By Margot Brews
The health-care sector has been on the cusp of substantial reform for some time. However, the introduction and application of artificial intelligence (AI) across various health-care disciplines will surely stand out as one of the most revolutionary eras in the industry.
The rapidly evolving field has been lauded as the key to unlocking greater quality in health-care services, introducing more efficient protocols and treatment pathways, as well as considerably increasing access to health-care across all demographics.
When we place this in a local context, taking into consideration that steps to implement the National Health Insurance are in motion, AI will be critical in helping implement specific elements, such as public health interventions. If we are to refer to the Covid-19 pandemic and its immense scale, AI was leveraged across various countries across the globe to predict the spread of the virus. In doing so, this allowed governments to implement protocols to curb its spread, as well as provide citizens with critical information in an effort to decrease its proliferation.
Looking at the medical schemes sector in South Africa, the industry aims to ultimately improve health outcomes for members and in doing so, encourage and maintain a better quality of life. AI has assisted Momentum Health Solutions in evaluating the delivery of health care in the future, with clear goals that include increasing access to quality health care, and using the unmatched innovation that AI offers in assessing member profiles more comprehensively.
This is to ensure that we are not only providing a service but understanding in the broadest terms possible what type of care a member requires, and partnering with them on that journey.
An example of this is closely analysing commonalities within a member’s treatment pathway. When we review clinical data such as doctors’ consultations, the discipline of the doctor and their particular field of expertise, along with the medication prescribed, we can more timeously start to see patterns developing. This indicates and therefore informs us that the member may have a more serious illness or chronic disease that requires clinical support on a more extensive scale, which we can then discuss with the member and facilitate.
To ensure we are providing tailored health-care solutions that steer away from offering members generic benefits, we have partnered with Amazon Web Services (AWS), which provides the most comprehensive services, tool, and resources in artificial intelligence today. Through the partnership we have been able to provide members with unique services and individualised care that ultimately ensures their health care is a priority.
While AI is indeed key to creating a more efficient health-care system, ethical considerations remain a concern for many when evaluating factors such as the protection and privacy of data and its ownership, as well as the accuracy of its outputs and conclusions. Having said this, risk mitigation protocols have been implemented to ensure that personal data is protected and ethical standards are maintained at the highest level.
AI is certainly the most effective solution in the 21st century when investigating ways to solve the health-care crisis, particularly in South Africa, where immense disparity exists between the public and private sectors.
Leveraging AI, from a medical scheme provider perspective and more broadly, will not only empower current and future workforces within the sector, but will also create greater opportunity for improved health-care services that can be sustained. When implemented and used for the benefit of all, AI has the potential to be South Africa’s health-care redeemer.
Margot Brews is the head of health risk management strategy at Momentum Health Solutions.
BUSINESS REPORT