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A code of practice for practitioners in private healthcare: a privacy perspective
- Authors: Harvey, Brett D
- Date: 2007
- Subjects: Information storage and retrieval systems -- Medical care , Medical records -- Data processing , Privacy, Right of Comparative studies
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:9735 , http://hdl.handle.net/10948/521 , Information storage and retrieval systems -- Medical care , Medical records -- Data processing , Privacy, Right of Comparative studies
- Description: Whereas there are various initiatives to standardize the storage, processing and use of electronic patient information in the South African health sector, the sector is fragmented through the adoption of various approaches on national, provincial and district levels. Divergent IT systems are used in the public and private health sectors (“Recommendations of the Committee on …” 2003). Furthermore, general practitioners in some parts of the country still use paper as a primary means of documentation and storage. Nonetheless, the use of computerized systems is increasing, even in the most remote rural areas. This leads to the exposure of patient information to various threats that are perpetuated through the use of information technology. Irrespective of the level of technology adoption by practitioners in private healthcare practice, the security and privacy of patient information remains of critical importance. The disclosure of patient information whether intentional or not, can have dire consequences for a patient. In general, the requirements pertaining to the privacy of patient information are controlled and enforced through the adoption of legislation by the governing body of a country. Compared with developed nations, South Africa has limited legislation to help enforce privacy in the health sector. Conversely, Australia, New Zealand and Canada have some of the most advanced legislative frameworks when it comes to the privacy of patient information. In this dissertation, the Australian, New Zealand, Canadian and South African health sectors and the legislation they have in place to ensure the privacy of health information, will be investigated. Additionally, codes of practice and guidelines on privacy of patient information for GPs, in the afore-mentioned countries, will be investigated to form an idea as to what is needed in creating and formulating a new code of practice for the South African GP, as well as a pragmatic tool (checklist) to check adherence to privacy requirements.
- Full Text:
- Authors: Harvey, Brett D
- Date: 2007
- Subjects: Information storage and retrieval systems -- Medical care , Medical records -- Data processing , Privacy, Right of Comparative studies
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:9735 , http://hdl.handle.net/10948/521 , Information storage and retrieval systems -- Medical care , Medical records -- Data processing , Privacy, Right of Comparative studies
- Description: Whereas there are various initiatives to standardize the storage, processing and use of electronic patient information in the South African health sector, the sector is fragmented through the adoption of various approaches on national, provincial and district levels. Divergent IT systems are used in the public and private health sectors (“Recommendations of the Committee on …” 2003). Furthermore, general practitioners in some parts of the country still use paper as a primary means of documentation and storage. Nonetheless, the use of computerized systems is increasing, even in the most remote rural areas. This leads to the exposure of patient information to various threats that are perpetuated through the use of information technology. Irrespective of the level of technology adoption by practitioners in private healthcare practice, the security and privacy of patient information remains of critical importance. The disclosure of patient information whether intentional or not, can have dire consequences for a patient. In general, the requirements pertaining to the privacy of patient information are controlled and enforced through the adoption of legislation by the governing body of a country. Compared with developed nations, South Africa has limited legislation to help enforce privacy in the health sector. Conversely, Australia, New Zealand and Canada have some of the most advanced legislative frameworks when it comes to the privacy of patient information. In this dissertation, the Australian, New Zealand, Canadian and South African health sectors and the legislation they have in place to ensure the privacy of health information, will be investigated. Additionally, codes of practice and guidelines on privacy of patient information for GPs, in the afore-mentioned countries, will be investigated to form an idea as to what is needed in creating and formulating a new code of practice for the South African GP, as well as a pragmatic tool (checklist) to check adherence to privacy requirements.
- Full Text:
A trust based model for enhanced adoption of diabetes self-management mobile applications
- Authors: Mainoti, Ganizani Fidelis
- Date: 2018
- Subjects: Medical records -- Data processing , Medical records -- Management , Mobile communication systems
- Language: English
- Type: Thesis , Masters , MCom
- Identifier: http://hdl.handle.net/10353/11041 , vital:37011
- Description: Information technology (IT) trust is an important concept as people today rely more on IT to perform their tasks than before. Extensive research in Information Systems (IS) has explored trust and how it affects clients’ selection of different IT artefacts. Literature found trust to be a key determinant of technology use and an accelerator of understanding user perceptions regarding technology. Users’ perception of a technology’s characteristics influences their initial decision to adopt it; they are less likely to try the technology once they perceive significant risk linked to the technology exploration. The study focused on trust in relation to adoption of mobile applications (apps) for self-management of diabetic treatment regimens. The aim was to identify factors that should be incorporated in these apps to positively influence user perception of trustworthiness for enhanced adoption. According to extant literature, there are a myriad of apps which are available and ready for use, but diabetic patients are not maximising these opportunities to actively participate in managing their conditions. This is in spite of the numerous benefits accruable from using these apps to aid treatment regimens away from clinical settings or with minimal involvement of health personnel. This work is a qualitative study that investigated the reasons behind the low levels of trust in mobile applications for self-management of diabetes. The research design involved a survey and the study employed interviews for primary data collection. Twenty participants were engaged in the intervention. Some of these respondents were diabetic patients on treatment and others were health staff specialising in diabetes treatment. The participants were asked to download and try, for one month or more, the Diabetes:M app from Google play store for android devices or from iTunes for IOS devices. Thereafter, interviews were held with the participants to investigate their perceptions of the diabetes management app. Based on the outcome of the investigation, the researcher put forward a model proposing the attributes of trustworthiness of diabetes self-management mobile apps for enhanced adoption. Research findings showed that the apps for diabetes self-management should be usable, possess sufficient functionalities, give accurate information for decision-making, be reliable, and secure in order to enhance the trust of diabetic patients.
- Full Text:
- Authors: Mainoti, Ganizani Fidelis
- Date: 2018
- Subjects: Medical records -- Data processing , Medical records -- Management , Mobile communication systems
- Language: English
- Type: Thesis , Masters , MCom
- Identifier: http://hdl.handle.net/10353/11041 , vital:37011
- Description: Information technology (IT) trust is an important concept as people today rely more on IT to perform their tasks than before. Extensive research in Information Systems (IS) has explored trust and how it affects clients’ selection of different IT artefacts. Literature found trust to be a key determinant of technology use and an accelerator of understanding user perceptions regarding technology. Users’ perception of a technology’s characteristics influences their initial decision to adopt it; they are less likely to try the technology once they perceive significant risk linked to the technology exploration. The study focused on trust in relation to adoption of mobile applications (apps) for self-management of diabetic treatment regimens. The aim was to identify factors that should be incorporated in these apps to positively influence user perception of trustworthiness for enhanced adoption. According to extant literature, there are a myriad of apps which are available and ready for use, but diabetic patients are not maximising these opportunities to actively participate in managing their conditions. This is in spite of the numerous benefits accruable from using these apps to aid treatment regimens away from clinical settings or with minimal involvement of health personnel. This work is a qualitative study that investigated the reasons behind the low levels of trust in mobile applications for self-management of diabetes. The research design involved a survey and the study employed interviews for primary data collection. Twenty participants were engaged in the intervention. Some of these respondents were diabetic patients on treatment and others were health staff specialising in diabetes treatment. The participants were asked to download and try, for one month or more, the Diabetes:M app from Google play store for android devices or from iTunes for IOS devices. Thereafter, interviews were held with the participants to investigate their perceptions of the diabetes management app. Based on the outcome of the investigation, the researcher put forward a model proposing the attributes of trustworthiness of diabetes self-management mobile apps for enhanced adoption. Research findings showed that the apps for diabetes self-management should be usable, possess sufficient functionalities, give accurate information for decision-making, be reliable, and secure in order to enhance the trust of diabetic patients.
- Full Text:
A privacy management framework for mobile personal electronic health records in South Africa
- Authors: Els, Floyd Nathaniel
- Date: 2017
- Subjects: Medical records -- Data processing , Medical records -- Access control , Electronic records -- Security measures
- Language: English
- Type: Thesis , Masters , MCom
- Identifier: http://hdl.handle.net/10353/12733 , vital:39316
- Description: South Africa’s health status is in constant dismay, especially while under the strain of the quadruple burden of disease. The adoption of personal electronic health records (PEHRs) can be seen as a means to improve this status by empowering patients to manage their health and lifestyle better. While from the healthcare provider’s perspective, PEHRs has the ability to reduce medical errors; provide better communication channels and enhance the monitoring of patients. Despite these benefits for both healthcare providers and patients, there are three distinct information security threats relating to PEHRs. These threats refer to the individual, data in transit, and at rest. South Africa is still considered to be inexperienced with PEHRs, and consider it a relatively new concept to the healthcare system. The National e-Health Strategy and Protection of Personal Information Bill were discussed and compared to international standards in order to ascertain South Africa’s current standing on mobile healthcare privacy. However, there are no specific privacy and security controls in place to protect patients that access personal electronic health records through mobile devices. Therefore, the aim of this study is the development of a privacy management framework (PMF) to mitigate these privacy concerns. Following an interpretivistic approach to research, qualitative data was analysed from literature, and the privacy framework evaluated through expert reviews. The proposed PMF consists of 3 tiers, beginning with the top tier. The first tier relates to an organisations interpretation and understanding of data privacy laws and regulations, and in ensuring compliance with these laws. The second tier refers to two support pillars to maintain the first tier. These pillars are based on elements of operational privacy, as well as auditing and reviewing. The third tier serves as the basic foundation upon which the PMF was developed. It is mainly focused with creating privacy awareness amongst healthcare providers and patients by creating: training regimes on security and privacy threats, efficient communication standards, and constant ongoing support from top level management.
- Full Text:
- Authors: Els, Floyd Nathaniel
- Date: 2017
- Subjects: Medical records -- Data processing , Medical records -- Access control , Electronic records -- Security measures
- Language: English
- Type: Thesis , Masters , MCom
- Identifier: http://hdl.handle.net/10353/12733 , vital:39316
- Description: South Africa’s health status is in constant dismay, especially while under the strain of the quadruple burden of disease. The adoption of personal electronic health records (PEHRs) can be seen as a means to improve this status by empowering patients to manage their health and lifestyle better. While from the healthcare provider’s perspective, PEHRs has the ability to reduce medical errors; provide better communication channels and enhance the monitoring of patients. Despite these benefits for both healthcare providers and patients, there are three distinct information security threats relating to PEHRs. These threats refer to the individual, data in transit, and at rest. South Africa is still considered to be inexperienced with PEHRs, and consider it a relatively new concept to the healthcare system. The National e-Health Strategy and Protection of Personal Information Bill were discussed and compared to international standards in order to ascertain South Africa’s current standing on mobile healthcare privacy. However, there are no specific privacy and security controls in place to protect patients that access personal electronic health records through mobile devices. Therefore, the aim of this study is the development of a privacy management framework (PMF) to mitigate these privacy concerns. Following an interpretivistic approach to research, qualitative data was analysed from literature, and the privacy framework evaluated through expert reviews. The proposed PMF consists of 3 tiers, beginning with the top tier. The first tier relates to an organisations interpretation and understanding of data privacy laws and regulations, and in ensuring compliance with these laws. The second tier refers to two support pillars to maintain the first tier. These pillars are based on elements of operational privacy, as well as auditing and reviewing. The third tier serves as the basic foundation upon which the PMF was developed. It is mainly focused with creating privacy awareness amongst healthcare providers and patients by creating: training regimes on security and privacy threats, efficient communication standards, and constant ongoing support from top level management.
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Guidelines for secure cloud-based personal health records
- Authors: Mxoli, Ncedisa Avuya Mercia
- Date: 2017
- Subjects: Cloud computing -- Security measures , Computer security , Data mining , Medical records -- Data processing
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/14134 , vital:27433
- Description: Traditionally, health records have been stored in paper folders at the physician’s consulting rooms – or at the patient’s home. Some people stored the health records of their family members, so as to keep a running history of all the medical procedures they went through, and what medications they were given by different physicians at different stages of their lives. Technology has introduced better and safer ways of storing these records, namely, through the use of Personal Health Records (PHRs). With time, different types of PHRs have emerged, i.e. local, remote server-based, and hybrid PHRs. Web-based PHRs fall under the remote server-based PHRs; and recently, a new market in storing PHRs has emerged. Cloud computing has become a trend in storing PHRs in a more accessible and efficient manner. Despite its many benefits, cloud computing has many privacy and security concerns. As a result, the adoption rate of cloud services is not yet very high. A qualitative and exploratory research design approach was followed in this study, in order to reach the objective of proposing guidelines that could assist PHR providers in selecting a secure Cloud Service Provider (CSP) to store their customers’ health data. The research methods that were used include a literature review, systematic literature review, qualitative content analysis, reasoning, argumentation and elite interviews. A systematic literature review and qualitative content analysis were conducted to examine those risks in the cloud environment that could have a negative impact on the secure storing of PHRs. PHRs must satisfy certain dimensions, in order for them to be meaningful for use. While these were highlighted in the research, it also emerged that certain risks affect the PHR dimensions directly, thus threatening the meaningfulness and usability of cloud-based PHRs. The literature review revealed that specific control measures can be adopted to mitigate the identified risks. These control measures form part of the material used in this study to identify the guidelines for secure cloud-based PHRs. The guidelines were formulated through the use of reasoning and argumentation. After the guidelines were formulated, elite interviews were conducted, in order to validate and finalize the main research output: i.e. guidelines. The results of this study may alert PHR providers to the risks that exist in the cloud environment; so that they can make informed decisions when choosing a CSP for storing their customers’ health data.
- Full Text:
- Authors: Mxoli, Ncedisa Avuya Mercia
- Date: 2017
- Subjects: Cloud computing -- Security measures , Computer security , Data mining , Medical records -- Data processing
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/14134 , vital:27433
- Description: Traditionally, health records have been stored in paper folders at the physician’s consulting rooms – or at the patient’s home. Some people stored the health records of their family members, so as to keep a running history of all the medical procedures they went through, and what medications they were given by different physicians at different stages of their lives. Technology has introduced better and safer ways of storing these records, namely, through the use of Personal Health Records (PHRs). With time, different types of PHRs have emerged, i.e. local, remote server-based, and hybrid PHRs. Web-based PHRs fall under the remote server-based PHRs; and recently, a new market in storing PHRs has emerged. Cloud computing has become a trend in storing PHRs in a more accessible and efficient manner. Despite its many benefits, cloud computing has many privacy and security concerns. As a result, the adoption rate of cloud services is not yet very high. A qualitative and exploratory research design approach was followed in this study, in order to reach the objective of proposing guidelines that could assist PHR providers in selecting a secure Cloud Service Provider (CSP) to store their customers’ health data. The research methods that were used include a literature review, systematic literature review, qualitative content analysis, reasoning, argumentation and elite interviews. A systematic literature review and qualitative content analysis were conducted to examine those risks in the cloud environment that could have a negative impact on the secure storing of PHRs. PHRs must satisfy certain dimensions, in order for them to be meaningful for use. While these were highlighted in the research, it also emerged that certain risks affect the PHR dimensions directly, thus threatening the meaningfulness and usability of cloud-based PHRs. The literature review revealed that specific control measures can be adopted to mitigate the identified risks. These control measures form part of the material used in this study to identify the guidelines for secure cloud-based PHRs. The guidelines were formulated through the use of reasoning and argumentation. After the guidelines were formulated, elite interviews were conducted, in order to validate and finalize the main research output: i.e. guidelines. The results of this study may alert PHR providers to the risks that exist in the cloud environment; so that they can make informed decisions when choosing a CSP for storing their customers’ health data.
- Full Text:
Engendering the meaningful use of electronic medical records: a South African perspective
- Chipfumbu, Colletor Tendeukai
- Authors: Chipfumbu, Colletor Tendeukai
- Date: 2016
- Subjects: Electronic records -- South Africa -- Management , Information storage and retrieval systems -- Management , Medical records -- South Africa , Medical records -- Data processing
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/18420 , vital:28635
- Description: Theoretically, the use of Electronic Medical Records (EMRs) holds promise of numerous benefits in healthcare provision, including improvement in continuity of care, quality of care and safety. However, in practice, there is evidence that the adoption of electronic medical records has been slow and where adopted, often lacks meaningful use. Thus there is a clear dichotomy between the ambitions for EMR use and the reality of EMR implementation. In the USA, a legislative approach was taken to turn around the situation. Other countries such as Canada and European countries have followed suit (in their own way) to address the adoption and meaningful use of electronic medical records. The South African e-Health strategy and the National Health Normative Standards Framework for Interoperability in eHealth in South Africa documents both recommend the adoption of EMRs. Much work has been done to establish a baseline for standards to ensure interoperability and data portability of healthcare applications and data. However, even with the increased focus on e-Health, South Africa remains excessively reliant on paper-based medical records. Where health information technologies have been adopted, there is lack of coordination between and within provinces, leading to a multitude of systems and vendors. Thus there is a lack of systematic adoption and meaningful use of EMRs in South Africa. The main objective of this research is to develop the components required to engender meaningful use of electronic medical records in the South African healthcare context. The main contributors are identified as EMR certification and consistent, proper use of certified EMRs. Literature review, a Delphi study and logical argumentation are used to develop the relevant components for the South African healthcare context. The benefits of EMRs can only be realized through systematic adoption and meaningful use of EMRs, thus this research contributes to providing a road map for engendering the meaningful use of EMRs with the ultimate aim of improving healthcare in the South African healthcare landscape.
- Full Text:
- Authors: Chipfumbu, Colletor Tendeukai
- Date: 2016
- Subjects: Electronic records -- South Africa -- Management , Information storage and retrieval systems -- Management , Medical records -- South Africa , Medical records -- Data processing
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/18420 , vital:28635
- Description: Theoretically, the use of Electronic Medical Records (EMRs) holds promise of numerous benefits in healthcare provision, including improvement in continuity of care, quality of care and safety. However, in practice, there is evidence that the adoption of electronic medical records has been slow and where adopted, often lacks meaningful use. Thus there is a clear dichotomy between the ambitions for EMR use and the reality of EMR implementation. In the USA, a legislative approach was taken to turn around the situation. Other countries such as Canada and European countries have followed suit (in their own way) to address the adoption and meaningful use of electronic medical records. The South African e-Health strategy and the National Health Normative Standards Framework for Interoperability in eHealth in South Africa documents both recommend the adoption of EMRs. Much work has been done to establish a baseline for standards to ensure interoperability and data portability of healthcare applications and data. However, even with the increased focus on e-Health, South Africa remains excessively reliant on paper-based medical records. Where health information technologies have been adopted, there is lack of coordination between and within provinces, leading to a multitude of systems and vendors. Thus there is a lack of systematic adoption and meaningful use of EMRs in South Africa. The main objective of this research is to develop the components required to engender meaningful use of electronic medical records in the South African healthcare context. The main contributors are identified as EMR certification and consistent, proper use of certified EMRs. Literature review, a Delphi study and logical argumentation are used to develop the relevant components for the South African healthcare context. The benefits of EMRs can only be realized through systematic adoption and meaningful use of EMRs, thus this research contributes to providing a road map for engendering the meaningful use of EMRs with the ultimate aim of improving healthcare in the South African healthcare landscape.
- Full Text:
Guidelines for the user interface design of electronic medical records in optometry
- Authors: Nathoo, Dina
- Date: 2020
- Subjects: User interfaces (Computer systems) , Medical records -- Data processing , Optometry -- South Africa -- Eastern Cape , System design , Workflow management systems
- Language: English
- Type: Thesis , Masters , MCom
- Identifier: http://hdl.handle.net/10962/148782 , vital:38773
- Description: With the prevalence of digitalisation in the medical industry, e-health systems have largely replaced the traditional paper-based recording methods. At the centre of these e-health systems are Electronic Health Records (EHRs) and Electronic Medical Records (EMRs), whose benefits significantly improve physician workflows. However, provision for user interface designs (UIDs) of these systems have been so poor that they have severely hindered physician usability, disrupted their workflows and risked patient safety. UID and usability guidelines have been provided, but have been very high level and general, mostly suitable for EHRs (which are used in general practices and hospitals). These guidelines have thus been ineffective in applicability for EMRs, which are typically used in niche medical environments. Within the niche field of Optometry, physicians experience disrupted workflows as a result of poor EMR UID and usability, of which EMR guidelines to improve these challenges are scarce. Hence, the need for this research arose, aiming to create UID guidelines for EMRs in Optometry, which will help improve the usability of the optometrists’ EMR. The main research question was successfully answered to produce the set of UID Guidelines for EMRs in Optometry, which includes guidelines built upon from literature and made contextually relevant, as well as some new additions, which are more patient focused. Design Science Research (DSR) was chosen as a suitable approach, and the phased Design Science Research Process Model (DSRPM) was used to guide this research. A literature review was conducted, including EHR and EMR, usability, UIDs, Optometry, related fields, and studies previously conducted to provide guidelines, frameworks and models. The review also included studying usability problems reported on the systems and the methods to overcome them. Task Analysis (TA) was used to observe and understand the optometrists’ workflows and their interactions with their EMRs during patient appointments, also identifying EMR problem areas. To address these problems, Focus Groups (FGs) were used to brainstorm solutions in the form of EMR UID features that optometrists’ required to improve their usability. From the literature review, TAs and FGs, proposed guidelines were created. The created guidelines informed the UID of an EMR prototype, which was successfully demonstrated to optometrists during Usability Testing sessions for the evaluation. Surveys were also used for the evaluation. The results proved the guidelines were successful, and were usable, effective, efficient and of good quality. A revised, final set of guidelines was then presented. Future researchers and designers may benefit from the contributions made from this research, which are both theoretical and practical.
- Full Text:
- Authors: Nathoo, Dina
- Date: 2020
- Subjects: User interfaces (Computer systems) , Medical records -- Data processing , Optometry -- South Africa -- Eastern Cape , System design , Workflow management systems
- Language: English
- Type: Thesis , Masters , MCom
- Identifier: http://hdl.handle.net/10962/148782 , vital:38773
- Description: With the prevalence of digitalisation in the medical industry, e-health systems have largely replaced the traditional paper-based recording methods. At the centre of these e-health systems are Electronic Health Records (EHRs) and Electronic Medical Records (EMRs), whose benefits significantly improve physician workflows. However, provision for user interface designs (UIDs) of these systems have been so poor that they have severely hindered physician usability, disrupted their workflows and risked patient safety. UID and usability guidelines have been provided, but have been very high level and general, mostly suitable for EHRs (which are used in general practices and hospitals). These guidelines have thus been ineffective in applicability for EMRs, which are typically used in niche medical environments. Within the niche field of Optometry, physicians experience disrupted workflows as a result of poor EMR UID and usability, of which EMR guidelines to improve these challenges are scarce. Hence, the need for this research arose, aiming to create UID guidelines for EMRs in Optometry, which will help improve the usability of the optometrists’ EMR. The main research question was successfully answered to produce the set of UID Guidelines for EMRs in Optometry, which includes guidelines built upon from literature and made contextually relevant, as well as some new additions, which are more patient focused. Design Science Research (DSR) was chosen as a suitable approach, and the phased Design Science Research Process Model (DSRPM) was used to guide this research. A literature review was conducted, including EHR and EMR, usability, UIDs, Optometry, related fields, and studies previously conducted to provide guidelines, frameworks and models. The review also included studying usability problems reported on the systems and the methods to overcome them. Task Analysis (TA) was used to observe and understand the optometrists’ workflows and their interactions with their EMRs during patient appointments, also identifying EMR problem areas. To address these problems, Focus Groups (FGs) were used to brainstorm solutions in the form of EMR UID features that optometrists’ required to improve their usability. From the literature review, TAs and FGs, proposed guidelines were created. The created guidelines informed the UID of an EMR prototype, which was successfully demonstrated to optometrists during Usability Testing sessions for the evaluation. Surveys were also used for the evaluation. The results proved the guidelines were successful, and were usable, effective, efficient and of good quality. A revised, final set of guidelines was then presented. Future researchers and designers may benefit from the contributions made from this research, which are both theoretical and practical.
- Full Text:
Health information technologies for improved continuity of care: a South African perspective
- Authors: Mostert-Phipps, Nicolette
- Date: 2011
- Subjects: Medical records -- Data processing , Medical technology -- South Africa , Medical innovations -- South Africa , Health -- Information services
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9730 , http://hdl.handle.net/10948/1619 , Medical records -- Data processing , Medical technology -- South Africa , Medical innovations -- South Africa , Health -- Information services
- Description: The fragmented nature of modern health care provision makes it increasingly difficult to achieve continuity of care. This is equally true in the context of the South African healthcare landscape. This results in a strong emphasis on the informational dimension of continuity of care which highlights the importance of the continuity of medical records. Paper-based methods of record keeping are inadequate to support informational continuity of care which leads to an increased interest in electronic methods of record keeping through the adoption of various Health Information Technologies (HITs). This research project investigates the role that various HITs such as Personal Health Records (PHRs), Electronic Medical Records (EMRs), and Health Information Exchanges (HIEs) can play in improving informational continuity of care resulting in the development of a standards-based technological model for the South African healthcare sector. This technological model employs appropriate HITs to address the problem of informational continuity of care in the South African healthcare landscape The benefits that are possible through the adoption of the proposed technological model can only be realized if the proposed HITs are used in a meaningful manner once adopted and implemented. The Delphi method is employed to identify factors that need to be addressed to encourage the adoption and meaningful use of such HITs in the South African healthcare landscape. Lastly, guidelines are formulated to encourage the adoption and meaningful use of HITs in the South African healthcare landscape to improve the continuity of care. The guidelines address both the technological requirements on a high level, as well as the factors that need to be addressed to encourage the adoption and meaningful use of the technological components suggested. These guidelines will play a significant role in raising awareness of the factors that need to be addressed to create an environment conducive to the adoption and meaningful use of appropriate HITs in order to improve the continuity of care in the South African healthcare landscape.
- Full Text:
- Authors: Mostert-Phipps, Nicolette
- Date: 2011
- Subjects: Medical records -- Data processing , Medical technology -- South Africa , Medical innovations -- South Africa , Health -- Information services
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9730 , http://hdl.handle.net/10948/1619 , Medical records -- Data processing , Medical technology -- South Africa , Medical innovations -- South Africa , Health -- Information services
- Description: The fragmented nature of modern health care provision makes it increasingly difficult to achieve continuity of care. This is equally true in the context of the South African healthcare landscape. This results in a strong emphasis on the informational dimension of continuity of care which highlights the importance of the continuity of medical records. Paper-based methods of record keeping are inadequate to support informational continuity of care which leads to an increased interest in electronic methods of record keeping through the adoption of various Health Information Technologies (HITs). This research project investigates the role that various HITs such as Personal Health Records (PHRs), Electronic Medical Records (EMRs), and Health Information Exchanges (HIEs) can play in improving informational continuity of care resulting in the development of a standards-based technological model for the South African healthcare sector. This technological model employs appropriate HITs to address the problem of informational continuity of care in the South African healthcare landscape The benefits that are possible through the adoption of the proposed technological model can only be realized if the proposed HITs are used in a meaningful manner once adopted and implemented. The Delphi method is employed to identify factors that need to be addressed to encourage the adoption and meaningful use of such HITs in the South African healthcare landscape. Lastly, guidelines are formulated to encourage the adoption and meaningful use of HITs in the South African healthcare landscape to improve the continuity of care. The guidelines address both the technological requirements on a high level, as well as the factors that need to be addressed to encourage the adoption and meaningful use of the technological components suggested. These guidelines will play a significant role in raising awareness of the factors that need to be addressed to create an environment conducive to the adoption and meaningful use of appropriate HITs in order to improve the continuity of care in the South African healthcare landscape.
- Full Text:
Applying blockchain technology to aspects of electronic health records in South Africa: lessons learnt
- Authors: Adlam, Ryno
- Date: 2020
- Subjects: Blockchains (Databases) , Database security , Data protection , Medical records -- Data processing
- Language: English
- Type: Thesis , Masters , MIT
- Identifier: http://hdl.handle.net/10948/45996 , vital:39405
- Description: The purpose of this study was to explore the applicability of blockchain technology as a viable alternative for the secure storage and distribution of electronic health records in a South African context. The adoption of electronic health records (EHRs) has grown over recent years. Electronic health records (EHRs) can be seen as electronic versions of patients’ medical history. EHRs promise benefits such as improving the quality of care, reducing medical errors, reducing costs, saving time, and enhancing the availability and sharing of medical records. Blockchain, in simple terms, could be seen as a distributed database controlled by a group of individuals. Blockchain technology differs from other distributed ledger technology by bundling unrelated data into blocks that are chained together in a linked-list manner, hence the name blockchain. Blockchain technology strives to provide desirable features, such as decentralization, immutability, audibility, and transparency. EHRs are traditionally constructed with a cloud-based infrastructure to promote the storing and distribution of medical records. These medical records are commonly stored in a centralized architecture, such as a relational database. The centralized architecture employed by EHRs may present a single point of failure. These kinds of failures may lead to data-breaches. The cloud-based infrastructure is effective and efficient from an availability standpoint. The increased availability of electronic health records has brought forth challenges related to the security and privacy of the patient’s medical records. The sensitive nature of EHRs attracts the attention of cyber-criminals. There has been a rise in the number of data breaches related to electronic health records. The traditional infrastructure used by electronic health records can no longer ensure the privacy and security of patient’s medical records. To determine whether blockchain is a viable alternative to these approaches, the main objective of this study was to compile a technical report on the applicability of aspects of blockchain technology to the secure storage and distribution of electronic health records. The study first conducted a literature review to gather background on the current state of electronic health records and blockchain technology. The results of the literature review were used to compile an initial report. Experiments were conducted with various aspects of blockchain technology to build a technical baseline and to ultimately validate the initial report. The insights gained from the experiments served to refine the initial report into a final technical report. The final deliverable of this study was to devise a technical report. The technical report serves as a generalized overview of the applicability of blockchain technology as a secure storage and distribution mechanism for electronic health records. The main topics covered by the technical report to outline the applicability of blockchain technology to EHRs are as follows: authentication, authorization, audit log, storage and transactions. The insights gained from the study illustrate that permissioned blockchain technology can enhance the traditional AAA security scheme employed by traditional EHRs. The AAA security scheme entails the use of certificate-based authentication and attributebased access control for authorization. Audit logs can be stored in a semi-decentralized architecture that can enhance the security and privacy of audit logs. Using blockchain technology for storing electronic health records might not be a viable alternative to traditional EHRs architecture. Blockchain technology violates certain privacy regulations as information is stored in a permanent manner. Furthermore, blockchain technology is not optimized for dealing with large volumes of data. However, blockchain technology could be used to store a cryptographic hash of electronic health records to ensure the integrity of records. Permissioned blockchain technology can enhance the EHRs transaction process by transacting health records in a peer-to-peer infrastructure. In doing so, the above-mentioned AAA security scheme can enhance the security, confidentiality, and integrity of electronic health records shared across organizational bounds.
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- Authors: Adlam, Ryno
- Date: 2020
- Subjects: Blockchains (Databases) , Database security , Data protection , Medical records -- Data processing
- Language: English
- Type: Thesis , Masters , MIT
- Identifier: http://hdl.handle.net/10948/45996 , vital:39405
- Description: The purpose of this study was to explore the applicability of blockchain technology as a viable alternative for the secure storage and distribution of electronic health records in a South African context. The adoption of electronic health records (EHRs) has grown over recent years. Electronic health records (EHRs) can be seen as electronic versions of patients’ medical history. EHRs promise benefits such as improving the quality of care, reducing medical errors, reducing costs, saving time, and enhancing the availability and sharing of medical records. Blockchain, in simple terms, could be seen as a distributed database controlled by a group of individuals. Blockchain technology differs from other distributed ledger technology by bundling unrelated data into blocks that are chained together in a linked-list manner, hence the name blockchain. Blockchain technology strives to provide desirable features, such as decentralization, immutability, audibility, and transparency. EHRs are traditionally constructed with a cloud-based infrastructure to promote the storing and distribution of medical records. These medical records are commonly stored in a centralized architecture, such as a relational database. The centralized architecture employed by EHRs may present a single point of failure. These kinds of failures may lead to data-breaches. The cloud-based infrastructure is effective and efficient from an availability standpoint. The increased availability of electronic health records has brought forth challenges related to the security and privacy of the patient’s medical records. The sensitive nature of EHRs attracts the attention of cyber-criminals. There has been a rise in the number of data breaches related to electronic health records. The traditional infrastructure used by electronic health records can no longer ensure the privacy and security of patient’s medical records. To determine whether blockchain is a viable alternative to these approaches, the main objective of this study was to compile a technical report on the applicability of aspects of blockchain technology to the secure storage and distribution of electronic health records. The study first conducted a literature review to gather background on the current state of electronic health records and blockchain technology. The results of the literature review were used to compile an initial report. Experiments were conducted with various aspects of blockchain technology to build a technical baseline and to ultimately validate the initial report. The insights gained from the experiments served to refine the initial report into a final technical report. The final deliverable of this study was to devise a technical report. The technical report serves as a generalized overview of the applicability of blockchain technology as a secure storage and distribution mechanism for electronic health records. The main topics covered by the technical report to outline the applicability of blockchain technology to EHRs are as follows: authentication, authorization, audit log, storage and transactions. The insights gained from the study illustrate that permissioned blockchain technology can enhance the traditional AAA security scheme employed by traditional EHRs. The AAA security scheme entails the use of certificate-based authentication and attributebased access control for authorization. Audit logs can be stored in a semi-decentralized architecture that can enhance the security and privacy of audit logs. Using blockchain technology for storing electronic health records might not be a viable alternative to traditional EHRs architecture. Blockchain technology violates certain privacy regulations as information is stored in a permanent manner. Furthermore, blockchain technology is not optimized for dealing with large volumes of data. However, blockchain technology could be used to store a cryptographic hash of electronic health records to ensure the integrity of records. Permissioned blockchain technology can enhance the EHRs transaction process by transacting health records in a peer-to-peer infrastructure. In doing so, the above-mentioned AAA security scheme can enhance the security, confidentiality, and integrity of electronic health records shared across organizational bounds.
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Factors affecting the adoption and meaningful use of electronic medical records in general practices
- Authors: Masiza, Melissa
- Date: 2012
- Subjects: Medical records -- Data processing , Medical records
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:9814 , http://hdl.handle.net/10948/d1018561
- Description: Patients typically enter the healthcare systems at the primary care level from where they are further referred to specialists or hospitals as necessary. In the private healthcare system, primary care is provided by a general practitioner (GP). A GP will refer a patient to a specialist for treatment when necessary, while the GP remains the main healthcare provider. The provision of care is, thus, fragmented which results in continuity of care becoming a challenge. Furthermore, the majority of healthcare providers continue to use paper-based systems to capture and store patient medical data. However, capturing and storing patient medical data via electronic methods, such as Electronic Medical Records (EMRs), has been found to improve continuity of care. Despite this benefit, research reveals that smaller practices are slow to adopt electronic methods of record keeping. Hence this explorative research attempts to identify factors that affect the lack of adoption and meaningful use of EMRs in general practices. Four general practices are surveyed through patient and staff questionnaires, as well as GP interviews. Socio-Technical Systems (STS) theory is used as a theoretical lens to formulate the resulting factors. The findings of the research indicate specific factors that relate to either the social, environmental or technical sub-systems of the socio-technical system, or an overlap between these sub-systems. It is significant to note that within these sub-systems, the social sub-system plays a key role. This is due to various reasons revealed by this research. Furthermore, multiple perceptions emerged from the GP and patient participants during the analysis of the findings. These perceptions may have an influence on the adoption and potential meaningful use of an EMR in a general practice. Additionally, the socio-technical factors identified from this research highlight the challenges related to encouraging the adoption and meaningful use of EMRs. These challenges are introduced by the complexities represented by these factors. Nevertheless, addressing the factors will contribute towards improving the rate of adoption and meaningful use of EMRs in small practices.
- Full Text:
Factors affecting the adoption and meaningful use of electronic medical records in general practices
- Authors: Masiza, Melissa
- Date: 2012
- Subjects: Medical records -- Data processing , Medical records
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:9814 , http://hdl.handle.net/10948/d1018561
- Description: Patients typically enter the healthcare systems at the primary care level from where they are further referred to specialists or hospitals as necessary. In the private healthcare system, primary care is provided by a general practitioner (GP). A GP will refer a patient to a specialist for treatment when necessary, while the GP remains the main healthcare provider. The provision of care is, thus, fragmented which results in continuity of care becoming a challenge. Furthermore, the majority of healthcare providers continue to use paper-based systems to capture and store patient medical data. However, capturing and storing patient medical data via electronic methods, such as Electronic Medical Records (EMRs), has been found to improve continuity of care. Despite this benefit, research reveals that smaller practices are slow to adopt electronic methods of record keeping. Hence this explorative research attempts to identify factors that affect the lack of adoption and meaningful use of EMRs in general practices. Four general practices are surveyed through patient and staff questionnaires, as well as GP interviews. Socio-Technical Systems (STS) theory is used as a theoretical lens to formulate the resulting factors. The findings of the research indicate specific factors that relate to either the social, environmental or technical sub-systems of the socio-technical system, or an overlap between these sub-systems. It is significant to note that within these sub-systems, the social sub-system plays a key role. This is due to various reasons revealed by this research. Furthermore, multiple perceptions emerged from the GP and patient participants during the analysis of the findings. These perceptions may have an influence on the adoption and potential meaningful use of an EMR in a general practice. Additionally, the socio-technical factors identified from this research highlight the challenges related to encouraging the adoption and meaningful use of EMRs. These challenges are introduced by the complexities represented by these factors. Nevertheless, addressing the factors will contribute towards improving the rate of adoption and meaningful use of EMRs in small practices.
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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.
- Full Text:
- 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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Physicians' perspectives on personal health records: a descriptive study
- Authors: Harmse, Magda Susanna
- Date: 2016
- Subjects: Medical records -- Data processing , Medical records -- Management , Information storage and retrieval systems -- Hospitals , Personal information management
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/6876 , vital:21156
- Description: A Personal Health Record (PHR) is an electronic record of a patient’s health-related information that is managed by the patient. The patient can give access to other parties, such as healthcare providers and family members, as they see fit. These parties can use the information in emergency situations, in order to help improve the patient’s healthcare. PHRs have an important role to play in ensuring that a patient’s complete health history is available to his healthcare providers at the point of care. This is especially true in South Africa, where the majority of healthcare organizations still rely on paper-based methods of record-keeping. Research indicates that physicians play an important role in encouraging the adoption of PHRs amongst patients. Whilst various studies have focused on the perceptions of South African citizens towards PHRs, to date no research has focused on the perceptions of South African physicians. Considering the importance of physicians in encouraging the adoption of PHRs, the problem being addressed by this research project thus relates to the lack of information relating to the perceptions of South African physicians of PHRs. Physicians with private practices at private hospitals in Port Elizabeth, South Africa were surveyed in order to determine their perceptions towards PHRs. Results indicate perceptions regarding benefits to the physician and the patient, as well as concerns to the physician and the patient. The levels of trust in various potential PHR providers and the potential uses of a PHR for the physician were also explored. The results of the survey were compared with the results of relevant international literature in order to describe the perceptions of physicians towards PHRs.
- Full Text:
- Authors: Harmse, Magda Susanna
- Date: 2016
- Subjects: Medical records -- Data processing , Medical records -- Management , Information storage and retrieval systems -- Hospitals , Personal information management
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/6876 , vital:21156
- Description: A Personal Health Record (PHR) is an electronic record of a patient’s health-related information that is managed by the patient. The patient can give access to other parties, such as healthcare providers and family members, as they see fit. These parties can use the information in emergency situations, in order to help improve the patient’s healthcare. PHRs have an important role to play in ensuring that a patient’s complete health history is available to his healthcare providers at the point of care. This is especially true in South Africa, where the majority of healthcare organizations still rely on paper-based methods of record-keeping. Research indicates that physicians play an important role in encouraging the adoption of PHRs amongst patients. Whilst various studies have focused on the perceptions of South African citizens towards PHRs, to date no research has focused on the perceptions of South African physicians. Considering the importance of physicians in encouraging the adoption of PHRs, the problem being addressed by this research project thus relates to the lack of information relating to the perceptions of South African physicians of PHRs. Physicians with private practices at private hospitals in Port Elizabeth, South Africa were surveyed in order to determine their perceptions towards PHRs. Results indicate perceptions regarding benefits to the physician and the patient, as well as concerns to the physician and the patient. The levels of trust in various potential PHR providers and the potential uses of a PHR for the physician were also explored. The results of the survey were compared with the results of relevant international literature in order to describe the perceptions of physicians towards PHRs.
- Full Text:
Understanding factors that influence the acceptance of electronic medical records by nurses in hospitals: a framework
- Authors: Makalima, Melissa
- Date: 2018
- Subjects: Electronic records -- Management , Information storage and retrieval systems -- Management , Medical records -- South Africa , Medical records -- Data processing
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/31488 , vital:31495
- Description: Globally, unlike in the past, it is rare for a patient to consult the same healthcare provider throughout his or her lifetime. However, this makes it difficult to maintain informational continuity of care. Researchers have confirmed that paper-based methods of record keeping do not meet the needs of informational continuity of care. As a result, the popularity of electronic means of recordkeeping, specifically, electronic medical records (EMRs), is growing. However, the implementation of EMRs in hospitals is not without challenges with these challenges playing a significant role in the failure of EMRs. One such challenge is a lack of user acceptance. Research reveals that nurses comprise the largest user group of EMRs in the hospital setting. However, there is inadequate literature that focuses on the factors contributing to EMR acceptance with nurses as the user group. Hence, the main problem addressed in this research study relates to the inadequate understanding of the factors that influence the acceptance of EMRs by nurses. In order to address this problem, a literature review and a case study were conducted to ascertain and investigate the factors that influence the acceptance of EMRs by nurses. A total of 39 factors were formulated. Subsequent to the formulation of these factors, knowledge on the impact of each factor on EMR acceptance was collected. Socio-technical Systems Theory (STS) was used as a theoretical lens through which to view the resulting factors. The STS dimension from which each factor originates as well as the STS dimension influenced by the factor were identified. The analysis of the different stages of acceptance as well as the STS analysis resulted in a framework that could play an important role in providing a better understanding of EMR acceptance by nurses in hospitals. It was anticipated that this study would contribute to a better understanding of the factors that hospitals should address in order to create a conducive environment for EMR acceptance by nurses within the hospitals.
- Full Text:
- Authors: Makalima, Melissa
- Date: 2018
- Subjects: Electronic records -- Management , Information storage and retrieval systems -- Management , Medical records -- South Africa , Medical records -- Data processing
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/31488 , vital:31495
- Description: Globally, unlike in the past, it is rare for a patient to consult the same healthcare provider throughout his or her lifetime. However, this makes it difficult to maintain informational continuity of care. Researchers have confirmed that paper-based methods of record keeping do not meet the needs of informational continuity of care. As a result, the popularity of electronic means of recordkeeping, specifically, electronic medical records (EMRs), is growing. However, the implementation of EMRs in hospitals is not without challenges with these challenges playing a significant role in the failure of EMRs. One such challenge is a lack of user acceptance. Research reveals that nurses comprise the largest user group of EMRs in the hospital setting. However, there is inadequate literature that focuses on the factors contributing to EMR acceptance with nurses as the user group. Hence, the main problem addressed in this research study relates to the inadequate understanding of the factors that influence the acceptance of EMRs by nurses. In order to address this problem, a literature review and a case study were conducted to ascertain and investigate the factors that influence the acceptance of EMRs by nurses. A total of 39 factors were formulated. Subsequent to the formulation of these factors, knowledge on the impact of each factor on EMR acceptance was collected. Socio-technical Systems Theory (STS) was used as a theoretical lens through which to view the resulting factors. The STS dimension from which each factor originates as well as the STS dimension influenced by the factor were identified. The analysis of the different stages of acceptance as well as the STS analysis resulted in a framework that could play an important role in providing a better understanding of EMR acceptance by nurses in hospitals. It was anticipated that this study would contribute to a better understanding of the factors that hospitals should address in order to create a conducive environment for EMR acceptance by nurses within the hospitals.
- Full Text:
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