Book Chapters

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Conceptualising heuristics for patient matching through an integration of insights from data alignment with the HPRS and DHA
(National Department of Health and CSIR, 2024-11) Du Toit, Kirsten; Fogwill, Thomas A; Viviers, Margaretha I; Montja, Motshidisi; Botha, Adèle; Herselman, Martha E; Rousseau, P
Purpose: The chapter explores heuristic approaches to enhance patient matching within the Health Patient Registration System (HPRS) in South Africa, focusing on integrating insights from data alignment with the Department of Home Affairs (DHA). The aim is to improve the accuracy and reliability of the national patient registry by addressing challenges related to data inconsistencies, cultural naming conventions, and the use of shared identifiers. Study design/methodology/approach: This research adopts an interpretative deductive approach grounded in the principles of ecological rationality. The study systematically analyzes patient matching within the HPRS, examining purposefully selected samples from the over 68 million registered patients, focusing on those verified by the DHA. The chapter proposes a conceptual framework for enhancing patient matching, integrating both deterministic and probabilistic record linkage methodologies. Findings: The findings suggest that employing a combination of key identifiers, implementing referential matching techniques, and developing algorithms that account for cultural and linguistic diversity can significantly improve patient matching accuracy within the HPRS. The research also highlights the importance of addressing data quality issues in both the HPRS and DHA reference datasets to ensure reliable patient identification across health systems. Originality/value: This study underscores the critical role of heuristic approaches in improving patient matching within national health information systems. It contributes to the broader discourse on digital health by offering practical strategies to enhance the integrity of patient registries, ultimately supporting the goals of equitable healthcare delivery under South Africa's National Health Insurance (NHI) scheme.
Conformity and Interoperability Assessment
(National Department of Health, and CSIR, 2024) Sibiya, Mhlupheki G; Samson, Akhona
In addressing the challenges of fragmented health systems in the healthcare sector in South Africa, the National Department of Health (NDoH) and the Council for Scientific and Industrial Research (CSIR) have embarked on a journey which resulted in the development of the Health Normative Standards Framework (HNSF). A testing laboratory was also developed to ensure vendor systems' conformity to the standard. The NDoH embarked on an interoperability journey since the first version of the Health Normative Standards Framework (HNSF) was gazetted in 2014 (National Department of Health, 2014). The infrastructure development enables health systems to undergo conformity assessment to fulfil the requirements stipulated in the HNSF. This chapter outlines a holistic view of the conformity assessment aspect of the interoperability journey taken by the NDoH. This chapter will cover the interpretation of the HL7 standards through use cases in the form of profiles developed by Integrating the Healthcare Enterprise (IHE). A selection of the profiles that are relevant and useful for the South African context was carried out. This was achieved through the localisation of IHE profiles. The NHSF localisation process started with the identification of national interoperability use cases. The linking to standards and profiles in these realisation scenarios provided guidance for building localisation and interoperable implementations. The localisation to the South African context was achieved by developing national specifications based on the prioritised use cases. The national specifications were shared with the health system vendors, and the selection of profiles needed to be relevant and useful to the South African context. The national specifications were shared with the health system vendors so that they could develop systems that adhere to these specifications. The specifications were implemented in a conformity assessment digital health innovation testing laboratory, which enabled interoperability assessment to ascertain systems readiness to integrate with other health systems in the NDoH ecosystem. The conformity assessment to IHE profiles on health systems at the international level is performed by IHE-accredited laboratories. This poses a challenge for South African vendors due to fees associated with the assessment activities. The initiative is meant to allow South African vendors to assess their system's conformity to HNSF, allowing them to interoperate with other health systems within South Africa.
Exploring functional dynamics of innovation for inclusive development: Event history analysis of an ICT4D project
(2021-08) Maarsingh, B; Grobbelaar, SS; Uriona-Maldonado, M; Herselman, Martha E
Information and Communication Technologies for Development (ICT4D) projects aim to improve the living conditions of marginalized communities. However, ICT4D interventions have high failure rates. We draw on the Technological Innovation for Inclusive Development Systems (TI4IDS) framework, which argues that ICT4D projects are embedded in a system affected by many different actors, stakeholders and institutions. We analyze this through a qualitative exploratory case study of an ICT4D project for Elderly Rural Women in Mafarafara in Limpopo, South Africa. We map a set of TI4IDS functions through event history analysis (EHA) to explore how ICT4D projects may be implemented. We draw conclusions regarding the dynamic exhibited in the projects and show how the focus shifted from the development of knowledge and guidance of search to knowledge diffusion during the uptake of the technology with a more significant focus on resource mobilization and market formulation towards the later phases.
Integrated framework for enhancing SDN security and reliability
(2023-11) Isong, B; Ratanang, T; Gasela, N; Abu-Mahfouz, Adnan MI
This paper addresses the issues of fault tolerance (FT) and intrusion detection (ID) in the Software-defined networking (SDN) environment. We design an integrated model that combines the FT-Manager as an FT mechanism and an ID-Manager, as an ID technique to collaboratively detect and mitigate threats in the SDN. The ID-Manager employs a machine learning (ML) technique to identify anomalous traffic accurately and effectively. Both techniques in the integrated model leverage the controllerswitches communication for real-time network statistics collection. While the full implementation of the framework is yet to be realized, experimental evaluations have been conducted to identify the most suitable ML algorithm for ID-Manager to classify network traffic using a benchmarking dataset and various performance metrics. The principal component analysis method was utilized for feature engineering optimization, and the results indicate that the Random Forest (RF) classifier outperforms other algorithms with 99.9% accuracy, precision, and recall. Based on these findings, the paper recommended RF as the ideal choice for ID design in the integrated model. We also stress the significance and potential benefits of the integrated model to sustain SDN network security and dependability.
Machine learning – Imaging applications in transport systems: A review
(2023-11) Adams, A; Abu-Mahfouz, Adnan MI; Hancke, GP
Transport systems are fundamental to supporting economic growth, and the need for smarter, safer, more efficient and climate neutral transport systems continues to grow. Maintenance and operation of transport infrastructure is expensive and has many difficulties. In recent years, the application of machine learning to solve problems has been pursued with varying success rates. Many open problems still remain at this stage. This paper provides a review of deep learning applications in transport systems. Multiple deep learning applications are discussed e.g. railway safety, self-driving cars, pedestrian crossing and traffic light detection. Reviewed papers are evaluated in terms of challenges, contribution, weakness, research gaps. Key research questions for future study are proposed: performance optimization, data set improvement and the need for research on real-time performance on edge devices.
Master Health Facility List training as an educational tool to reduce the number of organisational-based support Tickets
(National Department of Health and CSIR, 2024-11) Maremi, Keneilwe J; Thulare, Tumiso; Nunu, Vuyisa; Botha, Adèle; Herselman, Martha E; Rousseau, P
Purpose: This chapter explores the necessity of Master Health Facility List (MHFL) training to educate users who joined the system before the introduction of the nomination form. These users face issues associating themselves with their organisations within the MHFL system. The chapter addresses this gap by proposing targeted onboarding training designed to introduce the nomination form to these users and resolve organisational association problems, ultimately reducing MHFL support tickets in South Africa. Study design/methodology/approach: An exploratory qualitative approach was used, adopting a phenomenology design to understand how and why users experience difficulties with the nomination form. The study focuses on the lived experiences of previous MHFL users, providing a comprehensive account of these challenges and their potential solutions through training. Findings: The findings indicated that targeted MHFL training effectively resolves organisational association issues linked to the nomination form. Additionally, the training improves users' technical skills, enhances their engagement with the system, and reduces the number of support tickets logged. Originality/value: This research emphasises the importance of building technical skills in digital health and a capable workforce. This study emphasises the importance of building digital health skills and a capable workforce. The proposed training improves the functionality of the MHFL system, leading to more accurate data management, higher data quality, and better reporting outcomes.
Micro nano manufacturing methods for chemical, gas and bio sensors, water purification and energy technologies
(Intechopen, 2020-12) Akande, Amos A; Adeleye, AA; Adenle, AA; Mwakikunga, Bonex W
This chapter reports on the various methods of fabricating and manufacturing micro and nano sensor, membrane and energy devices. Firstly, the characteristic often sought after by scientists and engineers for effective and efficient performance of these technologies were thoroughly discussed in details together with the characterization techniques for evaluating them. Several state-of-the-art fabricating techniques for sensor devices, water and medical based-membranes, solar cells and batteries were also discussed.
Overview of an electronic health record and an electronic medical record to support the digital health system in South Africa
(National Department of Health, and CSIR, 2024) Herselman, Martha E; Rousseau, P; Botha, Adele; Botha, Adele; Herselman, Martha E; Rousseau, P
This chapter provides an overview of the importance of developing an Electronic Health Record (EHR) and an Electronic Medical Record to support the Digital Health System in South Africa. Information on the topics will be provided to help understand these concepts' challenges, building blocks, design elements, and realities and how an EHR and EMR can enhance a digital health system. Methodology/Approach: A qualitative exploratory literature review defines and explains the concepts. Using this method, one can map the existing knowledge of the phenomena and identify gaps the studies address. Document and thematic analysis were used to examine and interpret data from the selected articles to uncover meaning, gain understanding, and conclude. Understanding the challenges, building blocks, design elements, and realities associated with an EHR and EMR will add to its applicability in South Africa.
Pathways for mainstreaming resilience thinking into climate change adaptation and planning in the city of Cape Town
(Palgrave Macmillan, 2020-10) Snyman-Van der Walt, Luanita; Schreiner, Gregory O; Laurie, Suriana; Audouin, Michelle A; Lochner, Paul A; Marivate, Vukosi N; Pasquini, L; Davidson, A; Hadingham, T; Cameron, R; Brears, RC
Between 2015 and 2017, the City of Cape Town in the Western Cape Province of South Africa experienced three lower than average rainfall years. A changing climate has altered the rainfall patterns in the Western Cape, shifting most of Cape Town’s winter rainfall south and offshore. In 2017, this resulted in the lowest rainfall on record since 1945. In May 2017, the Western Cape Government declared the Province a disaster area amidst ever stricter water restrictions imposed on Cape Town’s residents, and in early 2018 National Government declared the drought a national disaster. Cape Town authorities have accepted these potentially replicating drought conditions as the “new normal” and resolved that future planning must strengthen the City’s resilience to the shocks and stresses associated with a changing climate. In July 2017 a focused, multistakeholder, multidisciplinary SDG “Lab” was hosted by the South African Council for Scientific and Industrial Research to facilitate the co-generation of new ideas to mainstream resilience into urban climate change adaptation and planning. The Lab resulted in a five pathways to enhance planning toward a climate-resilient Cape Town, which included technical and engineering solutions, environmental management approaches, as well as sustainable development and socio-political strategies.
Photoanode applications of polyene-diphenylaniline dyes molecules adsorbed on TiO2 brookite cluster
(InTechOpen, 2024-09) Elegbeleye, I; Maluta, E; Maphanga, Rapela R; Walter, M; Brügner, O; Zendehdel, M; Nia, NY; Samer, M
TiO2 has excellent photoelectrochemical properties, which makes its suitable for photoanode applications. TiO2 is widely utilized as semiconductor for dyesensitized photoanode owing to its excellent stability and availability. The brookite polymorph of TiO2 has been suggested to demonstrate better photocatalytic properties. In this work, we studied the adsorption of polyenediphenyl-aniline dyes on (TiO2) n = 8, 68 brookite clusters using density functional theory (DFT). We report our results on the UV–Vis absorption spectra of the dyes and dyes adsorbed on TiO2 clusters, adsorption energies of the dyes adsorbed on TiO2 clusters, electronic density of states and projected electronic density of states of the dyes adsorbed on TiO2 complex, and electron density of the main molecular orbitals involved in photoexcitation for dye-sensitized solar cells application. The calculated adsorption energies of D5@(TiO2)68, D7@(TiO2)68, D9@(TiO2)68, and D11@(TiO2)68 are 4.84, 4.78, 4.66 and 4.92 eV, respectively. The results of the adsorption energies are in the order D11@ (TiO2)8 > D9@(TiO2)8 > D7@(TiO2)8 > D5@(TiO2)8 and D11@ (TiO2)68 > D5@ (TiO2)68 > D7@ (TiO2)68 > D9@ (TiO2)68. This implies that D11 dye molecule reacts more strongly with (TiO2)8 and (TiO2)68 brookite clusters than the other corresponding dye molecules.
Recommendations for sustainable post COVID-19 eLearning development in rural schools in South Africa
(2023-12) Mthethwa, Siyabonga; Nthatheni, Ronewa G; Maremi, Keneilwe J; Thulare, Tumiso
Prior to the COVID-19 pandemic, many ICT initiatives were implemented in rural schools across the country to improve teaching and learning. This paper discusses the various factors that contributed to the failure to sustain ICT initiatives. Due to the risk of infection associated with face-to-face contact during the COVID-19 Pandemic, eLearning proved to be the sole means of ensuring educational continuity. The objective of this paper is to highlight factors affecting sustainability and provide recommendations that can assist in ensuring sustainable ICT initiatives in rural schools after the COVID-19 pandemic. This is accomplished by conducting a scoping review to investigate the sustainability of ICT infrastructure to enable eLearning. The following academic databases are used for scoping literature reviews: ScienceDirect, IEEE Xplore, and search engines such as Google. A total of 41 papers out of 800 publications were deemed appropriate for the analysis. The findings show that physical, management, social, and educational conditions all have an impact on the sustainability of ICT initiatives; thus, addressing these components can ensure sustainability.
A review of intrusion detection techniques in the SDN environment
(2021-11) Sebopelo, R; Isong, B; Gasela, N; Abu-Mahfouz, Adnan MI
Despite the advantages of Software-defined networking (SDN) over the traditional networks, SDN is facing several challenges such as security threats and attacks, dominated by a distributed denial of service (DDoS) attacks that target the controller. In recent years, the SDN has witnessed several research attentions leading to proposals and the development of countermeasures such as intrusion detection systems (IDS). IDS plays a critical role in detecting and preventing malicious activities on the networks. Several detection techniques have been exploited for the effectiveness of the IDS such as pattern matching, anomaly-based and specification-based. With the nature of SDN architecture, flow-based anomaly detection has been effective and commendable. Therefore, this paper conducted a review of some of the IDS schemes in the SDN environment. It was aimed to identify the solution offers, techniques, challenges and provide research directions. The findings show that IDS in the SDN is an active research area and several techniques exist and are dominated by machine learning (ML) which exploits the network traffic flow to detect abnormal behaviours. Intrusion detection on the SDN is still at large and more ML techniques needs to be explored, considering the critically of the SDN controller.
Robust edge spread function construction methods to counter poor sample spacing uniformity in the slanted-edge method
(2019-06) Van den Bergh, Frans
The slanted-edge method describes an algorithm for measuring the spatial frequency response (SFR) of digital imaging systems. The method can be applied to edges oriented at nearly any angle, but there are some angles that cause simplistic implementations of the algorithm to fail, or produce inaccurate measurements. These angle-dependent phenomena are demonstrated to stem from a lack of uniformity in supersample spacing in the edge spread function (ESF). Two well-known slanted-edge implementation variants are adapted to minimize edge orientation dependent errors. These robust slanted-edge implementations are demonstrated yield accurate measurements, regardless of edge orientation angle or moderate image noise.
The FHIR Based Master Household Index
(National Department of Health and CSIR, 2024-11) Sibiya, Mhlupheki G; Sibiya, Mhlupheki G; Tolmay, James P; Botha, Adèle; Herselman, Martha E; Rousseau, P
The Integrating the Healthcare Enterprise advocates for integrating distributed and heterogeneous health information systems. This is achieved by developing standards specifying protocols for the integrated systems to communicate as profiles. Integrating the Healthcare Enterprise (IHE) through its Information Technology Infrastructure Technical Framework Volume 2b Transaction B provides a Patient Identification Segment, which allows a patient's demographic details to be exchanged among the information systems within a Health Information Exchange ecosystem. In South Africa, however, healthcare services are extended to communities through Community Healthcare Workers (CHWs) who visit households. Therefore, there is a need to manage households similarly to patients in a Health Information Exchange (HIE) system. The IHE profiles currently do not have explicit profiles in their profiles catalogue that can be utilised to manage households in HIE systems. As opposed to patients being treated as subjects of care, community healthcare workers treat households as subjects of care. The COVID-19 pandemic and other epidemics highlighted the importance of associating information inside health systems with corresponding household information. This would assist health workers to efficiently conduct contact tracing to minimise the spread of contractable diseases. In this chapter, we present a format that can be used to represent household information in a standard that follows the Health Level Seven (HL7) standard. We also present an implementation of an Enterprise Master Household Index equivalent to an Enterprise Master Patient Index that utilises our proposed profile. In this chapter, a further evaluation of the management of household of care following a FHIR standard will be provided.
The importance of data integrity to ensure the quality of address information in the master health facility list
(National Department of Health and CSIR, 2024-11) Maremi, Keneilwe J; Thulare, Tumiso; Botha, Adèle; Herselman , Martha e; Rousseau, P
The address information in the Master Health Facility List (MHFL) is key in identifying the location of facilities. The primary responsibility for adding, editing, and deactivating facilities in the MHFL is handled by many health facility representatives from various facilities in various organisations. Facility Representatives must solely ensure the address information they add to the MHFL is valid and the geocode identifies the correct location of the facility; however, this is not always the case. The address information is often inaccurate, which compelled the creation of a data cleaning team to verify these addresses. Thus, this chapter aims to discuss the importance of data integrity to ensure the accuracy, reliability, and quality of address information in the MHFL.
The importance of skills-based set in solving support queries and providing input in improving the Health Patient Registration System
(National Department of Health and CSIR, 2024-11) Thulare, Tumiso; Maremi, Keneilwe J; Nthatheni, Ronewa G; Mthethwa, Siyabonga; Mahwai, Nare; Botha, Adèle; Herselman, Martha E; Rousseau, P
Purpose: HPRS is based on a Linux/Ubuntu platform and individuals are not familiar with the environment. Training in the language and environment is required to understand how the system functions, how to improve the system, and how to solve client-based queries. Therefore, the chapter aims to improve the maintenance and support by enhancing the skillsbase set to minimise the daily queries. Getting the skills will ensure that the different tier levels are adequately equipped to troubleshoot the issues encountered. It will also allow the various tiers to identify innovative ways to improve the system functionality and reduce the impact of system downtime. There is a lack of skills at the different tier levels required to assist in the effective operations of the support and maintenance environment. This research is being conducted to obtain insights regarding the importance of a skills-based set-in solving support queries. This research aims to provide recommendations to improve the performance of the Support and Maintenance ServiceDesk team in the HPRS environment. Study design/methodology/approach: This study took an exploratory qualitative approach and tried to explain how and why a certain phenomenon or behaviour behaves in a certain way in a certain situation. Inductive reasoning was used, which involves moving from the specific to the more general and from cause to effect by moving from effect to cause. Additionally, an online open-ended questionnaire was employed. The Lime Survey software was used to facilitate the online survey. Purposive, convenience, and snowballing sampling techniques were used for this investigation. Findings: The findings show that the support and maintenance team must have analytical, communication, time management, interpersonal, basic developer, adaptability, problemsolving, stress management, people skills, Ubuntu/Linux server basics, and technological skills-based sets. These skills-based sets - will solve support queries effectively and efficiently and ensure the continuous improvement of HPRS. Originality/value: The significance of this study lies in its contribution to the existing body of knowledge. With the continuous evolution of technology and the imperative for organisations to ensure that their workforce strategy is in sync with dynamic business priorities, adopting a skills-based approach has emerged as a highly effective organisational strategy. This approach optimises operational efficiency while enabling organisations to stay competitive in an ever-changing business landscape.
The transformative impact of electronic prescriptions: Enhancing patient care and healthcare efficiency
(National Department of Health and CSIR, 2024-11) Munsamy, S; Underwood, S; Labadarios, G; Ramsundar, Preshen P; Sha, M; Botha, Adèle; Herselman, Martha E; Botha, Adèle; Herselman, Martha E; Rousseau, P
Purpose: This chapter provides an overview of what constitutes the transformative impact of ePrescribing in enhancing patient care and healthcare efficiency by defining the concept and providing its value chain and ecosystem. It aims to synthesise key findings and insights to offer meaningful suggestions further to form the groundwork for a National South African Implementation. Study design/methodology/approach: This chapter applied a qualitative exploratory approach to study relevant literature on the phenomena of ePrescribing. Using this method, one can map the existing knowledge of the phenomena and identify gaps the studies address. Document and thematic analysis were used to examine and interpret data from the selected articles to uncover meaning, gain understanding, and conclude. Understanding this concept's challenges, building blocks, design elements, and realities will add to its applicability within an African context. Originality/value: By leveraging digital technology, ePrescribing systems can give clinicians real-time access to patient medication histories, drug interactions, and formulary information, enabling them to make more informed and safer prescribing decisions. It conceptualises ePrescription, highlighting possible challenges and opportunities within the emerging South African Health Information system. Findings: Electronic prescribing, or ePrescribing, has gained significant traction in recent years, potentially improving the efficiency and accuracy of the prescribing process in ambulatory care settings.
Towards National Health Information System use cases
(National Department of Health and CSIR, 2024-11) Botha, Adèle; Herselman, Martha E; Botha, Adèle; Herselman, Martha E; Rousseau, P
Purpose: The study aims to identify and prioritise National Interoperability Use Cases aligned with national health objectives to guide the development of a robust National Health Information System (NHIS). The primary objective is to produce a list of National Interoperability Use Cases, categorised by their importance and feasibility, to inform the development of a shared NHIS. The study aims to align these use cases with national health priorities, ensuring they are practical, interoperable, and adaptable to evolving technological environments. Study Design: A modified Delphi methodology was employed, engaging stakeholders across various health sectors through iterative rounds of engagement and feedback. The study employed clustering methodologies, specifically K-means clustering, to categorise the use cases by priority. Additionally, the Kemeny-Young Method was used for ranking, and consensus among stakeholders was measured using Kendall's W for validation. Findings: The study generated a prioritised list of use cases divided into four clusters based on their "Must have," "Should have," and "Could have" attributes. The clustering provided clarity on foundational and optional use cases, allowing for the strategic planning of the NHIS. The findings suggest a strong consensus on the importance of use cases related to Electronic Health Records, alignment between health information systems, and emergency responses. Value: The findings contribute to the ongoing efforts to develop an interoperable NHIS. While the research emphasises a systematic approach to use case prioritisation, it acknowledges the need for adaptability to emerging health technologies and continual reassessment. The framework presented aims to facilitate stakeholder collaboration and informed decision-making in developing the NHIS.

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