Medilink Network Inc. – APEA – Asia Pacific Entrepreneurship Awards

CORPORATE EXCELLENCE

Medilink Network Inc.

Technological breakthroughs are helping health care providers deliver services par excellence. These have become a driving force behind improvements in the health community--making health care more accessible to people, increasing patient safety, and allowing medical practitioners to work with greater ease. Indeed, technology has contributed greatly to the sector’s growth and is expected to shape the industry in years to come.

In the Philippines, MediLink Network, Inc. (MediLink) is among the companies pioneering technological solutions for the healthcare industry. Incorporated in 1999 as a joint venture between the Zuellig Group and the Equicom Group, MediLink has evolved to become one of the most successful health-tech companies in the country. The company’s commitment remains unchanged, which is to develop enterprise ICT solutions that promote efficiency, transparency, and sustainable profitable growth for the health community which is comprised of companies, members, health facilities, doctors, and insurers.

MediLink is first and foremost a company of geeks who enjoy working with each other, and trying new things. Sometimes new approaches work out, but sometimes these are utter failures. But for MediLink to have been operating successfully for nearly 20 years, the company had to be disciplined in creative destruction – to critically examine its services, be willing to discard outdated modes, and create new and better offerings from the ground up. Its CEO, Esther Go, says “once we lose that drive, and are no longer willing to do that to ourselves, we risk having our competitors do that to us.” This is especially true in technology, where boundaries are very fluid. The product development lifecycle could be very short as it is possible to go from concept to product within a few weeks or months.

Inspired by how Automated Teller Machines (ATMs) transformed the way individuals interact with banks, MediLink aims to do the same with how insured members interact with their health insurers. MediLink’s various portals allow users to “withdraw” from their health benefit limits instantly, from any device, anytime, anywhere.

Currently, MediLink’s portfolio has nearly 3 million members from the top health maintenance organization (HMOs) and insurance companies. Its electronic network has expanded beyond point of sale (POS) terminals into web and mobile applications, covering 100% of tertiary hospitals and 92% of secondary hospitals in the Philippines.

Many health care industry players still have paperintensive processes such as billing, claims submission and payment reconcilement. Together with its health industry partners, the company is collaborating to “electronify” healthcare authorizations and payments.

In particular, MediLink’s extensive electronic network allows service providers such as hospitals, clinics and doctors to verify member eligibility and request authorizations. By scanning a QR code, tapping a chip card or inquiring online, users can expect an instant response.

In cases where insurers or payors require preauthorization, MediLink provides escrow services to guarantee payments to providers. MediLink assures that these services are rendered according to payorprescribed-guidelines such as allowable conditions or benefit limits.

MediLink also allows health facilities to submit claims electronically with a verified approval code, given that these claims are processed in accordance with the member’s health plan. To monitor and prevent fraud, claims are adjudicated using business rules and artificial intelligence (AI) algorithms.

Prior to authorizing electronic payments, MediLink’s decision support system confirms that the claims presented by providers fall within the member’s benefit limits. The payments are then settled with providers on behalf of payors. The electronic proof-of-payment is provided to both payor and provider via their respective online portals to ensure transparency.

In addition, MediLink’s business intelligence services allow its clients to gain insight on utilization from a variety of dimensions. The insights such as member demographics, industry, geography, provider level, type of service, clinical diagnoses and clinical procedures, among others, could be used to identify key utilization cost drivers as a reference to develop targeted utilization management programs.

Demand for healthcare has been rising dramatically alongside economic growth. With rising discretionary incomes comes the increase in and early onset of lifestyle diseases such as hypertension and diabetes. However, supply of healthcare services have growth constraints due to the limited number of doctors, nurses and allied professionals that enter the workforce each year. The traditional mode of patients and doctor interactions faceto-face will lead to severe capacity constraints – high prices and long waits. For certain conditions, technology could support remote doctor consultation via voice and video chat. There are also health devices and sensors that capture patient vitals and send the results to a doctor or health facility.

To help keep members healthy while keeping costs under control, MediLink supports teleconsultations on its platform. The company also uses chatbots to answer simple queries. Furthermore, members are encouraged to keep lifestyle diseases under control and “gamify” health-seeking behaviors through integration with IOT devices, for example, by rewarding points commensurate with the number of steps taken.

Beyond improving efficiency through its wide range of services, MediLink continues to explore possibilities at the bleeding edge. In the health space, innovation is important because nobody has found the magic bullet. This is true globally. It is ironic that during the age of improved technology, scientific knowledge, better living conditions and personal freedoms, that more young people are experiencing early onset of lifestyle diseases such as hypertension, diabetes, coronary artery disease, various forms of cancer, stroke, gout. Ultimately, the success of any intervention or health technology is determined by how many people are helped to either avoid sickness, or preserve current health conditions without deteriorating.

The company is also making a name for itself outside the country. Last year, MediLink won in the Services and Solutions Category in Harnessing Machine Learning to Enable Efficient, Accessible and Affordable Healthcare during the International Innovation Awards 2017, besting entries from 16 other countries. MediLink President and Chief Executive Officer Esther Go was also one of the winners in the Asia Pacific Entrepreneurship Awards 2017 in the Philippines for the Healthcare Industry.

In the near future, the company is poised to extend its footprint beyond the Philippines and Singapore and broaden its presence in the Asia-Pacific region. The company believes that solutions enabling efficient, accessible and affordable health care are relevant not only to the Philippines, but in other markets as well. Health care, after all, is a universal human need.

CORPORATE EXCELLENCE

Medilink Network Inc.

Technological breakthroughs are helping health care providers deliver services par excellence. These have become a driving force behind improvements in the health community--making health care more accessible to people, increasing patient safety, and allowing medical practitioners to work with greater ease. Indeed, technology has contributed greatly to the sector’s growth and is expected to shape the industry in years to come.

In the Philippines, MediLink Network, Inc. (MediLink) is among the companies pioneering technological solutions for the healthcare industry. Incorporated in 1999 as a joint venture between the Zuellig Group and the Equicom Group, MediLink has evolved to become one of the most successful health-tech companies in the country. The company’s commitment remains unchanged, which is to develop enterprise ICT solutions that promote efficiency, transparency, and sustainable profitable growth for the health community which is comprised of companies, members, health facilities, doctors, and insurers.

MediLink is first and foremost a company of geeks who enjoy working with each other, and trying new things. Sometimes new approaches work out, but sometimes these are utter failures. But for MediLink to have been operating successfully for nearly 20 years, the company had to be disciplined in creative destruction – to critically examine its services, be willing to discard outdated modes, and create new and better offerings from the ground up. Its CEO, Esther Go, says “once we lose that drive, and are no longer willing to do that to ourselves, we risk having our competitors do that to us.” This is especially true in technology, where boundaries are very fluid. The product development lifecycle could be very short as it is possible to go from concept to product within a few weeks or months.

Inspired by how Automated Teller Machines (ATMs) transformed the way individuals interact with banks, MediLink aims to do the same with how insured members interact with their health insurers. MediLink’s various portals allow users to “withdraw” from their health benefit limits instantly, from any device, anytime, anywhere.

Currently, MediLink’s portfolio has nearly 3 million members from the top health maintenance organization (HMOs) and insurance companies. Its electronic network has expanded beyond point of sale (POS) terminals into web and mobile applications, covering 100% of tertiary hospitals and 92% of secondary hospitals in the Philippines.

Many health care industry players still have paperintensive processes such as billing, claims submission and payment reconcilement. Together with its health industry partners, the company is collaborating to “electronify” healthcare authorizations and payments.

In particular, MediLink’s extensive electronic network allows service providers such as hospitals, clinics and doctors to verify member eligibility and request authorizations. By scanning a QR code, tapping a chip card or inquiring online, users can expect an instant response.

In cases where insurers or payors require preauthorization, MediLink provides escrow services to guarantee payments to providers. MediLink assures that these services are rendered according to payorprescribed-guidelines such as allowable conditions or benefit limits.

MediLink also allows health facilities to submit claims electronically with a verified approval code, given that these claims are processed in accordance with the member’s health plan. To monitor and prevent fraud, claims are adjudicated using business rules and artificial intelligence (AI) algorithms.

Prior to authorizing electronic payments, MediLink’s decision support system confirms that the claims presented by providers fall within the member’s benefit limits. The payments are then settled with providers on behalf of payors. The electronic proof-of-payment is provided to both payor and provider via their respective online portals to ensure transparency.

In addition, MediLink’s business intelligence services allow its clients to gain insight on utilization from a variety of dimensions. The insights such as member demographics, industry, geography, provider level, type of service, clinical diagnoses and clinical procedures, among others, could be used to identify key utilization cost drivers as a reference to develop targeted utilization management programs.

Demand for healthcare has been rising dramatically alongside economic growth. With rising discretionary incomes comes the increase in and early onset of lifestyle diseases such as hypertension and diabetes. However, supply of healthcare services have growth constraints due to the limited number of doctors, nurses and allied professionals that enter the workforce each year. The traditional mode of patients and doctor interactions faceto-face will lead to severe capacity constraints – high prices and long waits. For certain conditions, technology could support remote doctor consultation via voice and video chat. There are also health devices and sensors that capture patient vitals and send the results to a doctor or health facility.

To help keep members healthy while keeping costs under control, MediLink supports teleconsultations on its platform. The company also uses chatbots to answer simple queries. Furthermore, members are encouraged to keep lifestyle diseases under control and “gamify” health-seeking behaviors through integration with IOT devices, for example, by rewarding points commensurate with the number of steps taken.

Beyond improving efficiency through its wide range of services, MediLink continues to explore possibilities at the bleeding edge. In the health space, innovation is important because nobody has found the magic bullet. This is true globally. It is ironic that during the age of improved technology, scientific knowledge, better living conditions and personal freedoms, that more young people are experiencing early onset of lifestyle diseases such as hypertension, diabetes, coronary artery disease, various forms of cancer, stroke, gout. Ultimately, the success of any intervention or health technology is determined by how many people are helped to either avoid sickness, or preserve current health conditions without deteriorating.

The company is also making a name for itself outside the country. Last year, MediLink won in the Services and Solutions Category in Harnessing Machine Learning to Enable Efficient, Accessible and Affordable Healthcare during the International Innovation Awards 2017, besting entries from 16 other countries. MediLink President and Chief Executive Officer Esther Go was also one of the winners in the Asia Pacific Entrepreneurship Awards 2017 in the Philippines for the Healthcare Industry.

In the near future, the company is poised to extend its footprint beyond the Philippines and Singapore and broaden its presence in the Asia-Pacific region. The company believes that solutions enabling efficient, accessible and affordable health care are relevant not only to the Philippines, but in other markets as well. Health care, after all, is a universal human need.