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Operational Review: Helios
Operational review
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Well positioned for growth |
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Our customer-focused,
health-centric and
passionate
team
thrives in
the dynamic,
demanding world
of healthcare. |
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Our brand reflects
fresh
thinking and
radiates the energy
which will catapult
healthcare
organisations
to greater success
and excellence. |
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Helios has expanded its
customer base and
continues
to grow its footprint
as an ICT
Healthcare
solutions
provider
in South Africa and
beyond its
borders into Africa. |
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The EMC VMAX storage
implementation, together with
some application
improvements,
has delivered the
availability of
the Nexus and UMS
databases to
more than 99.95%. |
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Overview of the business
Helios IT Solutions ("Helios") provides ICT solutions and
services to strategic partners in the healthcare industry
including Medscheme and its partner medical schemes
in the areas of administration and managed care. The
company also licences its systems to national and
international partners in order to pursue a diversified model
for revenue generation.
Helios boasts a leading edge technology platform together
with world-class transactional systems, which include
hosting, switching, administration, managed care and
clinical applications. The systems are seamlessly integrated,
robust and scalable supported by highly skilled, passionate
ICT staff that form the cornerstone of its business success.
Helios leverages off economies of scale to provide costeffective,
quality and reliable products and services and
continuously strives to achieve optimum and sustainable
results for its stakeholders. Helios holds 51% shareholding in
healthcare software specialist, Allegra.
We provide and create value by improving the customer
experience though stable, robust solutions and innovation
which empowers our customer base. We deploy leading
edge technology to facilitate this and always focus on quality
delivery. We have a motivated workforce which prides itself
on delivering service excellence and exceeding service levels
to improve efficiencies. We acknowledge that each client is
unique in its offerings and has different requirements and
strategic objectives and we, as Helios, strive to continuously
ensure that we provide flexible solutions to meet various
clients’ requirements.
Driving Health Centric Solutions
| Leaders in Innovative Healthcare Solutions |
| As Healthcare partners, we consistently provide sustainable and
innovative solutions of the highest quality, thus enabling our
clients to achieve their strategic objectives |
Develop
Innovative
Solutions |
Deliver
100%
Uptime
of Critical
Systems |
Compliance
to Relevant
Practice, IT
Governance
& Controls
Frameworks |
Drive
Client
Centricity |
Pursue
Sustainable
Revenue
Growth |
Achieve
Operational
Excellence |
Attract,
Develop &
Retain Talent |
Achieve
Business
Transformation
Objectives |
Strategic objectives: 2014-2016
Performance highlights
System performance
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Nexus and UMS – our integrated health administration
and managed care system, Nexus remains one of the
most robust healthcare administration and managed care
systems in the world. UMS is the Managed Care system
which focuses on the clinical, financial and risk assessment
management aspects during the hospitalisation process with
a view to lower the cost of healthcare without compromising
the well-being of the patient during their treatment.
Although transactional volumes have increased dramatically
insync with international membership growth, Nexus and
UMS have experienced high system availability of 99.95%
over the last year. |
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Electronic processing capability: On average, Helios
systems process 98% of all medical aid claims electronically.
More than one million real-time claims entering through
Nexus are processed per month. |
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Interfaces: Nexus and UMS seamlessly interface with
76 external parties and various suppliers, regardless of
technology and locations, which is one of our core strengths.
The table below shows a summary of the complexity and
vastness of the interfaces in place: |
| Flat file interfaces |
Volume |
| Number of third party systems with which Helios
interfaces |
76 |
| GEMS correspondence |
Volume |
| GEMS total SPN interfaces |
27 |
| GEMS total faxes received |
1 219 471 |
| GEMS total emails received |
900 039 |
| Real-time Claims |
Volume |
| Healthbridge |
3 970 447 |
| Allegra Connect |
12 442 654 |
| Claims |
Volume |
| Claims |
7 780 948 |
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Network uptime: Helios provides a wide range of network
connectivity solutions that suit its customer needs and
budget through a market leader in connectivity services,
Internet Solutions ("IS"). Helios currently provides
connectivity to various branches across South Africa and
other African countries, i.e. Swaziland, Zimbabwe, Namibia,
Botswana, and Mauritius. Helios’s Multi-Carrier MPLS-based
Private IP VPN solutions provide highly secure and
redundant offerings to ensure high availability and response
times that are optimal at all times to support real-time
applications. This MPLS network also combines voice and
data traffic on the same integrated network, increasing
efficiency while providing an ultra-flexible, multi-backbone
infrastructure. A 99.7% uptime was achieved from the core
MPLS links to Helios customers including Medscheme SA
branches for the financial year. |
Infrastructure
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Vmax implementation: The EMC VMAX storage
implementation, together with some application
improvements, has delivered the availability of the Nexus
and UMS databases to more than 99.95%. |
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Microsoft partnership: Helios has been awarded a Gold
partnership with Microsoft for “Hosting” and “OEM”, as well
as Silver partnership for “Virtualisation and Management”
and “Server Platform”. |
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Enterprise Backup solution: Helios has implemented a
new Enterprise Backup solution, which utilises the global
storage leader, EMC’s software and DataDomain hardware
to achieve optimal backup solutions for performance,
availability, scalability, retention and recovery. |
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Server and desktop virtualisation: Helios has successfully
implemented a hybrid virtualisation model for servers on
the
Microsoft as well as VMWare platforms. These solutions
provide us with the flexibility and cost efficiencies associated
with cloud platforms in service delivery, availability and
redundancy. The project has recently been extended to
the desktop environment and with the partnership of the
software and service providers; this will not only extend
our technology offering significantly, but also significantly
decrease the costs associated with desktops, and the
management thereof. These holistic solutions also provide a
suite of additional features, that are being implemented as
additional solutions and services, such as enterprise mobility
management, application virtualisation, enterprise Dropbox,
desktop, notebook and mobile device backups. |
Key projects successfully implemented during the year:
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Bank account project: Major deliverables for this project
were completed during the period under review. This
included a substantial enhancement to the Nexus financial
system which was amended to cater for the Zimbabwean
banking system with respect to collections and payments. |
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Year end project: The 2014 year-end project was
completed successfully, with the implementation of various
enhancements and data updates. |
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Disease authorisation: The project was completed
successfully. Development was done on Nexus Assessing
and Managed care. The aim was to create new disease
authorisation contracts for pharmacies with the plan to
which the disease authorisation would apply. |
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Additional automated pay runs: The project went live
in December 2013 to allow for additional pay runs where
service providers provide the benefit of additional discounts. |
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Statement re-write: The project went live in October 2013.
The purpose was the parametisation of statement sections
to allow more rapid implementation of changes to the
statement with minimal IT intervention. |
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Disease authorisation: This initiative was aimed at
automating chronic medicine interventions that had little
or no clinical impact while refocusing clinical resources
to cases where major impacts could be predicted. The
successful authorisation of the chronic disease for chronic
benefits triggers a basket of clinical appropriate drugs for
a given condition where each drug utilises rules/policies to
determine its clinical appropriateness. New functionality
was also developed to cater for key indicators that assist
both users and providers in identifying specialised drugs
that form part of the medicine authorisation which is now
presented on communication to both members
and providers. |
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The hospital benefit management system ("UMS") provides
real-time integration with numerous provider groups who
submit requests for new hospital authorisations. This
project focused on the improvement of the success rates
of the automation of these requests thus reducing the need
for manual intervention. In addition to the new requests,
the system receives requests for updates to existing
authorisations that form part of the case management
process. |
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GEMS Tenders - Clearing House: Helios has together with
myCARE which is a Pretoria based Managed Healthcare
organisation, secured a contract with GEMS to provide the
medicine clearing house functionality for its providers. This
is a first for Helios and the team is very enthusiastic about
this opportunity. The Helios team is working relentlessly
to provide the high standards of service as is expected by
GEMS. This will also mark the ring-fencing of a separate IT
Platform for this GEMS contract. The project is on track to
deliver the full solution by 1 January 2015. |
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Bonitas Fraud Management (FICO) and Helios ITS): Helios
has formed a joint venture with FICO which is a leading
fraud, abuse and wastage (“FAW”) solutions provider. A
software solution to combat this FAW shortcoming was
presented to the Bonitas Board of Trustees during October
2014 and they have approved Helios as the preferred bidder,
subject to terms and condirions, which we will comply
with. This is a great opportunity as we can then proceed to
market this solution to other schemes, in South Africa and
abroad, post the Bonitas implementation. It is also what we
consider to be a game-changer in our industry and we are
all very excited about this opportunity. |
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First Mutual Health (“FMH”): Helios has responded to
a request for a Healthcare Solution for FMH, which a
Zimbabwean based Health Insurance Provider. This is a
reasonably sized scheme with a diverse set of products
which require significant customisation of our bespoke
solution. Helios has been shortlisted as one of the preferred
bidders and the process is being finalised with a site visit
of our ICT infrastructure that will be undertaken by the
Executives of the FMH team. |
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Electronic health record (“EHR”): Helios has embarked
on a project together with our partners in Medscheme, to
derive and populate a comprehensive electronic health
record. This will facilitate a comprehensive view of the
treatment and health interventions on the patient with the
end goal of driving a single patient record throughout the
industry. This will also empower the Healthcare providers
in adopting treatment protocols that are better aligned to
patient needs reaction. |
Helios key performance indicators
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Key performance indicators |
Description |
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100% uptime |
Leading edge technologies from various hardware and software vendors such as Microsoft, Oracle, VMWare and EMC are utilised to ensure a solid technology platform with maximum uptime and high availability of systems. Various infrastructure monitoring and alerting applications are used to ensure the proactive notification and resolution of any potential incidents. The integrated approach to implementation of such technologies has resulted in improved efficiencies and excellent service levels. |
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Operational efficiencies |
Various innovations around visualisation, public and private cloud solutions are currently being implemented and these solutions will also support and optimise the environment, to fulfil the customer requirements around availability and business continuity. This holistic approach has been proven highly successful through the Oracle Technology stack to achieve vast capacity gains and cost savings. |
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Governance and compliance |
Governance is crucial and the emphasis is on information security and compliance within IT controls and management. External auditors perform an ISAE 3402 audit annually to provide assurance to all stakeholders, that the IT environment is sufficiently protected and controlled. |
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Customer-centricity |
Helios firmly stands by the fact that in order for our business to grow, we need to have a customer-centric approach with strong relationships and we need to understand our clients, their business, strategies and requirements. We will continue to support our clients and partners in innovative ways to ensure sustainable growth in their various organisations. |
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