Just a year ago, the thought of paperless scripts, integrated platforms for specialist referrals and video consultations seemed more futuristic than realistic. The medical aid industry is expected to spearhead innovative solutions to help contain the COVID-19 pandemic and ensure that members have safe access to service providers.
The iCanRefer digital platform and iCanScript web application are examples of how Bestmed Medical Scheme is getting it right.
Bestmed is the first medical scheme to partner with digital healthcare innovator Intermedix to bring general practitioners (GPs), specialists and healthcare providers an exciting selection of functionalities to maximise service efficiency and enhance patients’ medical outcomes. This unique partnership makes a specialist designated service provider (DSP) network available to GPs for easy referrals via iCanRefer. It also provides both GPs and specialists with the iCanScript digital health solution. A pilot phase proved to be successful and iCanRefer is currently being rolled out to more than 1 000 doctors countrywide.
Bestmed has also partnered with Intermedix’s parent company, CGM, to make secure virtual consultations available to network doctors via CLICKDOC Video Consultation.
iCanRefer is a digital platform for easy referrals. Bestmed’s network GPs no longer need to page through printed directories or move between digital programs to locate and contact Scheme-approved specialists.
Patients also benefit as this new digital health application provides GPs with a tool to find cost effective and Scheme-approved specialists near a patient’s home. iCanRefer is presented to GPs, as the gatekeepers to healthcare, to use to improve their patients’ care and health outcomes.
The iCanRefer solution works as follows:
- The Scheme manages the contracting and network management of all specialists.
- The Scheme provides the digital Scheme network specialist lists per discipline, which are updated to a central database at CGM.
- A GP can now, within their practice management system, open a new iCanRefer web application and search for specialists per discipline and area.
- Both in-network and non-contracted specialists are displayed. A GP can consult with a patient and make an informed decision on the right specialist for the patient based on network status, location and association with a specific hospital that is close to the patient’s home.
- A reason for the selection is required and recorded if a non-contracted specialist is selected. This allows for improved reporting and feedback to the Scheme to track doctor compliance and adherence to Scheme rules, as well as the reason for which a non-contracted specialist was chosen in certain cases.
- All specialist referral history is maintained in a patient’s record for quick review by a GP during future consultations for future referral.
- The referral document is printed with all the digital information regarding the specialist referral.
The benefits of using the iCanRefer solution for GPs:
- A GP can view all the specialists on a digital platform, get to know the specialists per discipline in their area and build relationships for future patient referrals.
- As all specialists who are registered in South Africa are displayed in the iCanRefer application, the same application can be used for any Scheme patient to find the right specialist for the patient.
- A GP can find all specialists via a digital search and geo-map, and view whether the specialist is within the Scheme network or not. GPs no longer have to refer to outdated paper copies and spreadsheets of specialists for every medical scheme.
- Specialist networks are maintained per discipline and medical scheme plan/option to ensure that a doctor can easily find a network specialist and that the patient is referred to cost-effective specialists who are linked to a specific hospital group.
- If a non-network specialist is used, the reason for the selection will allow the Scheme to contact the GP and/or the specialist to review and negotiate with the healthcare professionals.
- The iCanRefer application allows for improved reporting and feedback to the Scheme to track doctor compliance and adherence to Scheme rules, as well as the reasons for a non-contracted specialist being chosen in certain cases.
- Using an iCanRefer digital Angular web application, the solution can be scaled and integrated with other practice management solutions to ensure that more doctors are able to utilise the digital health solutions to connect with specialists.
The benefits of using the iCanRefer solution for patients:
- It is less likely that patients will have out-of-pocket expenses due to negotiated Scheme rates of the network specialists.
- A patient will receive a printed specialist referral form after the digital referral process. The form is pre-populated with all the relevant information from the patient’s GP to make the specialist appointment process simpler and easier for the patient. In future, the referral request will be able to be sent to the network specialists digitally to create an online booking, as well as to the medical scheme administrator to create an authorisation for the specialist referral, and set up a clinical treatment plan for the management of a chronic patient e.g. a diabetic patient.
- The patient can now be involved in the decision with their GP to find the right specialist as there are now options displayed for the GP/patient. Patient participation at point of care will ensure greater compliance and adherence to the clinical treatment plan with improved health outcomes for the patient.
iCanScript is an e-scripting web application, allowing GPs and specialists to generate a digital prescription that tracks and records all patients’ medicine history. It also allows a doctor to find cost effective generic medicine which appears on the Scheme’s medicine formularies.
The doctor can then issue a digital prescription and send the digital script with an Advanced Electronic Signature directly to the retailer or courier pharmacy to ensure improved patient medicine compliance, as the pharmacist is co-responsible for the patient to ensure that the patient receives their required medication.
A digital footprint is, therefore, created to ensure greater compliance and adherence from health professional and patients. It also ensures, through data analytics, that the overall health outcomes of a patient are improved. It tracks medicine prescriptions, what was prescribed and the frequency of prescriptions. It, therefore, also provides a patient’s history to the healthcare provider, which may improve outcomes.
The scheme’s formulary is also loaded onto the application. Healthcare providers, therefore, have access to it, making it easier to prescribe medicine within the formulary with little or no co-payments for the patient.
CLICKDOC Video Consultation
To ensure that precautionary measures are taken during the COVID-19 pandemic and that Bestmed’s beneficiaries still receive the medical care they need, CLICKDOC Video Consultation is now available to Bestmed’s network doctors for secure virtual consultations. The platform is user-friendly, and ensures convenient and efficient consultations.
Bestmed Medical Scheme remains committed to ensuring that healthcare practitioners are equipped with the latest in technology to provide efficient, cost-effective and Personally Yours services to our beneficiaries.