Company History and Profile

Iso Leso is a respected national network of optometrists with a reputation for delivering high quality service and products to its patients and members of medical schemes. Its mission is to ensure the viability and stability of the optometric environment for all role players.

Iso Leso was structured as a public company in 1999 and is wholly owned by the majority of registered South African optometrists. The Iso Leso network includes independent practitioners and retail optometric chains being equally represented.

Iso Leso is managed by a board that is elected by the majority of practicing optometrists in South Africa.

Iso Leso is the only Optometric Network that is owned by participating providers.

• There are limitations on individual shareholding to prevent dominance and encourage universal participation of all eligible optometrists.
• The company is managed by an elected board according to its Memorandum of Incorporation.
• Iso Leso abides to the highest levels of corporate governance in keeping with King III Corporate Governance framework/guidelines.
• To this end, we ensure that all our value partners share a similar philosophy. Iso Leso established a VisionPartner Program that invites ethical and transparent business partners to provide products and services as required. These partners include:
• The Graduate Institute of Optometry
• Insight Actuaries and Consultants
• Ophthalmology Management Group
• African Vision Institute
• Carl Zeiss, Essilor and Hoya Optical laboratories
• HealthBridge
• Ernst & Young Charted Accountants
• Integritas Consulting and Integritas Auditors
• Webber Wentzel Competition Attorneys
• Qhubeka Forensic Services
• Elsabe Klinck and Associates
• PredictX Data Analytics Tool

As a measure of our commitment to ethical and transparent conduct, we have engaged a respected independent actuarial company, Insight Actuaries, to audit our management and business processes on an ongoing basis.

This dedication to transparency and governance is a cornerstone of our engagement with medical schemes and service providers. We encourage schemes to interrogate our financial proposals and often share our intellectual capital to promote trust.

1. Network Coverage
   Large network offering country wide coverage.
   The network includes 2400 contracted optometry practices, which has resulted in 99.5% of all claims being paid directly. Only 0.5% of claims are member reimbursements as a matter of member choice. We actively manage the network, making sure that the scale and geographic coverage remains intact.The Iso Leso Network coverage has been measured by the biggest schemes in the country. All the schemes have found the Iso Leso provider footprint meets their access requirements.Iso Leso has a significant advantage in being owned by the majority of South African Optometrists which ensures network participation. In the unlikely event of the provider footprint being an issue in a remote location, our team actively engages with identified practices to encourage participation.

   Iso Leso has structured communication channels with the providers including sms, WhatsApp, email and national roadshows. New contracts are communicated via these channels to notify and invite practitioner participation.

2. Comprehensive Benefit Design and Quality Management
   The current Optometric Benefit design philosophy is detailed below with the emphasis on clinically appropriate care delivered via one of two designs.Eye care includes the delivery of professional services and prescription lenses. Innovations and progress are constantly reviewed for inclusion in our care models. Iso Leso has relationships with leading academic institutions as well as optical laboratories to validate new developments. This approach is reflected in our leading Artificial Intelligence and Integrated Eyecare platform, Optinet.In addition, Iso Leso has established a public-private partnership with Groote Schuur Hospital where we provide post cataract refraction, advanced contact lens fittings for corneal disease and transplant cases. This has facilitated access for Therapeutic training of Optometrists in our network. The clinical exposure in this tertiary environment assists our team in being at the forefront of clinical care.

   The principles of an ideal eye care benefit should allow:

   • A Comprehensive Vision Examination: is the basis of eyecare and global developments include Artificial Intelligence as part of care. The results of Artificial Intelligence screening must be integrated into the schemes disease management strategy as a critical Primary Care function.
   • Lens designs: cater to functional correction depending on age and occupational demands. The need for visual function at multiple distances is common to all jobs from basic to advanced tasks.
   • Frames and Lens additions: includes an aesthetic component which needs to be managed with an allowance to reduce scheme risk.
   • Contact Lens Materials: This is a lump sum value in lieu of spectacles and is deemed an either / or benefit.Iso Leso has two Benefit Designs to meet scheme requirements. These benefit designs can be applied to various scheme options to allow differentiation and cost containment. A: Fee for Service GRID for traditional benefit options.
     B: Bronze Package for lower cost benefit options.

     A: Fee for Service GRID:
     

   • Comprehensive consultation including Tonometry and Visual Fields.
   • Offer Comprehensive Base Lens cover including all 4 designs at Iso Leso Managed Care rates.
   • Include a Frame/LensXtenda allowance that allows market choice.
   • No co-payments within benefit limits.
   • 24-month individual benefit cycle from date of service.
   • Spectacles OR Contact Lenses in a benefit cycle.
   • Artificial Intelligence Innovation for Disease Management. B: BRONZE- Package Option for Lower Cost Product
     
   • Comprehensive consultation including Tonometry and Visual Fields.
   • Simplified ONE CODE FOR INCLUSIVE VISION EXAM AND MATERIALS.
   • Comprehensive Core Base Lens cover including Single Vision, Bifocal and Multifocals.
   • Includes a Basic Frame.
   • No co-payments within benefit limits.
   • 24-month individual benefit cycle.
   • Spectacles OR Contact Lenses in a benefit cycle.
   • Artificial Intelligence Innovation for Disease Management.
3. Disease Management Innovation 
   Artificial Intelligence Innovation-AEyeIso Leso was short listed by the BHF in the 2023 Titanium Awards for best paper:Iso Leso Network: Engaging New Technologies in Eyecare

   It is time to embrace Optometry into the healthcare team and leverage the advantage that Artificial Intelligence can deliver.

   Iso Leso has secured the rights to an advanced AI eyecare platform that will be integrated into future benefit designs – this means no third party to add cost and complexity.

   This screening tool brings the benefit of early eyecare disease detection, including:

   • Diabetic Retinopathy
   • Glaucoma and
   • Age Related Macular Degeneration (AMD)

   Uploading photographs of the back of the eye to the AI platform generates an advanced screening outcome for the detection of expected clinical changes in the suspected disease.

   This means that scheme members could benefit from an advanced screening within 30 seconds which has a high specificity of 95.5% and sensitivity of 86.5%.

   The AI screening results are a valuable resource in global disease management. Iso Leso has developed an advanced platform called Optinet that allows integration of screening results into the schemes reporting and disease management processes.

   The benefits of AI screening and reporting includes early detection and routine monitoring of the impact of interventions in disease management. As Optometry is a primary care profession with a significant national footprint, AI presents an opportunity to incorporate accessible and cost-effective care to the scheme and its members. Iso Leso has engaged on a national rollout to encourage and train providers in adaptation of these new innovations.

   Our team has engaged in investigating various applications of AI in ocular disease in other countries with the view of developing South African solutions with the scheme.

   The value of the platform and network management of Artificial Intelligence is validated by the fact that Discovery Health has contracted Iso Leso to manage their bespoke Diabetic Retinopathy Screening programme.