Technology-enabled self-care could overhaul SA healthcare industry
E-health can help consumers manage care to improve outcomes, reduce costs
Johannesburg - Engaging consumers to live healthier lives and adhere to evidence-based treatment plans using technologies that enhance personalised and self-care can play a major role in containing the rising costs in the South African healthcare system.
This is the view of Valter Adão, Healthcare and Life Sciences Industry Leader, at Deloitte, who was speaking at the 4th Annual Healthcare Summit, held last week in Johannesburg.
Realising this goal, he argues, entails leveraging familiar technology with incentives for consumers and providers to manage preventive, chronic and post-acute care. The personal health record (PHR) embedded in mobile communication devices – also known as mPHR – can be the “killer app” that may change the game for South African healthcare providers, consumers and funders.
“For a long time now, the healthcare industry has been focused on the implementation of electronic health records (EHRs), but has until recently largely ignored consumer adoption of mobile devices and applications, and the potential opportunity for integration. While large-scale EHR systems still dominate the landscape, they are seeing increased pressure to migrate to cloud and open platforms. The evolution has also sparked a nascent migration into mobile device applications that not only connect providers, but empower patients through applications such as mobile personal health records,” he says.
Adão’s views come as the South African healthcare system is increasingly being challenged to manage and reduce costs. Currently healthcare accounts for 8.5% of South Africa’s gross domestic product (GDP), with an anticipated increase in healthcare expenditure within the Public Sector.
Technology can help consumers of health and healthcare providers alike – particularly in the treatement of chronic conditions – by monitoring and managing their care to improve outcomes and decrease long term disease costs. User adoption of mobile communication devices (MCDs) such as feature cellphones, smartphones and other mobile tablet PCs has been high in Africa. This has been augmeneted by the ever reducing prices of these devices and internet technologies, e.g. in the next 12 months we will see the first sub-$100 smartphone. Portable technologies that can collect environmental and patient-entered information and transmit it via the internet to a personal health record (PHR) or directly to healthcare providers provide health programme implementers and policy-makers with mechanisms to help address the challenges faced by resource-constrained health markets in terms of the availability, quality and financing of health care.
Combined with actionable decision support, the MCD-PHR combination, or “mPHR,” can analyse aggregate data to activate mobile, patient-specific output such as medication reminders, healthy habit tips and medical bill reminders. Consumers who access such information and decision prompts from a portable communication device in an outpatient setting can make informed health decisions using fewer health system resources.
The mPHR has immediate utility in several areas where managing prevalent health problems currently show suboptimal results, for example, chronic conditions such as diabetes; asthma and obesity. At some point, patients with an mPHR might be discharged from a hospital sooner than before because of an enhanced ability to monitor progress without being in the hospital. Patients could also avoid or delay patients moving to nursing home and long-term care (LTC) facilities by using an mPHR.
“Although mPHR systems are in early-stage development, pilot projects demonstrate their potential to improve outcomes and reduce health system utilisation. The mPHR shows great promise as an optimal platform for engaging consumers in self-care. The mPHR enables health management programmes for conditions across the continuum through monitoring, real time decision support, education and the collection of aggregate data for trend analysis,” says Adão.
He says the positive impact and implications are clear. For consumers of healthcare, it means that they can benefit from better care and lower costs via access to real-time information that is useful in “teachable moments” when diagnostic and therapeutic decisions are made. These therapeutic interventions create an interdisciplinary care environment that directly involves the patient. For hospitals and physicians, it is a mechanism to activate and coach consumers of health to make better judgments about their care and to align provider incentives with optimal patient outcomes. mPHR is likely to be a key component supporting accountable care organisations and medical home initiatives.
For life sciences companies it provides a platform for demonstrating value (efficacy and effectiveness) of therapeutics and diagnostics within the context of an informed consumer population. If consumers agreed to share information, the consumer-reported database unlocks potential for manufacturers to learn more about product use and effectiveness within a demographic of the population.
For healthcare funders, it offers lower costs associated with fewer admissions and emergency room visits, avoidable drug-drug interactions, avoidable over-use of medications and increased use of self-care/over-the-counter therapeutics in treating common chronic conditions. Healthcare funders will have a new platform to fully engage with consumers and enable health and disease management programs.
“With growing recognition among policy makers, health plans and providers that the key to reduced health care costs and improved population-based outcomes is more effective consumer self-care, the mPHR is positioned as a natural progression of technological capabilities to help achieve this desired future state,” says Adão.
However, despite the potential, Adão notes that mobile health is still a fledgling market and current solutions have not yet reached scale where they are sustainable and generate significant revenues.
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