echoed by many others. “Decisions need to be made,” she says emphatically. “The government needs to determine how much money they have to spend and then put it out to tender. Basically, it just needs a decision about what we need to do and what our priorities are.” Foster is also a pragmatist, however, and is under no
illusion why delays in this process may occur. The South African government has many other, pressing priorities, after all, and with an election on the horizon politicians may well be forgiven for having their eyes on other priorities. “One thing is sure,” she says, “they need more capacity in the Ministry so people can actually take on this work and run with it.” Dedicated staff working specifically on eHealth
implementation from within the Ministry is something clearly identified in the National eHealth Strategy document, but Foster is also determined to involve all stakeholders in this process. “The Ministry of Health recognises the need for this
involvement,” she says. “The Strategy has as a priority the need to gather all stakeholders because in the past that just hasn’t happened. Trust has been an issue. The private sector vendor community is still obviously keen to engage, but they have been waiting for direction and the problem was that this direction was not there,” she continues. “The Ministry of Health now has to get to a point where they can say to the vendor community, ‘this is our need, this is what we want to achieve, these are our timescales; now what are your solutions?’” Foster is calling for positive action. “The easiest way
for all stakeholders to get together on this would be through some form of association,” she says, “although the situation at the moment is complicated because of the length of time vendors have been waiting for direction from the authorities. I believe the private sector will have no problem in working together – they just need the authorities on board with them, and maybe if it happened it would be a way of rebuilding that missing trust.” Another area of trust that needs to be established is
that between the health authorities and the healthcare users, and Foster believes there should now be a big programme of education and reassurance. “We need to involve the citizens as clients of any
eHealth system,” she explains. “In issues like patient identification, it is critical that they are involved – how are we going to identify them? Where are we going to store their information? Reassurance is needed, and it is something we should start to give from these early stages because the national patient master index is a transnational thing, so we are going to have to work on it early on in the process. “Thulani Masilela is a very competent individual
within the Ministry of Health, driving the implementation of the eHealth strategy,” she continues. “He is determined to keep eHealth high on the ministry’s list of priorities.” Aside from prioritising needs and establishing clear from government,
direction
www.projectsmagazine.eu.com Foster also looks
elsewhere in Africa and around the world for lessons to learn and good practice to adopt. “We need to get more people involved in healthcare
in African countries to talk together,” she says. “The health ministry in Mozambique is a good example of this. They have visited Cape Town twice recently to learn from eHealth experiences in the Western Cape. They are planning more visits, with a view to sharing some of the lessons they have learnt and also learn from what is being done here in South Africa. “Solutions originating in Europe or the USA may
not be the best for an African country, but a solution used in another African country may well be, so we need
ways of sharing information through
conferences and networking. “Of course, all this does need the buy-in of the
ministries,” she continues. “I think there should be more openness and a willingness to cooperate – and again this comes down to a matter of priorities, and at the moment these things are not a priority. It’s a case of ‘we have our own problems’.” Foster is a key player in the eStrategies conferences
held regularly in South Africa, and is now keen to expand the attendance at these events to include more stakeholders from around the developing world who are looking at similar or complimentary solutions and, of course, facing the same barriers to development. HELINA, the African Region of the International of
Medical Informatics Association, is one organisation she would like to see involved, while representatives from countries such as Ghana, Mozambique and Rwanda, where great emphasis is being put on eHealth development, should also be welcomed. “But we also want people from beyond Africa, so we
can share other successes,” she says. “Even though the models may not always be the same, we can always learn more, while I would also like to learn from other developing nations, like the Philippines and Pakistan. “At eStrategies, we need to avoid having just another
talkshop,” she continues. “We need people to set achievable goals at the conference, whether it is to work together, collaborate, share or develop something. We need to keep acting on the things we are talking about, and get people with sufficient authority, such as minister of health, to agree upon and set goals. “There are a lot of challenges. We have the money.
It may not be as much as we’d like, but it is there. Now we need to ensure that we have the political will and the skill, expertise and the capacity to lead this development. “I remain optimistic,” she concludes. “South Africa
has achieved all kinds of wonderful things, so I don’t see why we can’t do this as well. We just need to be patient. These things don’t happen overnight. In the past, we have had some grandiose plans for eHealth that have not come to fruition, so we need to start with humble plans and get the foundations down first – and that is what I will be pushing for.”
★ 15 “Now the
National eHealth Strategy has been written,
agreed upon and published, we
have to focus on how the Strategy is going to be realised”
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