Tech can Transform Monitoring of Healthcare Schemes

If our healthcare schemes haven't met the burgeoning expectations, the fault is not in their intent but in their delivery and performance assessment. The divide between 'haves' and 'have nots' in accessing quality healthcare has narrowed, but more needs to be done. The world must be fully on track to achieve the United Nations Sustainable Development Goal (SDG) 3.8, which envisages universal healthcare for all. There are still significant pockets within the world where out-of-pocket expenses on health is on an uptrend. A World Bank Report of 2019 says people in developing countries spend $0.5 trillion each year through out-of-pocket expenditures. To turn this situation around, we need to sharpen our focus on improving healthcare monitoring systems besides hiking health budget allocations.

Need for Monitoring Systems

Monitoring systems are crucial in healthcare schemes to track the program's effectiveness, efficiency, and compliance. By implementing monitoring systems, authorities can evaluate healthcare schemes' performance, identify improvement areas, and ensure that resources are utilized optimally. A robust technology infrastructure is essential for a successful healthcare scheme monitoring system. The monitoring system is similar to a GPS system in a car, providing real-time feedback to help the driver make better decisions and ensure that they are on the right track.

CSM Tech

What are the challenges?

One of the critical challenges in healthcare scheme monitoring systems is ensuring accuracy and efficiency in data collection, verification, and analysis. With vast troves of data generated daily from various sources such as hospitals, clinics, and insurance providers, it can be challenging to track and monitor every healthcare scheme effectively. Additionally, ensuring compliance with regulatory standards and safeguarding patient privacy adds another layer of complexity to the process. Moreover, the ever-evolving nature of healthcare policies and procedures requires constant updates to the monitoring system, creating additional challenges for healthcare administrators.

How CSM Tech navigated the challenge in scheme monitoring landscape

CSM, with its cutting-edge Scheme Monitoring System, part of its HealthEase stack, provides essential IT support to streamline state healthcare schemes. Our solution not only organizes and verifies vast amounts of data through advanced data mining but also ensures that the benefits of healthcare schemes are effectively delivered to the intended recipients.

Himachal Pradesh stands out as a trailblazer in India for effectively utilizing technology to implement a universal health protection scheme. The HIMCARE scheme implemented in the state democratized access by including beneficiaries who were excluded from the Centre's Ayushman Bharat scheme. Before onboarding an end-to-end automated system, the officials of the state health & family welfare department faced a bevy of challenges like lack of a centralized database to authenticate beneficiaries, multiple back and forth performed for verifying credentials of beneficiaries and empaneled hospitals, inconvenience stemming from the manual payment system, lack of enough transparency and the absence of a monitoring & evaluation mechanism raised the risk of duplication and frauds.

CSM Tech

CSM Tech struck the right synergy with the state officials by developing an end-to-end monitoring system for HIMCARE. Our solution helped the state to harvest an array of benefits like:

Easy registration, authentication, and renewal of beneficiaries
Creation of a centralized database with a unique ID for each beneficiary
Digitization of medical records
Efficient and timely grievance resolution with an auto-escalation feature
Easy empanelment of hospitals based on infrastructure readiness and healthcare demand in the catchment area
Advanced analytics and reports on the performance of hospitals and insurance providers, fund deployment, and utilization under the scheme

Who doesn't love happy outcomes? When governments aim to improve their healthcare programs, they should incorporate cutting-edge technologies into their policy strategies. Effective monitoring systems can improve patient outcomes by catching issues early, ensuring timely interventions, and ensuring everyone ends up healthier and happier.

AUTHOR:

Jayajit Dash

Senior Manager- Corporate Communications (Marketing)