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New ways must be sought to make the most of scarce healthcare resources

"There has been a great deal of industry-wide conversation around the looming nursing shortage. The unfortunate reality is that the situation has become dire, so much so that it poses a very real threat to the provision of healthcare across the board by driving medical costs even higher, globally and in South Africa, where we can ill afford it," ­cautions Reinder Nauta, executive chairman of National HealthCare group.
Source: Supplied. Reinder Nauta, executive chairman of National HealthCare group.
Source: Supplied. Reinder Nauta, executive chairman of National HealthCare group.

“It is disquieting to note that SA’s 2030 Human Resources for Health Strategy has raised concerns over this impending nursing skills deficit, projecting a shortage of 34,000 registered nurses by 2025 and pointing to disparities in health professionals per 10 000 population between rural and urban areas, and between the public and private sectors,” he says.

According to Nauta the solution lies in finding new ways of making the most of the resources we have.

“With technology, nursing and co-ordination of quality healthcare increasingly coming together to revolutionise the way people interact with healthcare for the better, this need not be an impossible situation. In fact, there are nowadays some highly affordable solutions for businesses looking to provide access to private healthcare as a standard employee benefit.

“Nurses have long played a pivotal role in working closely with both doctors and patients, and comprise 80% of the major primary healthcare professionals in the country, assessing need and enabling efficient provision of healthcare and greater individual attention for each patient.

Telenursing to the rescue

“By the same token, telenursing is rapidly establishing its place in global health systems, especially since proving its mettle when the pandemic placed healthcare under unprecedented strain, highlighting some surprising benefits for making the most of limited medical personnel to reach the greatest number of people over large geographic areas,” he suggests.

Nauta believes that telenursing's potential to assist the sick and elderly, and to connect them with doctors when needed, quickly and affordably even in the most remote rural areas is tremendous.

“In the context of high local costs of mobile data and traditional phone calls, WhatsApp has recorded more than 23 million users, and as SA’s most popular social platform used by nine out of 10 internet users it is entrenched as the chosen platform most used to communicate – and this is where telehealth really bridges the gap as a practical solution,” says Nauta.

The United States, Australia, Canada, Norway, the United Kingdom, New Zealand, Iran, Sweden and the Netherlands are among the countries that are using telenursing for triaging medical emergencies, which helps with clinical decision making to ensure resources are available where they are needed with optimal efficiency.

Emerging personalised healthcare

“Nurses are the ideal gatekeepers of healthcare coordination, making the most of investment in health by refining the provision of services to exactly where they are needed for greatest effect. The level of personal attention this allows puts personalised healthcare in the hands of any South African with a cellphone running WhatsApp,” asserts Nauta.

He adds that the convenience of the service also encourages people to seek health advice early, which can help to prevent an individual’s condition from deteriorating to the point where hospitalisation is required, while also minimising the need for time off work to recuperate or queue at public health facilities.

“As chronic diseases continue to claim more lives unnecessarily in our country, consider the potential for preventing and properly managing illness when patients are assisted more quickly at the level of care they require, especially when backed with a national network of pharmacies. In many cases telehealth or mental health counselling with a nurse can either resolve the concern or connect the person with primary healthcare or other resources appropriate to their individual medical condition,” suggests Nauta.

He explains that patients can contact a nurse immediately to set up a doctor’s appointment if needed, ensuring employees have access to medication, blood tests, x-rays, dentistry, optometry and so on to effectively provide for day-to-day healthcare concerns that need not break the bank for employers.

Primary healthcare triage

“Nurse-led triage comes into its own in the entry-level primary healthcare setting where high volumes of patients can be safely and effectively assessed. This was borne out by our experience with products such as the tech-savvy MediClub Connect – launched at the height of the Covid pandemic in May 2020 – which has shown that triage nursing can play a pivotal role in the primary healthcare environment by driving healthcare accessibility at a time of considerable need.

“Last year, this model was successfully deployed with the introduction of TymeHealth a medical insurance product for consumers which was launched by National HealthCare in partnership with TymeBank,” says Nauta.

“More recently, it was also implemented for BeWell, an employer-funded telemedicine empowered health plan designed and distributed in partnership with Standard Bank to support employees’ primary healthcare needs. In each of these instances it has been found to be the most effective and safest low-cost funding mechanism currently on offer in the primary healthcare setting.

“With viable, technology-driven solutions such as these, there is considerable scope to improve the experience and outcomes of healthcare by making it more convenient, more accessible, and much less expensive,” concludes Nauta.

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