Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, August 15, 2007

South Africa Showing Some Leadership in e-Health!

A recent report from South Africa has really brightened a dull day.

The report can be found here.

What the report suggests is the SA is moving steadily, and in a planned way, towards the procurement and implementation of a National Health Information System (NHIS).

It seems that more than Ireland and Lithuania have developed the e-Health bug (as reported in the weekend roundup)!

We are told that “The NHIS is intended to provide the country an overall patient information system, linking the private and public sector at local, district, provincial and national level. The public sector alone includes 369 general and 54 specialised hospitals, as well as 3 143 clinics and a number of support institutions such as medical laboratories.”

We are also told that the health department tender documents say this includes procurement of a major of a National Healthcare Management Information System (NHCMIS) which is to be installed and initiated in all the major public hospitals.

With this done an appropriately scaled-down version of the same NHCMIS in all the smaller hospitals and primary healthcare centres.

Modules selected for fast-tracking include those for patient registration, a core patient record data set, appointment scheduling and patient billing.

Priority is also be given to information systems related to disease surveillance and facility management. This makes a great deal of sense in a country that is battling and AIDS pandemic and which clearly needs to manage the available facilities as well as possible.

It is really a good thing in my view that a country such as South Africa is working to leverage what Health IT can offer and at least seems to have a plan!

A nice touch is the last paragraph of the article!

“The NHIS was dragged into the news at the weekend, when a health ministry spokesman suggested deputy health minister Nozizwe Madlala-Routledge was sacked in part for her alleged failure to produce a health IT policy.”

While part of the down fall of the minister may be related to some very strange views on the causation of AIDS, oh! if only we could see similar political accountability for inaction in the e-Health domain Australia!


Note: The comment provided following this post suggests I may have got the role of the Deputy Health Minister regarding AIDS wrong. Please review the comments found on this post.



Ogi Pishev said...

Don't let your guard down, David. Beware of government, any government.
Here is the real story, according to the Economist:

Sacking the wrong health minister - South Africa and AIDS
18 August 2007 The Economist
Doubts resurface about Thabo Mbeki's commitment to combating AIDS
UNTIL a few years ago it was easy for critics of South Africa's government to lambast its inade-quate efforts in fighting AIDS. The country is at the centre of a raging epidemic. Graves fill at a terrifying rate: the disease is now thought to kill 1,000 South Africans each day, most of them young adults. Some 12% of the population, more than 5m people, are infected with HIV, the vi-rus that causes AIDS. For too long the official response had ranged from denial of the problem to the promotion of traditional medicines and barmy dietary remedies, while the central govern-ment seemed reluctant to use Western medicines that had proved effective elsewhere. The health minister, for example, suggested as recently as last year that eating beetroot, garlic, lemon juice or the African potato might be the best way to combat the disease.
Thank goodness, therefore, that what appears to be a decent national programme for educating, testing and treating people was at last unveiled in 2003. The benefits are obvious. Most impor-tant has been the decision to provide anti-AIDS drugs to more of those who need them. Pills will not put an end to the epidemic, but they keep people with HIV alive much longer and patients become less infectious to others. They may also help to spread knowledge: there is an incentive to be tested for the virus if you can expect to get life-prolonging treatment. Even the government has got political benefits from the treatment programme. Although the president, Thabo Mbeki, still finds it hard for some reason to say that HIV alone causes AIDS, the sting has been drawn from attacks on his leadership by activists and others.
So here is a puzzle. The long-serving health minister, Manto Tshabalala-Msimang, who was largely behind the earlier, ineffective response to the epidemic, remains in post, although she has been ill and unable to work much. Yet her deputy, Nozizwe Madlala-Routledge, who is ac-tive and well-informed, and who with her boss absent helped to develop the treatment pro-gramme, has just been sacked. Mr Mbeki, who has long resisted calls to get rid of the ineffectual minister, has instead removed her effective deputy for, apparently, failing to respect the govern-ment's collective will. Mr Mbeki has rid himself of the wrong health minister. By keeping his old ally Mrs Tshabalala-Msimang in office when she is plainly a liability he has signalled that he val-ues loyalty above competence. He has also provoked doubts, again, about his own commitment to fighting AIDS—not least because Ms Madlala-Routledge's offence appears to have been to dare to travel to an AIDS conference in Spain against his wishes.
Too candid for the ANC? Ms Madlala-Routledge was certainly feisty. She was, for instance, fond of visiting hospitals unannounced. Often she witnessed dreadful conditions and poor manage-ment—and then talked honestly about these problems in public. To Mr Mbeki and others in the African National Congress-dominated government, this sort of initiative and candour were not evidence of a democratic representative doing her job but of an undisciplined cadre refusing to defer to her bosses, who prefer to discuss such matters behind closed doors. The question now is whether her sacking bodes ill for the implementation of policy. Ms Madlala-Routledge did not shift policy single-handed, but she was influential. With few ministers willing either to challenge the president or to volunteer leadership on AIDS, for example by taking a public HIV test, her absence will be sorely felt. Mr Mbeki himself should head the fight against the disease. His latest act has done his people, his government and his own reputation no favours at all.

Dr David G More MB PhD said...

Hi Ogi,

Thanks for that clarification - it certainly sounds like the wrong person got the bullet. There is no doubt the SA Government has handled the AIDS crisis very badly indeed. This clarifies where the buck stops. The President I suspect.