Battered and bruised, the management of global healthcare systems is reeling

The Covid-19 pandemic exposed the fragility of the South African healthcare system at a time when global health crises exert a greater level of influence on the pressures felt by these systems.

This was further highlighted by the healthcare demands associated with the contamination of the Durban beaches after the 2022 KwaZulu-Natal floods and, more recently, the cholera outbreak, which started in Hammanskraal and has now spread to other parts of Tshwane.

While the national narrative has been dominated by the fragility of the national health system, global healthcare systems were also significantly affected by Covid-19 and will continue to be affected by health crises for years to come.

We need to rethink and reimagine the value proposition when it comes to healthcare. There is a particular narrative which has been developing in the global healthcare space since before the Covid-19 pandemic. Technology can play a significant role in the future management of these fragile systems.

Healthcare disparity

The most significant factor in managing global healthcare systems is the current status quo of reactive treatment.

Global healthcare systems work off the basis of managing sick care. This means when a person is sick, they will be treated.

The challenge when it comes to this is that the global demand for healthcare far exceeds the capacity of these systems. And when you get a mass hospitalisation event — such as Covid-19 — care needs to be managed on a case-by-case basis. Now what happens to patients who have chronic conditions such as diabetes, high blood pressure, or in South Africa's case, tuberculosis?

While the immediacy of their care may not be as urgent as others who were severely affected by Covid-19 (and needed hospitalisation), managing a chronic condition requires significant resources that are already stretched.

There is a glaring disparity in global healthcare, which puts significant pressure on the management of these systems.

Moving forward, developing countries have a significant advantage over healthcare systems in developed countries with significant existing infrastructure. Developing countries can use technology to identify key trends and roll out the provision of telemedicine and the digitalisation of medical services to take the pressure off hospitals.

Increasing influence

The rise of telemedicine and the digitalisation of medical services has profoundly affected society. The shift from treating diseases to managing overall health is something that global healthcare systems need to aspire to.

While Covid-19 had a significant impact, it is not the only disease that can cause the collapse of healthcare systems. However, Covid-19 will be studied for many years and used to create technologies that help build predictive models that can play a massive role in risk management.

The ultimate goal is to build early warning systems to help manage healthcare.

Precision prescribing is the practice whereby healthcare professionals can accurately prescribe medication to manage chronic conditions and cure diseases. We are already seeing examples of this in the fact that continuous glucose monitors are now more commonly used to treat diabetes than the traditional finger prick method, where glucose levels are monitored twice a day.

There are also reported cases of doctors using 3D printers to print tattoos that extract data from a patient and continuously feeds it to healthcare professionals. Access to data such as this is invaluable.

A different approach

While the increased influence of technology may have its challenges and limitations, it cannot be ignored.

Though some healthcare professionals are reluctant about the increased influence of technology, it is not going away. We need to see how we can promote the use of technology to reimagine healthcare and how we can use technology to improve our service offering.

Modern healthcare professionals are well rounded in the traditional skills of a healthcare provider, but they are also becoming increasingly competent in areas such as risk management and data analytics, which will ultimately influence the care they provide.

In addition, digital natives (students born into a world of technology) are more receptive to the influence of technology than digital immigrants (people born into a world without extensive access to technology). However, the advancement of technology is never static and eventually, even digital natives are required to unlearn old skills and relearn new ones to be fit for purpose.

Additional challenges

While technology has the potential to have an overwhelmingly positive impact on the management of healthcare systems, South Africa has its own challenges to address.

Digitalised healthcare depends on connectivity. So a country like India, where smartphone penetration is predicted to hit 75% of the Indian population by 2025, will have a smoother transition to digitised healthcare than South Africa, where only close to half of our population has access to a smartphone and data.

The threat of load-shedding is also significant. Many hospitals are now spending considerable capital on measures to mitigate load-shedding. If not managed properly, this may have a lasting impact on the South African healthcare system.

While there are challenges that will slow down the influence of technology, its influence will never disappear completely. Technology will be the only way that we will move on from the treatment of diseases to the management of healthcare.

Healthcare professionals who not only have the best knowledge when it comes to healthcare provision but will have the digital skills to be able to disrupt their existing skills with new ones that will help them incorporate technology into the care they provide will be the future of healthcare management.

— Soni is director of MANCOSA’s School of Healthcare