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- EVENTS
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(South Africa) Digitalization creates large-scale and sweeping changes across economies, industries and business operations and public policy. One sector that is being disrupted significantly is the healthcare sector, with the healthcare system look very different in future than it is currently. Technology developments offer a unique opportunity to transform this industry in a way that will create and capture value and solve most of the structural challenges of the industry both globally and at a country level.
South African healthcare dynamics are largely characterized by low patient coverage, limited access, skills shortage, unaffordability, and disempowered consumers. There are multiple reasons for this state of the sector, most of which are macro-economic and social in nature, reflecting deep rooted structural and historical challenges.
With just over 8 million (under 14%) of the 59 million estimated population covered under medical aids, much of the population remains without private health cover. This, combined with the 42% high unemployment rate according to the expanded definition that includes discouraged job seekers that has been worsened by Covid 19, clearly demonstrates the enormous burden exerted on the state to provide quality healthcare cover to much of the population. While acknowledging the need to address these structural factors, this article primarily focuses on the role and impact that digital transformation in healthcare could mean for the South African healthcare system.
The current healthcare dynamics manifest themselves in the form of high cost and low access resulting from information asymmetry that exists between the consumer, funder, and health provider. This results in a provider induced demand. Four main areas of impact from digital transformation of the healthcare industry are briefly explored that springs some hope to the future of our healthcare system. These are tech-empowered intelligent care, care anywhere, empowered care and intelligent health enterprise. Implementation opportunities and challenges are summarized based on funding, people, process, technology, and data related factors.
1. Intelligent Quality Care
Advances in the use of wearables, facial recognition, precision medicine, robotics and medical printing will significantly accelerate the quality of care in a historically low diagnostic environment. This will enable early intervention and better health outcomes. Use of wearables remains low at 7.2% penetration, equating to 4.3 million users. While this reflects a 22.9% increase year on year, the penetration remains relatively low and could derail the benefits of a consumer centric care that is driven by data opportunities that this carries. The independent Communication of South Africa reports a 91.2% smartphone penetration. This provides the greatest opportunity for the role of facial recognition in innovations such as emotion detection, exercise apps that could improve lifestyle driven care. Use of robotics is likely to remain low given the expected low infrastructure investment of a strained state fiscus.
One promising discovery was the transplant surgery, successfully performed by Dr. Tshifularo and his colleagues in South Africa, takes Hirsh’s work one step further. It is the world’s first middle ear transplant using 3D-printed bones: It effectively replaced the hammer, anvil, and stirrup – the ossicles that make up the middle ear. Using 3D printing technology, the medical team was able to print these bones and reconstruct the ossicles in surgery.
2. Care Anywhere
Covid 19 has accelerated the adoption of virtual care. This brings care closer to home and works to resolve access challenges for people that historically have not had access to a health provider within reasonable radius. There exists limitations of technology infrastructure and data costs to this enabler that may slow utilisation. Collaboration between telecommunication companies and health insurers has seen some increased utilisation of virtual care to 100 000s in the wake of Covid 19. This is indicative of good adoption and well-engineered process that is supported by world class technology.
3. Empowered Care
Liberate data sources in compliance with data laws to clarify that patients are the ultimate owners of their clinical data and facilitate the transfer of this data between providers, according to the patients' wishes. This will drive a better electronic health records system and result in significant improvement in health outcomes. This will need to be a policy driven intervention that requires careful considerations on data standards and infrastructure. Central to improving efficiency to delivery of care is correcting the information asymmetry that stems from disempowered patients. The main challenges will be the time it may take to achieve the statutory changes. This shift is instrumental to achieving high levels of trust with patients, the main ingredient of the sustainable adoption of data privacy practices and laws. Key to the implementation is the creation of a central health identification system that is integrated to insurers that currently house the disparate patients records and enables the patient to transfer the data between various providers.
4. Intelligent Health Enterprise
The successful health enterprise of the future will be one that integrates all these solutions with a quality provider network solution to provide a data-driven solution. This enterprise will succeed in dismantling the non-macro and socio-economic challenges to create a health balance between the
patient, the funder, and the health provider. The result of this will be better information symmetries and will drive costs down, thus enabling greater access. This data driven patient centric solution will also achieve a better understanding of what could be an optimised routing experience for patients that delivers better health outcomes in the most effective route and channel.
While it is hard to accurately estimate how these factors will improve the low 8 million access, there is a strong argument that this will achieve high affordability that will likely see better coverage for the employed population. Much of the unemployed will continue to rely on state for care, but this may well enable the provision of care by state a greater reality than in the current climate. This at large reflects the great opportunities and hope for the healthcare system for enterprises and policy makers.
Vukosi Sambo is an experienced executive with over 11 years’ experience in insurance, banking, FMCG and Market Research. He is an expert specialist in data science, digital strategies, risk management and actuarial, business architecture, consumer research and insights, remuneration design, and operations management. He currently serves as the Head of Data Solutions at Medscheme, a leading South African health insurer with estimated over 3 million lives under administration.
Prior to Joining Medscheme, Vukosi served as Chief Data Officer at Kaelo, held senior roles in Discovery Bank, SAB, Nielsen and Discovery Health. He has won several awards including 2020 Global Top 100 Data Visionary. His background includes studies in Bachelor of Economic Science (Wits), Post Graduate Program in Artificial Intelligence from University of Texas (USA), Post Graduate studies in Risk Management (Unisa), Post Graduate Diploma in Business Administration (Unisa), Post Graduate Executive education in Digital Strategies for Business (Columbia Business School, USA), Certificate in Lean Six Sigma (BMGI University, USA) and Certificate in Advanced Forecasting for Data Analysts (Adcorp Analytics). He is currently studying towards MBA with Unisa SBL. He is a comrade marathon, two oceans marathon and Soweto marathon finisher.
Reference Material- CDO Magazine- Vukosi Sambo- Healthcare Digital Transformation
Medical Aid Membership- South Africa. Council for Medical Scheme Annual Report- Page 280 & 281
South African Population Statistics- Statistics SA
Unemployment Rate- Expanded definition
Digital Wearables Statistics- 2019 & 2020
Smartphone Penetration- South Africa- ICASA Annual 2020 Report (Page 33)
Virtual GP Consultations
Professor (Dr.) Mashudu Tshifularo- World first Ear Transplant, University of Pretoria