With growing concerns regarding the state of our public healthcare, South Africa is under immense pressure to leverage diverse innovative solutions and drive an aggressive agenda for digital transformation in order to ensure that all citizens have access to the health services they need, when and where they need them.

By Dr Bandile Hadebe, Executive for the Health Vertical at BCX

According to the BCX Innovation Report 2021, about 82.6% of the population relies on the largely subsidised public sector, while the remaining 17.4% relies on the health-for-profit private sector. However, the majority of available resources are concentrated in the private sector that results in an overburdened public sector, affecting the quality of services.

Interestingly, South Africa’s healthcare system, from the perspective of delivery of services, infrastructure investments, manufacturing and production of a wide range of goods and services, presents an opportunity for the sector to become a significant catalyst for economy recovery.

This potential for a positive economic impact by the healthcare industry is dependent on applying the appropriate technologies that promote efficiencies across both the clinical and administrative operations within the healthcare system. The recognition of the impact digital transformation can have on both services and administration has been lacking.

One of the reasons initiatives of digital transformation in healthcare have not yielded the intended successes is due to a fractured approach between strategy and change enablement which is necessary for rapid adaptation as the plan is implemented. Other identified factors include:

• Healthcare system is complex – The multiple and intricate procedural protocols that characterise different clinical disciplines present a cumbersome situation when attempting to automate processes and digitalise workflows across an entire hospital group or department of health, or even just one tertiary hospital.
• Stakes in healthcare are high – Because we are literally dealing with a matter of life and death in healthcare, prioritisation is often tilted towards traditional inputs that have been known to work for centuries such as investing in medicines and other consumables, and increasing the workforce.
• Many technology companies lack clinical insight – The assumption that an understanding of technology, in general, will lead to successes when deploying solutions in healthcare have led to many failed initiatives, resulting in fruitless expenditure amounting to billions of rands across both public and private sectors. This is the primary reason BCX established a dedicated health vertical practice that converges the skills of health experts and advanced techies across different technology capabilities.
• Electronic Health Records (ERH) often seen as a first step – Crossing the chasm in socialising the use of technology in healthcare requires that health organisations and technology providers prioritise simpler challenges which, however seemingly insignificant, impact on improving service delivery, such as queue management for outpatient departments or a bed bureau for efficient allocation of patients and transfers. EHR is complex and faces further resistance because it overhauls the manner in which doctors and nurses are accustomed to working.
• Regulatory constraints – While we have seen some greater progress following the increased demand for remote consultation during the peak of the lockdown in response to COVID-19, the Health Professions Council South Africa (HPCSA) ethical rules for members have played a large role in preventing the expansion of telemedicine, while in the medical devices space, the certification backlog at the South African Health Products Regulatory Authority (SAHPRA) is the most significant issue.

The key issue is how we start thinking differently about healthcare and technology, and where they converge. Our understanding of convergence must also extend to different role players to create the appropriate ecosystem. Creating appropriate cross-disciplinary teams that includes clinicians, operations managers, technology providers and patient advocacy groups is fundamental. This often means, in certain instances, competing firms have to collaborate for an initiative to be successful.

Another critical focus should be given to optimising manual processes through applying design-thinking principles and thorough mapping of user journeys for every participant in the environment that is being digitalised. Deploying technology in environments that have poor quality of workflows with unnecessary touchpoints merely expedites failure, frustrates users, and leads to abandoned initiatives and wasted investments.

It is also important to draw lessons from mature markets across the globe and other industries, because your organisation is often not the only one or the first one attempting these initiatives in digital transformation. Credible global bodies such as Healthcare Information and Management Systems Society (HIMSS) provide well-researched frameworks such as Electronic Medical Record Adoption Model (EMRAM) and other adoption models, to follow and adapt for your context when implementing health technology projects to improve services.

Although healthcare in South Africa is split between the well-funded private sector and a resource-constrained public sector, both sectors present potential markets for health technology products. Many technology providers are showcasing how high-end healthcare IT offerings can improve the quality of care in the struggling public sector, when implemented effectively.

We are finding that digital transformation can dismantle non-macro and socio-economic challenges, creating a healthy balance between the patient, the funder and the health provider, while driving costs down and enabling greater access. This data-driven, patient-centric solution is providing a better understanding of what could be an optimised experience for patients that delivers better health outcomes along the most effective route and channel.

With the potential implementation of the National Health Insurance (NHI) and a post-COVID-19 environment that highlighted the challenges of the healthcare sector and the need for digital innovation, digital transformation is likely to persist in the future, streamlining the industry.
Healthcare delivery models will move towards healthcare consumerisation and patient-centric models. This will benefit the needs of patients as well as create an environment of seamless cost-saving.

The country’s healthcare challenges present the biggest opportunities for digital innovation. By applying digital innovations, healthcare providers including hospitals can advance the health of the nation, while reducing costs. A healthy economy is well-funded and a wealth of opportunity awaits in digital solutions.