Glitches in migration to digital hospital records

Delays blamed on poor planning and lack of nurse training

The Eastern Cape department of health has spent R200m since 2021 in the rollout of digital infrastructure that has been marred by poor planning.

Some nurses have also complained that proper training was not provided to them in the implementation of the project.

The project is being implemented in two phases in 32 healthcare centres targeting highly litigated facilities that include Frere, Livingstone, Cecilia Makiwane, Bhisho and Grey hospitals.

Laptops, computers, printing machines, servers and routers, among other technology devices, have been bought as part of the implementation of the project.

The department also procured computer servers worth R45m as part of the rollout plan.

The purpose of the project is to create electronic medical records for patients, daily management of patients’ medical history and management of medico-legal records.

It includes the replacement of old computer equipment to ensure that hospitals were able to migrate from a “paper-based environment to an electronic environment”.

But the implementation has encountered challenges at many facilities due to lack of proper planning and lack of training of staff members.

United Nurses Trade Union of South Africa (Untusa) provincial chair Linamandla Malindi said: “I came across the project in 2022 where we were told that patients’ records were now going to be digitised.

“We were told the department was now at the stage of doing away with hard copies of patients’ folders. Our initial concern was that nurses were not fully equipped on the use of technology devices,” Malindi said.

“The other concern was that in the event of load-shedding, facilities with no backup generators were going to struggle when there was no power,” she said.

“I would not say the project has brought a difference because even with the technology devices that were bought, some were not operating at full capacity due to lack of maintenance and upgrades.

“We have not yet moved to a paperless environment,” Malindi said.

Democratic Nursing Organisation of SA provincial chair Sivuyile Mange said: “As Denosa in the Eastern Cape, we are in full support of this initiative because the department is bleeding severely from litigation due to poor recording.

“This comes with its own challenges, especially on infrastructure.

“The province is mainly rural with infrastructure backlogs and the issue of connectivity remains a big challenge in most healthcare facilities.

“A first-things-first approach would be assisting in the realisation of this rollout of ehealth services, otherwise it will forever remain a dream and fruitless expenditure may be incurred if proper resources are not put in place first.

“This is happening at a time when the National Treasury has put austerity measures, meaning no resources to support this rollout.”

Provincial health spokesperson Sizwe Kupelo said the digital rollout plan started in the 2021/2022 financial year.

“As part of the digital strategy, the department embarked on an ehealth project, which involves the implementation of health management system.

“The project is divided into two phases.

“The first phase involves the implementation of the patient administration modules and patient registration, processing central OPD [outpatient department] visits, ward admissions, transfers, discharges, revenue management and adverse event document digitisation,” Kupelo said.

We were told the department was now at the stage of doing away with hard copies of patients’ folders