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Open Access Highly Accessed Research article

Information technology systems in public sector health facilities in developing countries: the case of South Africa

Gregory B Cline1 and John M Luiz2*

Author Affiliations

1 Wits Business School, University of the Witwatersrand, PO Wits, Johannesburg, 2050, South Africa

2 Graduate School of Business, University of Cape Town, Breakwater Campus, Portswood Road, Green Point, Cape Town, 8005, South Africa

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BMC Medical Informatics and Decision Making 2013, 13:13  doi:10.1186/1472-6947-13-13

Published: 24 January 2013



The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa.


Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces) to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information.


Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace.


The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation.

Hospital information systems; Information management; Electronic health records; Africa; South Africa