Systems engineering perspective on eHealth implementations: case study of users

Abstract

The expected outputs and outcomes for healthcare services delivery were not realized by the implemented eHealth systems in South Africa. This paper investigates the impact of system engineering management (SEM) practices on the efficiency and effectiveness of eHealth systems in a South African institution in Gauteng Province. 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 no knowledge of SEM and limited knowledge of Information and Communications Technologies (ICT). Two eHealth projects implemented in the applicable facility show indications that the efficiency of eHealth projects is directly influenced by how well SEM is implemented. For this study, the environment category was the strongest contributor to efficiency of the Mobile application and the Electronic Medical Record (EMR) system. Users of both systems perceived that SEM was performed by both projects without proper proof of being managed through documented processes. The two projects were in the pilot phase and the Mobile application was perceived by users to demonstrate a higher outcome level than the EMR system.