All South Africans, whether on the public or private healthcare system, should carry a digital health wallet with their full medical/health records on their cellphone app or a QR-coded card for those without smartphones, urges Darelle van Greunen in Business Day.
Van Greunen writes:
The wallet streamlines the system, saves money and becomes a clinical necessity – and with this, no matter where you are, if you need attention, the doctor or healthcare provider can immediately access your full medical and health record and give you the attention you need.
This will go a long way towards addressing the reality of healthcare delivery in South Africa, which is defined by fragmented patient information and limited continuity of care. This is particularly so in the public healthcare system but also a pressing issue in private healthcare.
Too often, healthcare professionals must make critical decisions without access to a patient’s previous medical history, lab results, imaging, or clinical notes. Health information is scattered across multiple platforms, and in many parts of the country there is still a reliance on paper-based records.
Clinicians often have to repeat tests and assessments, with valuable clinical time lost, leading to increased costs, inefficiencies and the risk of medical error.
This is what health system experts call a broken patient journey.
A digital health wallet, which securely stores and allows controlled sharing of a patient’s health information across facilities and providers, offers a practical solution to this challenge.
Each visit to the doctor or clinic, each screening result, immunisation, referral or treatment, is securely logged on the wallet and aligned healthcare system. If a referral is not completed, the system can flag it. If follow-up care is delayed, providers can intervene. If a patient arrives at any clinic or hospital, their medical history travels with them.
There is an urgency for this, and we are hoping to do the first pilots for the digital health wallet within 18 months to two years as a collaboration between the Department of Health, trans-disciplinary researchers from Nelson Mandela University, the Swiss-based Movement Health Foundation, and public and private sector partners.
The wallet ensures that when patients move through the system, their story moves with them, which is how a modern health system should operate.
Patients should not have to retell their stories from scratch every time they see a new healthcare professional. Clinicians can only make good decisions if they have the history of previous investigations, medication, diagnoses and adverse events for each patient.
The patients, the healthcare system and the medical ecosystem benefit from the digital health wallet. It streamlines the system, saves money and becomes a clinical necessity as well as a medical-legal requirement, which could also help to reduce the number of medical-related claims.
South Africa has already taken steps towards a range of digital integration initiatives, such as the Health Patient Registration System and the National Digital Health Strategy. However, implementation remains uneven across provinces and facilities, and the absence of a universally applied, interoperable patient identifier limits continuity of care.
A digital health wallet would bridge these gaps, allowing different systems, public and private, to connect around each patient’s record.
Universities have a critical role to play in the development and roll-out of the digital health wallet. Through trans-disciplinary collaboration between engineers, clinicians, data scientists and community researchers, universities can help design and test digital health solutions that are evidence-based, context-appropriate and scalable.
But no single institution can do this alone. Building resilient digital health systems requires partnerships between the government, academia, industry, NGOs, healthcare providers and communities. It requires investment in infrastructure, regulatory frameworks that protect patients, and rigorous evaluation to ensure that innovations are shown to improve outcomes.
One of the most important factors for digital solutions to succeed is that they must be built with and for the communities that use them. They must be trusted by the people they serve. Trust is built through participation, strong governance and legal protections that ensure patient information cannot be misused.
Data security and patient confidentiality must be non-negotiable.
If we see digital health through this lens, the goal is not to digitise for the sake of it but to advance continuity of care and create a strong foundation for a sustainable, more efficient, patient-centred healthcare system.
If we get this right, we will not only improve efficiency across the whole system, we will move one step closer to a situation where no patient is lost, no record disappears, and no patient is screened for a life-threatening illness, only to be forgotten. We will save lives.
Note: To discuss the way forward for implementing digital health wallets in South Africa, on 11 March a Digital Health Symposium was hosted by Nelson Mandela University in partnership with the Movement Health Foundation. National and international health leaders, clinicians, technologists, researchers and policymakers attended.
Van Greunen is a distinguished professor of Information Technology and Director of the Centre for Community Technologies at the Nelson Mandela University.
Business Day article – Transforming SA patient care with a digital health wallet (Restricted access)
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