Regardless of where we are, Information and communication technology affect practically every area of our lives. It has a significant impact on our well-being and the economy in which we live and work. Similarly, technologies are altering the way of our lifestyle, and if we look around today, automation is the solution.
Thus, we can tell technology is advancing in every aspect of our lives. So, have you ever wondered how digital technologies are now being employed in the health sector of Nepal? Don’t worry! We will go through it in detail in this article. But first, let’s grasp the concept of what is digitalization and its role in the Health Insurance Sector in Nepal.
Concepts of Digitalization and Health Insurance Sector in Nepal
Digitalization has a significant impact on societal behavior and culture, business procedures of the service industry, and the financial structure and growth of the nation. However, technology is often seen as a threat to human occupations, which is why people might find the digital transformation in any field an overwhelming process.
But it’s important to understand that, while digital technologies are revolutionary and liberating, they are more of a means to achievement. The use of technology is all about re-examining current duties from fresh perspectives enabled by digital innovation, rather than transforming old techniques into more advanced forms.
On the other hand, the health insurance policy was implemented to minimize poverty and catastrophic health costs, acknowledging that the current healthcare system does not adequately identify and protect the poor.
However, regulating and addressing imbalances in health insurance access remains a major concern in Nepal. For instance, insurance is tariffed in Nepal. It indicates that Beema Samiti controls the products and pricing. It also implies that the marketing architecture for selling such a product is regulated. An insurer cannot offer more commission or suggest a promotion unless the regulator has given their approval.
Meanwhile, the overall marketing cost (including business promotion, acquisition costs, and commission) cannot exceed 25% of the purchase price in Nepal. As a result, all insurers charge the same price for the same products. Since distinction as a basis for innovation is not permitted, product innovation becomes obsolete.
In such a scenario, the development of adequate digital channels will allow customers to surf and accept insurance products. At the same time, the insurance company will also get a competitive advantage and an opportunity to expand its horizon. However, the main difficulty is implementing suitable digital transformation to improve opportunities for developing novel business models, procedures, systems, and software.
If we can implement technology in Health Insurance Sector, it will gain a competitive advantage, improve efficiency, enhance income, and allow customers easy health access. In this article, we will look into the state of digitalization in Health Insurance Sector and the challenges they face in going digital.
Uses of Technology in the Health Sector in Nepal
Nepal is one of the countries that continue to face challenges when it comes to health care and related services like health insurance. If we compare it to the insurance industry in developed countries, Nepal’s insurance industry is unquestionably underdeveloped.
At the same time, there is no adequate research conducted in Nepal’s insurance industry to assess current digital usage, obstacles impeding technological advancement, and customer expectations of technology-driven services. However, Information and Technologies are altering the way service is delivered and accessible in the health sector. Technologies are at the heart of responsive and resilient health systems.
Rapidly rising IT literacy has aided the growth of digital technologies in Nepal in recent years, particularly among young people and professionals, and social media is a key driver for internet use. According to DATAREPORTAL, there were 10.78 million internet users in Nepal in January 2021. Likewise, the number of internet users in Nepal is increased by 567 thousand between 2020 and 2021.
On the other hand, the government has pledged to improve the digital literacy skills of the population, while computer literacy is now a prerequisite for employment in the Nepali civil service.
Approach toward Digital Health Ecosystem in Nepal
Now that we understand technology is becoming a solution to every problem, why don’t we look at the prospects and best practices of how technology can be used and integrated into the most vital aspect of the health sector?
Digitization is bringing increased liberty and accountability as well as empowering decision-makers in Nepal’s health system. The availability of reliable, timely data and the growth of digital capabilities are allowing for new insights and analytical possibilities, strengthening the role of government as policymaker and custodian of the health sector.
It is especially relevant in the context of Nepal’s federalization, which has assigned budgetary and planning responsibility for health service delivery to the local level.
Moreover, the Nepal Government is providing funds for the national scale-up of numerous interoperable digital health initiatives, including the DHIS2, electronic or e-reporting, and the IMIS digital software platform for managing social health insurance in Nepal. This marks a crucial sign of success in the context of Nepal with restricted resources.
Meanwhile, Nepal is the first country to use open-source software to manage national social health protection programs (OpenIMIS).
Digital Health Information Management System (DHIS2)
The District Health Information System software (DHIS2), which is open-source and web-based, is designed to make data collection, validation, maintenance, analysis, and display easier.
The flexible user interface of DHIS2 allows the software to be customized to diverse health information activities without requiring specialized programming knowledge. You can submit the Data on a computer, laptop, or another device at the health center or in the field by community health workers using mobile phones or tablets.
It has advanced data visualization features, such as GIS mapping, which shows the place your service is sourced from. Similarly, it has several charts and dashboards that allow health managers to examine and better understand their data, resulting in more evidence-based decisions.
In total, 54 nations are implementing DHIS2 on a national basis, with 30 of them still in the early stages of implementation, including Nepal.
OpenIMIS Software Platform
The global OpenIMIS software platform is developed in collaboration with the Swiss and German Development Cooperation. They aim to foster an open-source solution for health insurance schemes that is affordable, easy to manage, constantly optimized, and interoperable with other ICT tools for health and social protection.
This program intends to establish a global community of practice around the open-source OpenIMIS software as a digital-global product that aids in achieving universal health care and social protection.
OpenIMIS is the first and only open-source program that connects beneficiaries with service providers and payers. The system is designed to manage a healthcare system’s complex relationships, including everything from enrolling beneficiaries to communicating and processing claims to calculating provider reimbursements.
The government and its partners have prioritized digital solutions, resulting in a dynamic digital environment in Nepal. Nepal government and its partner organizations have are prioritizing digital solutions, raising IT literacy and digital capacities, and digital infrastructure investments.
This movement has all helped a lot in creating a dynamic digital environment in Nepal. Over the last decade, digital health projects have expanded. And they now serve different components of health system operation and service delivery, ranging from health service data and human resources for health to health funding and care quality.
Yet, many of these applications are created without considering the needs or the possibility of data exchange. It has led to difficulty in gathering data and generating linkage across multiple digital systems. Similarly, the most significant hurdle is the fragmentation of the healthcare system in this country. Even the health ministry of Nepal lacks a comprehensive database of hospitals and medical institutes.
On the other hand, hospitals do not invest heavily in digitalization and technology in Nepal. It will obstruct the growth of a digital healthcare ecosystem. As a result, there is a barrier to realizing digital technologies’ potential to strengthen health systems and deliver better health care.
Although digitalization is unavoidable, we lack the allocation of adequate resources for digital capabilities development. We still have a long way to go in term of digitilization of Health care in Nepal.
Patients are still experiencing poor services, except for a few well-organized facilities. Long lines form for check-ups, and insurance claims are already giving tough times to patients. On top of it, the poorly managed administration of the hospital is not helping it either.
However, the industry cannot remain stagnant indefinitely. A shift in thinking is required, and once that occurs, I believe our country will move toward national digitalization.
We need an interoperable healthcare ecosystem as quickly as feasible. Based on current trends, let us hope to see some substantial changes in the next four to five years in Health Insurance Sector in Nepal.
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