Deep insights into patient care are only just starting to become visible.
Healthcare presents the perfect use case for ICT: not only can it manage, track and bill patients, but electronic health records and machine learning can provide crucial insights into care and treatment. In reality, it’s much messier: health record systems aren’t interoperable – if the records are stored at all – and data analysis is expensive, and needs a large data set.
While there are a handful of platforms to choose from, SAP is by far the largest healthcare solution being used in South African private hospitals. Netcare, Mediclinic and Life Healthcare hospitals all use some form of SAP software.
Hospitals in the public healthcare system use different systems, and much remains on paper. An effort is however being made to digitise the records, at least in Gauteng, which has allocated R79-million to the project.
Peter Mills, the head of healthcare, sales and service management at T-Systems in Johannesburg, has seen the SAP health industry template rolled out in 15 hospitals during his 10 years at the company, with a particularly large uptake in the last three years.
Hospital and hotels
He’s a pragmatist, declaring that ‘running a hospital is the same as running a hotel. The services you’re delivering to the patient are very similar’.
He says there’s a perception that SAP is expensive; and then answers his own question: “What’s expensive? At the end of the day, when a project fails, of course it’s expensive because you’ve got to redo it.”
He says when a hospital invests in a digital transformation project, it should be able to deliver a sustainable solution, and one that will continue to deliver value for at least a decade.
For one reason or another, some hospitals find they have to replace their systems every three or five years.
“And they’re not transferring patient records and they eventually lose that data.”
What had made all the difference with the adoption of SAP in South African hospitals, says Mills, was changing the model from capex to opex. T-Systems – a subsidiary of Deutsche Telekom – puts the SAP software on its balance sheet, and then the hospital pays it off over five to seven years, allowing it to use its capex for something else, such as medical equipment, or improvement of patient facilities.
He says he’s seen hospitals using different systems for payroll, ERP and clinical information, none of which are integrated.
When a patient is admitted to hospital, you can ‘drag and drop’ them into a bed using a SAP module. The tariffs are also generated for that bed, which could change, depending on the patient’s pathway through the hospital (an operating theatre, for instance, has different tariffs.)
Lab information is also integrated with the module, and when the time comes for being discharged, the patient’s bill is electronically ‘switched’ to the medical aim scheme.
Once a hospital has signed the contract (in the order of tens of millions of rand) for the SAP Healthcare Solution, the journey to train the staff is only just beginning. This is in marked contrast to the public system, where training appears patchy, and the staff are often under pressure with huge workloads.
Mills says rolling out an SAP system at a new hospital is far easier than at a hospital that has an existing system, in which case a skills assessment and change management process will need to be carried out. Mills says training is undertaken out at the hospital – in one case, T-Systems hired a bus with computer workstations and drove it to the hospital.
In an effort to demonstrate the effectiveness of technology, he says T-Systems and SAP have proposed that a key 250 bed public sector hospital in Gauteng be identified as a ‘transformation project’.
“We have said to government, ‘We’re not going to wait for you to draw us into these things’. We are going to proactively engage and prove our technologies, like we have done at the Newborns Neonatal Unit at Groote Schuur.
“We’re going to put down our own investments. We want to prove – in a public hospital – what we can do with technology.”
Improving the doctor
With more insights, the healthcare professional has more choices for treatment.
The American Society of Clinical Oncology (Asco) is using SAP HANA and its Connected Health platform to gain insights into trends of cancer patients across every tumour and cancer type.
Nevaan Maharaj, a business architect principle at SAP Healthcare Africa, says Asco either captures the data on the platform, or straight from specialised oncology equipment.
He says Asco is not using machine learning at the moment, because only a fraction of patient records have been captured electronically.
Once a million patient’s data is on the platform, there will have enough core data for deep analysis. Then machine learning can be used to understand common trends, which will lead to new predictive methods.
Meanwhile, the delivery of the healthcare in Africa is overwhelmingly through the public sector, and often the first intervention is through a community healthcare worker.
Charmaine Odendaal, the SAP Africa healthcare industry principal, says gaining insights from these patients is difficult, because much of the information is written down in exercise books.
“How do you start collecting this data and get it into a central system?”
Odendaal believes that, at least in Africa, partnerships with mobile providers will be key enablers in collecting and analysing data, which can then be used to guide healthcare strategy, adding that the healthcare content cannot be accessed by anyone else other than the patient and doctor.
“Governments have the will. They’re the heroes, and they making transformation happen, one little step at a time.”
But technology can only take you so far.
“You can talk about technology as much as you like, but at the end of the day there’s a beating heart – it’s about social impact.”