Wilma Liebenberg, chief executive officer of Knowledge Objects Healthcare, says an initiative as immense as National Health Insurance (NHI) needs appropriate technology and real-time risk management capabilities in order to succeed. It is vital that financial sustainability is ensured and much needed access to quality healthcare is made available to ensure that the needs of the nation are met.
Healthcare in South Africa is going through a major transition. Where do you see technology and risk management fitting into the NHI scenario?
The South African private healthcare system’s standardisation of clinical and funder coding, communication protocols and technical infrastructure are among the most advanced in the world. This makes rapid advances in risk management automation and artificially intelligent big data systems possible.
The private healthcare systemic model forms a microcosm of what the NHI will offer all South Africans with the same stakeholder involvement required.
NHI in South Africa is in a fortunate position to have such a working model as a baseline to offer benefits of hindsight, which can be evaluated and scaled appropriately to easily facilitate the transition. We have all the know-how, from a clinical and technical skills perspective locally, to ensure that NHI is well managed. In addition, we have world-class evidence-based treatment guidelines, coupled with the availability of granular data from advanced systems in real time, to ensure that health and financial risk management strategies are effectively executed.
It is imperative that technology forms the basis of the management infrastructure as this will cost effectively ensure that:
Administration costs are contained and the engagement for people accessing care through NHI is professional, streamlined and efficient;
Appropriate care is provided for patients, and patients at risk are identified and treated sooner so as to prevent disease progression and costly treatments due to late identification;
Fraud and abuse are proactively prevented;
Clinical outcomes of treatment can be demonstrated; and
The quality of care can be measured, facilitating peer review so that appropriate action can be taken with healthcare service providers who have consistently poor outcomes or in instances where poor quality of care is detected.
How did you become involved in your particular field?
I was involved in developing technology in various industries from the outset of my career. I transitioned into a consulting role and at one point consulted on healthcare administration and managed care technology. I found that the systems within the sector generally had long legacies and processes were quite manual and were in need of more modern technologies and programming languages. The industry also needed to enter the space of rules-driven artificial intelligence to improve automation and decision-making.
This was an enormous challenge, which we took on and surmounted. Unfortunately, our industry still has some out-dated legacy systems, but at Knowledge Objects our clients are fortunate to benefit from the investment, foresight and capability of the team.
Who are your role models?
My hardworking parents, whose values and tenacity ensured that impossible was not a word in my vocabulary from an early age. I consider every strong woman who paved the way for me to have the benefit of practising a trade that I love and am passionate about to be my role model. Anyone can change the world in a small way, and if I can be that “strong woman” for the next generation, even in some small way, then I would have accomplished my dream of positively contributing towards changing the world.
What was the best piece of advice you've ever received?
Actually I have four pieces of phenomenal advice that I received and that I always share:
Change is constant;
Think on your feet and stay calm in the storm;
There is no plan B, we make plan A happen! Why settle?
Pray circles around your challenge.
What is your secret indulgence?
Woollies chicken pancakes, Flamby pudding and Fizzers. Yes, I have a sweet tooth.
Nicci Botha has been wordsmithing for more than 20 years, covering just about every subject under the sun and then some. She's strung together words on sustainable development, maritime matters, mining, marketing, medical, lifestyle... and that elixir of life - chocolate. Nicci has worked for local and international media houses including Primedia, Caxton, Lloyd's and Reuters. Her new passion is digital media.
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