Department of Health: The Role of Technology in Implementing Universal Healthcare (NHI)

Mr Merlin Pillay, National Manager: CCMDD, National Department of Health on The Role of Technology in Implementing Universal Healthcare (NHI), at Healthcare Innovation Summit Africa 2024.

1. Ms Maggie Munsamy: NHI Technical Specialist - Contracting Head:CCMDD Mr Merlin Pillay National Manager: CCMDD August 2024 Healthcare Innovation Summit Africa 2024 Presentation : The Role of Technology in Implementing Universal Healthcare (NHI)

2. UHC

3. NHI

4. Technology in NHI Comprehensive and interoperable digital information system. Clear and accurate data on users, providers, benefits, products, and outcomes Produce information to: Measure equity, Measure aspects of users, providers and benefits, Plan strategic purchasing Identify inequities and deficiencies. Universal coding, both public and private sectors, preferably international, to allow benchmarking.

5. Technology in NHI Every person (health system user) in the country must have a portable electronic health record These unique patient records will belong to the patient (user) allow every provider to build on an existing health record without duplicating tests, treatment, and care. The records  will  be carried  on the Health  Patient Record System (HPRS), which is already in place. There will be access to depersonalised data 

6. Technology in NHI The law (National Health Act and the NHI Bill) provides the framework and assigns powers  to  achieve  the digital health information systems But… the  Regulations   and  the  data  governance, operating procedures, standard dictionaries, normative standards for interoperability, standard analytics, and publication of indicators all need to be developed, documented, and  managed.

7. A Technology enabled use case What is possible when public and private partnerships exist in an innovative system enabled by technology

8. Problem statement On a daily basis as much as 70% of a public health facility’s prescription load is the preparation of repeat prescriptions for patients on Chronic Treatment

9. Traditional Model of Medicine provision Patient to the Medicine Traditionally patients travelled to the medicine, i.e. the health facility

10. The challenge

11. The Challenge

12. The Challenge Patients have to travel long distances to facilities, sometimes with children in toe

13. IDEAL Model of Medicine provision Medicine to the Patient Ideally medicines should be delivered directly to patients

14. However with long distances to travel SOUTH AFRICAN LANDSCAPE

15. The location of homes make access difficult SOUTH AFRICAN LANDSCAPE

16. Homes are far apart making direct delivery inefficient or expensive. Formal physical addresses are a challenge. SOUTH AFRICAN LANDSCAPE

17. IDEAL compromise Model of Medicine provision Patient and medicine to a convenient location An ideal compromise will be to deliver medicines to locations that are convenient for patients

18. CCMDD High level process or Digital and Digital

19. CCMDD Improves patients convenience and waiting times. Non-CCMDD Visit CCMDD Visit The traditional patient service requires a patient to visit a public health facility 6-12 times a year, each time waiting 4-5 hours, after the facility opens With CCMDD patients visit a facility 2 times a year, and 4 visits a year to a pick up point waiting mostly less than 10 minutes.

20. CCMDD is implemented by 3600 facilities in 8 provinces and supported by 3000 private sector pick up points Public Health Facilities (3600) Pick up Points (3000)

21. Inputs: Public health facilities, medication pick up points, private healthcare facilities, national & local datasets containing demographic, administrative & HIV burden data, other geocoded data GIS is used to manage disparate datasets and support decision-making for the CCMDD programme - PLM provides ongoing insights and support to NDoH , Donors and private sector partners through various GIS tools and analytics OPPORTUNITY ANALYSIS CATCHMENT ANALYSIS PERFORMANCE MONITORING DECANTING ANALYSIS

22. Illegible script - 1

23. Illegible script - 2

24. Technology E-Scripting – 90% of prescriptions Prescriptions are processed by a second prescribing system Dispensing systems Stock Management and warehouse management systems Labelling and dispatch systems Courier systems Parcel management Reverse logistics Patient communication systems GIS analytics Contracting systems Finance systems Conditions and formulary management Reporting

25. CCMDD – THE NUMBERS 1 program 8 provinces 46 districts 100 conditions 3 000 pick up points 3 600 facilities participating 55 000 authorised prescribers 4 500 000 prescriptions per annum 7 000 000 patients benefitted 10 000 000 parcels dispensed and delivered per annum 75 000 000 parcels dispensed over the life of the program

26. Finally … CCMDD is a proven, successful, PATIENT CENTRIC approach to service PATIENTS in a manner that is beneficial to: 1. PATIENTS 2. Departments of Health 3. Communities & 4. Creating lasting partnerships with Private Sector

27. Thank You