Read the Conversation

EF. If you were to create a new startup in the healthcare sector, what would it be, and what needs would it address? 

HH: I would develop a product or a solution that delivers care to a broader market in South Africa, supported by appropriate funding models with an understanding of the regulations and barriers in South Africa. Creating an integrated, affordable patient-centric solution that is enabled by digital health solutions is vital. 

Providing quality healthcare to a wider population should also encompass chronic care options. 

EF: How do you see the healthcare ecosystem evolving in South Africa, and what is the role that Intercare is playing in aligning with this trend?  

HH: In terms of the health ecosystem, numerous partnerships and collaborations are already in place to strengthen it. International health literature has stated that healthcare requires partnerships and organizations with the same vision of serving customers to deliver care appropriately, affordably, and at scale. The question then becomes how to take these learnings, implement them, and put them into practice. The key is to leverage the capabilities that organizations have developed to form new partnerships. For example, digital health has the potential to be a pivotal part of delivering care and contribute to this ecosystem to make healthcare more accessible and affordable for more South Africans. 

Intercare's role is to provide primary healthcare capabilities in both digital and physical settings and to partner with appropriate levels of care to enhance access. For example, Intercare believes in collaboration and not necessarily owning everything. Partnerships are crucial in providing affordable healthcare by working with those who are already delivering care in those areas. Intercare has enabled clinic nurses, through our partnership with more than 150 Unjani Clinics countrywide, to connect digitally with Intercare doctors when clinically appropriate and at affordable prices for the end user. We believe in finding alternative ways to ensure that the service is sustainable for the customer paying for it without decreasing the fees of the health provider that needs to deliver it. 

We recognise that customer needs are dynamic and that offering convenience and accessibility is critical. Therefore, the Intercare healthcare ecosystem not only comprises primary care; it also includes day hospitals offering ambulatory care, sub-acute rehabilitation hospitals offering comprehensive, multi-disciplinary rehabilitative care, and acute hospital care through our partnership with an international industry leader, Mediclinic.  Collaboration with strategic partners allows Intercare to provide comprehensive, patient-centric services across the full continuum of care. 

EF: At the International Finance Corporation: Global Private Health Conference, you presented on the topic of developing resilient health systems in emerging markets. How can we develop resilient healthcare systems in South Africa? 

HH: The key to effective healthcare is to adopt a hybrid model that matches patients with the appropriate level of care. This may not always involve digital solutions but could also entail physical consultations if that is the appropriate level of care. For example, if a nurse consults with a patient, followed by a virtual doctor, and then the patient ultimately requires a physical visit, valuable time and resources may have been wasted. To enhance healthcare resilience, care must be delivered at an appropriate level, with a digital-first approach. 

In order to develop effective solutions for various care settings, it is essential to identify and partner with the right collaborators. The term "care setting" refers to the location and mode of care, such as digital or physical. Enhancing efficiency is critical to achieving healthcare resilience and enabling everyone to perform at their best. Streamlined processes and workflows can be created for patients, doctors, and other professionals in different care settings. 

EF: How can data and information be used to increase patient outcomes, how are you using it today? 

HH: As a business, we have evolved significantly over the last few years. We've been able to structure our data and use it to improve operational efficiencies such as reporting, gaining insights, and understanding certain trends. Once the data is structured, we feed it back to the appropriate audiences to improve patient care. 

Improving resilience involves enabling the movement of patient information, including clinical history, to the appropriate level of care. The more information that can be moved with the patient, the better health professionals can diagnose their care needs. Care coordination is key to managing a patient through various health settings in a fragmented healthcare system. 

EF: You are focusing on delivering affordable quality and providing integrated health care. How do you design a value proposition that encompasses affordability and quality? 

HH: When it comes to facilities, a lot of effort goes into determining the location and the layout of medical and dental areas. Support teams, such as nursing support and dental assistance, need to be centralized to lessen the burden of administration and clinical care coordination, helping doctors to manage their patients better. 

Affordability depends on the market. Many of our facilities are located in urban areas where most inhabitants are already insured, patients. However, our partnerships extend our clinical reach to rural and peri-urban areas. We are working with funders to ensure that clinical protocols and pathways are followed, enabling us to deliver affordable quality care in a private facility if the patient ends up there as the appropriate place of care. Utilization is key to management, and we don't want to discount doctors' fees. 

A low-premium insurance product does not necessarily equal a low consultation tariff, as it may have in the past. By looking at the package at the episode of care and the individual, we can realistically deliver and integrate care if all areas are covered from a delivery perspective. 

EF: Do you currently have any initiatives to adopt and educate physicians and nurses? 

HH: A current initiative is an online personal healthcare management tool enabling patients to access and manage their healthcare online. It allows registered users to schedule appointments online, view and update health information, make payments, renew prescriptions, access affordable consultations and condition-related information, and more. In addition, patients can access various levels of online mental health services. 

When implementing new initiatives, we must understand how it fits into the current workflows of our customers and healthcare professionals. It is a continuous change management process to streamline patient journeys and clinical workflows to ensure adoption.  

We collaborate with professionals and teams to share our knowledge and listen to their experiences.  By doing so, we can understand and address practical challenges to ensure that new initiatives are implemented efficiently. In some cases, we structure our business units in a way that does not disrupt the day-to-day work of health professionals. For example, our centralized online clinic is a digital practice with a team of health professionals and support staff. It functions like a facility with a receptionist and support staff. 

In practices where a doctor must work in a hybrid setting, we had to change our operational processes to support this new way of working. Implementing new initiatives without changing how we work would not lead to success. We need to adapt our way of working and support new initiatives in a way that is applicable to the specific audience. 

COVID-19 accelerated the digitalization process. However, we must be careful not to stop innovating and continue accelerating despite the pandemic. This is a risk for any industry, especially healthcare in South Africa, where we have not yet achieved the necessary infrastructure and technology to deliver quality care. 

EF: How do you see collaboration in South Africa evolving, and what is necessary to make collaboration a success? 

HH: I think partnerships are improving and evolving. This can be seen not only in the healthcare profession but in other areas of the healthcare industry. There are a lot of partnerships and new ways that companies are looking at it. 

Collaboration requires an abundance mentality. It requires the parties to be selfless and not scared of sharing. They must be willing to share and collaborate to benefit themselves and, ultimately, the customer. 

There are now more and more examples where different players are coming together. One example can be seen in the initiative between Intercare, Mediclinic, and Discovery. Last year, we developed a specific medical scheme insurance option that was digital first and then networked. This scheme was regional, requiring a lot of honesty and trust between three credible organizations.  

It required them to open up, be transparent, and understand each other's operating models to some extent to be able to deliver an affordable healthcare option. 

I believe that collaboration is evolving and can be accelerated, but trust is key to successful partnerships. In the past, companies wanted to own the customer, and nobody wanted to collaborate because it was unclear who actually owned the customer. However, there is now a better understanding that one can use their own capabilities to help someone else serve their customer. While we have our own customers and want to grow that base, we can also assist other institutions or companies in serving their clients or members. This is part of healthcare, and we believe in bringing our own clinical capabilities to third parties. As a result, there is now more focus on business-to-business transactions than on business-to-consumer transactions. 

EF: You are going to celebrate your first year as a managing director in 2024. What are you going to celebrate at the end of the year? 

HH: As the Managing Director, my priority is to ensure that the strategic initiatives we have embarked on gain traction and provide a return on the effort and investment we put into the last two to three years. We invested a lot of time, effort, and resources in building our capabilities, and now we must leverage them to get returns not only financially but also in other non-monetary indicators. 

Secondly, I would like to celebrate having a sustainable and engaged company. I firmly believe that if we are innovative in healthcare, we will be innovative in employee or team engagement. Team members, clinical professionals, and support staff need to be engaged, and we should prioritize employee well-being, especially in tough economic times. 

Lastly, I aim to ensure that we have a happy and engaged workforce that can support our goals because the business is nothing without its people. 

August 2023
South Africa