Opinion by Professor Darelle van Greunen
Distinguished Professor of Information Technology and Director of the Centre for Community Technologies, Nelson Mandela University.
This way, 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 current 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.
Healthcare professionals are too often required to make critical decisions without access to a patient’s previous medical history, laboratory results, imaging, or clinical notes. Health information scattered across multiple platforms, and in many parts of the country there is still a continued reliance on paper-based records.
Clinicians often have to repeat tests and assessments, with valuable clinical time lost, which leads 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, transdisciplinary researchers from Nelson Mandela University, the Swiss-based Movement Health Foundation and public and private sector partners.
In essence, the wallet ensures that when a patient moves through the system, their story moves with them, which is how a modern health system should operate. Patients should not have to re-tell 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.
Hence the beneficiaries of the Digital Health Wallet are the patients, the healthcare system and the entire medical ecosystem. It streamlines the system, saves the economy money, and becomes a clinical necessity as well as a medical-legal requirement, that could additionally help 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 continues to limit 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 transdisciplinary 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 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 entire 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.