Johannesburg, 14 Apr 1999
Medihelp, one of South Africa's largest medical schemes serving approximately 170 000 members, has over the past few years upgraded its computer systems with the installation of a network infrastructure designed by JSE-listed systems integration specialist, Datacentrix.
The upgrade enables Medihelp to integrate its legacy mainframe computer with a modern PC network and intranet facility linked to the Internet, giving both its members and suppliers - including medical practitioners, hospitals and pharmacists - instant access to information concerning Medihelp membership or claims, from receipt to assessment of payment.
Medihelp is one of the first major South African sites to utilise internet/intranet technology for access to sensitive medical data.
Datacentrix is one of South Africa's largest value-added integrators providing turnkey information technology solutions to corporate users. The company, which is highly accredited by HP, Compaq, IBM, Microsoft and Novell, supplies, supports and maintains hardware systems and networking infrastructures while providing software licensing, integration and support services.
"We needed an uniform technology that all suppliers could have access to - and one that would support our aim to keep the costs of health care down," said Anton Rijnen, acting General Manager of Medihelp.
The Datacentrix devised solution was installed to allow users to access mainframe held legacy data via the Internet. For security purposes data is downloaded from the mainframe to a PC network where, on an internal intranet, it can be accessed via Internet links.
In order to receive the maximum amount of electronic claims Medihelp is in the process of establishing a so-called HUB/VAN facility that will allow EDI enabled service providers or hubs/switches to submit claims directly to Medihelp. An extensive audit trail and query system will be available on the Internet in this regard.
Rijnen says the benefits of electronic claims processing are significant: "Compared to manual methods, considerable time is saved in the processing of claims allowing service providers to be compensated faster and more accurately."
"The upgrade is a key element in our mission to step up service levels and to 'manage down' the cost of health care and medicine," adds Rijnen, who reveals that e-mail and in-house design facilities have been added to the system to strengthen the links between Medihelp and its members and suppliers using visually attractive electronic communications media.
The Medihelp network comprises Novell local area networks at branches in Cape Town, Port Elizabeth, Bloemfontein, Pietermaritzburg and Nelspruit linked to the Pretoria head office in a wide area network. The total LAN/WAN solution is based on HP network infrastructure products managed by HP Openview. Links to the World Wide Web are facilitated by a Microsoft Internet server running MS SQL software. A Microsoft SNA server is used for communication between the SQL database and the mainframe. All server hardware are based on Hewlett Packard Netserver technology.
Security is a key area of consideration and Microsoft Proxy firewall technology is used to protect sensitive and private data as well as authenticate member accesses.
Reliability has also fallen under the spotlight. Currently the network infrastructure has maintained a high 99% uptime.
In addition Medihelp established a Call Centre to handle and route incoming telephone calls. A comprehensive document imaging system, linked to the Call Centre, was also included, facilitating the graphic capture of archive documents on CD ROM. Already more than 1000 CD's are in operation in Medihelp's electronic library. The document imaging system was a joint venture between Datacentrix and Top Info.
"Datacentrix is committed to working out the best solutions to assist Medihelp to meet its business challenges using current Novell and Microsoft technologies," says Datacentrix director, Klaas Lammers.
"After a thorough investigation into Medihelp's methods, we have a good appreciation of the organisation's requirements and are able to deliver 'best-of-breed' solutions that integrate into current and legacy computer systems - thus maintaining equity in these systems," adds Lammers.
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