​The City of Cape Town’s Health Department is hard at work investigating the feasibility of an electronic appointment booking system at clinics and what the blueprint for such a system would look like. A similar investigation is under way into a digital patient records system.
 
These are the first steps in a much bigger technological makeover envisioned for the department. A budget of R5 million has been set aside for the new financial year to facilitate the work going into the process.
 
‘Sadly, public health is often synonymous with long queues. But just because this is the norm doesn’t make it right. The investment being made with this budget allows us to work towards changing the norm and will allow clients the option of booking an appointment with a healthcare professional instead of clinics running solely on a first-come-first-served model. Of course, emergency cases will continue to be attended to on arrival,’ said the City’s Mayoral Committee Member for Safety and Security; and Social Services, Alderman JP Smith.

Currently, the only appointments available at City Health facilities are for services requiring follow-up visits such as chronic diseases, child wellness and tuberculosis. Typically these appointments have been given by date only, which has led to the practice of patients arriving at the start of the day, sometimes before the clinic opens, in an attempt to be first in the queue. In the past year, however, a service design initiative within City Health, in partnership with the University of the Western Cape, is seeing more and more facilities using appointment times spread throughout the day.

Patients are encouraged to arrive at their appointment time only and as a result these facilities have reported decreases in clinic congestion and patient waiting times. While these facilities have done admirably with existing resources, an electronic appointment booking system would be an invaluable tool and a significant step forward in ensuring that visitors to clinics can take less time off work and away from home in order to access the healthcare services they need.  

‘Currently patient files are kept and updated manually and stored at the clinics. This paper-based record system takes up a lot of space at clinics for storage of files and requires time from staff to look for patient records and update them manually after they visit the clinic. The time- and cost-saving associated with storing and updating patient files electronically would be considerable. In addition, digitising patient records would mean that clients can go to any clinic as their folder would be available in just a few keystrokes,’ said Alderman Smith.
 
With over 80 facilities providing a variety of health services, the City recognises that implementing a standardised electronic appointment system and a patient record system is a complex undertaking. The investigation into this particular aspect will take into account a number of things, including:

• what software solutions currently exist for appointment and patient record systems
• the type of electronic platforms clients would use to book appointments (e.g. mobile devices, electronic kiosks)
• how any potential software and platforms would integrate with existing City systems
• an audit of IT infrastructure and needs analysis

Considerations like software, IT infrastructure, and human resources would also form the backbone of the investigation into an electronic records and appointment system. Factors such as the vulnerability of the system in cases of theft and vandalism would also be a key consideration.
 
‘There’s a lot of hard work that lies ahead and I’m under no illusion that this will be a quick fix. It is certainly doable, but we have to find the right solution that will work for our staff and our clients. The City has committed itself, through the Organisational Development and Transformation Plan, to become a more customer-centric organisation. This is certainly a step in the right direction,’ added Alderman Smith.
 

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