Adequacy of healthcare information systems to support data quality in the public healthcare sector, in the Western Cape, South Africa

Thesis submitted in fulfilment of the requirements for the degree Master of Technology (MTech) in Information Technology In the Faculty of Informatics and Design, at the Cape Peninsula University of Technology (CPUT), 2013Healthcare services are vital to all human beings, as our daily lives depend on them. In South Africa approximately eighty per cent of the population uses the public healthcare services. In the current healthcare systems data corruption exists which threatens data quality in the systems. The aim of this study was to understand the existing information handling processes and factors that affect the accuracy and integrity of healthcare data. A qualitative research methodology, under the interpretive paradigm was used for this investigation. Activity theory is used to formulate an analytical framework, the “healthcare information system data quality activity theory framework”. This was very helpful for understanding the healthcare information handling process as an activity system that consists of actors with individual goals. Though the goals are varied, they are joined together by the common objective. The logic of the framework is that a realisation of goals in the activity system depends on a number of factors. At the beginning, there must be a synchronous inter-linkage between the goals of the actors, the mediating factors such as adequate tools, user skills, enabling policies, and the systematic procedures that are diligently enforced. It is assumed that any situation which prevents this inter-linkage will have a negative impact on the realisation of the sought objective. The framework therefore, was very helpful in informing questions, the data collection and ultimately, the analysis processes. The public healthcare sector is the main source of data; other sources were literature, the Internet and books. The analysis of data was done using content analysis to find what themes emerge and the relationship (s) between them in what is being analysed. The findings reveal a lack of adherence to information handling procedures and processes which lead to corrupt data in the systems. In addition, most users have limited skills, which is a hindrance to them in performing their duties as expected by the healthcare sector. In fact, the healthcare sector is also challenged by systems which are constantly slow or down, due to limited network capacity and human errors. The presence of these challenges suggests non-adherence to data handling procedures, which explains the existing corrupt data in the healthcare systems. Therefore the recommendation is that the public healthcare administration must enhance their training programs. The training must be re-designed to cater for the needs of all users, regardless of their background. It needs to improve user skills and boast their confidence in using electronic systems. Obviously, any changes and improvements need to be sustainable, and the sector is unlikely to succeed without enforcement of new procedures. Therefore, adherence to data handling procedures must be strictly enforced, with policies thoroughly communicated to the users. That way, the sector will not only have systems and related policies, but also ensure their full exploitation for improved service delivery in the public healthcare sector in South Africa