South Africa continues to confront a quadruple burden of disease, which includes a high HIV and TB burden. In line with National Development Plan 2030 (NDP) priorities, it is imperative that the health system manage patients in a comprehensive and coordinated way so that resources are efficiently used and patient care is maximised.
Integrated patient management is a key focus, significantly enabled by integrated health information systems. To redress health information systems fragmentation, the National Department of Health (NDoH) through its Health Informatics Directorate directed integration of the two vertical information systems previously underpinning HIV and TB service delivery. HIV and TB are pre-eminent public health priorities, with high rates of HIV-TB co-infection. The integration of information systems has been critical to improved care in particular among patients with HIV-TB co-morbidities.
Through considerable effort and investment by the NDoH and provincial Departments of Health, over 4000 health facilities nationwide now routinely digitise HIV, ART, presumptive-TB, DS-TB and PrEP data for individual patients, all in the same information system (TIER.Net). These digital data are stored together, with reports drawn and actioned to facilitate improved patient management. The maturation of all TB/HIV Information Systems related processes, including those related to the longitudinal patient record, is an important jumping off point for the evolution of broader digital health processes.