An access control model for a South African National Electronic Health Record System
- Authors: Tsegaye, Tamir Asrat
- Date: 2019
- Subjects: Medical records -- Data processing , Medical records -- Data processing -- Safety measures , Medical records -- Data processing -- South Africa , Medical records -- Data processing -- Access control , Medical informatics , Medical records -- Management -- South Africa , Health services administration -- South Africa
- Language: English
- Type: text , Thesis , Masters , MCom
- Identifier: http://hdl.handle.net/10962/97046 , vital:31390
- Description: Countries such as South Africa have attempted to leverage eHealth by digitising patients’ medical records with the ultimate goal of improving the delivery of healthcare. This involves the use of the Electronic Health Record (EHR) which is a longitudinal electronic record of a patient’s information. The EHR is comprised of all of the encounters that have been made at different health facilities. In the national context, the EHR is also known as a national EHR which enables the sharing of patient information between points of care. Despite this, the realisation of a national EHR system puts patients' EHRs at risk. This is because patients’ information, which was once only available at local health facilities in the form of paper-based records, can be accessed anywhere within the country as a national EHR. This results in security and privacy issues since patients’ EHRs are shared with an increasing number of parties who are geographically distributed. This study proposes an access control model that will address the security and privacy issues by providing the right level of secure access to authorised clinicians. The proposed model is based on a combination of Role-Based Access Control (RBAC) and Attribute-Based Access Control (ABAC). The study found that RBAC is the most common access control model that is used within the healthcare domain where users’ job functions are based on roles. While RBAC is not able to handle dynamic events such as emergencies, the proposed model’s use of ABAC addresses this limitation. The development of the proposed model followed the design science research paradigm and was informed by the results of the content analysis plus an expert review. The content analysis sample was retrieved by conducting a systematic literature review and the analysis of this sample resulted in 6743 tags. The proposed model was evaluated using an evaluation framework via an expert review.
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- Date Issued: 2019
Factors to improve data quality of electronic medical records
- Authors: Makeleni, Noloyiso Anele
- Date: 2019
- Subjects: Electronic records , Medical records -- Management , Medical records -- Data processing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19881 , vital:43618
- Description: Electronic Medical Record (EMR) systems have been identified as having the potential to improve health care and allow the health care sector to reap a number of benefits when implemented successfully. These benefits include enabling quick and easy access to patient files and also reducing the problem of misplaced or lost patient files. Such EMRs allow for patient records to be up to date, provided that health care practitioners capture standard and consistent data in the relevant fields. In Africa, there are only a few countries that have successfully implemented EMR systems due to social and technological challenges. Social factors include lack of computer skilled health workers, lack of adequate training, physician’s resistance to shift from using paper records to electronic records, either due to complex systems or the fear of being replaced by the systems. On the other hand, the technological factors include lack of Information Technology (IT) and clinical resources, lack of internet access, financial barriers to purchase the necessary technological hardware and implementation costs. A few South African health care institutions have implemented EMR systems, however, most of the public health care facilities still make use of a manual system to capture patient information. In the case where public health care facilities do have an EMR system implemented, there are problems with the consistency of the data that is captured. The inconsistency is caused by the different understandings that the health care professionals have regarding the importance of capturing the necessary information that is collected at various points in health care institutions, thus affecting data quality. For the successful implementation and use of EMR systems, everything within the health care organisation should be integrated. In other words, the steering committee and workgroup, the equipment, the product, the processes, the system and the facility design and construction should be incorporated to work together. The common problems identified in literature regarding data quality in EMRs include misspelled words, inconsistent word strings, inaccurate information entered on the record and incompleteness of the record. These problems lead to poor quality information, lack of accessibility of the record, poorly organised notes and inaccurate information about the patient. The South African strategy aims to implement a National Health Insurance (NHI) which will provide citizens with equitable access to health care. For the successful implementation of the NHI strategy, South African health care sectors should address the barriers which were identified and learn from other African countries that have successfully implemented EMR systems and had positive outcomes. Therefore, this study investigates how data quality can be improved on electronic medical records in public health care in South Africa? The qualitative research methodology approach was used for this study. Interviews were conducted with eight health care professionals at Klerksdorp, in the North West province to obtain data regarding the factors they would deem important for the improvement of data quality in EMRs. The Data Quality Framework (DQF) was applied in this study and six dimensions were identified as the factors to improve data quality. These dimensions include completeness, accuracy, consistency, conformity, timeliness, and integrity. From the analysis of the interview responses, it was discovered that there were, in fact, data quality issues experienced at the public health care facilities of South Africa. A need was identified for the use of data quality assessment tools and solutions to address the data quality issues or challenges that health care practitioners are faced with during their daily jobs. Seven barriers were also identified as having an impact on the successful implementation of EMRs at health care institutions. These barriers, together with the data quality issues, influence the successful use of EMRs and should not be overlooked. From these barriers the study developed seven Critical Success Factors which can be used by the National Department of Health to improve the quality of EMRs. , Thesis (MCom) -- Faculty of Management and Commerce, 2019
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- Date Issued: 2019