South Africa is a unique country, and in many ways because of our uniqueness we need novel solutions, writes Thoneshan Naidoo, Principal Officer of Medshield Medical Scheme. On the one hand we face a quadruple disease burden of HIV/AIDs and TB; high maternal and child mortality; rising non-communicable diseases burden; and high violence and injuries.
On the other hand, we have deep structural societal issues of inequality, poverty, and unemployment, which as our President has stated, is tearing the fabric of our communities apart and these issues have really come to a boiling point during the Covid-19 pandemic.
As the number of confirmed Coronavirus COVID-19 cases continue to rise every day, dealing with a pandemic of this magnitude, compounded with the underlying societal challenges, places even greater strain on the country’s precious healthcare sector, particularly in the overburdened public sector. Many challenges exist coupled with very limited resources across both the public and private health industries. The healthcare sector was not able to prepare for the pandemic well in advance nor was it able to deal with the pandemic being declared a national disaster, where rapid action is required.
This is not a public sector or private sector issue, COVID-19 is a national crisis, which demands that all players in the sector, including medical aid schemes, be nimble enough to embrace the current situation and turn the pandemic into an opportunity to serve their members and our nation.
Technology and 4IR for increased access to quality healthcare
It goes without saying that we are living in the technology age of the Fourth Industrial Revolution (4IR) and if schemes are to increase access to quality healthcare, they must put innovation and technology at the very core of their operations to avoid disruption.
The healthcare industry has recognised that technology must become part of everything it does. Stunning technological progress has led to successful treatment and management of previously fatal diseases such as HIV/AIDS and certain forms of cancer. Advances in Artificial Intelligence (AI), robotics and 3D printing, faster data processing and the lower cost of data storage at scale have been instrumental.
In this time of crisis, a number of hospitals internationally are turning to AI tools to detect Covid-19 on Chest CT or X-Ray scans. With accuracy rates reported at 98%, AI can provide another line of defence and safety for the overwhelmed, courageous and selfless frontline doctors and nurses that put their own lives at risk to ensure that our families, colleagues and communities receive treatment and are safe. Through continued enhancement and collaboration, AI has the potential to not only detect Covid-19 but to also provide staging of the disease and predict treatments i.e. identify which patients require a ventilator, or those patients that have recovered and no longer require one. In many overburdened healthcare setting where there is limited ventilators and hospital beds, AI can play an integral part of the healthcare ecosystem and greatly relieve pressure of the doctors and ensure patients receive the appropriate treatment.
Likewise, in a South African context, the use of technology and innovation can unlock quality access to healthcare and ensure that our precious healthcare resources is optimally used. Embracing these principles in our thinking, Medshield is proud to have launched Medshield SmartCare – an innovative virtual medical consultation tool – which has in fact paved the way for the adoption of telemedicine in South Africa. Since this programme’s launch, it has received very positive feedback, as it is not only convenient, but it puts the trust back into healthcare, and more recently is a way of accessing a GP during the current COVID-19 lockdown period.
Our sustainable partnerships with clinics and pharmacies, allow for a member to see a nurse who will conduct an initial assessment based on the patient needs and if necessary, dial up a GP who does a virtual consultation, and together they decide on how you should be treated and both give you guidance. We became the first medical scheme in South Africa to introduce SmartCare in July 2019. Our small size meant that we were nimble enough to adapt to the changing innovation landscape and to react quickly to put new measures in place. The Scheme has since extended the SmartCare benefits to include free WhatsApp GP consultation to simplify and increase access to care during lockdown.
As with the countries that have dealt with the COVID-19 pandemic before us, we may potentially see a continued lockdown of three months as was the case in Wuhan, China, or a partial longer-term lockdown – if this happens, will we be prepared enough to deal with the cases during this time and immediately after? The limited access to malls and businesses surely present a “new normal” where traditional consultations with your doctor will be more of a rarity. Medshield’s SmartCare allows for more virtual care which promotes professional collaboration and coordinates care across a continuum. Critical information for clinical decision-making is made available and care delivery is more targeted to the individual. Lastly, we foresee the ability to apply predictive analytics on data generated from existing supply chain information systems leading to improved supply chain management and demand forecasting.
For the patient, 4IR may spearhead at-home medical devices. Patients will be able to consult a doctor online and receive guidance on how to do a self-check or test from their own home. Furthermore, the industry of wearable health devices – such as those that monitor heart rate or sugar levels – is likely to increase and we will surely see a rise in ecommerce even in the delivery of medicine from pharmacies. With time and advancement, we will surely see the likes of healthcare AI being deployed in our country and in our homes as part of the integrated digital healthcare ecosystem.
Investment in healthcare technology puts people first
Studies show that healthcare has not benefitted from 4IR as fully as many other industries, and the industry has traditionally underinvested in digital technology. Fears of replacing humans with machines have meant that many industry players shy away from investing in technology to protect jobs. However, at Medshield we believe there is space for both.
Medshield has implemented definitive measures to ensure continuous access to care for our members even during the nationwide lockdown, whilst protecting our more than 280 employees. We have prepared our business continuity plans to maintain the high levels of service that our members expect from us. Technology has allowed us to continue offering services online, sourcing laptops for most staff allowing them to work from home. We reduced our office capacity to 70 people at a time, keeping our call centre open from 9am to 2pm to ensure continued access to care. A people-first approach should be central to any medical scheme’s strategy and by adopting this we have not only secured our members, but also ensured the safety of our staff, who are healthy and capable of servicing our 160,000 members.
Social distancing has been deemed a necessary intervention to slow down the spread of the virus, but keeping people in isolation may have numerous wider social impacts. People need to also take care for their emotional well-being, especially in situations where they have to deal with confinement in close proximity. We all need to keep our minds occupied with positive things, eat healthily, maintain a good exercise regime and get adequate sleep. Not only does this help to keep our bodies healthy, but it also keeps our minds healthy and focused on the new normal beyond COVID-19. Medshield offers members this assurance of care by opening up various communication channels all possible with technology, to aid in their overall wellbeing. Without technology providing options for socialising, shopping and now also accessing medical attention, social distancing becomes very difficult for most people to adhere to.
With a history that dates back over 51 years, the Scheme is driven by its mission to provide access to affordable high-quality healthcare through partnerships at very competitive prices in comparison to the market. Medshield is a transparent and sensible supporter of national initiatives to provide greater access to quality healthcare for all South Africans especially during this pandemic. We have great trust and confidence in South Africa’s experienced healthcare professionals, and they have our full support during this challenging period. We will continuously monitor the COVID-19 situation and communicate as regularly as possible to ensure our members have continued access to affordable quality healthcare. Medshield calls for a collaborative approach in the interest of the entire country and in the interest of the wellness of all South Africans.
 2019 Accenture Digital Health Tech Vision, available at https://www.accenture.com/us-en/insights/health/digital-health-tech-vision-2019