So, what exactly is Artificial Intelligence (AI)? AI is not a single technology but a combination of various advanced techniques, including machine learning, deep learning, and natural language processing, among others. These technologies work together with data, analytics, and automation to help organisations innovate and achieve their objectives more quickly and accurately.
The healthcare industry is highly complex, heavily regulated, and often slow to change. However, AI has already revolutionised many other sectors and holds significant potential to enhance healthcare delivery—while also introducing risks that are difficult to predict.
AI is poised to fundamentally reshape healthcare and medical schemes in South Africa by driving innovation across diagnostics, treatment, operations, and public health. Despite the complexity and regulatory challenges inherent in the healthcare sector, AI’s ability to analyse vast and diverse datasets enables more accurate diagnoses, personalised treatment plans, and efficient care delivery—ultimately improving patient outcomes and system sustainability.
What is AI-driven Personalised Healthcare Pathways?
AI-driven healthcare pathways use advanced artificial intelligence, predictive analytics, and vast clinical and behavioral data to create dynamic, personalised health journeys for patients. These pathways continuously adapt in real time as new health data becomes available, ensuring recommendations remain relevant and precise for each individual.
For example, one of biggest medical schemes in South Africa has a platform that serves over 2.1 million members by analysing one of the world’s largest clinical and lifestyle datasets to deliver hyper-personalised health advice. The platform treats every member as unique, dynamically adjusting health recommendations based on their specific health status, risk factors, and engagement patterns—similar to how a GPS app recalculates the best route based on real-time traffic data.
Key features and benefits of AI-driven personalised healthcare
Precision diagnostics and treatment: AI examines genetic, clinical, and lifestyle data to tailor treatment plans, improving accuracy and outcomes. In oncology, AI helps identify targeted therapies by matching genetic markers to effective drugs, improving survival rates and reducing side effects.
Dynamic, real-time adaptation: AI continuously analysing new patient data—such as lab results, wearable device metrics, and clinical updates—to refine care pathways and recommendations, enabling proactive adjustments to treatment and prevention strategies.
Operational efficiency: Automating routine tasks and providing clinical decision support reduces clinician workload and streamlines patient management, allowing more focus on personalised care.
Preventive and proactive care: AI predicts health risks and suggests preventive measures tailored to individual profiles, shifting healthcare from reactive treatment to proactive health management, which can reduce hospital admissions and improve long-term outcomes.
However, alongside these promising advances, it is crucial to remain mindful of the ethical considerations, data privacy concerns, and potential risks associated with AI implementation. Responsible adoption, ongoing evaluation, and collaboration among healthcare providers, medical schemes, regulators, and technology partners will be key to unlocking AI’s full potential.
Closing remarks
AI offers a transformative opportunity for South Africa’s healthcare landscape – enhancing quality, accessibility, and efficiency while supporting the evolving needs of patients and medical schemes alike. Embracing this technology thoughtfully will be essential to building a more resilient, innovative, and equitable healthcare system for the future.
Health Insights – July 2025