A systems engineering perspective on eHealth implementations 'efficiency and effectiveness: a case study involving suppliers'

Abstract

The implementation of eHealth systems in South Africa did not generate the expected output. This paper investigates the impact of system engineering management (SEM) practices on the efficiency and effectiveness of eHealth system in two South African institutions in Gauteng and the Western Cape Province, respectively. The System Engineering Capability Model (SECM) is combined with the four major outcomes for eHealth systems as concepts in designing open ended questions for narrative enquiry addressing efficiency and effectiveness as part in the context of a result based development framework to collect stories from multidisciplinary teams in healthcare having varying knowledge of SEM. Three eHealth projects implemented in the two facilities show indications that the efficiency of eHealth projects is directly influenced by how well SEM is implemented. For this study, the environment capability category was the strongest contributor to efficiency for two projects and the technical capability category was the highest for the other one. Two of the eHealth projects were in the pilot phase and demonstrated low system outcome levels; however the third project in the operations phase showed a better system outcome level despite its low capability maturity level.