The cost of fragmented healthcare

During recent research into how South Africans experience healthcare, one patient described what happened after a routine surgery. The operation went well, but months later, the hospital changed its record-keeping system, and her post-operative notes were lost during the transfer. When she needed them again, they were simply gone. She had to start from scratch, retelling her history and tracking down fragments of paperwork that had been cohesively organised, now lost to an administrative process she had no part in.

She was not alone. Researchers repeatedly heard similar stories from many patients, highlighting a common underlying issue in healthcare. Medical history is seldom stored in a single location; instead, it exists in fragments across various institutions and devices that have interacted with a person's care at different times.

Where your health information lives

When asked where their health records are stored, South African patients give mixed and uncertain answers. About 20% mention hospital or clinic filing systems, while nearly as many say their private doctor has the only record. Some keep notes on their phone or laptop, in a folder at home, or depend on their medical aid app. None of these methods provides a complete overview, and most patients are unsure of the exact location of their full health history.

In a separate survey of 97 general practitioners, a third of them named fragmented, poorly integrated records as the biggest shortcoming in their current systems, ahead of every other complaint they were asked about. For most of these doctors, a consultation, often just a review of a patient's history, lasts about fifteen minutes. One doctor put it plainly: paper records get misplaced over time, and missing files can affect patient care, continuity of treatment, and the doctor-patient relationship. That description points to clinical risk, independently arrived at by dozens of practitioners who describe the same daily.

Nurses said almost the same thing - naming fragmented records as the clinical problem that affects them most directly, whether that shows up as an incomplete handover between shifts or a medication history nobody can fully confirm.

Pharmacists raised a related concern from their own side of the counter: without a shared view of what a patient is already taking, they are working partly blind when it comes to catching dangerous interactions or duplicated prescriptions.

A problem South Africa did not invent

It would be easy to read all this as a uniquely South African failure, a symptom of an under-resourced system straining under too much demand. The evidence from elsewhere suggests otherwise.

In Canada, a country with a well-funded, universal healthcare system, the numbers look strikingly similar to those in South Africa. Only 29% of Canadian doctors currently share patient information with anyone outside their own practice. Less than half of Canadians can access their own electronic health records. More than 70% of electronic health information in the country never moves between the providers who could use it. Canada Health Infoway, the national digital health agency, estimates that better-connected health data could save the country as much as $2.4 billion a year, largely by avoiding duplicated tests, wasted time, and administrative rework.

Canada's federal government reintroduced legislation in February 2026, the Connected Care for Canadians Act, requiring every health technology company operating in the country to make its systems interoperable and banning the practice of blocking patients or providers from moving their own data between platforms. A Canadian hospital doctor described the problem to a journalist in terms any South African clinician would recognise instantly: a patient arrives with no records on file, mentions vaguely that they have "some heart issues" and see "a specialist for autoimmune stuff," and the actual details take days to track down from wherever they happen.

The cost is more than financial

Every one of these gaps carries a cost, only part of which is measured in money. Repeated tests and duplicated administration add up across a health system as large as South Africa's, but the more serious cost is human. Picture a person brought unconscious to an unfamiliar hospital after an accident, unable to tell anyone about a chronic condition, an allergy, a daily medication, or a recent diagnosis. The clinicians treating them are working without that history, because the one place it lives did not travel with the patient that day. Good care depends on those providing it having the full picture, and when that picture is missing, the cost falls on the person receiving care, in the quality of the decisions made on their behalf.

That raises a fair question. Why should a doctor, a hospital, a medical aid, or a government department be the party holding the definitive copy of a person's health history, when each of them only ever sees a fragment of it? A doctor's file covers what happened in that practice. A hospital's system covers an admission or two. A medical aid's records show what was claimed, which covers billing rather than the full clinical picture. A government clinic's file rarely leaves the building in which it was created. The one constant across every visit and every test result is the patient. Their information is worth more and more useful with them than when locked inside whichever institution happened to capture it that day.

Where NgamiMyself fits in

This is the problem NgamiMyself addresses. It gives a person one secure place to hold their own health record, built to travel with them rather than remain behind at the clinic, hospital, pharmacy, or practice that created it. Patients decide who can see their information and when, and doctors, nurses, pharmacists, and hospital staff gain access to a fuller picture at the moment they need it most. For the type of scenario described earlier, of an unresponsive person, NgamiMyself includes an emergency view. It shows only what a first responder or doctor needs in the moment: blood type, allergies, current medications, and other details required to treat someone safely, without exposing the rest of a person's private history.

In the long term, NgamiMyself works alongside the systems already used by hospitals, doctors, pharmacies, and government health departments, adding a shared layer that connects the records each of them already holds. The project is currently in its pilot phase, gathering evidence and refining processes to guide its growth.