Purpose: The purpose of this review is to establish the extent to which processes followed in the development of the South African eHealth Strategy conform to the recommendations provided in the National eHealth Strategy Toolkit published by the World Health Organisation (WHO) and the International Telecommunication Union (ITU) in 2012. Method: For each of the steps recommended by the Toolkit, the processes followed in the development of the South African eHealth Strategy are rated against the recommended processes. Results: Overall, the processes followed in the development of the South African eHealth Strategy conform well to the recommended processes. Weaknesses were found with respect to management and resourcing of the development process and the engagement of multisectoral stakeholders.Conclusions: In general the processes conformed well to the recommendations.
In this article, we report a case study of educational issues in northern Alberta. Using interviews and observations, we provide the different perspectives held by educators, students, parents, and community members about the goals and purposes of schools, the curriculum, and the language of instruction. Practices in the schools tended to maintain the status quo: a southern approach to education, with an emphasis on a provincial curriculum and English as the language of instruction. These schools did not reflect the realities of northern communities, such as a concern for Aboriginal languages, in spite of policies that provided for local control. Keywords: school leadership and culture, northern education, Aboriginal education, Alberta education, First Nations education Dans cet article, nous présentons une étude de cas axée sur des enjeux pédagogiques propres au nord de l'Alberta. À l'aide d'entrevues et d'observations, nous avons exploré différents points de vue exprimés par des enseignants, des élèves, des parents et des membres la communauté au sujet des buts de l'école, des programmes et de la langue d'enseignement. Les pratiques décrites au sein des diverses écoles participant à cette recherche avaient tendance à maintenir le statu quo : une approche de l'enseignement provenant du Sud avec une place de choix accordée au programme provincial et à l'anglais comme langue d'enseignement. Ces écoles ne reflétaient pas les réalités des communautés du Nord, tel le souci des langues autochtones, en dépit des politiques qui prévoient un contrôle local. Mots clés : leadership et culture de l'école, éducation en régions nordiques, éducation aux autochtone, éducation en Alberta, enseignement aux Premières nations.
IntroductionThere are few examples of functional health information exchange environments or data linkage centres in the African settings. New opportunities are emerging as unique health identifiers and patient registration systems are being established nationally in many countries, and increasingly individuated health data are available for linkage, often linked to priority global health initiatives such as to support HIV and tuberculosis services.
Objectives and ApproachWe sought to establish a province-wide health information exchange and data centre for individuated health data, leveraging a unique identifier and available individuated data. The intention with the Provincial Health Data Centre (PHDC) was to create a single well-governed environment which could simultaneous fulfil the functions of an exchange directly supporting care, as well as support research requests. Often the demands of academics, funders and global agencies for reporting result in data consolidation for research and reporting taking precedence over service delivery.
ResultsThrough pragmatic use of data from all sources, the PHDC is able to usefully enumerate many health conditions of interest with sufficient fidelity for both service and research purposes. For research data requests, there has been a huge improvement in data governance alongside increased data availability as a result of the single environment with clear procedures for patient protection, and the benefits of data linkage prior to anonymisation. Many of the inference approaches have benefited hugely from interactions with researchers, which has in turn improved the quality of outputs for routine care.
Conclusion / ImplicationsIn maturing digital health environments which are establishing consolidated data environments for the first time, aspiring from the start to a single well-governed environment for both patient care and research, is a virtuous model with many benefits over fragmented data linkage efforts
IntroductionIn the Western Cape Province of South Africa, a wealth of patient-level data is collected through many separate electronic systems, which share a unique health identifier. However, clinicians primarily access paper folders, which can be unreliable, difficult to locate and are at risk of loss. Patients frequently attend multiple facilities and their information may not be accessible across facilities, hampering continuity of care.
Objectives and ApproachFacilitated by the unique health identifier, a provincial Health Information Exchange (HIE), harmonises patient level data from routine systems into a health information exchange daily. The Single Patient Viewer (SPV) has been developed as a prototype web-based electronic health record and data access portal. SPV integrates clinical data for a single patient both longitudinally and cross-sectionally, in tabular and graphical views, to assist clinicians in rapid information discovery. The application is designed as a web application that calls a multi-purpose API that facilitates interoperability with the HIE.
ResultSPV is in an extended pilot phase with over 200 clinicians using the portal, either for clinical care provision, or for clinical audit activities. The application has evolved to include referral, follow-up (voice call and messaging) and reporting functionality.
In the past 6 months, over 17,000 patients have been viewed with an average daily search of 150 patients. An anonymised user survey with 52 participants showed that users felt that SPV was enjoyable to use, easy to learn, innovative, and supportive and valuable to their work.
Conclusion / ImplicationsSPV has been developed as a global public good project and will be made freely available once matured. A unique feature of the development of SPV is that clinicians were using it while it was being built, enabling constant clinical user feedback. SPV demonstrates the value of integrating health data for clinical viewing while interoperable systems mature.
