Best Practice Guidelines: Healthcare Practice Management & POPIA Compliance Framework

Best Practice Guidelines: Healthcare Practice Management

POPIA Compliance Framework




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6. Debtors & Patients: Roles & Purpose

6.1. Debtors & Patients Business Processes

Patients & the myGC patient app

Create myGC profile


x

Information Quality:
  • myGC's information fields populate the information fields in GoodX. This ensures that the practice has complete and accurate personal information.

   Updated Information:
  • The practice can update information through myGC or at least once a year requesting patients upon arrival at the practice to check if their information is correct and/or update their information.
   x  Communication to Data Subject:
  • When the patient uses myGC, the practice is assured that information is received directly from the patient.
  • Information is shared voluntarily.
  • myGC is a local South African app and no data is transferred internationally.
  • myGC is the perfect app to update the practice's data. However, the practice must still accept/approve the change of information.
  • myGC puts the control over sharing data with third parties in the hands of the patient. The patient can choose at any time to stop the sharing of Personal Information.

Patients are connected to the medical practice via the myGC (myGrandCentral) patient app.

  • The patient will receive an automated email from the medical practice, which will take him or her to the correct URL where he or she can register a patient profile to be able to use the myGC app.
  • The patient must complete and upload all the necessary information and documents to activate his or her myGC profile.
  • The patient must make sure that the email he or she uses to sign up, is the same email he or she wants to receive statements, invoices, scripts or any related clinical forms from the doctor.


Debtors and Patients Business Processes


x

Information Quality:
  • Reception has to complete all the debtor and patient fields in GoodX so that personal information is complete and accurate.
   Updated Information:
  • Validations ensure updated personal information.
  x Communication to Data Subject:
  • Make sure that when information is not obtained from the debtor or patient, a note should be made of the source of information, contact particulars and the reason why a third party provided the information.
 
 Data Subject Objections & Corrections:
  • If data subjects want to object to information or request destruction or update of information, they have to complete Form 2 of the Regulations of the POPIA. They have to submit proof of identity before the practice should attend to requests. Results of the request should be communicated to data subjects.
 
 Confidentiality:
  • Access control should be in place.
  • User logs are kept in GoodX of who had access to information and changes information.
  • A clean desk policy should be followed to keep personal information confidential.
  • Hard copies must be protected and kept from public access.
 
 Destruction of Information:
  • If you want to destroy hard copies containing personal information, you should make sure that the hard copies are destroyed permanently and not left in a dustbin which an unauthorised person can access. Example: use a shredder for paper.
  • Waste companies should sign operator agreements.
 
 Archiving & Restriction of Information:
  • Software applications should archive OLD information and add access control.

Create new debtor
A Medical Debtor is the person who is responsible for the account, e.g.

  • The main member of the medical aid and who signs an agreement accepting responsibility for the medical account of his or her dependants;
  • Any major private patient;
  • The guardian(s) of any minor patient;
  • Any person signing an agreement who accepts responsibility for the medical account on behalf of a patient (guarantor).

Make sure the following demographic information is correct and captured on the system:

  • Debtor and patient full names and surname
  • ID Numbers of both
  • Medical aid and plan, medical aid number and dependant number
  • Contact information of debtor and patient

At the opening of a patient electronic file, the patient validation and benefits check can be done to see if the patient is active on the medical aid. Some demographic information can be imported from medical aids, depending on the information different medical aids make available for import.


Add dependants

Dependants are the persons for whom the medical debtor is responsible. The main member will be responsible for all the invoices for dependants posted on his or her file.

Make sure that the dependant codes correlate to the dependant codes listed on the medical aid card to ensure successful claim processing. 

Dependants can be children, spouses, stepchildren or even grandparents.


Patient validations and benefit checks

Validate all medical aid patient files before the patients consult with the practitioner to ensure that demographic information is up to date. Update any incorrect or outdated information.

Use the benefit check to ensure that there are funds available on the medical savings account. Only three benefit checks are available on each patient file per day. The practice will request medical aid if a certain amount is available and the system will reply with the availability. The system does not show the amount that is available in the patient’s savings account. Only the amount that the user has typed into the benefits checker will be checked.


Debtor and Patient Documents

  • There are different types of documents that can be scanned and uploaded into the software and linked to the electronic file of the patient.
  • Debtor document types: Financial, Personal or Practice documents.
  • Patient document types: Medical, Financial, Personal, Practice, Portrait or Correspondence documents.
  • Compulsory documents can be marked as required in the Web App. The document icon will show red until all necessary documents have been uploaded.
  • The debtor and patient IDs and medical aid documents can be scanned and stored in the debtor’s file.
  • This will eliminate the cost of printing and filling space and it will always be available in electronic format.
  • The Practice can use a shredder. If the Practice shreds confidential documents with details about their patients then they can increase the trust these people have in the practice. By shredding documents and making sure patients know this happens, they can be confident that their data is being treated securely and with respect.


Printing File Cover Sheet (Desktop App) and Debtor Cover sheet (Web App)

x

Information Quality:
  • Printing the file cover sheet and having the debtor sign, proves that the practice has done due diligence to obtain accurate personal information.

  x  Communication to Data Subject:
  • The T&C of the practice as printed on the file cover sheet should add the following clauses:
    • to explain to data subjects the purpose of processing their information;
    • consequences of failure to provide all relevant information;
    • the reasons for the collection;
    • when the information will be shared with third parties, e.g. specialists;
    • communicate that medical aid validations are performed to update and confirm personal information;
    • the rights of data subjects (access, rectification, objection, complaints).

  • Printing cover sheets will help to ensure that the patient confirms his/her details by signing the printout.
  • The practice can place terms and conditions on the cover sheet to be signed by the debtor (Desktop App).
  • By signing the cover sheet the debtor/patient accepts the practice's terms and conditions, eg for the settlement of the account, and confirms that the information on the system is correct and up to date.
  • Email this File Cover Sheet (Desktop App) or Debtor Cover sheet (Web App) to any other medical practitioner who has been involved in the treatment of the patient.


Make a patient Inactive

If dependants get their own medical aids or pass away, they can be marked as inactive on the system. This will ensure that no further correspondence will be sent to those patients. All new notes and/or correspondence will be done on the new patient accounts or electronic files.

Some clinical notes can be copied from the old electronic files to the new electronic files.


Search Methods for Bookings

  • Providing a search function that searches your Desktop or Web App for Debtors is a method that offers users a way to find content (such as Debtor or Patient demographic information) quickly and easily. The search function makes it easier for users to locate and access debtors or patients instead of having to scroll/navigate through the list of bookings or debtors especially if it's a big Practice.
  • The search function allows the user to search in the Desktop and Web app. 
  • The user can search for functions, booking or any patient details in the program from the Diary or the Debtor Input screen.
  • When a patient phones the practice to book an appointment, search the database with information that is unique to that Patient/Debtor example their ID number. This will make it easier to find the correct patient quickly. Never disclose any personal information over the phone when a patient phones for an appointment. 


Facial Recognition for Patients


x

Information Quality:
  • Our POPIA compliant software is designed with best-practice security encryption features to protect your patient's information and protect your practice against criminal activity.

  • Facial Recognition is an analytics feature that identifies and authenticates a specific person by their facial features.
  • The process starts with a photo that is taken during the first visit and matched to the ID document of the person. The photo is then stored in GoodX under the patient's profile for future identification of the patient.
  • The photo can be taken at the myGC kiosk or with a webcam at reception.
  • When the patient visits the practice again, the receptionist presses the PI (patient-identifier) button to activate the facial recognition functionality.
  • The Web App uses biometrics to map the geometry of the face of the person entering the premises with the data on the software.
  • Cross-referencing the result of this scan quickly confirms identity on the system and gives the receptionist quick access to the following functions:
    • Debtor demographics information;
    • Account details;
    • Booking details;
    • Options to create tasks and/or bookings etc.

Benefits for the Practitioner?

  • Assists the practitioner to identify the patient in e.g. the waiting room, which makes the patient feel welcome and important.
  • The practitioner can verify that the correct Patient is being treated.
  • You can protect the Patient's interests and clinical information through increased biometric accuracy.
Benefits for reception?
  • Increased administrative efficiency.
  • The certainty that the correct Patient file is sent to the Practitioner.
  • Avoid the risk of duplicate Patient files.
  • Improved Patient relationship with the Practice.

Benefits for the Patient:

  • Facial recognition reduces the risk of identity theft OR medical aid fraud.
  • Improved Patient experience and relationship with the Practice.
  • Increased trust in the Practice.
  • Increased security of personal information of the Patient.