Wesley Diphoko, Head of the Independent Digital Lab (02 June 2017)

CAPE TOWN - The Life Esidimeni debacle has put a spotlight on one of the major challenges in the South African health system. 

The report by the Health Ombudsman differed from the MEC’s statement about the number of people who died.

When the report was released, the Ombudsman indicated that there were 94 and more deaths between March and December last year. That number at the time was double the number that was reported by the Gauteng directorate of mental health which was 48.

The Moseneke inquiry has heard of how health professionals were unable to communicate their real thoughts about decisions taken by officials.

Family of patients who died at the facilities have shared stories of how they were not informed about the health status of their relatives. The common theme highlighted is the lack of information.

Currently, there’s no single national information system that provides information on patients. The other challenge relates to access to information by health professionals, patients and relatives of patients and their ability to communicate with each other about problems in the systems. Relatives of patients have limited ability to communicate with health institutions to get updates on their relatives. Government health professionals have limited access to information about what is really happening in the health institutions.

The government through the Ministry of Health and the National Health Insurance led by Aaron Motsoaledi is working hard to build a healthcare system that cares for everyone.

The National Health Insurance (NHI) is a financing system that will ensure South African citizens (and legal long-term residents) are provided with essential healthcare, regardless of their employment status and ability to make a direct monetary contribution to the NHI fund.

Human right

The NHI is informed by the fact that healthcare is a human right and that is a widely accepted international principle. This right should not depend on how rich we are or where we happen to live. The right to obtain healthcare is written in the Constitution.

Currently, large numbers of South Africans continue to die prematurely and they suffer unnecessarily from poor health and access to health information. Treatable conditions are not being treated on time and preventable diseases are not being prevented - also due to lack of access to information.

This is in spite of the fact that the government has tried its utmost since 1994 to ensure that everyone in the country has equitable access to necessary healthcare services. There are still serious challenges, mainly caused by a skewed healthcare financing system. Without NHI, the burden of disease in the country will not be reduced, because the majority of the population - and the section suffering the greatest ill health - will not access good quality healthcare.

So far the focus in this process has been on infrastructure and human resources by building new hospitals, renovating some and development of health professionals. This is the necessary part of creating a world-class health system. The missing layer, however, is the information layer. The fact that very few people knew what was happening at Life Esidimeni and the fact that it was difficult to communicate challenges illustrates a broken information system that should inform all concerned about the well-being of the patient.

If the NHI is to succeed in transforming the South African health system and avoid the Life Esidimeni tragedy, information will have to form part of the solution. In future it should be possible for the health minister and a health MEC to have a single view of health status within the country or province.

The government health leader should be able to pick up challenges in the system without having to read big health documents. Access to information for relatives and patients should make it possible for the sick to have better access to care.

This is just one way in which information can truly benefit the health system in South Africa. Beyond this point, information can enable prevention of diseases through access to data that can inform all concerned about the real state of health of the country.

Big data is one area that needs to receive attention as South Africa works towards the NHI system.

Health data

Big data in the health sector means that large amounts of new research papers, clinical trials, scientific studies, and patient health information can be turned into useful information to take care of the patient. Currently it’s impossible for doctors and medical researchers to keep up with even a tiny fraction of health data.

Through effective use of data, machine learning and artificial intelligence (AI) can be used to speed-­read through not only the vast academic literature, but also CT scans, electronic medical records, and mountains of data from clinical trials and genomic studies. AI can also provide support by giving drug makers critical insights into who benefits most from their treatments and changing the way hospitals manage their administrative operations.

In order for society to derive benefits from health data, there will also be a greater need for collaboration between the public and private health sector as well as drug makers, health research institutions and health academic institutions.

The Infonomist has been working towards developing tools that can enable better access to health data. This process will include all players in the health sector with the aim of providing better healthcare through access to information for the African continent. The value of this process will trickle down to the economy and enable citizens better informed about health to be more productive.

Wesley Diphoko is head of the Independent Media Lab and founder of the Kaya Labs.