The case for a Health Information Exchange (HIE) in South Africa
The fragmented nature of South Africa’s health system negatively impacts both the cost and quality of healthcare. This has raised concerns amongst leaders and policymakers alike, including the Competition Commission’s Health Market Inquiry (HMI) panel whose recommendations included the need for innovations that increase efficiencies in healthcare delivery and funding; greater transparency on health outcomes; less fragmentation; and a move towards care coordination. Aligned to these recommendations, the South African Government also recognises the importance of digitisation in improving access to quality healthcare in its National Digital Health Strategy. The CareConnect Health Information Exchange (HIE) has been developed to respond to the above imperatives.
Founded jointly by six of the largest private healthcare organisations in the country, Discovery Health, Life Healthcare, Mediclinic, Medscheme, Momentum Health and Netcare (the Founding Members of CareConnect), the HIE enables the sharing of patient health information between authorised organisations, thereby enabling fragmented systems to exchange information.
CareConnect HIE enables the integration of healthcare data from various sources to provide a single online entry point for healthcare providers and funders to access relevant patient information in the interest of improved health quality and outcomes.
It is a condition of participation in the CareConnect HIE, that all participants agree to the Data Use and Reciprocal Support Agreement (DURSA), which establishes the rules of engagement and obligations. This agreement specifies the principles around the sharing of data and the permitted purposes for sharing data. Data security is a key element of the DURSA and each participant is obligated to ensure sufficient mechanisms to ensure the safety of the data.
CareConnect will enable the integration of healthcare data from various sources to provide a single online entry point for healthcare providers and funders to access relevant patient information. CareConnect will facilitate data flows between data providers and data consumers. This means that when required, data will be ‘pulled’ from the data source, i.e the medical scheme/hospital/pathologist/radiologist/healthcare service provider and provided to the healthcare provider, hospital or medical scheme requiring the data.
About CareConnect
The benefits of participating in CareConnect:
- CareConnect will enable healthcare providers to access patient information via the HIE regardless of where they are. Information relating to a patient’s health conditions (including results from blood tests and radiology screens) will be available to the healthcare service provider. This will prevent the need for unnecessary duplicate pathology and radiology services, thereby driving efficiencies and cost savings.
- Improved patient outcomes by supporting effective care processes across the continuum of care.
- More effective care coordination between the patient’s healthcare service providers.
- Improved patient engagement and experience by providing relevant data to healthcare providers without the patient having to provide the same data repeatedly.
- More efficient throughput of patients through Emergency Departments (ED).
- Easier and quicker access to comprehensive, accurate and relevant patient and member information at the point of care.
- CareConnect will save the healthcare service provider time by delivering real-time clinical and benefit information.
- Saving time during an emergency situation by enabling the healthcare service provider to access the patient’s demographic, clinical and scheme information.
- Better understanding of the patient upon referral from other physicians as the patient’s historic health data will be available to the referred physician.
- Increased ability to foster innovation and create a shared culture of continuous improvement in the health system.
- Improved case management by the medical scheme as the patient’s updated health record will be available to the scheme’s case managers.
- CareConnect will enable more efficient claims control and processing as procedures/tests performed and hospital discharge summaries will be readily accessible.
The evolution of CareConnect
- HIE.ZA Working Group and Colleaga Gartner team explore HIE
- Founding Members sign MOU to envision a shared Health Information Exchange
- Founding Members retain Colleaga / Gartner Team to establish feasibility and desirability of a Health Information Exchange for the SA private health system
- Founding Members agree on Consensus HIE Roadmap
- Founding Members and Colleaga/ Gartner Team begin CareConnect High Level Planning Phase
- CareConnect Operating Model, Vendors and Technology Architecture designed
- MVP Technical Requirements
- CareConnect Establishment
- CareConnect Registration
- Vendor selection and contracting
- Pilot Phase – POC
- Set foundational principles
- CareConnect operational
- HIE platform implemented (HealthShare and PI)
- Use Cases implemented and incorporation of ancillary healthcare providers and associations
- Enablement of independent players in the SA care continuum
- Industry wide engagement