“NHIMA Simplifies Digital Healthcare”
… Njapau says this will enhance efficiency and access through the eNHIMA System, Health Information Portal, and biometric identification.
By Francis Maingaila ♥️
Lusaka, Zambia24 (August 3, 2024) — The National Health Insurance Management Authority (NHIMA) has transformed healthcare access with its new digital initiatives and enhanced its services through digital innovations.
Michael Njapau, NHIMA Director General, told Zambia24 at the Agriculture and Commercial Show that the eNHIMA System, Health Information Portal (HIP), and biometric identification are transforming the process by enhancing efficiency and allowing members to manage their claims digitally and seamlessly, achieving a 98% adoption rate, which significantly improves the user experience and streamlines the overall process.
He said the introduction of the eNHIMA system, Health Information Portal (HIP), and biometric identification has enhanced operations, achieving a 98% adoption rate.
“These digital tools enable paperless services, allowing members to manage their claims efficiently without needing to visit in person,” he said.
Njapau told Zambia24 in interview at the exhibition stanthat these digital solutions aim to boost efficiency and improve user experience.
“The eNHIMA system lets members track claims in real-time, and the Health Information Portal (HIP) offers personalized health information and services,” he noted.
Biometric identification further enhances security by verifying identities and reducing fraud and administrative errors.
Njapau explained, “These tools not only streamline the claims process but also ensure greater accuracy and security in managing sensitive health data.”
The move to digital platforms addresses previous challenges such as lengthy claim processing times and errors from manual record-keeping.
Although NHIMA faced initial resistance and technical issues, extensive training and a gradual implementation strategy helped overcome these obstacles.
Njapau added that NHIMA uses data analytics from customer satisfaction surveys and actuarial studies to enhance patient care and anticipate trends.
Feedback from health centers, such as those in Ndola, showed high satisfaction rates due to personalized care plans, prompting further improvements.
NHIMA’s Accelerated Accreditation Initiative aims to expand services to 24 underserved districts. For example, John Phiri from Chipata received essential treatments through NHIMA, which would have been financially burdensome otherwise.
The initiative includes setting up Mini Hospitals and Zonal Health Centres and collaborating with the Global Fund and International Labour Organization (ILO). The Mini Hospital in Kalabo district, for instance, has reduced travel needs and improved local healthcare access.
To manage costs while ensuring quality care, NHIMA has negotiated better rates with providers and explored cost-effective treatment options.
“Our agreement with a Lusaka hospital to lower dialysis costs has benefited many patients,” said Njapau.
NHIMA maintains financial sustainability through careful fund management and diverse funding sources.
Njapau emphasized, “Preventive healthcare is vital for reducing long-term costs. Our wellness programs have significantly improved community health.”
Public communication is crucial for NHIMA, which engages members via a toll-free line, social media, SMS, and email. The mass registration campaign has significantly increased registrations in rural areas.
Njapau noted, “Our communication channels have effectively boosted awareness and registrations.”
NHIMA ensures accredited providers deliver quality care by setting standards and monitoring performance.
A patient from Solwezi commented, “I resolved my claim quickly through the toll-free line, showcasing NHIMA’s effective support systems.”
For high-cost treatments, NHIMA provides personalized care plans and supports providers through the Claim Advance Payment (CAP) initiative.
Njapau mentioned, “A Kitwe hospital secured funding for new equipment, enhancing care quality.”
Collaboration with public healthcare providers includes renovating departments, expanding service points, and recruiting additional clinicians.
NHIMA also invests in the continuous education and training of healthcare workers to stay updated with advancements. Recent training in Lusaka on cardiac care techniques has improved patient outcomes in cardiology.
With over 3,200,000 principal members and 1,500,000 beneficiaries, NHIMA has processed over 7,000,000 claims and maintains a pre-authorization turnaround time of 48 hours.
Njapau stated, “Our complaint resolution rate is 96%, with 98% of queries resolved.”
At the 96th Agriculture and Commercial Show, Njapau highlighted NHIMA’s benefits, particularly for the informal sector, and cited the prohibitive cost of a CT scan. “NHIMA has become essential for many Zambians,” he said.
Member testimonials reflect NHIMA’s impact. Grace Banda from Lusaka shared, “NHIMA covered a major surgery cost, easing my financial burden.”
Michael Tembo added, “NHIMA’s coverage for my daughter’s specialized treatment was invaluable.”
Njapau concluded, “The positive feedback from members underscores NHIMA’s vital role in providing accessible healthcare to Zambians.”
The organization’s efforts showcase how integrating digital solutions can enhance healthcare delivery and expand access across Zambia.