Trisha Crawford speaks on Specialized Data Management at Healthcare Innovation Summit Africa 2022.

1. Specialized Data
Management
HEALTHCARE
INNOVATION
SUMMIT AFRICA
2022

2. What is Information Management?
Data is the lifeblood of any organisation. Records are a subset of the overall data
and information used in an organisation. Records provide information about
decisions made and actions undertaken. Records serve as evidence a company’s
business actions and regulatory compliance.
All records in the Company, be they scientific, financial, administrative, or
regulatory/legal must be managed in a manner that adheres to national and
internationally accredited standards.
Records Management has mandatory requirements in terms of how the full lifecycle
related to these records, “from creation or receipt through processing, distribution,
organisation, and retrieval though disposition”. These are all supported by retention
schedules relating to all business functions within the Company.

3. Primary Health Care
Records Management

4. Background
Currently the Department of Health is experiencing major problems in management of patient records. There are
multiple factors that contribute to the problem:
v Lack of infrastructure for filing, sorting and archiving
v No process for tracking patient files throughout a clinic
v Long waiting times for files that cannot be found
v Patients leave with their files after their visits
v When files cannot be found, duplicate files are opened for the same patient
v Different identifiers are used across facilities, districts and even in different disease areas
v Major litigation issues with missing files (PAPIA Act)
Ekurhuleni Risk Management Report (May 2021)
v Records management rooms are not compliant with SOP requirements (Preventing deterioration of
records)
v Medical records are not disposed as per requirement by SOP’s

5. Methods
Develop an electronic records management system that
can track and trace physical records throughout a clinic.
This system needs to be able to be implemented on any
device.
It must be developed specifically for Records Management
and be completely adaptable “per clinic” without
requiring additional software development funding.
Each patient file location was mapped and loaded into
the system. This can also be changed by the users!
Each patient file is then captured into the system using
their unique identifier (HPRN Number, Patient File
Number etc.)

6. Results
System Users can
v Move records across the site
v Add new records as required
v De-activate old inactive records
v Quick and easy to use!
Super Users can be assigned to work in the main module which allows for the following:
v Manage Users
v Manage geographical locations
v Draw reports in real-time:
v Show movement of files across the site. Each file is allocated a unique identifier which can track the file.
v Look at time and motion of files to determine where there may be gaps in the process
v RFID Technology can be linked into the System which by using RFID tags and short-range scanners you can locate
missing files.
System can be used in any site
be it Department of Health
Clinic, Clinical Research Sites or
even Site Offices.

7. eTick

8. Background
Currently all facilities in Ekurhuleni are collecting health indicators using the District Health Information
System (DHIS) which was developed by the Health Information Systems Program (HISP). However, before
data can be captured into DHIS is has to go through layers of manual data collection until aggregated
data can be captured.
All indicators are captured from register books which are placed at each service delivery point and
completed by the Clinician after each consultation.
Each day the administration staff collect the data manually on a tally sheet and use this to compile a
weekly report on all services provided by the clinic. The weekly data is then collated monthly and finally
captured into DHIS at sub-district level.

9. Example of a Paper Register Book

10. Daily Data Collection Process,
Current DHIS Data Collection at Facility
Level

11. Solution
The solution was to develop an Electronic Tick Register - eTick Register – that would replace the paper
registers.
A partnership was formed with the Ekurhuleni Department of Health, The Aurum Institute and TC Data
Consultant to replace the cumbersome paper registers within the clinic’s.
Clinicians would capture their own data electronically and each day the data would be immediately
uploaded into DHIS and the Sub-Districts would have access to real-time data. They would be accountable
for signing off on all their patients daily.

12. Example of the System

13. Benefits
v Large cost saving on stationary using an eTick system
v Data is backed up so no lost data
v Linkage with DHIS
v Tracing of files for follow-up Visits
v Managing patients at follow-up visits as Patient History is available
v Use in place of “Daily Verification Tool”
v Use to operationally manage the Clinicians time (E.g. 1 Clinician only initiates 5 patients on ART a day)

14. Methods
A touch screen system was developed and customised to
be used on any device (tablet or computer). The system
was developed using the exact same indicators that are
collected on the paper register with reports to summarise
the daily statistics.
eTick was implemented in 3 Pilot Sites in the Ekurhuleni
District for a period of 6 months. After each month the
data quality was assessed, gaps identified, addressed and
closed.
The system was then adapted to the pilot findings and
released into production in one Primary Health Clinic for
a year.

15. Additional Functionality
Patient Registration: Registers each person visiting the clinic.
Waiting List: Patients are placed onto a waiting list as soon as they enter a facility. The Clinician can at
any point in time see exactly how many patients are in the waiting area. A patient can also be referred
or redirected to another service. If a patient waits to long they will be flagged or if they leave without
being seen a reason will be captured.
Back Capture: A Clinician has the ability to back capture patient files should they not have time during a
consultation. The effective date of the consultation will be captured.
Edit Consultation: All patient consultations can be edited to ensure excellent quality data
MERGE: If duplicated patients are detected in the system the files can be merged into one master patient
file.
Reports: New reports for Clinicians to sign have been developed to ensure Clinicians take ownership of
their data
History: Patient History can be reviewed in the system.

16. THANK YOU!!
Trisha Crawford
trisha@tcdataconsultant.co.za
+27 82 875 7575