HEALTH INFORMATION SYSTEMS - THE IMPACT OF DISRUPTIVE TECHNOLOGIES Presented by: Reg Magennis, Hubert Wentzel EOH

"That it will ever come into general use, notwithstanding its value, is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble.” The Times, London, 1834 Disruptors...

Medical scheme “product” life cycle Time Declining beneficiaries Escalating costs Inefficiency Waste Innovation SuccessSuccess

Healthcare is moving from its perpetual IT laggard status to becoming one of the most vibrant, dynamic and complex IT sectors Gartner: Hype Cycle for Healthcare Provider Applications, Analytics and Systems, 20 July 2015

Source: Frost & Sullivan

Framework: for discussing the impact of disruptive technologies on the medical scheme sector Patients/ beneficiaries Distribution channel Partners Professional Practitioners & Service Providers Payers Disruptive Technology Innovative service models

Healthcare Provider IT is increasingly recognized as crucial to operational efficiency, effectiveness and competitive differentiation. It is also an essential ingredient of industry transformation. Gartner: Business Drivers of Technology Decisions for Healthcare Providers, January 2015

The “space” between doctor and patient is filling with technologies that will improve preventive, diagnostic, therapeutic, follow up and outcome medical care.

Digital technologies predicted to disrupt healthcare Source: The 7 Biggest Innovations in Health Care Technology by Brian HonigmanThe 7 Biggest Innovations in Health Care Technology Brian Honigman Wearable Tech- like Google Glass 3D Printed Biological Materials Hybrid Operating Rooms Digestible Sensors Nanobots in Blood Fingertip Surgery 3D Printed Biologicals

Examples of adopted innovative Provider technologies Enlightened/ Productive Remote ICU E Visits (pre-existing relationships) Patient portals (with EHR) Interactive patient care systems Advanced clinical research information systems Source: Gartner 2015

Framework: for discussing the impact of disruptive technologies on the medical scheme sector Patients/ beneficiaries Distribution channel Partners Professional Practitioners & Service Providers Payers Disruptive Technology Innovative service models

To remain competitive and efficient in a changing digital world: Payers need to transform their foundation IT architecture…. By (for example): Replace legacy administration platforms; Increase digitization of inbound & outbound communication; Business process automation; Process and product standardisation Source: 15 June 2015 Saraswati Pramudi, Wipro BAS Architecture Practice

Innovation/ disruption in payment processing:

Examples of innovative adopted PAYER technologies Enlightened/ Productive Enterprise Patient Financial Systems (linked to EHR) Integrated Clinical/Business Enterprise Data Warehouse Patient/ beneficiary portals Home health monitoring Source: Gartner 2015

Social media platforms: Data can be used for sentiment analysis, cross selling, up selling, fraud detection and more. Mobile apps: Consumers are increasingly demanding mobile apps on various devices to enable an “always on” relationship with health insurers. Telematics & wearable technology: e.g. to gather real-time information on driving behaviours, health metrics for use in underwriting, risk assessment, premium calculation: Requiring big data analytics to unlock value/ insights. Technologies disrupting payers & their distribution/ broker partners

Is the medical schemes sector innovating in the emerging landscape of digital technologies?

Required: services built on transformed IT architecture Embracing the changing landscape of digital and medical technologies Big Data: Smart, scientific, predictive Innovative service models: responsive to digitally enabled patients & practitioners Technology: Connected / Digital Health Success Time

Required: knowledge of how health services are connecting digitally The medical scheme sector is already experiencing technology enabled disruption… Source: IoT: 2015: 18,2bn 2020: 50bn

Real time claims payment processing Based on- Source:

Gartner Hype cycle for healthcare

Components of a full ICT capability / architectural building blocks Managed Services Big Data and Digital Data centres and Virtualisation Private/public/ hybrid cloud Security, governance and compliance Performance Management & Optimisation Mobile and end-user computing Networks and Unified Communication Source Data And Database Management Customised Application Development Enterprise Resource Planning Systems BI & Analytics IT Management and Optimisation Other Factors: Legislation POPI Federation… …

Innovative ICT roadmap Areas for attention: Technology assessment Data regulation Benefit design DSP regulation ARM standards Quality measurement Scheme reporting

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