Government passed the National Health Insurance (NHI) Act on 13 June 2023 and has since received plenty of opinions from various sources on how the ambitious public healthcare system should be run once it is fully implemented.
The MANCOSA School of Healthcare (SoH) is one such voice, with this set of experts praising the fact that the NHI aims to provide universal healthcare services for all citizens, regardless of socioeconomic status. To this end, they believe that the best way to achieve this is to embrace the culture of innovation that has always been a driving force in the South African healthcare system.
“While most global healthcare systems cautiously consider the future impact of digitised healthcare, South Africa is presented with a perfect opportunity to position itself as an African leader in this space by ensuring that digital innovations play a central role in the development of the NHI,” says Mehnaaz Olla, a Manager at the MANCOSA SoH.
Key interventions
Olla points out that, despite the uncertainty traditionally associated with digital innovation, technology will play a crucial role in the development of the NHI by supporting key components and goals of the program.
These developments will be manifested in several ways:
• Technology will be essential in establishing comprehensive health information systems to support the NHI. With these systems facilitating the efficient collection, storage and maintenance of patient data, ensuring uniform electronic health records that healthcare providers may easily access;
• Telehealth and remote monitoring platforms can enhance access to healthcare services, specifically for underserved communities in remote areas, in keeping with the goal of equal access to healthcare for all South African citizens;
• Health Information Exchange platforms can facilitate the secure exchange of patient information among healthcare professionals, resulting in improved coordination of care, reduced redundant testing and improved continuity and quality of care across multidisciplinary teams. This aligns with the NHI’s goal of integrated care;
• Technology will also play a crucial role in building robust financial management systems to support the funding, billing and reimbursement procedures within the NHI framework. With these systems helping to ensure transparency, accuracy, accountability, and efficient management of financial resources. This could potentially address the concerns of many South Africans regarding the management of funds; and
• Technology is the key to developing and upgrading the healthcare infrastructure, including establishing digital networks, connectivity, and information technology systems. This will be essential to ensure support and seamless functioning of different technology systems.
Clarifying an uncertain future
The Covid-19 Pandemic had a telling impact on global healthcare systems. In its wake, the current operational methods which rely on treatment as opposed to healthcare management exposed the fragility of these systems when confronted with mass patient scenarios. “The Pandemic left many global healthcare systems questioning how they failed to predict the emergence of Covid and the significant demands it would impose on healthcare systems globally. It became apparent that healthcare systems need to be proactive instead of reactive when it comes to risk management,” says Olla.
Artificial Intelligence (AI) is playing an increasingly significant role in shaping the future of healthcare as it helps to revolutionise various aspects of the industry and facilitating its progressive and positive impact on people’s wellbeing. Trends taking the lead in the healthcare space include medical imaging, where AI enhances the accuracy and speed of diagnostic processes. “For example, algorithms can analyse large numbers of medical images such as X-rays, CT scans and MRIs helping to detect abnormalities. A global trial of a breast cancer predicting algorithm, trained on 38 444 mammogram images from 9 611 women, was the first to combine imaging and Electronic Health Records and played a significant role in saving the lives of many women. Further, this algorithm could predict biopsy malignancy and differentiate between normal and abnormal screening results. Imagine the impact this would have in South Africa?” explained Olla.
AI supports precision medicine by analysing vast amounts of patient data like genome sequencing, medical history and lifestyle factors allowing personalised treatment approaches. By leveraging machine learning algorithms, AI can identify patterns and predict the risk of contracting an illness or the early management of a chronic medical condition. Further, it can optimise drug therapies and modify treatment plans to help individuals manage their healthcare.
“Finally, AI algorithms can process patient data in real-time, identifying patterns and predicting health outcomes or challenges. This enables early intervention with predictive analytics. This aligns with the ultimate goal of optimal healthcare to provide a proactive rather than reactive care,” says Olla.
Cost burden
Technology and digitalisation come at a significant cost to companies. This cost is often priced into the production of the product, which impacts pricing models. There are substantial concerns that digital innovations would drive up the price of healthcare, which goes against the goals of the NHI.
Olla points out that the cost implications of implementing custom-built AI platforms in healthcare are expected to be high owing to the research, development and maintenance. This may also be due to the lack of adequate infrastructure, software, hardware and appropriately skilled professionals in South Africa and the possible need to use global resources, which will attract a higher cost.
“However, it is important to approach the cost implications of custom-built AI platforms in healthcare with a balanced perspective. While there may be a significant initial investment and increased costs, the potential long-term benefits, cost savings, and improved patient outcomes can offset these expenses. It’s time for South Africa to readjust its approach from spending to strategic investing. Embracing risks opens the door to rewards,” says Olla.
While Olla is optimistic about the future innovations that AI can offer healthcare systems, she does share the concerns that these digital innovations could place a significant cost burden on the NHI.
“It is important to stress the need to conduct a thorough evaluation of the cost implications associated with the introduction of AI in healthcare. Strategies must be developed that guarantees affordability and equity within the NHI framework to build a sustainable future for healthcare. Balancing the potential benefits, long-term cost savings, and the principles of universal health coverage can help shape policies and approaches that integrate AI effectively while aligning with the goals of the NHI,” says Olla.
