e-health Records in a Public Hospital:

Kapkatet District Hospital

Presenter: Dr. Kenneth Sigilai

Medical Superintendent

KAPKATET DISTRICT HOSPITAL

Location: Bureti district, Kericho county, Rift Valley province.

In The BeginningAll our Medical records were Manual: Patients carried OPD Books.

(OPD Card system collapsed long ago)Patients Registered Manually as they came

Multiple registers maintained at every pointMR Receipt books used to collect cost-

sharing revenue.

Medical Files archives

The Problem with manual systemOPD Book :

Got lost, torn & tattered.Easily Landed on the wrong hands

RegistersGot tornDifficult to trace RecordsConsumed lots of stationary

MR receipts:Money Disappeared

Our SolutionHospital commissioned an integrated

Hospital Management system. ( year 2006)Tasked local vendors to develop a system

tailored to GOK-MOH Data capture, clerkship and accounting norms

Development phased depending on funding ability. Funded largely using cost-sharing funds.

Currently covers the whole of Outpatient services and part of in-patient services

OPD Registration Desk

What Does It Do?Register PatientsUsed by outpatient clinicians for clerkshipUsed by diagnostic services to post resultsUsed by pharmacy staff to dispenseRevenue collectionGenerates reports for sectional heads &

hospital managers

System modules• Out patient:• Registration• Clinic Officer• Laboratory• Payments• Pharmacy

• In patient:• Admission• Ward Attendance• Payments• Discharge

• RevenueReceipts and payments

• Laboratory laboratory test, results and

reports• Pharmacy

Purchases, stock control & dispensing

• Maternitymaternity information

• ReportsMOH standard reports

INFORMATION FLOW CHART

Reg. CO. Lab

Revenue.

Pharmacy.

Dismissed

Admission.

Patient-File.

Pharmacy.

Billing.

Discharge.

OUT PATIENT PROCESS

IN PATIENT PROCESS

Milestones OPD fully functionalLearning curve complete: most staff members

now conversant and compliantOver 50 computer terminals activeFuture plans:

Roll out the system to cover all in-patient services

Paperless OPD

Impact Waiting time drastically reduced in

OPD Reception/Registration area (2 minutes)OPD Clinics (7 minutes)Pharmacy (4 minutes)Revenue office. (5 minutes)

Medical records trace-ableOPD reports instant and real timeIncreased demand for service (more clients)Revenue has increased 10 times (from 0.5

million in 2006 to 4.5 million, 2012 / month)

Lessons learntIts possible to apply technology in resource

constraint settingsE-records significantly assist hospital

managementIncreased work-load and reduced revenue

leakages leads to more resources for improving hospital environment, infrastructure and services

It requires visionary leadership to innovate

RecommendationsMOH should embrace IT, e-records &

electronic HMSThere is need of standardization Central sourcing of software could greatly

cut cost and allow smaller facilities access e-records