Kenya is a country of 42 million people and us$783 GDP per capita. Drawing on relative stability and a robust and growing economy, Kenya’s ministry of health (MOH), with support from local and global partners, are working to strengthen the national health system and address key health challenges, including a high prevalence of HIV and aids, tuberculosis, malaria, and high infant and maternal deaths. Together, they are reigniting progress toward health goals, including the millennium development goals by facilitating implementation of a broad base of health and related services.
As part of these efforts, the MOH has prioritized the nationwide implementation of organized, sustainable, and synchronized electronic medical information systems.
Since 2005, I-TECH has drawn on expertise from the University of Washington and the University of California, San Francisco, to support this work. As a key member of the Kenya electronic medical record (EMR) system technical working group, I-TECH worked to implement and standardize the EMR systems used in the management of national HIV and aids care and treatment data. Similar efforts have focused on ensuring that different electronic systems can communicate with one another (interoperability) and that health care workers, administrators, and staff are well trained to use and maintain them.
I-TECH designed and developed an electronic medical records system, KenyaEMR, in 2012 to support the care and treatment of HIV/aids. With the system in hand, I-TECH supported the implementation of 15 “model” EMR sites that demonstrated standardized implementation, generated best practices, and provided detailed information on the costs and efficiencies of using an EMR system. I-TECH then supported the implementation of KenyaEMR in 300 health facilities throughout Kenya—one of the largest EMR rollouts in Africa. I-TECH supports the use of the system through extensive capacity building of the health managers and through on-site training to mentors on system use, who then train other staff at the facility. The system provides a very good platform to conduct case-based surveillance of HIV/aids and other infectious diseases as efforts are geared toward data quality and data use.
In addition to these efforts, I-TECH Kenya provides technical assistance in the design and development of a national gender-based violence database. I-TECH also supports the MOH in the design and development of a national unique patient identifier (NUPI).
In 2014, I-TECH Kenya expanded its scope to include laboratory information systems (LIS).
In all efforts, I-TECH Kenya will continue to work closely with local partners to develop and implement programs that can be successfully transitioned to local ownership, ensuring sustainable progress toward Kenya’s long-term health goals.
I-TECH Kenya collaborates with local partners to:
- Standardize electronic health information systems in Kenya, streamlining data collection so that more accurate, complete, and accessible information is available to health care workers, leaders, and managers at all levels of the health system through establishing standards and guidelines for electronic health information systems and integrating these into policy.
- Create an environment of system interoperability in Kenya, allowing information sharing between systems (for example, between EMRs and pharmacy and laboratory information systems), and develop a national deployment plan to guide this progress.
- Design and develop high-quality, nationally standardized curricula for health care administrators and system users.
- Strengthen MOH and partners' capacity to equip facility personnel with the skills and knowledge to use systems and oversee KenyaEMR implementation and laboratory information system implementation through classroom orientations, workshops, mentorship, and self-based (online) study.
- Prepare health managers to take up their role overseeing and supporting the implementation and use of EMR and LIS systems.
- Streamline training costs and increase effectiveness by shifting to a facility-based training model, aimed at building on-site champion mentors capable of providing on-the-job training and mentorship to facility staff responsible for using the system to collect or report on data.
- Enhance on-site mentorship through the integration of e-learning technologies.
- Support pre-planning site assessments and continuing monitoring and evaluation of all activities, to encourage effective planning and rapid, data-driven response to challenges during implementation.
- Continue progress toward implementing KenyaEMR, a customized EMR system, to a total of 300 public health facilities across four regions of Kenya, including preparing for transition of KenyaEMR to local stewardship and management. To ensure sustainability, I-TECH will foster a local community of developers and implementers to advance open-source software development within Kenya.
- Design and develop KenyaEMR to be deployed at public health facilities, and expand system functionality through development of new features and enhancements.
- Design and develop a customized, open-source laboratory information system to be deployed at public health facilities.
- Support the implementation of a laboratory information system at the public health facilities in Kenya, including preparing for transition to local stewardship and management.
- Develop, implement, and support a national-level gender-based violence database, to bring together reporting from facilities throughout Kenya and support data-based interventions.
- Design and develop a national unique patient identifier (NUPI) to support patient treatment and care.
- Conduct data quality assessment on EMR data and collaborate with the MOH and other stakeholders on defining and supporting standard procedures for data quality assessment in EMR systems.
- Support the MOH to conduct cohort analyses on key patient outcomes in the HIV treatment cascade and on quality-of-care issues via EMR data.
- Improve KenyaEMR system for cohort analyses, and provide technical assistance to the MOH to define a research agenda for non-routine analyses using EMR data.