Summary Clinical solutions

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The Ministry of Health (MoH) Kenya has for over 20 years provided HIV prevention, care & treatment services through various health centers with the support of the United States government (USG). To monitor and report on the progress towards management and eradication of this epidemic, the HIV/AIDS program has been recording, collecting, collating, analyzing and storing this data using paper records. This process has been tedious and slow towards effective service provision especially with the need to not only focus on the provision of accurate and improved patient care but also on providing timely and accurate surveillance outputs to inform better policy decisions geared on eradication of the disease.  

To add to this, the President’s Emergency Plan for AIDS Relief (PEPFAR) initiated the development of EMR systems in Kenya. Several systems erupted in this accord, but two (KenyaEMR and IQCare) have predominated the HIV/AIDS service areas for the last ten years. KenyaEMR was initially up to 2016 supported by ITECH and IQCare was supported up by Palladium through KeHMIS I project between 2011 and 2016. In 2016, the KenyaHMIS II project which runs through to 2021 was initiated to support the development and implementation of both systems (KenyaEMR and IQCare).  In 2016, the KenyaHMIS II project which runs through to 2021 was initiated to support the development and implementation of both systems (KenyaEMR and IQCare).  

In 2017, there was a shift in program requirements to a more patient-centred approach, there was a need to enhance EMRs from just mere data capture and reporting tools to more advanced systems that enabled real-time care provision and reporting. EMRs were enhanced with improved clinical workflows to enable Point of Care use by providers in the health facilities. Additionally, there was an extension of clinical services by the introduction of mobile solutions (mUzima, Afyamobile and CHT). This enhanced service provision beyond facilities to the communities through mobility achieved by the mobile solutions. This maturity has been key in tracking the continuum of care at the facility level, tracking the UNAIDS  FAST Track Goals towards achieving 95:95:95 goals and alignment towards the Country Operation Planning (COP) priorities for epidemic control.  

The solutions are designed with 5 key functionalities to enhance care provision and value addition to the program through: 

Registration, appointments and triaging

• Ability to uniquely identify patients using the patient search feature, identify duplicate records through the duplicate finder feature and merge duplicate records through the patient merge feature. 
• Ensure providers adherence to MOH guidelines by complying with the guidelines around patient identification 
• Program enrolment by ensuring the required program-specific details are captured 
• Providers are able to manage facility workload and appointments using the appointment management features in the system 
• Providers are able to record vital signs, nutrition information and obstetric history 

HIV Testing and Prevention (HIV Testing Services (HTS), HIV exposed infants (HEI), Prevention of Mother to child infections (PMTCT), Key populations (KP), Pre exposure prophylaxis (PrEP))

• Digitized forms and workflows to capture program-specific data  
• Optimized workflows for client/ patient-centred care 

• Enhanced for flexible service delivery by offering multi-platform support (HTS on desktop, phone, tablet) 

HIV Treatment, TB/HIV and Maternal & Neonatal Child Health (MNCH) services 

• Optimized clinical workflows 
• Digitized clinical summary forms 
• Case summary charts 
• Provider support in adhering to MOH guidelines through clinical decision support features like flags; automated data validation through inbuilt system rules; reports and line-lists 

Interoperability 

• Automated facility workflows through Automated order and receiving of viral load information between KenyaEMR and VL/EID system; The e-prescription and e-dispense data exchange with ADT;  
• Automated client support through text messaging for adherence and appointment management via T4A &Ushauri systems.  
• Automated reporting of indicators to KHIS (Kenya’s DHIS2 system) and 3 PM (Platform for Partner Progress Monitoring). 

Reporting and Data Management 

• Simplified data retrieval through MOH registers, reports and line-lists, PEPFAR reports and line-lists, EMR Dashboards and Ad hoc reporting. 
• System Data Quality Audits through automated DQA checks and reports. 

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