South African Journal of Industrial Engineering
versión On-line ISSN 1012-277X
Telemedicine applications have had much success in strengthening health systems worldwide. Unfortunately, many systems are implemented without decisions based on proper needs assessments. In South Africa, this 'technology push' approach has led to a large amount of equipment standing dormant. It is proposed that the potential of telemedicine be measured prior to implementation, thus 'pulling' the technology towards a clinical need. A decision support system is developed that uses health informatics and computational intelligence to determine the need for telemedicine and to allocate equipment in a network of facilities to achieve the best cost benefit. The system facilitates the collection and storage of electronic health record (EHR) data in a data warehouse. A linear programming model is used with a genetic algorithm. The system was developed and tested for the South African public health sector, using data from 27 hospitals in the Western Cape Province. Results have shown that if telemedicine workstations with specific peripheral equipment, as determined by the algorithm, were implemented in the given period, an estimated R8.7 million in referral costs could have been saved for the 27 hospitals. Thus the case study provided evidence for the benefits of implementation in the chosen network of hospitals. This new application of health informatics could provide telemedicine management with a useful tool for making implementation decisions based on evidence. Future work would include the development of similar systems for other markets.