the improvement of the organisational performance and healthcare service delivery are those of knowledge management capability. The regression analysis showed that most of the inter-correlations were significant, thus confirming the theory that knowledge management capabilities have a direct influence on organisational performance and healthcare service delivery. The research contributed theoretically to a comprehensive understanding of the relationship between knowledge management principles and factors that influence organisational performance and healthcare service delivery. Practically, the research contributed to confirming the use of knowledge management by the Gauteng Department of Health could to the improvement of its overall organisational performance and healthcare service delivery. The study further demonstrated the impact of knowledge management activities as a driving force for organisational change and the effect of knowledge management on the improvement of workforce productivity and organisational effectiveness. The new knowledge management capability model could additionally assist the Gauteng Department of Health determining the extent to which knowledge management is used and where to focus in developing and implementing knowledge management strategy. The study encourages practitioners to take cognisance of the fact that organisations are unique and that the factors which enhance or impede knowledge management are to be thoroughly examined. This case study was endorsed for its significant contribution to regional healthcare system, as well as the broader national healthcare structure. / School of computing / Ph. D. (Information Systems)

Data quality is one of many challenges experienced in electronic healthcare (e-health) services in South Africa. The collection of data with substandard data quality leads to inappropriate information for health and management purposes. Evidence of challenges with regard to data quality in e-health systems led to the purpose of this study, namely to prioritise data quality challenges experienced by data users of e-health systems in South Africa. The study followed a sequential QUAL-quan mixed method research design to realise the research purpose. After carrying out a literature review on the background of e-health and the current status of research on data quality challenges, a qualitative study was conducted to verify and extend the identified possible e-health data quality challenges. A quantitative study to prioritise data quality challenges experienced by data users of e-health systems followed. Data users of e-health systems in South Africa served as the unit of analysis in the study. The data collection process included interviews with four data quality experts to verify and extend the possible e-health data quality challenges identified from literature. This was followed by a survey targeting 100 data users of e-health systems in South Africa for which 82 responses were received. A prioritised list of e-health data quality challenges has been compiled from the research results. This list can assist data users of e-health systems in South Africa to improve the quality of data in those systems. The most important e-health data quality challenge is a lack of training for e-health systems data users. The prioritised list of e-health data quality challenges allowed for evidence-based recommendations which can assist health institutions in South Africa to ensure future data quality in e-health systems. / Computing / M. Sc. (Computing)

M. Tech. Business Information Systems / Field-based healthcare is the provisioning of healthcare outside a traditional healthcare facility whose location is fixed. Although healthcare is not location and time dependent, the delivery of the service is often constrained to particular location and time. That is, although data accuracy and timely access to medical information is vital, healthcare service providers are not mobile enough to provide the on-demand healthcare service to patients. With restricted mobility, mistakes, unavailability and inaccuracy of information can have life-threatening consequences. To this point, this mini-dissertation argues that Mobile Information Technology (IT) Innovation could leverage field-based healthcare. Thus Mobile IT is considered essential to reducing medical errors, enhancing patient safety and improving quality of healthcare service delivery. Mobile IT can also be leveraged to meet ICT infrastructural challenges of field-based healthcare. That is, to enhance this service delivery, Mobile IT innovation will include the use of mobile devices such as mobile phones, smart phones, pocket computers, wireless networks and other technologies such as Radio Frequency Identification, smart cards, as well as information systems accessed through these technologies. In recent years, cases of Mobile IT application in healthcare service, particularly in South Africa, suggest the use of Mobile IT for disease management, monitoring as well as evaluation of patient care activities. There is a need for an empirical study to highlight the determinant factors that influence Mobile IT innovation for field-based healthcare. In response to this need, this study captured and unraveled the complexity of Mobile IT innovation for field-based healthcare through a case study conducted at a healthcare service provider.

Text in Afrikaans / Die probleem wat in die studie ondersoek word is: wat die aard van die behoefte aan gemeenskapgesondheidsinligtingdienste (GGID) in Suid-Afrika, met besondere verwysing na Bloemfontein en Mangaung, is. Daar word van 'n verkennende studie gebruik gemaak om die navorsingsdoelstellings te bereik. Die metodes wat gebruik is, is literatuurstudie, gevallestudie en opname. Die tegnieke wat gebruik is, is vraelys, skedule en onderhoud. 'n Oorsig oor gesondheidsorg, met die klem op primere gesondheidsorg as agtergrond vir gesondheidsopvoeding en -inligting, word gegee. Daar word verwys na die rol van verskillende biblioteektipes en die bibliotekaris. Redes vir die ontstaan van gemeenskapgesondheidsinligting, die verspreiding van GGID in die buiteland en die fvksionering daarvan word beskryf. 'n Ondersoek is in Mangaung en Bloemfontein gedoen om die behoefte aan GGID en die aard van gesondheidsinligting te probeer bepaal. 'n Model word saamgestel uit die behoeftebepaling en die literatuurstudie / The subject investigated by this study is: the nature of the need for community health information services (CHIS) in South Africa, with special reference to Bloemfontein and Mangaung. An exploratory study has been used to achieve the research objectives. The methods used are review of the literature, case study and a survey. The techniques used are a questionnaire, schedule and interview. A review of health care, emphasizing primary health care as a backgound to health education and information, is given. The role of different types of libraries and the librarian is discussed. Reasons for the development of community health information, the distribution of CHIS overseas and their functioning are described. An investigation was done in Bloemfontein and Mangaung to gauge the need for CHIS and the nature of health information. A model has been formulated, based on this survey and the literature review / Information Science / M. Bibl. (Inligtingkunde)

Text in Afrikaans / Die probleem wat in die studie ondersoek word is: wat die aard van die behoefte aan gemeenskapgesondheidsinligtingdienste (GGID) in Suid-Afrika, met besondere verwysing na Bloemfontein en Mangaung, is. Daar word van 'n verkennende studie gebruik gemaak om die navorsingsdoelstellings te bereik. Die metodes wat gebruik is, is literatuurstudie, gevallestudie en opname. Die tegnieke wat gebruik is, is vraelys, skedule en onderhoud. 'n Oorsig oor gesondheidsorg, met die klem op primere gesondheidsorg as agtergrond vir gesondheidsopvoeding en -inligting, word gegee. Daar word verwys na die rol van verskillende biblioteektipes en die bibliotekaris. Redes vir die ontstaan van gemeenskapgesondheidsinligting, die verspreiding van GGID in die buiteland en die fvksionering daarvan word beskryf. 'n Ondersoek is in Mangaung en Bloemfontein gedoen om die behoefte aan GGID en die aard van gesondheidsinligting te probeer bepaal. 'n Model word saamgestel uit die behoeftebepaling en die literatuurstudie / The subject investigated by this study is: the nature of the need for community health information services (CHIS) in South Africa, with special reference to Bloemfontein and Mangaung. An exploratory study has been used to achieve the research objectives. The methods used are review of the literature, case study and a survey. The techniques used are a questionnaire, schedule and interview. A review of health care, emphasizing primary health care as a backgound to health education and information, is given. The role of different types of libraries and the librarian is discussed. Reasons for the development of community health information, the distribution of CHIS overseas and their functioning are described. An investigation was done in Bloemfontein and Mangaung to gauge the need for CHIS and the nature of health information. A model has been formulated, based on this survey and the literature review / Information Science / M. Bibl. (Inligtingkunde)