Electronic Health Record Interoperability as a Pathway to Advancing Universal Health Coverage in the South African Healthcare System

Kabelo Given Chuma

doi:10.25159/2520-5293/19839

Authors

Kabelo Given Chuma University of South Africa https://orcid.org/0000-0002-5817-6063

DOI:

https://doi.org/10.25159/2520-5293/19839

Keywords:

electronic health record (EHR) interoperability, Sustainable Development Goals (SDG), healthcare systems, public hospitals, South Africa, universal health coverage (UHC)

Abstract

Electronic health record (EHR) interoperability is widely considered the backbone of a sustainable health system and the foundation of achieving universal health coverage (UHC), as it facilitates the seamless exchange of patient information across various levels of care. Despite the South African healthcare commitment to UHC through reforms like the National Digital Health Strategy, EHR interoperability remains a persistent challenge for public hospitals across the country. This study explored EHR interoperability for advancing UHC in the South Africa healthcare system. A qualitative exploratory approach was adopted, utilising a multiple case study design. Data were collected through semi-structured interviews with system developers, healthcare managers, information technology (IT) officers, and policymakers. Data were thematically analysed using ATLAS.ti software. Findings revealed that EHR systems in public hospitals operate in silos, leading to fragmented care, duplication of services, and delayed health delivery, all of which undermine the goal of achieving UHC. Major obstacles identified include inadequate digital infrastructure, lack of interoperability standards, limited digital literacy among healthcare staff, and absence of a clear strategic roadmap and policies. The study recommends the implementation of a national digital health strategy with clear guidelines, timelines, and evaluation metrics. Investing in robust infrastructure and fostering multi-stakeholder collaboration are vital to successful EHR deployment. A policy is proposed to support scalable and sustainable EHR interoperability across hospitals. This study underscores the urgent need for an inclusive and coordinated digital health strategy to accelerate progress towards UHC in South Africa, ensuring equitable access to quality healthcare for all citizens.

Author Biography

Kabelo Given Chuma, University of South Africa

Kabelo Given Chuma holds a Ph.D. in Information Science from the University of South Africa (UNISA) and currently lectures in the Department of Information Science within the College of Human Sciences. His research interests span several critical and emerging areas, including big data and analytics, data cybersecurity, information security, health information security, data and network security, and health information governance. He also focuses on electronic health records, records management, mobile security, and internet banking security, reflecting a deep commitment to advancing secure data management practices in both healthcare and financial sectors.

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