Latest news with #Medshield
Zawya
a day ago
- Health
- Zawya
The future of medical schemes depends on technology, trust and transformation
In an era where technology advances are transforming every aspect of our lives, accessing information about healthcare should be just as seamless and efficient. The complexities of dealing with a medical scheme can seem daunting, and technology can significantly reduce these complexities and improve access to the right information at the right time – imagine effortlessly managing your healthcare needs online, much like booking travel or managing your finances. Kevin Aron, principal officer at Medshield Medical Scheme We understand that medical aid members want clear, simple, and fast access to their benefits. They want to feel supported when they are unwell and before problems start, and most importantly, they want options that match their digital or face-to-face preferences. Improving efficiency while enhancing the member experience Most members contribute a significant portion of their monthly budget to their medical scheme. It's only fair that those contributions are used efficiently. The less we spend on administration, the more we can direct toward members' healthcare services. That's why Medshield has invested in digital systems that reduce costs and streamline operations. We have automated processes that integrate with communication channels and other digital tools to improve processing and overall efficiency. This allows us more time to focus on what matters most: caring for our members. Medshield members now have more ways to engage with the Scheme beyond traditional phone calls or email correspondence. Our member mobile app and WhatsApp service channel allow members to access important information and services at their convenience 24/7. We launched our enhanced Medshield member app at the end of last year, which resulted in a 20% increase in usage. We are continuously monitoring the uptake to ensure long-term value. Many members continue to supplement app use with calls to our call centre, suggesting that confidence in digital-only services is still developing. Current development priorities include improving app functionality for automated hospital authorisations and chronic medication approvals. For example, members could input procedure reasons directly into the app, reducing the need to phone the contact centre. It has the potential to simplify a currently manual process. In addition, Medshield is exploring further digital service enhancements. Predicting and managing clinical risk Beyond operational and access improvements, Medshield proactively uses technology to manage clinical risk. By applying artificial intelligence and predictive modelling with clinical biomarkers, the Scheme identifies members who may be at risk of hospital admission within the next three to six months. Once these members are identified, the Scheme provides clinical support, including clinical coaching or referral to a general practitioner or specialist. The goal is to prevent unwarranted admissions, reduce the need for emergency care, and improve health outcomes for our members and their families. Technology is also being used to identify members likely to be readmitted post-discharge, for example, due to wound infections. Early engagement helps to identify clinical risk, prevent complications and avoid unnecessary re-hospitalisation. In addition, Medshield is piloting facial scan technology that can analyse up to 20 clinical health parameters from a person's facial image. Medshield is utilising this as a mass digital health screening tool to direct members to appropriate care to reduce high-cost episodes and to support earlier intervention. Behaviour change and lifestyle health Lifestyle-related diseases remain one of the most significant cost drivers for medical schemes. Conditions such as type 2 diabetes, high blood pressure, and obesity are closely linked to behaviours such as inactivity, poor diet, and unmanaged stress. Medshield is working to address this through behaviour change programmes like Medshield Mind and Medshield Movement. These initiatives support members with educational materials, coaching, and practical advice for managing their health, including child and family-focused interventions. One proof of concept currently underway has shown that members living with type 2 diabetes can reduce or stop medication with consistent lifestyle improvements while under medical supervision. This programme aims to empower members to improve their quality of life. Interventions are tailored based on a member's clinical risk profile, ranging from low-touch digital education to personalised nurse coaching. Due to current regulations under the Medical Schemes Act, the Scheme cannot offer financial incentives for improved health outcomes. However, behaviour change remains a key focus area in chronic disease management. Remaining accessible beyond digital tools Although the demand for access to digital channels continues to increase, many members still prefer to meet in person. Medshield has made enhancements to our regional offices and walk-in centres and recently relocated our Cape Town and Durban branches after conducting a survey and engaging with members to understand their needs. Looking ahead, the Scheme is reviewing its benefit design for the 2026 cycle with a strong focus on prevention. With one of the highest solvency ratios in the industry, Medshield is well-positioned to consider enhancements to its preventative benefits while aiming to limit contribution increases. Additional efforts are focused on predicting avoidable healthcare episodes and ensuring members are guided toward appropriate care earlier in their treatment journey. In today's healthcare environment, members want more than just cover. They want easy access to support, whether online or in person, which helps them stay healthier for longer. Medshield adapts to these changing needs by using innovative technology, enhancing day-to-day processes, and proactively addressing health issues before they escalate. It's about making healthcare work better for real people in real life.
The Citizen
4 days ago
- Health
- The Citizen
Why a flu jab is still the smartest thing you can do this winter
According to Dr Redelinghuys, it's almost guaranteed that not getting the jab will encourage infection. Getting your jab this winter is a smart move. Picture: Hein Kaisee Snotty noses, aching heads and school or work absenteeism. It's the gift that keeps on giving, but that nobody wants. This year, the season of viral giving started earlier than usual, and flu is spreading with a momentum and efficiency that politicians would envy. Medical doctor Jonathan Redelinghuys said that flu season is not something to be brushed off with a cup of tea and two Panados. 'Respiratory viruses are all over during winter, with RSV or Respiratory Syncytial Virus, rhinovirus, Covid-19 and influenza being among the most common,' he said. 'Although rhinovirus is generally associated with less severe symptoms and is what we call the common cold, influenza is a different beast entirely.' Scarily, the H1N1 variant, more commonly known as swine flu, is the one to watch this season. 'This illness is likely to be more severe than the common cold and may be life-threatening in vulnerable populations, with hundreds of deaths each year attributed to it,' he said. Swine flu is as dangerous to health and wellbeing as blue light brigades or lane splitting motorcyclists are to motorists' blood pressure and safety. It's unpredictable, fast, and often hazardous. Flu can have bad side effects Situational awareness about your own health is always critical. Even what we'd call the common garden variety of flu can become extraordinarily infectious, physically damaging, and the side effects could include overexertion of key organs, such as the heart and the respiratory system. We all know Covid-19, the chanting protester that just never goes away. Luckily, the flu is not quite like Trump's tariff threats, which have stumped the global economy. Unlike cell phone networks dropping calls or traffic jams, you can do something about it. 'Fortunately, circulating influenza variants are vaccine-preventable,' said Redelinghuys. 'Although many myths surround the vaccine, and many people conflate catching the common cold around the time of receiving the vaccine as being a result of the vaccine, the overwhelming evidence supports the safety and efficacy of the vaccine.' Also Read: Quarter Life – your first existential crisis Medical funder Medshield noted in a consumer health advisory that getting vaccinated now is more important than ever. 'Getting the flu shot is one of the simplest, most effective ways to stay healthy and keep those around you safe,' it read. 'It's not just about avoiding a few days of discomfort. It's about preserving your time, energy, and potentially your life.' Don't dodge the jab And yet, each year, just like many people who were implicated in the Zondo Commission continue to evade the law, there's a large contingent of people who dodge the jab entirely. Some forget, others leave it to fate. According to Dr Redelinghuys, it's almost guaranteed that not getting the jab will encourage infection. For those who catch it and act fast, there's Tamiflu, said Dr Redelinghuys. It's officially known as Oseltamivir. It's a big word, but it's not a magic bullet, and the meds do not wear a Superman cape. 'This medication is most effective if initiated within 48 hours of symptoms and is generally not useful after the first few days,' Dr Redelinghuys said. 'Unfortunately, this medication may be quite expensive, and stock often becomes low as the winter months progress.' And it's not always a smooth ride. 'There is also a greater risk of developing significant side effects to this medication than the vaccine, and there are strains of influenza that are resistant to Oseltamivir,' he said. In other words, prevention is better than a cure attempt. 'Generally, the vaccine becomes available from late March, and it is best to take it as early as possible in order for the immune system to mount a robust response prior to the start of flu season,' Redelinghuys said. Don't expect miracles, though. 'It is important to note that an influenza vaccine will not protect you against the other viruses, and you should not expect to be 'cold-free' after getting the vaccine,' he said. It's a targeted defence, not a total forcefield. Vulnerable people must consider it Medshield's advisory highlighted the importance of vaccination for vulnerable individuals, including pregnant women, children under five, the elderly, those with underlying medical conditions, and people residing in densely populated or underserved communities. 'Even if you're young and healthy, flu viruses spread easily, and many people are contagious before showing symptoms,' it read. Flu vaccines are available at most clinics, pharmacies, GP practices and even workplace wellness drives. Now Read: Love hurts: Seven common sex injuries
