Framework for the implementation of a patient electronic referral system: case study of Nairobi province.

Abstract

A research into the area of usage of leTs in health with a particular focus on developing a framework for e-referral for exchanging patient information between health institutions in order to provide continuity of patient care is detailed. A background of the structure of health care delivery services in Kenya is first outlined. An initial observation shows that there is an imbalance in the distribution of health care providers particularly in government hospitals and that the operations are manual. Also hospitals are run as single entities with no information to link among them resulting to discontinuity in care delivery thereby leading to very inefficient patient care because of lack of care continuity and high costs in care delivery. Literature in strategic role of IC'Ts in health care citing the current and emerging technologies in electronic health care delivery is reviewed. It shows that the challenges of cost and quality care can be overcome if the services were delivered electronically. However, health care information systems are tailored based on the results of assessment needs for individual hospitals. The key challenges to electronic health care delivery include standards, privacy, trust, security, costs and lack of leT skills. From this study, it was found that majority of public health institutions have not embraced use of [eT tools for handling patient health data and information. In contrast, a few private for profit making hospitals have installed software packages for keeping track of local transactions in administrative activities and resource management flow. In both the case of public and private health institutions, very little medical information is processed and most of the records are still kept manually and archived on papers. To address these challenges, the researcher has proposed a patient e-Referral framework to improve the integration of primary care and specialty care through a common interface. The proposed framework provides a starting point for further work in solving the problem of inefficient referral system