The implementation of the National Healthcare Insurance (NHI) fund is a major cause for concern in the healthcare industry. Faced with issues of funding, the potential impact of revenue on the private healthcare sector and an increasing urgency to implement and execute the system envisaged by the Department of Health – it’s difficult to be optimistic about the chances of success. However, given that equality and access to healthcare is such a critical constitutional imperative, it’s up to healthcare providers, Original Equipment Manufacturers (OEMs), and ICT service providers to guide the Department of Health on matters relating to technology.
What is the NHI?
An initiative driven by the Department of Health, the NHI is intended to be a healthcare financing system that provides all South African citizens and long-term residents with essential healthcare, regardless of their employment status. The NHI’s role is purely to provide finance for healthcare. It will not be used to manage hospitals or clinics (whether public or private), instead the NHI will enter into agreements with public and private facilities and healthcare professionals to provide services. Patients will be able to select any NHI-contracted provider nearby to have their regular health needs met.
What are our biggest technological challenges in implementing NHI?
Many have questioned the technological and data readiness of South Africa to deliver on the promises of NHI, and this is understandable. If the United State of America (USA) nearly derailed Obamacare, its Patient Protection and Affordable Care Act of 2010, because of an online platform failure, South Africa is going to have to be extra cautious in the planning and implementation of the NHI. Therefore, a strong systems integrator is needed to ensure the success of such a project.
In order to avoid failure, the NHI is going to require a secure central patient database, a robust core system, massive integration and a strong hand with security and auditing compliance. The right systems integrator partner can bring the necessary experience to take accountability and ownership for driving and coordinating the many moving parts and providers that will be required from a technology perspective. Moreover, it will provide leadership and decision-making advice.
How are we going to face the data and information technology challenges that lie ahead in the roll-out of the NHI?
Aside from infrastructure and connectivity, patient data will require urgent attention; we’ll need to put together a blueprint of technology and data standards. More important than the technology itself is how we pull it all together. It’s going to take some creativity and agile thinking, but this blueprint needs to cover how we’re going to:
- Establish and manage core patient/health data as well as the infrastructure for its exchange and security.
- Establish national, provincial and regional registries that act as a single source of truth for data purposes.
- Create personal health records in line with global standards, that can be easily accessed by citizens and services providers with patient consent.
- Advocate clinical decision support systems for health practitioners, in order to promote collaboration and better use of resources, such as automation, data analytics and unified communications.
- Leverage health data analytics and medical research for better management of the health sector and enhance governance digital tools (such as blockchain and biometrics) in the area of security and compliance in order to prevent fraud and data theft.
Bringing it all together
Under the supervision of a strong systems integrator, it’s possible to use information services as the golden thread in leveraging technology, big data analytics, connectivity infrastructure and ICT service provider solutions. These technologies will therefore be instrumental in building a technology-enabled healthcare financing system that can become an essential platform for driving equitable access to healthcare. To this end, healthcare providers, OEMs and ICT service providers will all need to work together closely to overcome the challenges presented by the NHI.
Kumar Utpal, Regional Sales Manager for Banking and Insurance at In2IT Technologies.