Discovery Health system integration is a ‘watershed moment in oncology’

At the end of 2014 ICON reached an agreement with Discovery Health’s Key Care options on business-to-business integration that will reduce the administrative burden and ensure faster authorisations and better quality care for cancer patients.

The new year kicked off on a high note for ICON when a partnership with Discovery Health, South Africa’s biggest medical aid scheme, was formalised, resulting in the implementation of a shared software integration system. E-Auth now links directly into the Discovery system, which automates the authorisation process. The new integration went live for patients on the Key Care Options at the end of January 2015.

ICON Operations Executive, Dr Ernst Marais, described the business-to-business system integration with Discovery as a watershed moment in oncology. “This is a significant achievement for ICON,” he said. “Once it is up and running and the kinks ironed out, e-Auth integration will vastly reduce the administrative work in practices, cut down on the administrative burden for medical schemes and save costs on non-healthcare expenditure. This will ultimately lead to better quality care and that is our main aim at ICON.”

Traditionally, oncologists had to submit comprehensive treatment plans to medical aid schemes and then wait for approval. “This authorisation process was a big frustration in practices because, in some instances, it would take two to three weeks to get authorisation and this could have a very negative impact on the level of care patients were getting, causing much anxiety,” said Dr Marais.

He said ICON had been in discussion with Discovery Health for years to find ways in which the network and the medical aid administrator could work together. Then in 2014, Discovery Health and ICON finally agreed on integration for patients on the Key Care Options plan.

E-Auth has predetermined rules and clinical protocols, which have all been developed by the network oncologists, and after information is entered by clinicians according to the established and agreed protocols, authorisation is immediately granted.

Dr Marais had high words of praise for ICON’s development team. “They did a sterling job. They worked closely with the team at Discovery Health and deserve a special mention. Developers, Piet Theron and Michiel van Aarde really moved mountains to make this happen.”

He said plans are currently under way to integrate similar systems with other medical aid providers. The next step would then be to integrate e-Auth on the billing side, to ensure more accurate billing and less inefficiency in the system.

“ICON is constantly evolving and growing in its role,” says Dr Marais. “Over the past eight years we have continuously made advances in our main objective, which is to provide quality cancer care across South Africa. Reducing the administrative burden for healthcare funders and providers was always one of our main objectives and now we have a software system that achieves that.”