Positive health: The passport approach to improving continuity of care for low income South African chronic disease sufferers

Master Thesis

2017

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University of Cape Town

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Research Problem: The South African health system faces numerous challenges associated with its status as a middle-income developing nation. Wasteful expenditure and poor clinical outcomes arise from inefficient inter-organizational communication of patient information and the lack of a centralized health database. Research question: How does the experience of chronic disease patients with their health information inform the development of future health records in low income population groups? Proposition: Exploration of patient and health care workers experiences of medical records can inform their future development to enhance continuity of care. Objectives, methodology, procedures and outcome: Identification of an appropriate format, technological basis and functional design of a prototype medical record system by means of a phenomenological study conducted through in-depth interviews of patients and doctors in order to improve clinical care. Left and right hermeneutics were used to analyse the data and develop themes. Findings: Health records play a critical role in the clinics workflow processes, document the patients' management and clinical progress. They are an important intermediary in the relationship between the patient and the facility. Inefficiencies in the paper-based system lead to ineffective consultations, loss of continuity of care and discord between practitioners and patients. Improvement of the records format is required to provide ubiquitous access to health and improve patient health literacy.
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