The convergence of systemic threads shaping a future South African healthcare dispensation : a technology management perspective

Abstract

ORIENTATION: Underpinning healthcare service delivery are a number of support systems. This paper focuses on the development of a healthcare services framework that reflects the systems that need to be integrated, from a technology healthcare support perspective. RESEARCH PURPOSE: The purpose of this paper is gain an understanding of some of the intricacies associated with the management of the transition to a future South African healthcare dispensation, with reference to the convergence of technology, financial healthcare and sociopolitical systems. MOTIVATION FOR THE STUDY: South Africa is in the process of implementing the National Health Insurance initiative and the approach adopted will have a significant impact on the business model design. RESEARCH DESIGN, APPROACH AND METHOD: A multidisciplinary literature study was undertaken. In addition, a limited narrative enquiry was also conducted. Practitioners interviewed were from the healthcare, informatics and management and technology sectors respectively. The research study constituted an insight study – analytically descriptive and not statistical in nature. MAIN FINDINGS: The literature reflects two very contrasting and different business models of healthcare service provision, namely a primarily curative and preventative stance. Each assumes a very different convergence of technology, healthcare, financial and social systems and consequently gives rise to contrasting business models. The dominant model appears to be based on primary healthcare, with a different technology support infrastructure to the previously-adopted curative approach. It is a model that would also appear to necessitate a complex adaptive management approach, necessitating a bottom-up as opposed to a top-down hierarchal management orientation. CONTRIBUTION/VALUE-ADD: The National Healthcare Insurance initiative entails a very fundamental restructuring of the healthcare infrastructure. The insights gained from this research study could serve as a source of information and reference for South African institutions that will need to implement such systems in the future.