Alfred Coleman

eHealth integration and interoperability issues: towards a solution through enterprise architecture

Investments in healthcare information and communication technology (ICT) and health information systems (HIS) continue to increase. This is creating immense pressure on healthcare ICT and HIS to deliver and show significance in such investments in technology. It is discovered in this study that integration and interoperability contribute largely to this failure in ICT and HIS investment in healthcare, thus resulting in the need towards healthcare architecture for eHealth. This study proposes an eHealth architectural model that accommodates requirement based on healthcare need, system, implementer, and hardware requirements. The model is adaptable and examines the developer’s and user’s views that systems hold high hopes for their potential to change traditional organizational design, intelligence, and decision-making.

Using a Virtual ICT Training Framework to Support Doctors in Rural Hospitals in South Africa

Abstract This paper investigated how ICT skill levels of doctors deployed to rural hospitals contribute to effective usage of computer-mediated tools in hospitals in South Africa. A case study approach was used. Participants were selected from a population group of doctors. Ten doctors were selected from ten government-owned hospitals for interviews. Data was collected using semi-structured open ended interview questions. Doctors were asked to rate their knowledge on computer and e-health skill and indicate if they need training. The findings revealed that majority of the doctors in rural hospitals (n=75%) are computer illiterate. When those with computer skills were asked to rate their knowledge in computer usage, 46% said they were novice, 42% were average and only 12% stated that they were experienced. The results led to a proposed virtual ICT training framework to provide basic ICT training through virtual tutoring to support doctors in rural hospitals.

Improving computer-mediated synchronous communication of doctors in rural communities through cloud computing: A case study of rural hospitals in South Africa

This paper investigated how doctors in remote rural hospitals in South Africa use computer-mediated tool to communicate with experienced and specialist doctors for professional advice to improve on their clinical practices. A case study approach was used. Ten doctors were purposively selected from ten hospitals in the North West Province. Data was collected using semi-structured open ended interview questions. The interviewees were asked to tell in their own words the average number of patients served per week, processes used in consultation with other doctors, communication practices using computer-mediated tool, transmission speed of the computer-mediated tool and satisfaction in using the computer-mediated communication tool. The findings revealed that an average of 15 consultations per doctor to a specialist doctor per week was done through face to face or through telephone conversation instead of using a computer-mediated tool. Participants cited reasons for not using computer-mediated tool for communication due to slow transmission speed of the Internet and regular down turn of the Internet connectivity, constant electricity power outages and lack of e-health application software to support real time computer-mediated communication. The results led to the recommendation of a hybrid cloud computing architecture for improving communication between doctors in hospitals.

The Use of ICT Tools (Mobile Phones) to Improve Awareness of Pregnancy Danger Signs among Pregnant Women in Rural Communities of South Africa

AbstractThe present study investigated awareness of pregnancy danger signs, symptoms and associated factors among a group of South African pregnant women attending prenatal care clinics in rural setting. A case study approach was used. Fifteen participants were purposively selected out of a population of pregnant women in five rural community clinics. Data was collected using semi-structured open-ended interview questions. The interviewees (pregnant women aged 15 years and older, who attended 1 of 5 prenatal care clinics) were asked to tell in their own words their knowledge and awareness about pregnancy danger signs among pregnant women. The findings revealed that the participants’ actual knowledge about the danger signs and symptoms of pregnancy complications was very low. Again, self-perceived awareness about pregnancy danger signs was very limited. However, it was further revealed that 93% of these pregnant women own mobile phones. The results led to a proposed Pregnancy Danger Signs Mobile Architectu...

An Integrated Model to Share Patient Health Records in Public and Private Hospitals in South Africa

Abstract This paper investigated how patient health information is transferred and shared between government owned hospitals and private hospitals in South Africa. A case study approach was used. Participants were selected from a population group of doctors. Ten doctors were selected from five government and five private hospitals for interviews. Data was collected using semi-structured open ended interview questions. Doctors were asked to tell in their own words how patient data are stored, managed and transmitted when patients move from one government hospital to another government hospital as well as from one government hospital to a private hospital and vice versa. The findings revealed that Patient health information created in government or private hospital are stored, managed and transmitted in paper or electronic form exclusively within that hospital. No patient data is shared between the government and government hospital or between government and private hospital. The results led to the recommendation of integrated electronic health record model to assist doctors share patient information between private and government hospitals.

A Virtual Community of Practice Framework to Support Doctors' Practices in National Health Insurance (NHI) in South Africa

Abstract The introduction of National Health Insurance (NHI) in South Africa poses major challenges to doctors in rural communities who serve high number of patients daily. This paper investigated how doctors in rural hospitals in South Africa use Virtual Community of Practice (VCoP) to share experience with specialist doctors to improve on their practices. A case study approach was used. Ten doctors were selected from ten hospitals in the North West Province. Data was collected using semi-structured open-ended interview questions to inquire about availability of ICT infrastructure, doctors’ workload, methods and frequency of consultation, task type, and satisfaction of using computer-mediated tool. Findings revealed that an average of 15 consultations per doctor to a specialist doctor per week was done through face-to-face or telephone conversation. The results led to a proposed VCoP Framework based on the principles of responsibility, connectedness and reverence to assist doctors render quality healthcare services under the NHI project.

Pr e-selection of Traditional Medicine for Clinical Trials in Developing Countries Through the Use of Information and Communication Technology (ICT): A Case Study of South Africa Health Department

Abstract A high percentage of South African population depends on traditional medicine for treatment but no clinical and scientific validation has been documented in terms of quality, safety, timely and effectiveness of this traditional medicine for treatment. This paper investigated the methods of pre-clinical trials of traditional medicine (herbs) by the health department of North West Province of South Africa. A case study approach was used. Six participants were drawn from an entire population of doctors who are members of the Traditional Medical Council of South Africa and members of Food and Drug Board of South Africa. Data was collected using semi-structured open-ended interview questions to inquire about pre-selection methods for pharmaceutical drugs for clinical trial; pre-selection methods for traditional medicine (herbs) for clinical trial and how effectiveness and the risk factor of any drug is determined. The findings revealed that pre-clinical trial methods are the same for both pharmaceutical drugs and traditional medicine. Both pre-clinical phase use human and animals as subjects of the trial. However participants approached to partake in pre-clinical trial of traditional medicine were reluctant to volunteer because of lack of time, adverse effect of trial on their personal health and uncertainty of Compensation for Occupational Injuries. It became evident that no traditional medicines have been tested on human to be registered with the Medicines Control Council or be prescribed as treatments for any disease in South Africa. The results led to a proposed Pre-clinical Traditional Medicine ICT Framework (PTM-ICT Framework) to collect data on traditional medicine (herbs) directly from the general public and Traditional Medicine Practitioners to ascertain the safety and efficacy of that herb to serve as information needed at pre-selected stage of clinical trial of traditional medicine.

Ef fective Blood Distribution in Rural Hospitals through ICT Service Oriented Architecture (SOA) Framework: A Case Study in Rural Hospitals in South Africa

Abstract Blood is a vital product in healthcare services as most surgical and emergency activities in hospitals depend on blood transfusion. Blood inventory management in rural hospitals at North West Province of South Africa has become a cause of concern to medical practitioners who need blood supplies to save lives. This study investigated various methods used in blood management at rural hospitals. A case study approach was used. Data was collected using semi-structured open-ended interview questions. The interviews were recorded, transcribed and coded. The findings revealed that blood is ordered according to a strict policy. Blood requisition is sent to hospital administrators who order blood from the South African National Blood Service (SANBS) by telephone, postal services and sometimes traveling to SANBS’ offices. Challenges like constant electricity power outages and lack of e-health application software to support e-stock management of blood were revealed. An ICT Service Oriented Architecture (SOA) framework based on the principles of integration of services and interoperability of ICT systems was proposed.

E-Health Readiness Assessment for E-Health Framework for Africa: A Case Study of Hospitals in South Africa

This study assessed e-healthcare readiness of rural and urban hospitals in North West Province of South Africa. Outcome of assessment led to creation of e-health architectural framework for e-health solutions. Assessment was conducted in usage of ICT in patient healthcare record system, processes and procedures in consultation among healthcare professionals, prescription of medication, referral of patients and training of healthcare professionals in ICT usage. The study was in two phases and six hospitals were selected. E-healthcare readiness assessment focusing on need, technological, engagement and social acceptance readiness were assessed. Data collected used group interviews and qualitative questionnaires. Findings showed that computers were not used for clinical duties and no e-health solutions were found. E-health Maturity Level was at level zero. Recommendations and compilation of Provincial E-Health Framework (PEHF) were made. The findings were unexpected and therefore, of great benefit to healthcare institutions which intend to implement e-health initiatives in hospitals.

Empirical investigation on the influence of organizational systems mechanisms(OSM) on employees motivation to effectively use human resource information systems: A Case of South African Universities

The aim of this paper is to report the findings of an investigation into the influence of organizational structures on the motivation of South African university employees to effective use HRIS. HRIS is a management system that assists organisations with the management of employees, employees details and activities which aims to benefit the university collective duties such as strategic planning. Several Literature studies have indicated our concern which is HRIS is highly underutilized in the universities and there is need to understand what the critical factors are causing this underutilization. Our research used a quantitative approach and 300 university employees which included academic and non-academic staff members participated in the study. The Self deterministic theory of work motivation (SDT-Work motivation) was adopted as the theoretical underpinning due to its unique ability to emphasis on intrinsic and extrinsic motivation. Furthermore to support the utilized theory the study included Organizational System Mechanisms (OSM) which serve as external factors that could influence positively or negatively the usage of HRIS especially within the South African context. Questionnaires were distributed through the use of a survey monkey. The findings of the research discovered that organizational politics and organizational culture had a strong influence on employees willingness to effectively use HRIS. The results indicated that organizational ethics was a well handled issue in South African institutions.