Success Stories

Introduction

Globally, digital health is a dynamic and multifaceted phenomenon. According to the Global strategy on digital health 2020-2025, the vision is to improve health for everyone, everywhere by accelerating the development and adoption of appropriate, accessible, affordable, scalable, and sustainable person-centric digital health solutions to prevent, detect and respond to epidemics and pandemics. These digital health infrastructure and solutions can radically change health outcomes and support Sustainable Development Goals if supported by sufficient investment in infrastructure, governance, and workforce capacity.

HealthIT, a USAID-funded project whose goal is to contribute to evidence-based decision-making by Health Sector stakeholders in Kenya has been at the epicenter of supporting the Government of Kenya in the digitization of its health systems and government-led investments in digital healthcare. The project supports the Government of Kenya, National and County Ministry of Health (MoH) in the evolution, enhancement, management, and interoperability of digital health systems in order to meet current and emerging health needs.

Situation analysis

As part of its five-year Big 4 Agenda (2018–2022), the Government of Kenya through MoH has prioritized the attainment of universal health coverage (UHC). The recommendation on the use of Information and Communication Technologies (ICT) for health to improve quality and provide safe patient-centric health services and effective HIV programming and management led to digital health investments. One such investment is the strengthening of health information systems across the spectrum of data collection, information generation, analysis, and utilization to support effective decision-making among producers and consumers of health information.

MoH has also developed several policies and guidelines that relate to the use of national health information systems. These systems are now enabling the generation of data at different levels, often stored in different formats across various systems and locations, making access, sharing, and analysis difficult or impossible to achieve thus contributing to a lack of clear monitoring and evaluation mechanisms. The Ministry of Health (MoH) has ongoing efforts geared towards digitizing health records and making different health information systems interoperable.

MoH, in partnership with other stakeholders, among them USAID HealthIT, embarked on digitizing Kenya’s health service delivery. These initiatives also complement the piloting and implementation of the Kenya National Digital Health Platform (DHP), a system envisaged by the MoH as a robust and sustainable Electronic Health Records (EHR)system following global best practices and supporting the current and future needs of the Ministry. The HealthIT project provides technical support to MoH in the development of the DHP. Together, these digital interventions will result in improved data quality and reporting, healthcare services, and ultimately better health outcomes and programming.

Methodology

USAID through HealthIT in this regard enhanced patient-level data collection and decision-making through the provision of ICT infrastructure at the facility site level with a goal to improve patient care and outcomes in the scale up on the use of Electronic Medical Records (EMR) system for patient-level management including HIV /AIDS. The deployment of the infrastructure will also support the roll-out and uptake of the Digital Health Platform.

USAID-HealthIT’s implementation approach was to collaboratively work with; the Ministry of Health (MoH), County Governments, 7 other Universities across the country (referred to as County Proximate Universities (CPU)), Service Delivery Implementing Partners (SDIP), and Digital Health and Strategic Information Partners in the scale-up. The process involved the following steps; Stakeholder engagement, Facility identification and gap assessment, ICT equipment procurement, ICT equipment deployment, Quality assurance, Documentation, Routine ICT technical support, and System sustainability plan. The scale-up of digital health solutions included Ushauri App, Web ADT, MLab & EID VL, Integrated DHP/KenyaEMR, CHT app/ HTS, NDW and KHIS – AIR.

The facility ICT gap assessment identification focused on the availability of hardware infrastructure, staff capacity, stable source of power, access to communication facilities, and physical security of the site. A procurement plan was developed by the project based on Facility Assessment Reports and provided equipment description and standards. Identification and award of the tender to successful vendors followed by ICT deployment in the digital health systems scale-up ecosystem. After the deployment of the ICT equipment, proper installation and configuration of the EHR in the selected health facilities, and provision of basic training on the use of the EHR system at the facilities took place.

The project works in collaboration with the county department of health, service delivery partners, and county-proximate universities to support the continuous utilization and sustainability of digital health. Through the development of the responsibility matrix with the different stakeholders, each party as tasked to take up their respective roles so as to enhance sustainability. This is illustrated in Figure 4.

Results

(a) Counties and Health facilities Reached

USAID HealthIT working the with National MoH, NASCOP, the County Health Management Teams from the County Departments of Health, and the 7 county-proximate universities equipped 165 health facilities with ICT equipment among them 40 model facilities during the digital health systems scale-up exercise that took on a 360-degree implementation approach that including ICT infrastructure, technical assistance on Electronic Health Records system deployment, and capacity strengthening on the equipment and system end users on how to use the infrastructure The scale-up took place in four phases as per the schedule below:

(b) Equipment Supplied

Equipment supplied to the various facilities included;

Conclusion

Expected changes in data collection, transmission, storage, interoperability, and use due to these digital solutions

The digital health systems scale-up will enhance the interoperability of digital health systems and is expected to further support data collection, availability of data and reporting to strengthen decision-making both at the facilities, county, and national MoH. It will also ensure greater participation in the exchange of data and information by different actors in the healthcare ecosystem. Health workers, who previously just reported data, can now leverage digital technologies to play a more active role that influences the organization of healthcare delivery programming. Clients can now receive better health care through a continuum of delivery. With digitization, the government, and MoH can optimize the accessibility of data for use, systems maintenance, and payment for health care.

The deployment across the country in pictures: