Gaining Ground

In the realm of sports medicine, the pursuit of optimal performance and rapid recovery is paramount. Much the same can be said of the desire for recovery after surgery, and where there’s a need there’s a way. Such is the case for hybrid healthcare models that combine the best of both worlds – a human face-to-face professional interface with that of modern technology – to help patients recover optimally, and in many cases, by up to 60% fasterwith a 50% reduction in pain.^[1]

Such is the demand and exponential growth of digital solutions in healthcare, both in South Africa and abroad, with the HealthTech sector now one of the fastest growing industry categories today. This is not only driven by our digital evolution as a species but by an increase in demand for better ways to live and be healthy, and adoption of the ‘prevention is better than cure’ proven ethos.

The rapid adoption of technology-based or enhanced solutions has, in the main, been met with open arms, however, there are still those practitioners who are hesitant to change and who look on technological applications as a threat.

Rather than a threat, I subscribe to the mindset that they are an opportunity, such as in the case of introducing a hybrid healthcare model like the one we introduced into South Africa towards the end of last year, that is now successful in providing the expertise of a multi-disciplinary clinical MSK (musculoskeletal) team at the tip of a patient’s finger.

For clarity, a hybrid model is a blend of in-person and virtual care, where virtual care can even be seen as the first contact point for the patient, and where required, is referred to in-person care, as well as being the perfect complement to practitioner-led programmes. Virtual care is also the glue holding it all together, between in-person sessions, to ensure continuity of care, compliance, and maintenance of momentum through the recovery period.

Virtual physical recovery programmes, present a transformative solution to overburdened public and private healthcare systems battling with an expanding population and diminishing resources. In South Africa, 80% of the population is currently reliant on a very stressed public healthcare systems with the balance having access to private sector care. And with the National Health Insurance (NHI) on the horizon, the country is going to need to look at healthcare delivery and quality through new lenses if it is to ever be efficient and practical.

Overburdened healthcare systems are true of most developed and developing countries around the world. But hybrid models in South Africa have the potential to alleviate this with the result being the necessary comprehensive care that patients deserve and that practitioners want to and can deliver.

South Africa also has the added challenge of access to healthcare. This is not only physical access, but financial. With a population of more than 61 million,^[2] many of whom are based in remote and rural areas and who have limited access to any form of healthcare, this challenge is real. In my opinion, the adoption of virtual care models and systems offers a promising avenue to enhance access, elevate the standard and quality of care as well as the expertise on offer and at the same time, provide an affordable means for healthcare and self-empowerment.

Patients themselves, are also requiring a more modern approach to their healthcare needs, that gives them the advantages of in-person consultation and intervention where needed, with the convenience of choosing where and when to do home exercises for example. Hybrid systems encourage patients to re-calibrate how they receive healthcare, especially physiotherapy and biokinetic services, where hands-off is often of greater benefit to the patient, promoting self-empowerment, less dependency, and more ownership of their healthcare conditions, as statistics show that in the traditional approach, only 20% - 30% of patients complete their home exercise programme, negatively impacting their recovery.

For practitioners, the adoption of hybrid healthcare is entering an exciting time and space. We can work collaboratively in a hybrid model, where the ‘app’ or ‘platform’ becomes an extension of our in-person practice, with the added benefit of objective outcomes measures of the patient’s activities in a home environment through recorded detailed tracking and measurement, repeated pain scales and many other assessments as required.

The imperative for a hybrid model in South Africa is multifaceted.

In short, hybrid care facilitates the integration of specialised expertise into the primary care settings with personalised and real-time adjusted treatment plans, while empowering greater autonomy in patients managing their own health and recovery. By embracing a modern approach that combines virtual consultations with in-person interventions, individuals can reclaim agency over their well-being while minimising dependency on expensive traditional healthcare systems. This convergence of resources will not only optimise patient outcomes but will also enhance the professional development of practitioners while reducing the burden on the existing and strained healthcare system.

With hybrid models addressing the availability of professional healthcare in the physical recovery and rehabilitation sectors in South Africa, and across the African continent, where there are too few practitioners to the number of patients, we can strive to reach more patients and manage them optimally.^[3] The ratio in South Africa, is currently around 0.15 Physiotherapists per 100,000 population overall,^[4] while in the private sector this climbs to 0.6 Physiotherapists per 100,000 population (similar to that of the USA). It is clear that there is a crisis of accessibility to care in the public sector, servicing a population of more than 50 million at a ratio of as low as 0.04 (close to that of Turkey)!

Navigating the operating model in South Africa requires a nuanced understanding of local dynamics. While parallels exist with global trends, contextual factors such as socioeconomic disparities and cultural norms, healthcare regulation and the context of the NHI, necessitate tailored strategies. By aligning with the priorities of funders and empowering patients to play an active role in their healthcare journey, practitioners can navigate the evolving landscape with confidence and efficacy.

In the short to medium term, the trajectory of hybrid health in South Africa and the broader African context is poised for significant growth. As awareness spreads and infrastructure improves, we can anticipate the proliferation of innovative care delivery models tailored to the unique needs of diverse populations. While challenges remain, the momentum toward integration and collaboration signals a promising future for healthcare on the continent.

There will also naturally be a resistance to change in some quarters in adopting more AI-driven interventions, but good change is also hard, and something we recognise at Genie Health. Those who adopt AI and leverage technology as an enabler will certainly out-compete those who don’t, as ultimately, the old school way of doing things will be enhanced and eventually replaced as the world moves ever deeper into the 4^th industrial revolution and the digital realm.

It will not mean, however, that we will lose our humanity. That’s up to us.