Health Systems Integration in Improving Patient Management

INTRODUCTION

Kenya is one of the counties in the world implementing the Universal Health Coverage program (UHC). In the pilot counties (Machakos, Isiolo, Kisumu and Nyeri) there have been tremendous increase in the number of patients seeking health services. This translates to volumes of patient’s data being collected on daily basis. Ministry of Health (MOH) and Counties have invested in numerous health information systems to help manage this data. One of these systems is the laboratory Information management system (LIMS). The LIMS system helps to manage laboratory data so as to guarantee accurate results are reported by ensuring high degree of adherence to the set quality standards as well as reducing the manual transcriptions of results from the analyzers.
The greatest challenge has been ensuring that there is seamless communication between LIMS and other health Information management systems especially on referred cases e.g. Viral load and Early infant Diagnosis (EID), and ensuring that the patient is put on appropriate care in a timely manner.

METHOD

A team from various stakeholders in the health informatics space (MOH, APHL, Palladium group, Clinton Health Access Initiative (CHAI) and Ministry of Health Kenya developed a multilevel integration protocol that leveraged on already existing technologies and expertise. On release of either Viral Load or EID results, the integration engine sends the results automatically to the requesting facility on email and to the national dashboard. An integration between LIMS and Ministry of Health, allows the same results to be sent via a text message and delivered to the requesting facility that may not even have access to the internet. This communication is Realtime and the results will be available to the farthest corner of the county as soon as they are ready.

RESULTS

The TAT for VL and EID testing has been reduced from a high of 30 days for VL and EID to the current average of 10 Days for VL and 5 days for EID. Clinicians don’t have to wait for paper-based results, they can access the electronic results and put the patient in proper care ASAP.

CONCLUSION

Quality laboratory testing is a fundamental bedrock in supporting UHC. Shortening the time it takes to get results especially on referred cases is in most cases a matter of Life and death. Systems supporting health services should be integrated to ensure that patients are timely managed and the quality of care is guaranteed.