Transforming South Africa’s health sector : The eHealth Strategy, the implementation of electronic document and records management systems (EDRMS) and the utility of maturity models

Purpose The purpose of this paper is to explore the challenges of transforming South Africa’s health sector through the country’s eHealth Strategy and particularly one of its key components, the implementation of an integrated Electronic Document and Records Management System (EDRMS). Design/methodology/approach The study conducted an extensive review of literature and used it as a basis to analyse the challenges as well as opportunities in South Africa’s transformation path within its health sector based on the nation’s eHealth Strategy. Findings South Africa’s health sector faces three main transformation challenges: inequity, legacy of fragmentation and a service delivery structure biased towards curative rather than preventive services. Health information systems provide a solid platform for improving efficiency but, within South Africa, these systems have been highly heterogeneous. A recent study showed the country had more than 40 individual health information systems scattered in all provinces, with over 50 per cent not adhering to any national or international standards and more than 25 per cent being stand-alone applications that shared information neither locally nor externally. The eHealth Strategy offers a robust platform to start addressing the legacy of fragmentation and lack of interoperability. However, it also raises a few other concerns, including the use of different terminology such as Electronic Medical Record (EMR) interchangeable with Electronic Health Record (EHR), or EDRMS parallel with Electronic Content Management (ECM). In addition, there is the opportunity to explore the use of the maturity model concept in the EDRMS implementation experiences within South Africa. Originality/value This paper demonstrated the complex nature of the legacy of fragmentation in South Africa’s health information systems and explored three aspects relating to terminology as well as maturity models that should be considered in the country’s future eHealth Strategy.