COUNTRY FOCUS: NAMIBIA
He adds that patients also have a range
of benefit structures from different
medical aid schemes, with different
pricing mechanisms, which adds layers
of complexity.
“The key is to deploy a solution that
simplifies all of this complexity, allowing a
single view of the patient, with high levels
of automation and sophistication, freeing
up healthcare professionals to spend
more time with the patient,” he said.
“There are a range of offerings in the
market that are very simple to deploy
and simple to use, but without the
sophistication to address all of these
elements effectively, forcing hospitals
to throw people towards a system
deficiency. Our solution doesn’t ignore
these complexities, it simplifies them,
with an appropriate level of control,
flexibility and ease of use.”
With some other countries having
a multitude of medical schemes
operating, submitting medical aid claims
and checking the eligibility of patient
benefits for certain procedures or care
can be a time-consuming administrative
burden without the appropriate
solutions in place.
“We integrate to Medikredit, a switching
company for medical aid claims that has
enabled real-time eligibility checking,
“
THE HEALTHCARE SOLUTION
DEVELOPED BY CONVERGE FILLS
A VERYCLEAR GAP IN THE LOCAL
HEALTHCARE INDUSTRY’S DIGITAL
TRANSFORMATION EFFORTS.
among other rich functionality,” said Joubert.
“Healthcare organisations using our solution
can quickly check that patient benefits are
still intact and that the medical aid will
cover the costs. Once the service is billed,
the claim can be submitted to the medical
aid scheme immediately and with minimal
rejections since the eligibility of the claim
was performed beforehand. This integrated
approach ensures a dramatically lower claim
rejection rate.”
Joubert adds that a large part of the coinnovation
project focused on reducing
the operational complexity inherent within
healthcare organisations.
“We made use of best practices, but also
ensured the system is localised to serve the
specific operational needs of African private
sector hospitals,” he said.
“This was achieved through more than
a decade of working side by side with
healthcare entities to understand their
pains and architect solutions, along
with an active inclusion of industry thought
leaders through the system enhancement
process. “We also extended the standard SAP
solution by integrating our own solutions to
augment what is already offered, including
PatientMyth (a digital patient survey and
intervention platform), Impi (a clinical
incident management platform), Virtual
Forms (a form digitalisation platform) and
Triton (an advanced acuity based nursing
planning and optimisation solution).
“We have partnered and/or integrated
with a number of other leading entities
including, but not limited to, Cerner, Elsevier
and Medikredit.
“We are constantly evaluating and
integrating other products and partners
into our ecosystem to ensure that
healthcare providers can source all IT
related products and services from one
point of accountability. Our solutions offer
simplification and predictability, extending
to timeline, budget, appropriate levels of
sophistication and standardised levels of
care, to cover all permutations of healthcare
in Africa.” •
44 INTELLIGENTCIO
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