This study comparatively investigates the integration of medical records management requirements in the ICTs/electronic health systems in two hospitals: a public and private hospital in the Umhlathuze Area, KwaZulu-Natal Province, South Africa. The study made a comparison and examined whether the current management practices support service delivery in the context of the Batho Pele principles. In doing this, the study reviewed extensive literature on records management by assessing the depth of the integration of ICTs in the management of medical records in South Africa. The targeted study sample in both the public and private hospital was 193.
TopBackground
The world is now migrating to the Fourth industrial revolution, where technology, more than ever before, has become an enabler to all organisational processes. Many organisations have adopted ICT systems in managing records as well as to deal with expanded knowledge within their environments (Wamukoya, 2006; Lott, 2007). Organizations are now searching for the best practices and norms as they apply information communication technology (ICT) in their transition to digital platforms in the digital age. This chapter assessed the depth of the integration of medical records management requirements in the ICTs/electronic health regimes in two hospitals - public and private, in South Africa. Usually, when properly implemented, ICT systems that have integrated records management functionalities would permit the capture, organisation, use, retention, and disposition of records more efficiently in an effective manner (IRMT, 2008). In an earlier study, Luthuli (2017) posits that the integration of records management requirements in the ICTs system in health environments proffers benefits in terms of medical records being accessed, shared widely and used by several people at the same time and in different places; thus improving overall health management. The IRMT also agrees and affirms that in an environment such as a developing country, where resources are scarce or distances are great, the ability to provide access to information without the boundaries of time or space can dramatically increase information sharing and enhance health service and operations (IRMT, 2009, p.7). This is why the integration of medical records managemenent requirements in the implementation of ICTs in hospitals can facilitate work processes and thus improve service delivery. This is so because good medical care relies on well-trained doctors and nurses as well as high-quality facilities and equipment; which in return, relies on good recordkeeping (IRMT, 1999, p.1). Without accurate, comprehensive, up-to-date and accessible patient case notes, medical personnel may not offer the best treatment or may, in fact, misdiagnose a medical condition (IRMT, 1999, p.2). Good records can also ensure that the hospital administration runs smoothly and therefore save time and other resources. The application of ICT in the management of medical records can therefore quicken health service delivery (Luthuli, 2017)
Context of the Study
The study focused on two hospitals – a public (X) and private (Y) in the Umhlathuze Area, KwaZulu-Natal Province, South Africa. The actual names of the two hospitals are withheld for confidentiality. Public X hospital is based in the Umhlathuze area north-east of Durban, KwaZulu-Natal (KZN) province, South Africa. The hospital, a 554-bed space, carries out a public health functions under the government and is state-owned. It provides district, regional and tertiary health services to communities from the uThungulu, uMkhanyakude and Zululand regions. It is situated in a suburb which is five kilometres away from the town of Empangeni (Luthuli, 2017). The hospital opened in 1970 as a convalescence hospital. It was initially intended to be one of the tuberculosis settlements in the province but has now grown to be one of the largest hospitals in the Umhlathuze area. The hospital has a staff complement of well over 1,200 and services about 7,700 patients per month, including referrals from other hospitals. The hospital has fourteen departments (Luthuli, 2017). Private Hospital X is located in Richards Bay. It was established in 1991. It is run by private organization associates and has 15 departments. The services it offers include, among others: anaesthesiology, biokinetics, dentistry, diagnostic radiology, ear, nose and throat surgery, maxillo-facial and oral surgery, neurosurgery, ophthalmology, orthotics, and prosthetisry. Other additional services include: a 24-hour accident and emergency unit, coffee shop, milk bank, pre-admissions, radiology, wound care, diabetic care laboratories, cancer support group, on-site covered parking, retail pharmacy, stork’s nest, and emergency service 911 (Luthuli, 2017). Both hospitals have designated medical records management functions that serve their varied communities. However, over the past years, questions have been raised about the effectiveness of the records management services provided in both hospitals in enabling the delivery of quality health care in the province (Luthuli, 2017). Therefore, assessment of the extent and depth of records management requirements in the implementation of ICT regimes that facilitate quality health delivery was appropriate.