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Canopy Care Management

Smart, Scalable and Outcomes-Focused Care Coordination

At Smartchoice Technology, we believe that effective healthcare management begins with intelligent care coordination. Our Canopy Care platform is purpose-built to empower administrators, providers, and interdisciplinary care teams to manage chronic disease, improve patient engagement, and reduce unnecessary utilisation—while remaining fully compliant with South African regulatory requirements.

Backed by the enterprise-grade PLEXIS Quantum Choice™ platform, Canopy Care transforms fragmented processes into cohesive care journeys. Whether you're managing a growing member base, modernising outdated systems, or aligning with NHI goals, Canopy offers the tools to scale with confidence.

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Risk-Based Member Stratification and Targeted Outreach

Canopy enables healthcare organisations to proactively identify high-risk members through:

Integrated Health Risk Assessments (HRAs)
Claims and clinical analytics
Configurable risk scoring algorithms

This structured stratification supports targeted enrolment into care programmes, ensuring clinical teams prioritise members most in need of coordinated support—driving better outcomes and cost containment.

Disease Management Programmes at Scale

From diabetes and hypertension to HIV and asthma, Canopy supports comprehensive disease management through:

Pre-configured, condition-specific care plans
Real-time alerts and gaps-in-care notifications
Patient engagement tools, appointment reminders, and shared goal tracking
Interdisciplinary collaboration via shared casebooks

This approach enables medical schemes and care teams to deliver personalised, high-impact interventions—reducing complications and avoidable hospitalisations.

Tailored Care Plans & Multidisciplinary Collaboration

Every care plan in Canopy is:

Customisable to the individual’s clinical condition, goals, and preferences
Aligned with scheme rules (including PMB compliance and risk/savings logic)
Informed by input from doctors, nurses, social workers, and the patient

Care teams operate from a centralised casebook—modelled on clinical charts—ensuring clarity, accountability, and continuity of care.

Why Choose Canopy?

Feature	Value
Rules-based care plans	Drive proactive, consistent disease management
Member stratification	Prioritise resources for high-risk members
Automated workflows	Reduce manual workload and turnaround time
Real-time dashboards	Track progress and identify gaps in care
Interoperable APIs	Enable mobile apps, portals, and remote workflows
Secure document storage	Maintain confidentiality and compliance

Real-Time Data Integration with Quantum Choice™

Canopy is natively integrated with Quantum Choice, ensuring:

Bi-directional syncing of member, claims, and provider data
Single view of each member’s clinical and utilisation history
Longitudinal tracking of outcomes and adherence over time

This member-centric architecture ensures that interventions are based on accurate, up-to-date data—enhancing both decision-making and reporting.

Cost Control, Outcomes Improvement

Administrators using Canopy have reported:

Reduced ER visits and hospital admissions
Improved chronic condition adherence
Lower administrative overhead via workflow automation
Better ROI tracking on disease management investments

Canopy also supports value-based contracting by quantifying the clinical and financial impact of care interventions over time.

Data Security and Compliance by Design

Built for international standards and local regulations:

POPIA-ready architecture with encryption, access controls, and audit trails
Native ICD-10 support for accurate coding and analysis
EDI and payment protocols that meet HIPAA-equivalent standards

Your data is protected, compliant, and always available when and where it's needed.

Designed for South African Health Systems

Whether replacing a legacy platform or supporting a new administrator, Canopy is:

Technologically aligned and comparable with major players (e.g. Medscheme Nexus, Discovery Fusion)
Fully compatible with NAPPI, PMBs, and South African benefit models
Adaptable to support NHI-aligned care coordination models

With modular integration and reusability of configurations, there’s no need for rip-and-replace—Canopy fits within your current ecosystem while modernising your care capabilities.

Canopy supports healthcare providers in reducing unnecessary hospital admissions by enabling proactive, data-informed care. Through early identification of high-risk individuals, the creation of personalised care plans, and seamless coordination of interventions, the platform helps to prevent avoidable hospital stays—enhancing patient outcomes while containing costs.

Canopy empowers healthcare administrators to deliver more with less—reducing overutilisation by shifting from reactive to preventative care. With early risk detection, streamlined care pathways, and targeted interventions, the platform ensures resources are allocated where they matter most, improving efficiency and outcomes simultaneously.

Canopy places patients at the centre of care—enhancing satisfaction through personalised, coordinated, and efficient service delivery. Tailored care plans, secure communication, and reduced hospital visits help patients feel informed and supported. With intuitive dashboards and better clinician availability, members gain greater control over their health while providers deliver higher-quality care. The outcome: a 32% improvement in satisfaction scores, alongside more effective resource utilisation.

Canopy enhances operational efficiency by automating routine processes, easing administrative workloads, and improving resource allocation. From intelligent care coordination to auto-generated documentation, the platform simplifies complexity—freeing up clinical and administrative teams to focus on delivering high-quality patient care.