Integrating Health Management Information Systems for Patient Referrals: A Case study of Kenyatta Referral Hospital and the Nairobi Metropolitan Hospitals

Abstract

Successful implementation of patient care information systems (PCIS) in health care organizations is fundamental. In line with United Nations millennium development goal on improving healthcare, there is an urgent need to improve on our health care delivery services through the use of lCTs. However this process is faced with several challenges. This study focused on the various challenges that inhibit the successful integration of Health Management Information systems between Kenyatta as a referral hospital and other referring hospitals around in the Nairobi metropolitan. The study was undertaken in recognition of the main challenges in the patients.' referral process between a referral hospital and referring centers. The research was a survey of nine (9) hospitals that refers patients to Kenyatta National Hospital in the Nairobi metropolitan area. The survey critically evaluated the challenges and motivations faced by hospitals towards successful implementation of electronic referral hospital systems. The study assessed the hospital's management/ administration, nature of the profession for medical/health workers and their attitudes, ICTs, technical capacity and capabilities required to support the electronic referral process in a hospital. Data was collected through the use of questionnaires from the health workers (Doctors, Nurses, Clinical officers etc), hospital administrators/management and the lCT staff in the hospitals. Interviews and observation were also used on selected doctors, hospital administrators and lCT staff to enhance objectivity. The findings uncovered a range of issues, some of which are specifically related to ICT infrastructure in the hospitals, attitudes of the health workers towards information technology in the referral process, their professional and ethical considerations. Others were in regard to management support in the hospitals and the level of ICT literacy in the hospitals from all members of staff. It was evident that the benefits of the patients' e-referral are enormous. The funding for the ICT infrastructure, the ICT literacy levels, health workers Attitudes and hospital's management are some of the major challenges that the hospitals have to contend with. Using the research findings, a framework was developed that, would help the hospitals and the government to analyze the implementation process of the electronic referral system in hospitals in a standardized approach in the exchange, management and integration of data that supports clinical patient .care and the management, delivery and evaluation of healthcare services, as stipulated by HL 7 mission statement of clinical interoperability.