Bonitas is committed to building on the success of the GP Network. The role of the family doctor as co-ordinator of care is essential in ensuring that members receive cost-effective quality care, that is sustainable for the future.
The burden of chronic disease is ever-increasing, in both prevalence and costs related to treatment and complications. The scheme aims to deal with this pro-actively by enrolling patients in disease management programmes focused on improving the control and clinical outcomes related to the common chronic diseases.
Bonitas has initiated the Integrated Care programme in order to achieve the following:
- To share relevant and important clinical information with the doctor (only in patients who have given consent).
- A Bonitas Clinical Coordination Committee (BCCC) has been established that comprises of practicing clinicians, performing an advisory role to the Scheme. This assists in promoting meaningful healthcare initiatives within the Bonitas GP network.
The program has initially focused on the diagnosis and treatment of the diseases mentioned below.
- Diabetes
- Asthma
- Hypertension
- Dyslipidaemia
- Depression
The Integrated Care Approach therefore has the following key areas of focus:
- Identification of high risk beneficiaries
- Bonitas uses a predictive analytical modeling technique that identifies beneficiaries at risk of deteriorating disease.
- Beneficiary consent and enrolment
- A Bonitas case manager contacts the beneficiary for informed consent to allow for data sharing with the treating GP.
- Structured referral and education
- Patients are always referred to their GP and supportive education regarding compliance to treatment is provided
- GP notification and updates following care manager interviews
- The Bonitas care management team will share clinical information with the treating GP where problems are identified. Please be on the lookout as you, the general practitioner, will receive this information either by email or fax.
- Monitoring patient compliance to disease management plans
- Once the patient has consented and enrolled, Bonitas will monitor compliance in order to ensure adherence to the doctor’s management plan. Patients will be reminded to visit their treating doctor, if necessary.
- The role of the BCCC and the distribution of disease guidelines
- The BCCC with the support of the regional IPA leaders are actively involved in assisting with this program. The committee has developed guidelines to assist the busy GP in the management of his/her patient .We have posted the guidelines to the network doctors in hard copy format. If you have not yet received your copy, please call the Bonitas call centre on 086 111 2666 and we will ensure that you receive a copy. Together with the BCCC, the aim is to further empower the GP and extend the guidelines to additional chronic illnesses/diseases.
Bonitas is supportive of the importance of continuing professional development (CPD) in an attempt to improve the clinical outcomes related to the management of these chronic illnesses.
Bonitas sincerely looks forward to your on-going support in an attempt to improve the health of your patients and their beneficiaries.
