Slide 1: Netcare's strategic journey
Netcare’s strategic journey Dr Richard Friedland 27 September 2024
Slide 2: Netcare Limited CareOn
“ NETCARE LIMITED CAREON
Slide 3: Contents
Contents 1 Netcare today 2 The methodology informing our strategy 3 The “why” behind “what” it is we do and “how” we do it? 4 Our journey so far in Netcare and where are we today 5 What does success look like, and how do we measure it? 5 Putting it all together
Slide 4: Netcare today
Netcare today
Slide 5: Netcare today
Netcare today 86 Netcare 911 sites 49 acute hospitals 200+ response vehicles 9 903 beds Netcare Netcare Hospitals 911 7 helicopters 12 day clinics 4 fixed wing aircraft 480 000 inbound calls p.a 14 mental health hospitals Netcare 1 007 beds Akeso Netcare 65 primary healthcare Medicross facilities 9
Slide 6: Centres of Excellence
Centres of Excellence Netcare attracts a higher acuity of hospital admissions due to: 36 Emergency The only hospital 1 379 ICU beds and The only dedicated Largest ECMO Centre 4 regional Transplant Departments - 82.8% group with 4 594 HC beds private burns unit in in SA at Netcare Centres across the
Slide 7: Africa's largest healthcare environmental sustainability programme
Africa’s largest healthcare environmental sustainability programme Phase One (2013-2023) Phase Two (2021-2030) Substantially outperformed targets ahead of schedule Ambitious targets set for Phase Two First phase of our environmental sustainability strategy successfully completed with significant sav
Slide 8: The methodology informing our strategy
The methodology informing our strategy
Slide 9: What does Alice in Wonderland, a blue ocean, Warren Buffett and a moat have in common?
What does Alice in Wonderland, a blue ocean, Warren Buffet, ectrodactyly, a moat and finally an architect all have in common?
Slide 10: The curious tale of Alice and the Cheshire cat
The curious tale of Alice and the Cheshire cat
Slide 11: Swimming in a red ocean
Swimming in a red ocean
Slide 12: Swimming in a blue ocean
Swimming in a blue ocean
Slide 13: What type of businesses does Warren Buffett invest in?
What type of businesses does Warren Buffett invest in?
Slide 14: What type of businesses does Warren Buffett invest in?
What type of businesses does Warren Buffett invest in?
Slide 15: Widen the moat (Warren Buffett quote)
Managers of the businesses we run, I’ve got one message to them, which is to widen the moat. And we want them to throw crocodiles and sharks and everything else, alligators, I guess, into the moat to keep away competitors. Warren Buffet
Slide 16: What really differentiates us?
So when you think of our organisation, what really differentiates us or are we an “also ran” or do we really have a sustainable competitive advantage?
Slide 17: What does success look like, and how do we measure it?
What does success look like, and how do we measure it?
Slide 18: Netcare strategy building the moat
Netcare strategy building the “moat” A ten-year journey transforming the way we deliver health and care Netcare’s strategy responds … and leverages off our unique … to create sustainable decisively to the three global ecosystem of assets and services … competitive advantage healthcare megatrends … f
Slide 19: The WHY behind WHAT we do and HOW
The “WHY” behind “WHAT” it is we do and “HOW” we do?
Slide 20: Healthcare provision is fundamentally flawed
Globally, the provision of healthcare in terms of the relationship between providers, funders and patients as we know it, is fundamentally flawed CAREON NETCARE LIMITED
Slide 21: Costs of healthcare have spiraled
Costs of healthcare have spiraled, but has this been justified by the improvement in outcomes? We are estimated to all be living at least a decade longer, but we have been less successful in addressing non-communicable diseases, diseases of lifestyle and chronic illnesses
Slide 22: Fast death vs. Slow death
“Fast death” vs. “Slow death”
Slide 23: Lifespan vs. Healthspan
“Lifespan” vs. “Healthspan” Source: https://peterattiamd.com/move-defines-live/
Slide 24: The current model of care
The current model: Why did you have your tonsils removed? “The doctor told me so” • The current model is fragmented, characterised by siloed and episodic care • We generally still know little about the patient before and even after they leave us • Patients have abrogated their rights and responsibil
Slide 25: The emergence of Participatory Health and Care
The emergence of ‘Participatory Health and Care’ • Over the last 10 -15 years, emergence of a fundamental shift in the provider patient relationship towards a more participatory approach and attempts at improving compliance and co-responsibility • Participatory care is aimed at making patients equal
Slide 26: Patients to People to Person centred care
“Patients” to “People” to “Person” centred care Changing our perspective to understanding all patients are people first sounds obvious, but it wasn’t always so Over the last 10 years we have witnessed large public sector organisations recognising that whilst overall population health remains importa
Slide 27: Our journey so far in Netcare and where are we today?
Our journey so far in Netcare and where are we today?
Slide 28: The WHAT? and the HOW?
The WHAT? and the HOW? CAREON NETCARE LIMITED
Slide 29: Changing our strategy toward person centred health and care
We embarked on changing our entire strategy and approach towards adopting person centred, health and care How were we going to do this? How could we ensure we remained engaged with patients during their acute care but also afterwards in promoting their wellness? The single most important first step
Slide 30: Building the business case for our strategy
Building the business case for our strategy The common view was that almost all IT projects cost three times more than originally budgeted, took twice as long to complete and produced a fraction of the benefits Given the size and scale, the significant costs involved and the risks to execution, we n
Slide 31: Quantifiable and non-quantifiable benefits
Quantifiable benefits and non-quantifiable benefits Quantifiable benefits Nursing Medical Liability Printing and File storage Administration stationery ICU and High care Insurance premiums General wards Liability claims Litigation costs Non-quantifiable benefits Nursing benefits Consistency of Care
Slide 32: Our global partners in delivering our strategy
Our global partners in delivering our strategy Deutsche Telekom Apple: Capsule IBM Watson Health SAP: (Clinical Solutions): iOS mobile operating Technologies: Micromedix: Finance, Electronic medical platform Digital integration of Drug interaction, administration, records all medical equipment dosag
Slide 33: The challenge we faced
The challenge we faced was this … ICU chart for the first heart transplant patient - 1967 Patient ICU chart at Netcare Milpark Hospital - 2018 33
Slide 34: More than 50 years later, very little had changed in record keeping
More than 50 years later, despite huge advances in medicine and surgery, very little had changed in our record keeping ICU chart for the first heart transplant patient - 1967 Patient ICU chart at Netcare Milpark Hospital - 2018 34
Slide 35: Moving from paper based to fully digitised and mobile
The task was enormous – moving from being totally paper based and manual to being fully digitised and mobile 2018 2024
Slide 36: Change management and adoption of electronic medical records
Change management and adoption of electronic medical records was our greatest risk • This programme was the highest risk project we had ever undertaken in Netcare • We had to fully integrate all our equipment into the EMR, link all radiology and pathology requests and reports seamlessly into the rec
Slide 37: Change management and adoption of electronic medical records
Change management and adoption of electronic medical records was our greatest risk Many of our nurses had not used computers regularly, so we started with the very basics, using Candy Crush to familiarise them Nurses have embraced this digital revolution with passion and commitment In fact during ou
Slide 38: Netcare's acute hospital electronic medical record system
Netcare’s acute hospital electronic medical record system Salient stats Digitisation of our Netcare is Current hospitals, real-time, single cust Benefits to patient safety, improved mobile enabled clinical in Souther Hospitals digitised 45 clinical outcomes and patient Beds 9 566 records engagement
Slide 39: Digitisation's impact on enhancing patient safety
Digitisation’s profound impact on enhancing patient safety 1 2 3 4 5 Up to 60% of all The provision Netcare’s digital With introduction Digitisation will prescribing errors of electronic e–scripting of IBM Watson help eliminate up in hospital arise scripting can approved by SA Health to 60% of poten
Slide 40: Quantifying the costs and benefits of CareOn
Quantifying the costs and benefits of CareOn Rm Projected opex vs. benefits Rollout capex to April 2024 321 Implementation opex to April 2024 348 Benefits realised (gross) FY 2022 37 FY 2023 104 H1 2024 63 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 IRR >21% Benefits Opex 40
Slide 41: Digitisation of electronic medical records across our delivery platforms
Digitisation of electronic medical records across our 7 delivery platforms CareOn Netcare Hospitals CareOn Akeso Aria Netcare Akeso Netcare Cancer Care Netcare website Heal Care@Work Netcare Medicross Netcare Netcare app Occupational Health CareOn NephrOn Netcare 911 National Renal Care
Slide 42: Setting the standard internationally
Setting the standard internationally In June 2024, Netcare won the Digital Innovation Award at the seventh annual International Quality Awards held in London. The prestigious awards, spanning eight categories, highlighted the achievements of exceptional quality professionals, teams, and organisation
Slide 43: Netcare's digital strategy comprises three distinct pillars
Netcare’s digital strategy is comprised of three distinct pillars
Slide 44: Netcare's digital strategy comprises three distinct pillars
Netcare’s digital strategy is comprised of three distinct pillars Sequence of achieving person centred health and care, that is digitally enabled and data driven is different 1 Digitally enabled 2 Data driven 3 Person centred health and care Timeline Timeline Timeline 4 – 6 years to April 2024 2 – 3
Slide 45: Clinical efficiency
Clinical efficiency
Slide 46: Clinical Efficiency – What do we mean by this?
Clinical Efficiency – What do we mean by this? Enhancing patients’ safety and outcomes at the most appropriate cost and ensuring we are providing appropriate care in terms of: Why are we doing this? • We are living in an increasingly resource constrained environment “Learning to do more with less” •
Slide 47: Machine learning model – Sepsis prediction
Machine learning model – Sepsis (bloodstream infection) prediction Promoting the safest care Why is it important? How will we achieve it Next steps • Life-threatening bloodstream • Developed a predictive analytic • Developing a suite of predictive GIBS/PPS HEALTHCARE INDUSTRY INSIGHTS infections ass
Slide 48: Person centered health and care
Person centered health and care
Slide 49: What does person centred health and care mean at Netcare?
It is important to define… what does person centred health and care mean at Netcare? Person centred Health and care Putting patients We recognise Encouraging Committed to But also ensuring first and at the patients as people to actively providing high ongoing care centre of individuals, and particip
Slide 50: Why does digital engagement matter?
Why does digital engagement matter? Digital engagement is a strong predictor of loyalty • > 60% of consumers expect to be able to change or schedule a People using patient-centric digital models1 healthcare appointment, check medical records and test results, are more likely than those who don’t to
Slide 51: Why does digital engagement matter?
Why does digital engagement matter? Ease of doing business also keeps people loyal and engaged in healthcare • Closely connected to access, ease of doing business also keeps people loyal and engaged in healthcare. Together, these factors make up the entire experience of navigating and interacting ac
Slide 52: The Netcare app: Phase 1
The next phase of patient and person centred engagement The Netcare app: Phase 1 – improved out-of-hospital convenience Tailored medical appointments Virtual GP consultations Geolocation by Netcare 911 emergency services Online hospital pre-admissions Purchase gap cover 52
Slide 53: The Netcare app: Phase 2
The next phase of patient and person centred engagement The Netcare app: Phase 2 – in-hospital ease of use (over next 2 years) 2024 2025 • Hospital care guide • Meal orders • Compliments and complaints • Prescriptions • Gratitude cards • Account settlements • Summary of Care • Coffee shop orders • C
Slide 54: Providing a Summary of Care
Providing a Summary of Care Giving patients access to a full summary of the care they received from Netcare Applying Generative AI to help ‘de–jargonise’ complex medical terminology Focusing on “What matters to you” 54
Slide 55: So What? - A lesson in Health Literacy
“So What?” - A lesson in Health Literacy Initially poor uptake and engagement with less than 5% of patients engaged with the App or even looked at their results Lack of understanding of results and the potential impact on reducing mortality or the risk of dying and quality of life We needed to expla
Slide 56: User Engagement Metrics
User Engagement Metrics User Registration Average time spend on the Mobile application overtime
Slide 57: User Engagement Metrics
User Engagement Metrics Between 1 - 17 Sept 2024, 58.00% of all user engagement sessions were spent on articles, recipes, patient outcomes, dialysis sessions and patient symptoms. 20.64% 14.29% 9.51% Recipes 4.39% Articles Patient outcomes Dialysis 9.17% Symptom Activity
Slide 58: What does success look like, and how do we measure it?
What does success look like, and how do we measure it?
Slide 59: Netcare Litmus test
What does success look like and how do we measure it? Netcare Litmus test Grow above Improve our 1 the market 2 margins and returns Substantially Increase the differentiate our 3 service, care and 4 embedded value of our patients clinical outcomes
Slide 60: In life challenges are inevitable, however defeat is optional
in life challenges are inevitable, however defeat is optional Roger Crawford
Slide 61: An ongoing force for social good
An ongoing force for social good My Walk made with Soul An initiative founded by Netcare and Adcock Ingram Critical Care My Walk recycles PVC into school shoes To date: >107 000 kgs PVC diverted from landfill >200 000 Pairs of school shoes donated to school children in underprivileged schools across
Slide 62: Putting it all together
Putting it all together “ CAREON NETCARE LIMITED
Slide 63: Thank You!
Thank You! Dr Richard Friedland 27 September 2024