Leaders in the healthcare industry

Medshield is one of the most experienced, knowledgeable, reliable medical schemes in the country

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Medshield is one of the most experienced, knowledgeable, reliable medical schemes in the country. Regan van Heerden, Executive: Corporate Services, discusses the Scheme’s legal and IT spheres, explaining the importance of compliance and providing efficient IT support in the digital age.

Briefly, tell us how Medshield has evolved over the years and what it is synonymous with today?

The character of Medshield has essentially changed very little over the past decades. Excellent service delivery and value-for-money health insurance have, for as long as I’ve been with the Scheme, been characteristics of our product offering and way of doing business.

Along with this, the Scheme also strives to stay relevant to the ever-changing needs of the consumers in the health insurance space. To this end, I see Medshield being synonymous with being a quality, good-value offering while also being aligned with the needs of the younger generations.

You are the Executive: Corporate Services. What sections do you oversee? Please tell us more about the IT and legal spheres and what your responsibilities entail? What are some of the strategies you’ve developed to support business in this space?

Predominantly, my responsibility within the organisation relates to overseeing the information and communications technology (ICT) provisioning for the Scheme.

With Medshield being a self-administered Scheme, the ICT function is of a broad scope and includes all required infrastructure and systems related to the Scheme’s administration platform, customer servicing through a contact centre, web services and various other stakeholder touchpoints.

The management of data relating to all aspects of medical aid administration, such as member claims and medical aid contribution data, also forms part of the department’s responsibilities. For the most part, strategically, the focus has been on keeping Medshield relevant to its target market, from an ICT perspective.

This has included staying in touch with digitisation trends and also ensuring that we leverage the benefits inherent in efficient data management and analysis.

Within the legal sphere, I’m responsible for aspects such as contract management, compliance and overseeing any legal matters in which Medshield is involved. The Medshield Project Office also forms part the Corporate Services division and is responsible for project management within the Medshield environment.

The healthcare industry is a highly regulated one. What are the repercussions of not adhering to the Medical Schemes Act and the Scheme rules?

Adherence to the relevant laws and regulatory provisions is quite simply not negotiable. Medical schemes are closely monitored by the Council for Medical Schemes, and non-compliant schemes are dealt with decisively.

How do you ensure compliance at all times?

Within our organisation, we have our legal department, Scheme Secretariat and the Office of the Principal Officer collectively keeping an eye on compliance. This way, we ensure that no law change, regulatory update or circular issued by the CMS is overlooked.

You work with sensitive member data as well as numerous managed healthcare service providers. How efficient is your IT support, both internally and externally, and system integration and why are these aspects so crucial?

Quite right—medical aid administration is an IT-intensive landscape wherein the provision of efficient IT systems and services is imperative. Medshield has a complex interface structure with its numerous third-party service providers, for which efficient maintenance and support is critical. Fortunately, Medshield’s ICT provisioning model has enabled us to partner with industry leading service providers, which put a best-of-breed ICT infrastructure and highly skilled, function-specific resources at our disposal. This, coupled with our experienced and competent internal IT department, provides for a highly functional, fully integrated IT environment.

Technology systems have become far more robust and sophisticated over the past few years. How has Medshield embraced technology and the advancements of Industry 4.0? What are the opportunities and what are the challenges?

First and foremost, the focus is on providing a highly reliable and effective ICT environment. As mentioned earlier, this is achieved by partnering with competent service providers and utilising the best-of-breed technology. Medshield is currently partnered with Emid ICT Solutions, who take care of the provisioning, maintenance and support of the Scheme’s operational ICT environment, and Helios IT Solutions (Pty) Ltd, from whom the Scheme licenses its administration platform.

With regards to Industry 4.0, our focus thus far has been to leverage the benefits to be found in the vast databases we have at our disposal. This is, however, a journey and we have a long way to go to fully realise the value inherent within our data. The utilisation of business intelligence tools and even AI mechanisms is a strategy we’ve put in place, aimed at making better use of the available data.

An opportunity within the healthcare insurance space, which Medshield has not explored to date, is the use of data gathering devices or “wearables” as a means to gather valuable member data.

The cost relating to these devices as well as the membership profile of the Medshield member base has thus far proved to be prohibitive. This is, however, a challenge we continue to keep an eye on, going forward.

Cybercrime is an ever-increasing challenge, thus IT capabilities are paramount. How do you protect against cyber-attacks and ensure the safety of your data?

This is addressed by segmenting the cybersecurity challenge into two broad aspects or areas of focus.

Firstly, our physical environment, with the help of our service partners, is protected against cyber-attacks by means of the best-of-breed technology, the most up-to-date systems and software applications and well-structured security methodologies, updates and policies.

Secondly, the challenge of social engineering or the “human factor” is addressed by consistent efforts to keep people informed and to ensure an awareness of these threats.

As you rightfully point out, this is an ever-increasing challenge and it is an area, which receives constant attention and focus from the IT team.

Please tell us more about your educational and career journey. What set you on your current path and ignited your passion?

I completed my schooling in Port Elizabeth and have a BComm (Law) degree from Nelson Mandela Metropolitan University. My career in healthcare administration started at a large medical aid administrator in Johannesburg as an Internal Auditor. I then took up an opportunity as a Project Manager in that organisation, at which time, I obtained a qualification in Advanced Project Management.

Within the Project Management role, I found myself working on many ICT-related projects. I found this to be an area that interested me and, eventually, it led to me fulfilling a permanent IT management role.

What does good, effective leadership mean to you and how do you demonstrate these traits on a daily basis?

For me, an essential aspect of being an effective leader is mutual respect between a leader and their subordinates. I believe this to be the cornerstone of any working relationship and team dynamic. Along with this, an effective leader needs to have a strong character and an ability to achieve buy-in and belief from his/her team with regards to the greater strategic vision of the division and organisation.

On a daily basis, I strive to put a concept I learnt about in place, referred to as the principle of legitimacy. In short, this means that subordinates within your team need to feel like they have a voice and will be heard, the leadership style and rules need to be consistent and predictable (the same today as tomorrow), and the team dynamic is to be based on fairness and reasonableness.

What are some of the most crucial leadership lessons you have learnt during the course of your career?

In short, it’s the fact that we never stop learning. It’s important to be cognisant of needing to maintain an open mind and embrace the fact that we don’t know it all. I take comfort in knowing that I have evolved as a leader over the past few years and will likely continue to do so in the future. 

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