Are Technology and Empowered Patient Self-Care the Key to Unlocking an Effective NHI?
Deon Bührs, Managing Director of Genie Health SA, suggests that technology-enabled services are the ‘unreasonable man’ in complementing decent universal healthcare and that self-empowerment is the only solution to sustainable healthcare.
South Africa’s National Health Insurance (NHI) bill, signed days before the country held general elections, has faced its first major hurdle. The Gauteng High Court has now ruled that the National Health Act (the Act) cannot force doctors to register for a “certificate of need” meaning government cannot control where healthcare providers can practice. But hope is at hand – in the form of technology.
Already a contentious topic before becoming law, the NHI will face several more challenges, including the cost of its implementation, before it finally comes to be and will continue no doubt, to be polarising for some time to come.
Taking a step back from all the noise, there is a school of thought that a young democracy can benefit from a well-considered blend of socialism and capitalism, particularly when it comes to healthcare and education. I would concur – to a degree.
The fact is our public healthcare system and the spiralling costs of the private offering need to find parity. A sad situation indeed, because at one stage, South Africa had one of the best public health sectors in the world, where groundbreaking heart transplants, for example, were performed and healthcare innovation was world class.
To the question of universal healthcare then.
If it means that universal healthcare is a fundamental human right that everyone should aspire to, then it’s a yes, the NHI is essential. But not as a political tool to garner votes.
Let’s be clear, there is already healthcare for all in South Africa through the public health system, free at the point of care for those who cannot afford care. But it is the quality of this care and the effective management of these services that lie in stark contrast to that of the private healthcare system.
So, aside from opposition to the National Health Act (NHA) looking to control where doctors are posted, the other major challenge the act is going to face, is the massive cost of providing a functioning NHI, as per the bill. Conservatively, this has been estimated at more than R200 billion a year, while some estimates are closer to R1 trillion.
With an already strained tax base, it is time therefore to adopt new thinking as to how to deliver healthcare in a cost sensitive and effective way.
In my mind, the most effective ways of ensuring there is universal care that works, is recognising and supporting the role the patient plays in empowering their own health, recovery and wellness journey, and technology’s role in deploying, managing and maintaining healthcare and wellness.
Here’s how we ‘fix’ it.
The unreasonable man test – the groundwork for new ways of healthcare delivery
Change must happen, but the extent of that change often depends on what Irish playwright and political activist, George Bernard Shaw, once stated as: “The reasonable man adapts himself to the world: the unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man.”
In this context, technology could be the ‘unreasonable man’, pushing the boundaries of progress and our solution.
For instance, we already know that a traditional healthcare delivery system, with its associated costs and accessibility challenges for those living in remote parts of our country just won’t cut it. No amount of the government forcing doctors to go where they don’t want to, or where the authorities decide is going to work. But unlocking technology as the new delivery channel of healthcare complimented by affordable and fast internet, could well be the solution to cracking the code of healthcare for all.
Through technology we can drive the patient-centric approach to health and open the door for patients to better access the multi-disciplinary team of healthcare professionals they need – wherever the patient or the provider is, and at more cost effective and affordable rates.
The best of both worlds – prevention, and when required, recovery
An example of doing things differently, is a new approach to musculoskeletal health that has been facilitated by digital transformation and has been introduced in the USA more than five years ago and is finding growing adoption in South Africa.
With objective improvements in patient outcomes, satisfaction scores and recovery times, virtual care teams can support patients through their recovery programmes, ensuring improved compliance and ownership of their health journey. Empowering patients to embrace exercise and activity over surgery and pharmaceuticals where appropriate, has a dramatic impact on the overall healthcare spend – for the patient and the provider.
Imagine patients having the choice to access a multi-disciplinary team of experts anywhere in the country – from the comfort and convenience of their own home or workplace, all at the tips of their fingers. No need to be transported to a clinic or hospital every time they need healthcare services. This is entirely possible, with platforms like Genie Health, that provide a hybrid approach in complementing in-person care with virtual care.
NHI needs a strong front loader like these hybrid platforms that provide the full range of allied healthcare services, to reduce the burden of care and cost on an already strained system. These digital services reduce unnecessary hospital admissions, surgeries, medication and travel costs and allow the existing framework to be brought up to date and even surpass expectations.
ICASA has reported that over 75% of the population have Internet access in South Africa and that more than 90% of South African have a smartphone. Pressure on Mobile Network Operators to provide zero rated data for healthcare applications (as they have done in education and other areas) mounts.
With patients empowered to take ownership and care of their healthcare and recovery through digital technology, complemented with the ability for healthcare practitioners to engage and support their patients outside of any geographical constraints through virtual care platforms, the actual location of many practitioners will no longer be relevant. Practitioners will be able to support the in-person care where required in a hybrid approach.
If the ultimate question is how we make healthcare more affordable and accessible to all South Africans, then the answer must be to renew our focus on the key stakeholder, our patients – and empower them to drive their own health, by using technology as the backbone for sustainable health.
It could well be, that with a renewed mindset, health-empowered citizens and access to life-changing technology, the NHI is the true gamechanger for progress in Health and Care .
