A system architecture for ensuring interoperability in a South African national electronic health record system

ountries such as South Africa have attempted to leverage eHealth by digitising patients' medical records with the aim of improving the delivery of healthcare. This involves the use of an electronic health record (EHR) which is a longitudinal electronic record of a patient's information. The EHR includes all the patient's encounters that have been made with different health facilities. In the national context, the EHR is also known as a national EHR, which enables the sharing of patient information between points of care. However, a lack of interoperability exists between many South African health information systems making communication between these disparate systems impossible. As a result, the sharing of patient information is inhibited and the benefit of improving healthcare delivery cannot be realised. This paper proposes a system architecture for addressing interoperability challenges and indicates how interoperability can be ensured in a national EHR system. The proposed system architecture is differentiated from other national EHR system architectures found in the literature in order to emphasise its novelty. Secondary data obtained from a systematic literature review was analysed using content analysis, resulting in 9482 tags which informed the development of the proposed system architecture.