Back to top

Data interoperability of health information systems in public hospitals in Gauteng province of South Africa

There is a great demand for data interoperability in the healthcare industry as a result of broader and longer-standing changes, but long-standing obstacles have also been hindering this trend. It is undeniable that healthcare providers are struggling to embracing interoperability because they are trapped in silos within a plethora of disparate systems of health information. South African public hospitals, clinics, and care centres operate with siloed health systems that are vertically and horizontally fragmented, which results in a limited scalability and ineffective data interoperability between systems. This is a possible source of many inequalities, misconnections between hospitals, duplicate healthcare services, and information blockage in healthcare systems. Nevertheless, the pattern of operating in silos threatens to undermine the ability of public hospitals to provide multidisciplinary and coordinated care that patients require to meet quality and cost demands. Therefore, digital technologies such as data interoperability and big data analytics are more resilient to eliminate data silos and fragmentation in healthcare and promote coordination across multiple dimensions.
The purpose of this study was to investigate data interoperability of Health Information Systems in public hospitals in the Gauteng province of South Africa, with a view to proposing a framework that can be used as a reference to breakdown data silos, fragmentation and promote data sharing, and collaboration between public hospitals. The study used a conceptual framework developed from literature review and the Institutional Theory to link the central constructs of, and serve as a guideline for, the study. The study adopted a mixed methods research approach through a convergent parallel design to understand the multi-dimensional and complex nature of data interoperability in public hospitals. Data of the study were collected using a multi-level sampling technique with qualitative data collected from the management staff through semi-structured interviews and document analysis, whereas quantitative data were collected from clinical and administrative staff using a questionnaire.
The findings revealed that public hospitals had not put policies, procedures, and strategies in place to support and promote the adoption and implementation of data interoperability. It was further revealed the most prevalent obstacles to data interoperability among public hospitals include the absence of trust and transparency, a lack of management support, the inflexibility of outdated systems, poor bandwidth and connectivity, budgetary restrictions, high cost of reliable network infrastructure, a lack of political support, insufficient laws and regulations, and poor adherence to standards.
The study suggests a framework for data interoperability to assist public hospitals to eliminate data silos and fragmented systems to facilitate secure data sharing and coordinated care. The framework can be used to assist legislators and policymakers in formulating successful data interoperability implementation strategies. It is concluded that data interoperability across public hospitals and between systems can be embraced through breaking down data silos and automating data access, sharing, capacity building, investment in infrastructure, and fostering collaboration. The study recommends that the government, public hospitals, and other stakeholders, including non-profit organisations, regulatory bodies, and the private sector must work together to develop a range of new initiatives and strategies that can be used to overcome interoperability challenges.

Keywords: data interoperability, data standards, public hospitals, scalability, fragmentation of systems, information blocking, South Africa, Health Information System (HIS), Electronic Health Records (EHRs), data sharing, Health Information Exchange (HIE), data silos, legacy health systems, Patient Health Information (PHI)

Full Name
Dr Kabelo Given Chuma
Programme