Lessons from nature on how to improve healthcare

In nature, everything works in ecosystems where networks of creatures interact with one another and their environment. Inside these interconnected communities, the system as a whole gets stronger as the individuals grow and thrive. Discovery’s shared value ecosystem works in much the same way – it connects the various parts of (and participants in) the healthcare system and helps, even rewards, each one for improving themselves and the system as a whole.

In other words, this approach helps to build healthier people, a stronger healthcare system and better healthcare at a lower cost. If that sounds perfectly natural, that’s because the shared value ecosystem is inspired by nature itself.

Lesson 1: Every organism is the centre

Consider the sea otter. Sea otters feed on sea urchins, which graze on giant kelp. If you were to remove the sea otter from the ecosystem, the sea urchins would run amok, feasting on – and destroying – the underwater kelp forests, which so many animals depend on, including humans. (Kelp forests absorb huge amounts of carbon dioxide and protect coastlines from storm surges.)

From this vantage point, the sea urchin can be viewed as the centre of the ecosystem. From another, it’s the sea otter; from yet another, it’s the human. Clearly, each individual organism is in its own way the centre of the ecosystem. Similarly, the shared value ecosystem puts you and your health at the centre of care. How does it do this? By not simply paying doctors and hospitals for delivering care, but paying them more for delivering better care that improves patients’ health. Everybody benefits as healthcare improves and costs come down, and the healthcare system becomes more efficient.

Lesson 2: Everything is connected

The animals in The Lion King sing about ‘Circle of Life’… and the shared value ecosystem has the same all-for-one outlook. Shared value connects and benefits all the parts of the whole: doctors, nurses, hospitals, pharmacies, healthcare providers, patients and even the broader society.

It does this by creating networks of healthcare providers, hospitals and pharmacies, which function like ecosystems that ‘reward’ those who join for giving better care. There are also interconnected chronic-condition care programmes, such as Diabetes Care, Cardio Care, Mental Health Care, HIV Care and Kidney Care, which work through a network of doctors, with the GP at the centre to coordinate care. Plus there’s an electronic system of health information and records for easy sharing and a digital ecosystem that easily connects you to the healthcare you need.

Lesson 3: There’s safety in numbers

Have you ever seen a herd of buffalo stare down a pride of attacking lions? The lions will go for what they see as the weakest of the herd. The herd, meanwhile, bands together to form an intimidating wall of power that charges the lions and chases them away. The shared value ecosystem also uses scale and interconnection to increase the power of its individual parts.

As more people, practitioners, hospitals and partners plug into the ecosystem’s networks, better healthcare and more cost-savings are possible. That’s why the shared value ecosystem gets more powerful as it grows. Just as it helps you to get healthier, it also helps doctors, hospitals and the entire healthcare system to give better care at a lower cost. As in nature – and in that herd of buffalo – the ecosystem is designed to benefit all parts of the whole, and the whole itself.

Lesson 4: Nothing goes to waste

In a natural ecosystem, there’s no such thing as waste – what one creature discards another will devour. Because the shared value ecosystem channels each member’s premium into a system that pays for better healthcare and improved patient health, waste is prevented and you, the member, get so much for what you pay. ‘Historically, one of the problems with healthcare is that the emphasis is on the volume of services that you provide,’ says Discovery Health CEO Dr Jonathan Broomberg, ‘so the more you do, the more you get paid. We’re trying to change that by saying to doctors and others that we will continue to pay them for what they do, but if they get better results – and not just greater volumes – we will pay them more.’

The ecosystem is also built to monitor waste and prevent healthcare fraud. Software and a team of analysts constantly assess claims – over just the past few years, this has saved an estimated R5.1 billion in possible fraudulent claims, meaning premiums are lower (probably 15% lower) than if that waste went undetected. Discovery’s Medicine Unit is another monitoring tool that analyses and finds ways to manage the cost and inflation of medicines. This means that, within the shared value ecosystem, less is spent on day-to-day medication and more is available for cutting-edge, high-cost medicines.

Lesson 5: Every participant plays a crucial part

Whether it’s the buffalo working in the herd or the sea otter keeping the ocean in balance, every species in an ecosystem has its unique role to play. Similarly, each participant in the shared value ecosystem is instrumental in the system’s success. Doctors, other health practitioners, hospitals and pharmacies play the role of delivering care that improves patients’ health. Patients/members play the role of improving their own health and engaging with networks and connections to grow and strengthen the healthcare system, thereby boosting the health of other patients/members. And everybody plays the role of sharing those benefits throughout the ecosystem – especially you.

‘The shared value ecosystem puts you and your health at the centre of care. How? By not simply paying doctors and hospitals for delivering care, but paying them more for improving patients’ health.’

‘Software and a team of analysts constantly assess claims – this has saved an estimated R5.1 billion in possible fraudulent claims, meaning premiums are lower than if that waste went undetected.’