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A direct line to medical supportSOPHISTICATED software programmes are helping the managed health-care system dramatically reduce unnecessary visits to doctors and specialists - so helping to cut the cost of health care.
Sanlam Health's MedXpert medical advice line is a round-the-clock toll-free facility giving medical guidance and emotional support to members of medical aid funds and employers linked to the organisation. Professional nurses backed up by a medical doctor answer members' telephone queries with the aid of computer programmes developed at the University of Columbia and adapted for local use by a multidisciplinary medical team. The information given enables members to make informed decisions about their health. The service includes the assessment of symptoms, counselling, home care and mother-baby programmes - as well as referral to local professionals, community services and support groups. Psychiatric nurses are also available to counsel emotional problems. Problems not resolved during the call are solved with the aid of a research laboratory. The system aims to give every medical aid member direct telephone access to confidential, expert medical advice at any time of the day or night. Says Pieter Swanepoel, MedXpert senior international manager: "It ensures that members get the appropriate level of care for their circumstances and do not waste money or time in obtaining ineffective or inappropriate medical care. Emergencies are also dealt with efficiently. "We believe that a well-informed member taking co-responsibility for his or her own health is a more cost-effective and responsible user of medical care." Protocols to deal with a range of ailments - from cuts and allergies to more serious complaints such as poisoning and even AIDS-related illnesses - are housed in a sophisticated computer databank which has not previously been available in South Africa, says Swanepoel. Even doctors phone into get advice, he adds. "We not only provide an advice service, we try to prevent patients making unnecessary visits to doctors' rooms wherever possible." Sanlam Health medical director Dr Herc Hoffman says that in a recent incident a person calling in on behalf of a child suffering from sinusitis had been advised by a nurse consulting the MedXpert protocols to have the child checked out for diabetes. This was after more than one visit to a doctor had failed to diagnose the symptoms of the disease. The MedXpert protocols were spot-on. The child was subsequently admitted to an intensive care unit with severe diabetes. Dr Hoffman says that in the first two months since the system was set up in January this year, MedXpert staff dealt with inquiries from some 1 500 callers - 67% of whom would normally have visited a general practitioner. But because MedXpert was able to deal with most of the problems upfront only 24% of callers had, in fact, gone on to visit a doctor - representing an estimated cost saving of R100 000. MedXpert can handle inquiries in several languages including English, Afrikaans, Xhosa, Zulu and Sotho.
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