While technological advances in healthcare have the
potential to become a massive gamechanger in the way healthcare service are
delivered, healthcare professionals’ fear that it could reduce their role in providing
care and impact on their earnings, and regulatory limitations are hampering
optimal implementation in South Africa.
This was one of the messages coming out of this week’s Business
Dialogue on the future of healthcare hosted by Life Healthcare and Business Day
Conceding that advancements in healthcare technology could
drive the provision of more accessible, better
quality healthcare services at a reduced cost, Deputy Director-general for NHI
in the Department of Health, Dr Anban Pillay cited issues as a lack of infrastructure
and connectivity, outdated regulation and some healthcare providers’ belief that
it could make them redundant, as some of the obstacles impeding the rollout of
He cited the current implementation of a patient
registration system in the state sector, e-scripting, ATM pharmacies and the introduction
of pill-packing robots in some government hospital pharmacies as examples where
technology is already making a big difference in streamlining healthcare
services in the public sector.
“Where it is possible, there are huge opportunities.
However, we will need to find a way of convincing all role players of the
benefits and take them along in the decisions to prevent those who are benefitting
from the current system and who are reluctant to embrace new technology from
creating obstacles to implementation,” Dr Pillay said.
Life Healthcare CEO, Dr Shrey Viranna noted that South
Africa is still stuck in the “paradigm of brick and mortar” that is not needed
to implement innovative technologies. There is also a need to relax regulation
that prevents the implementation of services such as virtual consultations and
the use of non-clinical skills to augment those of physicians such as
radiologists, enabling them to diagnose and triage patients remotely.
Axel Bauer, Senior Partner of McKinsey and Company’s Hong
Kong office cited technological developments in the areas of Artificial Intelligence
(AI)-based diagnostics and molecular biology such as liquid biopsy as some of
the biggest advances in detecting diseases much earlier and with more precision.
He pointed out the advantages of digital platforms such as the “GoodDoctor” application
developed in China that gives more than 400 million people access to 24/7, online
consultations which are supported by systems that allow patients who need
emergency care to quickly access services. In addition, so-called mini-clinics have
been introduced where patients can access machine-driven imaging services that
allow them to be scanned without the presence of a healthcare professional to
establish whether they need to see a physician. However, he cautioned that without
and end-to-end online-off-line system that ensures continuity of care, the
advantages of these technologies won’t be achieved.
Referring to South Africa’s dire shortage of doctors,
Accenture CEO, Vukani Mngxati, emphasised the huge role mobile digital technologies
can play in expanding healthcare services to rural areas.
“As the country is going through health reforms such as the
NHI, we have an absolute opportunity to put the basics in place that will allow
us to “leapfrog” existing technologies and introduce new technologies to the
advantage of the millions of patients who still don’t have access to a doctor,”
According to Dr Pillay, regulation should be dynamic and
move to accommodate new technologies but that it requires evidence that it is
affordable and will provide the right outcomes and broaden access.
“We need to ensure that everyone understands where we
are going, especially those who see innovation as an obstacle. If we don’t, it
could create a culture of fearmongering, causing a negative spiral of
resistance,” Dr Pillay said, citing the example of ATM-dispensing pharmacies
that took more than 18 months to get the approval of the Pharmacy Council
because of a perception that it could leave pharmacists without jobs.
Panelists concluded that the private sector, healthcare
providers, funders and regulators should work together in ensuring that the
opportunities new technologies can bring are achieved in a way that is
patient-focused while allowing for healthy competition.