HEALTHCARE SERVICE SCIENCE WEBCAMPUS

BACKGROUND

Services are so interwoven in our day-to-day lives that they are generally taken for granted with little though as the design, implementation and management of these services. Services currently account for 63% of South Africa’s Gross Domestic Product (GDP) and Healthcare services undoubtedly forms a significant component of the Services economy, namely 8.5% of the South African GDP. This is considerably higher than the 5% recommended by the World Healthcare Organisation (WHO). High-income countries, according to the Department of Health (2011:9), typically spent an average of 7.7% of their GDP   on health whilst middle income countries spent 5.8%, and low income countries spent 4.7%. While a significant percentage of South Africa’s GDP is spend on healthcare services it needs to be noted that only 4.2% of the GDP is spent on the public healthcare sector that covers 84% of the population. This changes the picture quite considerably; this 84% of the population translates into 42 million people who mainly utilize the public healthcare sector. This needs to be seen within the context that South Africa currently has a significant shortage of healthcare professionals. The cost of healthcare globally is also escalating rapidly and the sustainability of healthcare services to the less economically enabled sector of the population is under threat. Within the media anecdotes and reports of ineffective healthcare services rendered to communities are on the increase and political pressure for a transformation of the healthcare services industry has resulted in South Africa launching what has become termed to be the National Healthcare Insurance (NHI) initiative. It is directed at making sure that all citizens of South Africa (and legal long-term residents) are provided with essential healthcare, regardless of their employment status and ability to make a direct monetary contribution to the NHI Fund. This translates into more than a mere financial consideration it implies the need for an extensive review and where relevant transformation of the country’s healthcare services infrastructure.

While the clinical aspect of the healthcare value chain, namely primary healthcare directed at the prevention of disease, as well as the diagnoses, treatment, rehabilitation and home care of patients from a services delivery perspective remains the key focus, the support systems that enable service delivery need also to be brought into the spotlight in the transformation of the overarching healthcare services delivery infrastructure. It is here where technology has a key and vital role to play. Technology in this context translates into three key considerations: Context – Systems – People.The context is that of healthcare services delivery. The systems are diverse ranging from electronic medical records to healthcare information, electronic healthcare, mobile health and telemedicine to but name a few. The people or human aspect remains one of the most difficult aspects of the technology transformation process as entails capacity building and change management to ensure the availability of knowledge, skills and experience in the design, implementation, utilization, management and in some instances the phasing out of the healthcare technologies concerned. The GSTM in particular is well positioned to play a key role from a healthcare services science and technology management perspective in research and capacity building. This notwithstanding, in view of the extensive nature of the healthcare transformation that is envisaged, it was deemed essential that a far broader based academic initiative needed to be undertaken to address the research and capacity building processes within the healthcare services domain, With this in mind the GSTM has currently formed an alliance with the Universities of Cape Town and KZN to address the issues concerned. It is envisaged that this academic alliance will in the near future be extended and its thus a case of watch this space for future developments in this regard.

Dr Louwrence Erasmus, of the GSTM, will be heading-up the development of the Healthcare Infrastructure and Technology domain within the GSTM. Dr Richard Weeks will be tasked with dealing with the “service science” component of this domain. Currently a course is being researched and developed that will address the fundamentals of healthcare service science. GSTM students will also be afforded the opportunity to undertake their research projects within the field of healthcare services. Inthe near future further details in this regard will be made available on this WebCampus.

 THE HEALTHCARE SERVICE SCIENCE MODEL

The following model has been developed to portray the systems that inherently at a high level play a role in effective healthcare services delivery.

Source: R Weeks, GSTM

The model reflects the core systems that come into play healthcare services delivery from a macro level perspective. The primary clinical services value chain are reflected in blue, while the mauve elements of the model represent the support systems. In this regard the National Health Insurance (NHI), within the public sector, will in future play a crucial funding or financial role. From a technology management systems perspective the following model assumes relevance:

Source: GSTM

The context in this instance will be healthcare services. The systems will comprise a host of technological systems; electronic health (eHealth), mobile health (mHealth), telemedicine, electronic prescriptions (ePrescriptions); electronic medical records (EMR), and a number of similar systems. It needs to be noted that the definitions attributed to these systems tend to overlap in some instances, the common denominator being technology used in supporting healthcare services management and delivery. The human aspect is probably the most critical as it entails skills and knowledge required for the development and utilisation of the systems concerned. I addition the culture of the institution, “the way we do things around here” can make or break the introduction of new technology within the healthcare services system.

 CONCLUDING COMMENTS

This WebCampus in effect constitutes an inherent but very specific component of the larger Service Science WebCampus, but in view of the importance that the healthcare infrastructure and technology domain has attained within the GSTM it will be directed at providing more specific information in this regard. The healthcare service science needs to be seen as a very distinct component of the healthcare infrastructure and technology domain and not as a new field standing in isolation thereof. It in a sense serves as a bridge between the engineering service science and the healthcare infrastructure and technology domain.