IQ Health, part of the IQ Business Group, says the current e-transaction process within the healthcare industry is in dire need of help and believes its HEALTHe product range is the ideal solution.
The company says the healthcare process is plagued with inefficiency and the end-result is a frustrating experience for both practitioners and patients.
We are really trying to build a technology infrastructure in this industry to make sure that all the role-players benefit properly.
Andre Sharpe, Executive Director, IQ Health
IQ Health proposes that by making the right technology available, the gap between the front- and back-end of the market will close, which in turn would improve communication. The company claims this will consolidate and fast track the process of amalgamating the fragmented healthcare administration processes into a set of "single event" transactions.
The aim is to target the front-end of the market and gain an understanding of what is required, and then provide the back-end with the necessary technological infrastructure to secure a smooth transaction process and establish an industry standard. The company says it is well positioned to implement this plan, having partnered with established industry players in addition to owning and developing technology that services both the provider and medical aid administration ends of the market.
Acquiring support
IQ Health is a combination of three organisations. Its origin lies in the merger between Fedsure Health Technologies and Compuline Systems. According to Andre Sharpe, IQ Health executive director, Fedsure Health acquired a portion of Compuline Systems and started Fedsure Health Technologies.
In June 1998, the IQ Business Group was formed which later acquired both Fedsure Health Technologies and Compuline Systems to form IQ Health.
IQ Health then acquired a 50% stake in the front-end businesses and medical practice management software of Integrated Technology Holdings.
At that stage, one of the biggest barriers to entry into the market was the complexity of the healthcare environment. Sharpe describes the industry as "far more complex than banking, far more complex than logistics. It`s not just common sense, there are a lot of legalities, quirks and legacy that one has to understand and keep track of."
Key strategy
IQ Health`s key strategy is to manage and improve all aspects of healthcare transactions across the industry. It also aims to help establish the industry standards required to effectively manage IT in healthcare.
"Rather than trying to deal with the originator and receiver of the transaction at arm`s length, we believe that with our understanding of the industry and technology in our possession, we could fast track the process of developing the required standards and improve communication at a technical level," says Sharpe.
An example of the current convoluted healthcare process is when a medical aid member visits a doctor. The transaction process as a whole - from the visit to the point where the doctor gets reimbursed by the medical aid or insurance company - takes about 20 to 60 days.
Sharpe says the company`s technology allows one to complete 100% of the transaction in about six seconds, during which time the claim will be transmitted from the point of service to the medical aid company, making use of switching technology.
The administration and back-end systems have to be technologically enabled to handle this particular part of the process. The online progress of the medical industry has been slow, Sharpe says, partly because of this lack of proper infrastructure and appropriate technology.
Sharpe explains that within a single healthcare claim there are about 112 checks that have to be completed. Details such as membership status, scheme rules, drug prices, procedural tariffs and fraudulent submissions all have to be verified.
"You need quite complex technology to automatically apply all these rules to a claim transaction in a real-time online environment. So essentially, it doesn`t help you to get a transaction in fast if you don`t, in your own administration system, have the ability to process it online," says Sharpe.
"We are really trying to build a technology infrastructure in this industry to make sure that all the role-players benefit properly."
End-to-end targeting
The company sees the first phase of its business plan as achieving a strong presence in the front-end and medical aid administration market, which will enable it to leverage the potential efficiencies that exist between providers and medical aid schemes.
Sharpe says it is particularly in the medical aid administration market where IQ Health offers best-of-breed technology products. The technology assists with end-to-end administration activities such as contribution and claims management, financial reporting, information analysis and e-commerce. He describes it as "an ERP [enterprise resource planning] product for healthcare administration".
New MD Collin Bridge is ensuring the company focuses on external aspects such as the application and growth of e-commerce and its technology base. The launch of the company`s HEALTHe product range forms part of this focus.
The company has offices in Cape Town, Port Elizabeth and Johannesburg, and satellite offices in Zimbabwe and Sydney. Its clientele stretches into many parts of Africa including Swaziland, Zimbabwe and Botswana.
The HEALTHe product range includes HEALTHe ID, HEALTHe Cash, HEALTHe Zone and HEALTHe Credit. This range is currently being piloted and is scheduled to go live in June. HEALTHe Collect, which allows employers to integrate their payroll systems with medical aid administration systems, is scheduled to roll-out in July.
According to Sharpe, the company`s foreseeable future looks bright - he says it is on target for a projected profit figure, after tax, of R14 million for 2000 following a profit of R8.5 million for 1999.
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