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Towards effective healthcare for SA

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Vukani Mngxati, MD: Healthcare and Public Sector practice at Accenture South Africa, discusses what’s needed to effect accessible and affordable healthcare systems in South Africa.
Digitisation has been the enabling force behind the world’s most effective and successful healthcare systems. Global healthcare leaders have learned that the three pivotal pillars of healthcare — accessibility, effectiveness and affordability — all have information technology at their core.
We know this: many South Africans aren’t receiving an acceptable level or quality of healthcare. Any workable, effective solution to the situation the country faces must, first of all, be responsive to those citizens’ wants and needs. It must be people-centric. Reform is only successful if people receive (and perceive) value.
From experiences in other countries, we know that, in general, citizens want healthcare that is, fundamentally, of a good quality. They want access to information, too — in order to better plan their lives. Most of all, people want a system that feels compassionate.

The three pillars of healthcare
Across the globe, three pillars shape healthcare discussion. They are: access, effectiveness and affordability. What changes from country to country is the importance placed on each factor based on the country’s specific set of circumstances.
In the United States, for example, affordability is key. In Europe, effectiveness (quality of care) is often considered uppermost. Here in South Africa — as in many other emerging markets — access to healthcare services is our most critical issue.
The debate around what policies, funding and governance models are best suited to the South African healthcare context is ongoing. The NHI (National Health Insurance system) is the solutions put forward by government.
While deliberations may continue for some time over what policy is best, there is no disagreement in this regard: both access to and quality of care in the country are lacking.
Right now, healthcare leaders need to focus on the role digitisation will play in the journey towards improving healthcare access and effectiveness, no matter what solution is eventually put in place.

Digitisation & information
As a first step, digital technology means that critical healthcare information can be collected, analysed and shared. All intelligent decision making requires information — without it, paralysis results. From a healthcare planning perspective, it is impossible to accurately budget for healthcare at either the provincial or national levels without the right information. More basically, it is impossible to assess what the country’s real healthcare needs are — or to know whether the budget is suitable for those needs.
Providing effective healthcare also means understanding every individual patient and his or her medical history. An effective, digitised means of collecting, analysing, storing and confidentially sharing that information among healthcare providers is necessary for improving the care patients receive.

Digitisation & access
While the South African situation is acute, all countries — even developed nations — struggle with issues of healthcare access.
Having instituted their own reforms, leaders in other countries have learned that digital technology is a critical enabler of healthcare access. No country can solve all its access issues by simply training more people. A global truth is that physicians tend to gravitate to cities, leaving rural areas without required skills.
Technology means, however, that a physician can provide care without physically being at that location. India, for example, uses telemedicine widely to project expert care out to rural areas.
In South Africa, the demand for healthcare services is simply growing faster than the supply. However, digital technology can be used to enable the healthcare system to care for more people — and to care for them better.
There are three primary ways that digital information technology can improve access to healthcare:
* By moving healthcare work to local workforces — community healthcare workers can, for example, be empowered with tools that allow them to conduct simple tests such as taking blood sugar readings, meaning citizens in rural areas don’t need to travel to clinics for these tests.
* By moving work to citizens themselves — in other words, by increasing the amount of self-service and self-care citizens engage in.
* By moving work so that citizens can care for, assist and educate one another.

Towards access, efficiency and affordability
What ultimate form healthcare reform in South Africa will take is, at this stage, unknown. What is known is that digital information technology must form the basis of that change.
A large part of the task South Africa faces currently is simply the need to digitise healthcare information, so that this data can be collected, analysed and shared.
The result: better decision making — budgets, strategic purchasing decisions and governance can all benefit from the guiding hand of tech. Access to medical histories also improves the care patients receive.
The second element is allowing the healthcare system to serve more people — something digital tools can facilitate.
South Africa’s healthcare leaders needn’t decide on the shape reform takes before they implement a digital strategy. In fact — that digital launchpad must be in place before to fast track healthcare transformation.