Long waiting times at medical facilities and the widespread use of paper-based patient records in the healthcare industry are fuelling fears among urban South Africans about their prospects of receiving adequate medical attention in an emergency. Almost two thirds of urban residents who participated in an Accenture healthcare survey said they were “extremely concerned” or “very concerned” about being unable to report vital medical information to emergency personnel in the event of a serious accident or medical emergency. “The concern is that, should they be confused, semi-conscious or unconscious, and thus incapable of reporting crucial data about allergies, relevant family history or chronic medical conditions, they may receive treatment that could put their health at further risk,” says Dr. Roze Phillips, Senior Manager at Accenture South Africa. “This is especially so if emergency personnel have to rely on paper-based patient records,” she says. “Paper records are easily lost, may be scattered among different care-givers in different formats, may not exist at all, or may simply not be available at the time and point where they are needed.” These concerns are not exaggerated considering that 39 percent of South Africans surveyed said they or a family member were taking chronic medication for existing conditions. The survey, conducted for Accenture by market research specialists AC Nielsen during April 2006, involved personal interviews with 2 468 respondents in urban households across the country. This sample is representative of 92 percent of the urban adult population of South Africa and 58 percent of the total adult population. Apart from probing respondents’ attitudes towards medical emergencies, the Accenture survey investigated the challenges they face when seeking medical attention at doctors’ rooms, clinics and hospitals in both the public and private sector. Long waiting times hamper access The most common barriers to quality healthcare are long waiting times, including delays caused by patients having to repeat their medical histories. “Having to answer the same questions again and again was most frequently cited by respondents who visit multiple medical practitioners,” says Phillips. This was the case for a significant percentage of the households surveyed. “Over the course of the past five years, a third of South Africans have visited three or more general practitioners. Of these, no fewer than 61 percent say they repeatedly have to recount their medical histories.” This trend at least partly explains the long waiting times reported by respondents visiting medical facilities. “According to our findings, 24 percent of urban South Africans wait more than an hour to see the doctor,” Phillips says. Long waiting times to collect chronic medication were also widely reported. In Metro areas, 39 percent of people using chronic medication wait longer than one hour, while in KwaZulu-Natal, the figure is as high as 50 percent. “This is cause for concern,” says Phillips. “The need for chronic medication should be predictable if you consider that a supposedly known group of patients require it on a monthly basis.” Electronic health records could ease the pressure Commenting on the survey findings, Phillips says they underline the fragmented state of data in the South African healthcare system. “Unlike industries such as financial services and airlines, which have achieved a high level of integration, the health sector suffers from extremely limited access to the right patient information at the right time. Fragmented data not only detrimentally affects access to and the quality of healthcare, but also costs incurred through duplicated or redundant healthcare procedures.” While no statistics are available on wastage due to duplicated health procedures in South Africa, indications are that the amount is considerable. In the United States, almost one third of total health spending is duplicated, fails to improve patient health or even exacerbates it. This equates to $3.1 trillion wasted over five years, or $600 billion per year, according to a study by the US Centre for Evaluative Clinical Sciences. Based on conservative estimates, the use of electronic health records, known as eHRs, could result in savings of at least $31 billion per year in the United States. Similarly, studies by the Regenstrief Institute and Santa Barbara County in the United States show that duplicate tests decreased by 13 percent and 20 percent respectively through information sharing. Phillips says the introduction of eHRs in South Africa could significantly ease the pressure on the healthcare system, improve the quality of care and help to stem the tide on healthcare inflation. “Having accurate electronic patient records could greatly improve the lack of timely access to critical patient information,” she says. “This would in turn reduce medical errors, decrease the frequency of redundant procedures, and improve the cost and quality of healthcare. Admissions would be quicker, diagnoses faster and more precise, and inappropriate intervention in medical emergencies would be prevented.” |