On 26 September, a PMI Business Club meeting focused on the adoption of digital technologies in healthcare and the challenges of managing organisational change. Discussions covered the accreditation of medical institutions, the difficulties involved in opening a hospital, and collaboration between organisations. One of the key presentations explored GPI Holding’s experience. Tinatin Koberidze, Deputy Director of Services and Innovation, introduced the company’s Real Freedom of Choice initiative and discussed the digitalisation of healthcare services across more than 150 clinics.
The initiative allows policyholders to receive treatment at a participating clinic of their choice while paying only the portion of the cost specified in their insurance policy. They no longer need to pay the full amount upfront, collect documents or wait for reimbursement. To make this possible, GPI integrated information exchange and service authorisation processes between the insurer and its partner clinics.
According to Koberidze, implementing these changes required more than developing new technology. It also involved understanding how partner clinics operate, training teams and reconsidering established working practices. We spoke with her about the challenges of implementing the project, making health insurance easier to use and the changes she expects to see across the healthcare sector in the coming years.
M: An “integrated healthcare ecosystem” is a broad concept. What should it actually mean for patients?
For policyholders, an integrated healthcare ecosystem should, above all, mean simplicity. People should not have to act as intermediaries between different systems, clinics and insurance companies, collecting documents, paying the full cost of treatment upfront and then waiting to be reimbursed.
At GPI, we have been actively working towards this for the past decade. We were among the first companies in Georgia’s insurance market to begin systematically digitalising insurance processes. Since then, we have continued to explore how new technologies can better serve our customers’ needs.
One important example is our Real Freedom of Choice initiative. For us, freedom of choice means more than simply being able to select a preferred clinic, particularly if the policyholder must first cover the entire cost of treatment and then submit a reimbursement claim. We wanted customers to be able to use their insurance directly at any participating clinic of their choice, paying only their share of the cost under the policy. GPI and the clinic handle everything else between them.
This is what developing a digital healthcare ecosystem means to us: making access to services as straightforward as possible for the customer.
M: More specifically, how does Real Freedom of Choice differ from the traditional freedom-of-choice model?
Under the traditional model, policyholders could choose their own clinic, but in many cases they had to pay the entire bill themselves, collect the necessary documentation and then submit a claim to their insurer for reimbursement. We felt that while this gave customers a choice, it did not make using their insurance particularly convenient.
With Real Freedom of Choice, customers can use their insurance directly at any participating clinic they prefer, paying only their share of the cost at the point of service. GPI settles the remainder directly with the clinic. From the customer’s perspective, this is a simple change, but making it possible requires a fairly sophisticated digital infrastructure.
The project reflects our approach to innovation: technology should make insurance easier to use, regardless of how complex the underlying systems may be.
M: Beyond the technology itself, what did it take to bring more than 150 clinics into a single system?
The project involved considerably more than building the technology. Each of the more than 150 clinics has its own workflows, requirements and technological environment. We knew from the outset that developing a single standardised solution and offering it to every clinic would not be enough.
Working closely with our partner clinics, the GPI team conducted a detailed assessment of their existing processes, experiences and needs. We used those findings to develop the system, followed by a collaborative implementation process involving staff training and continuous improvements. It was particularly important to us that the clinics themselves were involved in developing the solution.
M: Which proved more difficult: implementing the new technology or changing people’s behaviour and established working practices?
Developing technology is challenging, but changing workflows and organisational cultures that have evolved over many years is often even harder. Our experience has shown that creating good technology alone is not enough to bring about meaningful change.
Connecting more than 150 clinics to a single system required us to understand how each organisation worked, study its specific needs, review existing practices, train teams and maintain an ongoing feedback process. We also drew on the clinics’ professional knowledge and experience when designing the system.
At GPI, our digital development relies not only on technological expertise but also on our experience of managing change. We are prepared to rethink an entire process if we believe doing so will make the customer’s experience easier.
M: Where are the most significant gaps in communication between different parts of the healthcare system today, and how can digital platforms help address them?
One of the most problematic areas is the exchange of information between healthcare providers, funding organisations and patients. In our experience, connecting the information-sharing and authorisation processes between clinics and insurance companies remains a significant challenge.
With Real Freedom of Choice, we connected the workflows of clinics and the insurer, digitalised information exchange and service authorisation, and integrated the new system into everyday operations. As a result, customers can now use their insurance directly at more than 150 clinics without unnecessary administrative procedures.
For us, this is the real value of digital development: customers should experience the benefits of technology when they receive a service.
M: How do you determine which innovations are worth implementing and which are unlikely to deliver meaningful benefits to policyholders?
GPI has always aimed to be among the first companies in Georgia’s insurance market to introduce new technological capabilities. However, when making these decisions, our first consideration is what the technology will actually change for the policyholder.
If it reduces bureaucracy, saves time, makes insurance easier to use or gives customers access to something they could not previously do, then it has value.
The idea behind Real Freedom of Choice emerged from a specific problem: even people with health insurance sometimes had to pay the full cost of medical services out of pocket and wait to be reimbursed. Technology allowed us to change that process. Today, customers pay only their share at the clinic, while GPI and the healthcare provider handle the rest.
When evaluating an innovation, we focus on how much easier it makes accessing services.
M: Patient data needs to move between different organisations. How can healthcare services become more convenient without compromising trust or data security?
Digital transformation in healthcare is impossible without data security. Medical information is particularly sensitive, so convenience, speed and security must be considered together from the very beginning.
At GPI, we develop digital services with the aim of ensuring that information shared between different systems is used for clearly defined purposes, handled securely and governed by transparent procedures. In the case of Real Freedom of Choice, one of the technology’s key functions is to enable timely information exchange and service authorisation between the clinic and GPI.
Customers do not need to understand the technical details, but they should know what information is being shared, why it is needed and who receives it. Making services more convenient must go hand in hand with transparency about how data is used. Both are essential when evaluating the quality of a digital service.
At the same time, the role of a modern insurance company should extend beyond financing medical treatment. Insurance should increasingly help people manage their healthcare needs, from prevention and primary care to diagnostics and treatment.
This is also the direction in which we are developing our digital platforms and services. We want insurance to be easy to use, while ensuring that customers feel supported when identifying, planning and accessing the healthcare services they need.
M: Which technological development do you believe will have the greatest impact on healthcare in the coming years?
Artificial intelligence will bring significant changes to healthcare. We are also working in this area, with plans to further simplify and accelerate reimbursement processes, funding approvals at clinics and pharmacies, and access to services.
We are exploring opportunities to automate processes using emerging technologies. It is important to evaluate new systems in real working environments before making claims about their results or potential scale. Beyond these applications, AI is also creating new opportunities in personalised medicine, telemedicine and data integration.
Our experience has demonstrated how important it is to connect different processes. When developing Real Freedom of Choice, GPI and its partner clinics shared their expertise and worked together to simplify both insurance procedures and access to medical care.
I believe the next major step will be bringing artificial intelligence, data integration and personalised services together within a single system. For GPI, it is important to be among the first to turn these capabilities into accessible services for customers.
M: How do you measure the impact of innovation, and what do you consider the most important indicator of success?
Processing speed, cost reduction, customer satisfaction and improvements in health outcomes are all important indicators. Ultimately, however, what matters most to us is how the customer experience has changed.
We monitor processing times, operational efficiency, levels of automation and the reduction in manual tasks. We also assess whether accessing services has become easier for policyholders, how many steps have been eliminated from the process and how quickly customers can receive the care they need.
At GPI, we measure the success of technology by the improvements it brings to customers’ everyday experiences. People may not even notice the technology itself, but they should feel its benefits when using our services.
M: Looking five years ahead, what would need to change for you to consider the digital transformation of healthcare a success?
For me, the clearest sign of success would be a situation in which customers no longer have to think about how many different organisations, systems and procedures are involved in receiving a single medical service.
They should be able to choose a doctor or clinic, access the treatment and funding they need, and manage the subsequent steps quickly and easily. If, five years from now, a patient can say, “I simply went to the clinic, received the care I needed, and the system took care of everything else,” that would be the strongest possible evidence of successful digital transformation.
M: Finally, what enables GPI to continue introducing digital innovations and making progress in this area?
First and foremost, our organisational culture. We see digital development as an integral part of business development, and we have operated according to that principle for years.
Having modern systems is important, but an organisation must also be willing to critically assess its own processes, experiment and, when necessary, completely replace practices it has relied on for many years.
The second important factor is our continued focus on customer needs. When planning a technology project, we begin by identifying the problem the customer needs us to solve. GPI has been actively introducing digital technologies to Georgia’s insurance market for years, and we intend to continue that work.
When we see an opportunity to make accessing services easier for customers, we are prepared to invest the effort required to introduce it, even before it becomes common practice across the market.
