Digital Transformation in Healthcare – South Africa Context

Digital transformation is growing at a slow rate in medical schemes or healthcare compared to other industries such as banking and insurance. The healthcare sector needs to embrace the digital transformation and adopt and optimize on use of technology, otherwise, the sector will be left behind. Other sectors have taken advantage of technology, for example in the retail sector, nowadays people shop online, bank, and do travel bookings online. The logistic business has also embraced digital transformation in that most activities are now done through devices at the convenience of one’s office or home. The recent HPCSA conference included topics such as Telemedicine’s where several digital transformation and innovations in the health sector were also presented. What was evident in the discussions was that progress in accelerating digital transformation is pounded by a slow pace of regulation and other relevant guidelines. The topics discussed clearly revealed that the health sector is still far behind compared to other countries. For example, there is a gap in the adoption of digitally enabled tools for diagnosing, providing treatment, and better management of chronic conditions and other conditions. Electronic medical records are still not a part of routine care both from the supply and the funders side except a handful of players. On the funders side, you do find several medical schemes that invest in technology, for example, there are schemes that are already implementing digital application forms for smooth onboarding of new members. This is with the aim of going digital and reduces paper application forms. Similarly, with the submission of claims of which more than 98% are submitted in electronic form has transformed significantly. Strategies such as digital marketing are typically used to reach the target market and communicate more effectively with members. Several schemes have invested a lot in product development such as mobile apps, developing communication channels through online and social media platforms. Social media platforms provide an opportunity for brand repositioning, it also provides an opportunity to reach a new target market and access to a larger pool potential client base. Social media platforms could also be used as a tool to improve service to clients, create convenience, provide instant interaction with clients. However, very few medical schemes optimize on these platforms, particularly small to medium schemes. There is still a need to measure value add of digital transformation to members, chiefly where the quality of care is concerned. *Address correspondence to this author at the General Manager Research and Monitoring, Council for Medical Schemes, South Africa; E-mail: m.willie@medicalschemes.com The Health Professions Council of South Africa is a statutory regulator of healthcare professions in South Africa. Medical schemes are non-profit organisation which are registered with the Registrar of Medical Schemes. Members belonging to a scheme make contributions and in return receive medical cover according to the rules of the scheme. A recent study conducted by Willie (2019) which was an unstructured survey on the use of medical scheme mobile app by members. The survey revealed than more than 75% of the respondents did not have the app installed. Some of the sentiments for not using the app were: • Lack of awareness about the app • The app is complex • No reason to use the app • Does not meet my needs Digital disruption has great potential in healthcare, the main areas of investments are certainly Big Data analytics and AI (Artificial Intelligence). Some of the big data analytics tools are useful for improving efficiencies where some of the tools can be automated, this potentially could yield better utilization of human resources and could potentially have huge cost savings. In the main, Big data and AI tools are used to profile clients, medical service providers and look at healthcare utilization patterns and trends. Some of the techniques such as predictive analytics are important in that they can be used not only to profile member but create a strategy to combat attrition. Insights from the data could be useful for data drive decision-making process that potentially save huge downstream cost for medical schemes. There is also great potential in investing in digital marketing and the optimal use of mobile apps. DIGITAL TRANSFORMATION INNITIATIVES IN THE PUBLIC SECTOR SOUTH AFRICA HEALTHCARE There are several innovations that must take place in the public sector in South Africa as far as digital 2 Global Journal of Immunology and Allergic Diseases, 2019, Vol. 7 Willie and Nkomo transformation is concerned, chiefly these are still at beta phases and their overall impact and outcomes are still to be realized. Furthermore, there are pockets of digital innovations in the public sector dating back to 2014, some are initiatives employed at provincial level whiles others are deployed at the national level. An integrated holistic approach at the national level could ascertain value add and impact in the sector. Box 1 below depicts the Department of Health’s (DoH) digital and eHealth developments and implementation from 2014. USE OF ARTIFICIAL INTELLIGENCE IN HEALTHCARE Artificial Intelligence (AI), Machine Learning (ML) and Big Data Analytics are some of the most talkedabout technologies in recent years. According to Bali, Garg, and Bali (2019), AI aims to mimic human cognitive functions, such as the ability to reason, discover meaning, generalize, or learn from experience. Popular AI techniques include machine learning methods for structured data, such as the classical support vector machine and neural network, and the modern deep learning, as well as natural language processing for unstructured data (Jiang, 2017). Machine learning is the foundation of modern AI and is essentially an algorithm that allows computers to learn independently without following any explicit programming (Uzialko, 2019). The use of AI is already at advanced stages in other industries, the adoption in healthcare is growing at a steady rate, however, there is no doubt AI is certainly going to change the face of healthcare delivery. AI is being employed in a numerous setting, for example, Year Digital developments 2014 Aviro launched their innovative eHealth app. North West department of health outlines eHealth plans (RHIS) Cell – Life’s iDART hits the target. Tier. Net, the software application that monitors patients on HIV and TB treatment. The NDoH has issued a tender for a service provider to conduct an evaluation of the use of the Tier.Net NDoH sets out eHealth standards evaluation process 2015 The Mpumalanga DoH issues eHealth tender eHealth rollout high on Gauteng’s agenda Mobenzi has partnered with the Anova Health Institute to support the Limpopo (DoH) with the deployment of the Mobenzi mHealth technology emocha launches TB mHealth platform in South Africa NDoH is working with the CSIR to develop an eHealth system to accompany the rollout of NHI North West DoH announce eHealth pilot 2016 emocha Boosting MDR-TB linkage to care in South Africa emocha’s miLINC for MDR-TB mHealth platform was designed after the NDoH approached John Hopkins University The Human Research Science Council (HSRC) has announced the development of a new mHealth app aimed specifically at pregnant teens NDoH using eHealth to improve health facilities South Africa adopts WHO’s HIV ‘Test and Treat’ guidelines 2017 mHealth aiding in the diagnoses of burn injuries Generic and Biosimilar Medicine of Southern Africa has asked the South African government to accelerate the evaluation and registration of more affordable biosimilar medicines in South Africa. South African medical information-exchange company, Healthbridge, has announced their acquisition of Infosys software solutions’ healthcare division WHO and ITU to use eHealth to strengthen health services in Africa South Africa digital health accelerator attracts top eHealth startups 2018 The National Department of Health (NDoH) has identified IT and health information systems (HIS). The South African Medical Research Council (SAMRC) has partnered with Jembi Health systems NPC Philips and UJ renew MoU to empower healthcare professionals Digital health Cape Town have announced the commencement of their second accelerator programme A new mobile app, called ViaOpta Hello, has been unveiled to help hundreds of thousands of South African living with blindness and severe visual impairment 2019 a subsidiary of CompuGroup Medical SE has developed an e-scripting solution that is helping over 1,000 South African doctors ensure medication adherence among their patients. Aviro Health launches whatsapp channel to support HIV self-testing Box 1: Digital developments in the public sector. Digital Transformation in Healthcare – South Africa Context Global Journal of Immunology and Allergic Diseases, 2019, Vol. 7 3 funders, as well as administrators, use it to adjudicate and process of claims, hospital facilities for assessing bed occupancy. AI is also used to analyses unstructured data such as images, videos, physician notes to enable clinical decision making and information sharing. Other commentators such as Reddy (2018) argues that AI is more prevent in the area of medical diagnosis. AI systems can analyze huge volumes of data faster far more than humans, this improves efficiencies in identifying medical diagnoses than doctors. It should be noted that AI cannot completely replace the medical profession but could be used as a tool to optimize currently process and reach medical conclusions and decision-making factor, thus saving costs and improving quality of life. APPLICATIONS OF ARTIFICIAL INTELLIGENCE Artificial has the potential to change the healthcare industry in South Africa for the better, this is subject to optimal use in both the supply and demand side of the health care ecosystem. AI is deliver