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.

Thesis (MTech. degree in Business Information Systems.)--Tshwane University of Technology, 2008. / This study is about exploring and understanding the collective work activity involved in medical record keeping for patients within a district hospital. The unit of analysis was the activity of medical record keeping as a system.

Theoretically, the use of Electronic Medical Records (EMRs) holds promise of numerous benefits in healthcare provision, including improvement in continuity of care, quality of care and safety. However, in practice, there is evidence that the adoption of electronic medical records has been slow and where adopted, often lacks meaningful use. Thus there is a clear dichotomy between the ambitions for EMR use and the reality of EMR implementation. In the USA, a legislative approach was taken to turn around the situation. Other countries such as Canada and European countries have followed suit (in their own way) to address the adoption and meaningful use of electronic medical records. The South African e-Health strategy and the National Health Normative Standards Framework for Interoperability in eHealth in South Africa documents both recommend the adoption of EMRs. Much work has been done to establish a baseline for standards to ensure interoperability and data portability of healthcare applications and data. However, even with the increased focus on e-Health, South Africa remains excessively reliant on paper-based medical records. Where health information technologies have been adopted, there is lack of coordination between and within provinces, leading to a multitude of systems and vendors. Thus there is a lack of systematic adoption and meaningful use of EMRs in South Africa. The main objective of this research is to develop the components required to engender meaningful use of electronic medical records in the South African healthcare context. The main contributors are identified as EMR certification and consistent, proper use of certified EMRs. Literature review, a Delphi study and logical argumentation are used to develop the relevant components for the South African healthcare context. The benefits of EMRs can only be realized through systematic adoption and meaningful use of EMRs, thus this research contributes to providing a road map for engendering the meaningful use of EMRs with the ultimate aim of improving healthcare in the South African healthcare landscape.

The importance of records management to the provision of healthcare services cannot be overemphasised. If medical records are not managed properly, this might result in the provision of poor healthcare services. This is because usually if medical records are not properly managed, the healthcare institutions attain inaccurate, untimely, incomplete and unauthentic records or the records fade completely. Records that are not managed properly are easily lost, modified, altered, misfiled and/or damaged, which results in a struggle to locate them and, eventually, much time is lost. Records of this kind may not support healthcare service providers properly in decision-making, problem-solving, monitoring and evaluation of service for continuous service improvement. This study utilised the five elements of trusted records management (records management governance practice, staff capacity and competencies, recordkeeping system and technology, and records archival processes) to investigate the development of a framework to embed medical records management into the healthcare service delivery practice for effective records management practice. The study predominantly utilised a quantitative approach with some support from a limited scope of qualitative data to augment numeric data. The data was collected using the four different techniques, namely questionnaire, interview, observation and system/documents analysis. The study revealed that the mode of medical record management was not effectively enabling the institution to manage medical records properly due to lack of integrated medical records management framework into the healthcare business process. The medical records management technology also lacked file tracking system, records backup, and audit trail which compromise records safety and security. The study recommended supply of the necessary resources, with a framework that the healthcare institutions may adopt to embed medical records management into the healthcare service delivery. ECM may also be implemented to incorporate electronic records management systems, information management, web content and other add-ons to support the records management framework in ensuring effective discharge of all records management functional requirements on the healthcare business process. A further study was recommended about the development of an online outpatient consultation system and medical records access to avoid patient long turnaround time for service. / Information Science / D. Litt. et. Phil. (Information Science)

The adoption of digital health technologies has dramatically changed the healthcare sector landscape and thus generates new opportunities to collect, capture, store, access and retrieve electronic personal health information (ePHI). With the introduction of digital health technologies and the digitisation of health data, an increasing number of hospitals and peripheral health facilities across the globe are transitioning from a paper-based environment to an electronic or paper-light environment. However, the growing use of digital health technologies within healthcare facilities has caused ePHI to be exposed to a variety of threats such as cyber security threats, human-related threats, technological threats and environmental threats. These threats have the potential to cause harm to hospital systems and severely compromise the integrity and confidentiality of ePHI. Because of the growing number of security threats, many hospitals, both private and public, are struggling to secure ePHI due to a lack of robust data security plans, systems and security control measures. The purpose of this study was to explore the security of electronic personal health information in a public hospital in South Africa. The study was underpinned by the interpretivism paradigm with qualitative data collected through semi-structured interviews with purposively selected IT technicians, network controllers’, administrative clerks and records management clerks, and triangulated with document and system analysis. Audio-recorded interviews were transcribed verbatim. Data was coded and analysed using ATLAS.ti, version 8 software, to generate themes and codes within the data, from which findings were derived. The key results revealed that the public hospital is witnessing a deluge of sophisticated cyber threats such as worm viruses, Trojan horses and shortcut viruses. This is compounded by technological threats such as power and system failure, network connection failure, obsolete computers and operating systems, and outdated hospital systems. However, defensive security measures such as data encryption, windows firewall, antivirus software and security audit log system exist in the public hospital for securing and protecting ePHI against threats and breaches. The study recommended the need to implement Intrusion Protection System (IPS), and constantly update the Windows firewall and antivirus program to protect hospital computers and networks against newly released viruses and other malicious codes. In addition to the use of password and username to control access to ePHI in the public hospital, the study recommends that the hospital should put in place authentication mechanisms such as biometric system and Radio Frequency Identification (RFID) system restrict access to ePHI, as well as to upgrade hospital computers and the Patient Administration and Billing (PAAB) System. In the absence of security policy, there is a need for the hospital to put in place a clear written security policy aimed at protecting ePHI. The study concluded that healthcare organisations should upgrade the security of their information systems to protect ePHI stored in databases against unauthorised access, malicious codes and other cyber-attacks. / Information Science / M. Inf. (Information Security)

In the last decade, the deployment of Electronic Health Records has increased tremendously in many developed countries. This increasing trend intensifies the need for developing countries like South Africa to implement electronic health record systems in state owned hospitals to facilitate e-referral processes to improve health care delivery. The aim of this research was to investigate the current process of patient record keeping, management, and the referral process of patients within the same hospital and to other hospitals and based on the findings compile an Electronic Health Record (EHR) framework to facilitate e- referral processes. This research study was based on a qualitative case study approach. A multiple data collection technique was used which included group interviews, questionnaires, document analysis and informal discussions with the hospital workers. Data were analysed by categorization and thematic approach. The findings obtained from state hospitals indicated that there is no EHR system which accommodates patient health record systems to facilitate e-referral processes. These findings led to a compilation of the Limpopo Electronic Health Record System (LEHRS) to aid e-referral processes in state hospitals. The increasing need for accurate, reliable, available and accessible EHR will be addressed by the implementation of LEHRS as information will be stored in a central database in a useable format and will be easily accessed. / Computing / M. Tech. (Information Technology)

In the last decade, the deployment of Electronic Health Records has increased tremendously in many developed countries. This increasing trend intensifies the need for developing countries like South Africa to implement electronic health record systems in state owned hospitals to facilitate e-referral processes to improve health care delivery. The aim of this research was to investigate the current process of patient record keeping, management, and the referral process of patients within the same hospital and to other hospitals and based on the findings compile an Electronic Health Record (EHR) framework to facilitate e- referral processes. This research study was based on a qualitative case study approach. A multiple data collection technique was used which included group interviews, questionnaires, document analysis and informal discussions with the hospital workers. Data were analysed by categorization and thematic approach. The findings obtained from state hospitals indicated that there is no EHR system which accommodates patient health record systems to facilitate e-referral processes. These findings led to a compilation of the Limpopo Electronic Health Record System (LEHRS) to aid e-referral processes in state hospitals. The increasing need for accurate, reliable, available and accessible EHR will be addressed by the implementation of LEHRS as information will be stored in a central database in a useable format and will be easily accessed. / Computing / M. Tech. (Information Technology)

Health practitioners collect health data on a daily basis at health facility levels in order to monitor and evaluate the performance of priority national health programmes (District Health Plan 2012:6). Routine data quality for health programmes monitoring need a collective intervention to ensure clear understanding for what data to be collected at primary health care setting. The aim of the study is to explore the understanding of routine health data, determine the use of routine data and feedback mechanism at primary health care clinic setting. Quantitative descriptive research design was used to answer the research question on this research study. Structured data collection questionnaire was used for the study to accomplish the research purpose and reach the study objectives. A total of 400 participants was sampled, and 247 responded. One of the findings was that the understanding of routine health data by Health Practitioners was at 82.6% (% = f/n*100, f= 3242 and n= 3926). / Health Studies

Health practitioners collect health data on a daily basis at health facility levels in order to monitor and evaluate the performance of priority national health programmes (District Health Plan 2012:6). Routine data quality for health programmes monitoring need a collective intervention to ensure clear understanding for what data to be collected at primary health care setting. The aim of the study is to explore the understanding of routine health data, determine the use of routine data and feedback mechanism at primary health care clinic setting. Quantitative descriptive research design was used to answer the research question on this research study. Structured data collection questionnaire was used for the study to accomplish the research purpose and reach the study objectives. A total of 400 participants was sampled, and 247 responded. One of the findings was that the understanding of routine health data by Health Practitioners was at 82.6% (% = f/n*100, f= 3242 and n= 3926). / Health Studies