June 27, 2006 Despite the high cost of health care that urban South Africans on medical aid already shoulder, almost half are prepared to pay between R20 and R100 per month extra to have their health records maintained electronically instead of on paper. Even those not prepared to pay say they would have more confidence in electronic health records (EHRs) as opposed to paper. These are some of the findings of a recent Accenture healthcare survey, in which 2 468 respondents in urban households across South Africa were asked to rate the quality of their health care experiences, the obstacles they face in accessing medical attention and medication and their attitudes towards paper-based and electronic health records. The sample is representative of 92 percent of the urban adult population of South Africa and 58 percent of the total adult population. "What the findings show is that the South African public wants, and is ready for, EHRs," says Dr. Roze Phillips, an Accenture senior manager. "By far the majority of respondents, 63 percent, feel that EHRs would improve the quality of healthcare in South Africa." Commenting on respondents' willingness to carry the cost of having their records electronically maintained, she says almost 50 percent of those on medical aid are willing to pay for this. Among this group, 19 percent are prepared to pay as much as R100 per month—over and above their existing medical aid contributions—while 29 percent are willing to pay between R20 and R80 per month. Younger people see the most value "Interestingly, it is not necessarily the highest income groups who would be the most willing to pay for EHRs," says Phillips. "In fact, higher income groups are less likely to want to pay for this service, while the mid-income groups, LSM 5 and 6, are the most likely." The survey also found support for EHRs across all race and age groups, with younger respondents being especially likely to recognise the value of EHRs. "This is probably due to a higher level of comfort and acceptance of computers," says Phillips, pointing out that 72 percent of respondents aged 16 to 24 are in favour of EHRs, compared to 56 percent of those over 50. Not only are South Africans ready for EHRs, the technology is ready too. "Although initially slow to take off globally, the tide is turning decisively in favour of EHRs," says Wayne Borchardt, an Accenture senior executive. "Historically, adoption of EHR solutions has been slowed by technological inadequacies and other challenges unique to healthcare, such as physician resistance and privacy concerns. However, these inhibitors are being overcome and the tangible benefits of the solutions are proving compelling." According to Accenture's global research, fully fledged national EHRs are already in place in New Zealand, Denmark and Canada. In the United States, where several states have established or are piloting EHR solutions, hospitals' spend on EHRs is expected to increase by $300 million over the next four years. In Australia, state and territory governments are collaborating on a joint venture to create a national health information network, and in England, government allocated billions to modernise the medical record-keeping systems of the National Health Service. How South Africa can benefit from EHRs Phillips says there is a pressing need in South Africa, where the health care system has a high level of data fragmentation, to bring the individual patient into the heart of the health care ecosystem. "EHRs that are accessible to patients and health care professionals in any hospital or health care centre in South Africa promise a consolidated view of health information that makes patient centricity and health care integration possible." She says the benefits for citizens would include better health services, shorter delays in service availability, greater care continuity and accessibility, improved efficiency in resolving health problems and personalised treatment. For health care professionals, improved information flow makes it easier to obtain better quality information and measure results, thus supporting better clinical decision-making and simpler administration, in turn increasing productivity and decreasing the amount of resources dedicated to IT systems. "In the case of government, EHRs represent an opportunity to dramatically improve the lives of the general population of South Africa, quickly and quantifiably and with the added benefit of freeing additional budget for other healthcare initiatives," says Phillips. Accenture's involvement with recent international EHR projects in the United Kingdom, France, Italy, Spain, South Australia and Singapore has shown that correct private sector and government investment decisions are the key to successful health care data integration, according to Borchardt. Rather then reinvent the wheel, South Africa can leverage the experience of other countries, localised for South African conditions. "Regardless of geographical location, the key success factors for implementing EHR solutions are universal," he says. "In Accenture's experience, these are to design a solution that complements existing systems, is interoperable and not a fixed-vendor solution, and emphasises organisations' business requirements and governance, in addition to technology changes." Borchardt says that although rising demands on health care are combining with unsustainable cost increases to create a crisis in health care, advances in medical and information technologies present significant opportunities to transform health care and make collaboration in the sector a reality. "To capitalise on these opportunities, it is critical that all constituents of the health care system, meaning government, industry and patients, take collective responsibility. By working together full health care integration becomes a reality as opposed to having isolated pockets of connectedness that benefit only a small portion of health care providers and patients." To Top |