by Juliette Doyle

Healthcare in SA

The role of business intelligence in the healthcare sector

Solutions to the healthcare providers should be examining solutions for better healthcare
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Healthcare in South Africa has always been a contentious issue. This contention is mainly due to the fact that the topic is so varied and covers issues affecting both the private and public sectors.

“Of course, we all understand that locally the public sector faces an ongoing challenge of resources and remains under pressure to deliver services to our citizens. However, beyond the market concerns of management, underfunding and a legacy infrastructure, can anything be done to correctly support the requirements of improving access and quality of care for all?”, asks Martin Rennhackkamp, chief information officer of PBT Group. 

He adds, “If we take, for example, that the figures given by SouthAfrica.info are correct, whereby they state that the government contributes about 40% of all expenditure on health, then certainly we can understand why the public health sector is under pressure to deliver sufficient services.”

Furthermore, according to the National Treasury's Fiscal Review for 2011, gross domestic product spend on health was divided as follows:

  • R120.8-billion (48.5%) in the private sector, which covers 16.2% of the population or 8.2-million people. Many of these individuals have medical cover.
  • R122.4-billion (49.2%) in the public sector, made up of 84% of the population, or 42 million people. These individuals often generally rely on the public healthcare sector.
  • The remaining R5.3-billion (2.3%) is donor and non-governmental organisation spend.

 

Continues Rennhackkamp: “Looking at such spend and the current challenges that exist within the healthcare sector as a result, providers could, and should still be examining realistic solutions to help manage access and, more importantly, the quality of care – much of which can be delivered by technology and technology partners in South Africa. Take for example, the area of business intelligence (BI), which is technological solutions that allow organisations to integrate information from their many databases.

"BI is not just a ‘nice-to-have’ system for companies trying to manage data, like customer information or medical claims, but it is in fact a business tool that, when utilised correctly, can give an organisation – like a healthcare institution – the means to smarter and quicker decisions. For example, having already analysed information on a patient on hand means it can be accessed quicker whereby the healthcare providers can make the right decision up front. Furthermore, using advanced analytics (which forms part of BI) within the healthcare sector allows for healthcare organisations to analyse risk, whereby early on in the process, they can detect any claims that may be fraudulent or have significant errors.”

Broken down further, what can a BI platform really deliver in real business terms to the local healthcare sector? Research shows that:

From a financial analysis point of view:

  • BI allows administrators to access all the accounts in one file – from invoices, to deposits, to paying suppliers and staff.
  • BI allows the organisation to see exactly where its funds are going to and if there are any problems with the cash flow – and if there are, what the organisation can do to improve the cash flow.

 From a claims perspective:

  • BI helps organisations to manage claims properly, as well as improve response times to claims and prevent fraudulent claims.
  • BI can be used for software solutions for hospital call centres, with an analysis of every individual call detail record and helping constant patient support while keeping costs down.
  • With secure, necessary clinical information, doctors can diagnose and prescribe medication more quickly and provide a more holistic quality service. 

For patient care analysis:

  • Providers have the skill to observe and predict patient diagnoses and use of healthcare services in order to improve patient care, decrease waiting time, and order more successful treatments.
  • Providers can implement and track managed care programmes, through which hospitalisations can be prevented, and patients can improve more and faster in their own comfortable surroundings, reducing hospital costs and contention. 

 

“As a result, just merely examining the practical implications of BI, if undertaken correctly, the platform gives the right people access to the right information at the right time, as it delivers a single portal for the any healthcare institutions to share information with its medical practioners and allow them to make informed decisions – to the benefit of the institution and their ability to deliver on their patient care promises,” says Rennhackkamp. 

“Technology can and will deliver effective solutions to allow the healthcare sector to become more equipped and informed and, certainly, from an administrator perspective, an institution like a hospital would gain the ability to ‘stay ahead of the game’ and actively help patients receive the best care, at a reasonable cost,” he concludes.

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