The presenting problem
More than 20% of medical insurance claims paid out are consumed by the 6% of members who suffer from chronic disease. Research has shown that interventions at the primary-care level (i.e. in the GP’s rooms) can make all the difference in successfully managing these conditions.
Management of chronic disease in South Africa is often fragmented, leading to poor patient outcomes, but international research shows that coordinated care enabled by Chronic Disease Technology (CDT) can reduce hospital admission for specific conditions by as much as 60%. Care costs are reduced by 23-26% and patients’ long-term quality of life is improved by 10-14% because they have fewer complications.
Medscheme, the second largest insurer in South Africa, realised the impact of fragmented care on its business and actively looked for ways to use technology to improve chronic-disease management.
Medscheme worked together with Med-e-Mass and MediSwitch to run a pilot CDT system in 2016.
MedeMass provided HealthOne, an electronic health record (EHR) that assists with record keeping and clinical care. MediSwitch provided LifeDoc, an electronic personal health record (PHR) that puts the patient in control of monitoring their health via their smart devices.
HealthOne and LifeDoc joined forces and their software was tethered to various medical funders. A CDT solution emerged, resulting in effective management of chronic disease and its associated costs.