A little-known government agency, the Digital Health Agency, made an announcement last week Sunday Nation To introduce a new animal named – National Health Information Exchange.
All healthcare providers in the public and private sectors have been asked to start building applications to enable them to communicate and exchange information. What is it all about?
An information register that contains all data on all health service providers and on the activities of all professionals, and is connected to a portal that contains data on all medical records, including statistics on all hospitals in the market, the services they are able to provide, all patient interactions and data on activity in the body. Kenyan medical services.
Promoters are touting this new system as one that will enable what they terminologically the portability of medical records. It will be the sole source of truth for all medical data.
I went to the latest Auditor General’s report on the National Hospital Insurance Fund (NHIF) to read what it says there about the accuracy of medical data – and how it affects service delivery and the effectiveness of the national health insurance provider.
This report reveals that the National Health Insurance Fund is losing billions of shillings because the technology and system it uses does not generate accurate statistics and data, even on rudimentary and basic information such as member numbers, hospital names and employer codes, and the number of patients receiving the service. .
There are cases where billions are lost because hospitals receive claims paid far in excess of set limits, and where irregular amounts are paid to hospitals to perform major surgeries when they do not have the capacity. The report indexes duplicate payments for cesarean sections and vaginal deliveries, and duplicate claims with the same medical procedures on the same admission dates but different discharge dates.
The auditor highlights 28,000 claims where the same patient was admitted to different hospitals at the same time, and cases where different hospitals had the same name but different billable amounts and different hospital codes.
It is clear that if a health information exchange system is successful and implemented well, it has what it takes to change the rules of the game. But there are major obstacles ahead. Primarily, the debate over the constitutionality of some aspects of the legal framework underpinning the government’s Universal Health Coverage programme, including specific acts of parliament that have been introduced such as the Digital Health Act, the Primary Care Act, and the Funding for Facilities Improvement. The law, has not yet been settled by the Court of Appeal.
In fact, the only reason the health information exchange project continues is because the Ministry of Health is exploiting the loophole that the Court of Appeal allowed to take place even while awaiting a final ruling on the constitutionality or unconstitutionality of certain aspects of the legal framework.
The second and perhaps most difficult obstacle to the project is politics. We are in a political environment where public disdain for decision-makers and skepticism are at an all-time high – where news about any mega project the government wants to undertake inevitably generates anxiety-filled debates, loud protests and conspiracy theories.
In a sense, some of the developments we are witnessing now can be viewed in the context of what appears to be an increase in investment activity and engagement by the Gulf oil states in this region and especially in Kenya.
yesterday, Reuters She stated that Kenya is close to borrowing a huge sum of $1.5 billion from the Emiratis and that the interest rate will be much lower than Eurobonds in February this year. I believe the specific entity lending us money is the largest listed company in Abu Dhabi, International Holding Company (IHC).
In fact, the Emiratis are giving us bailout money because the inflow will fill the gap caused by the delay in disbursement of funds that we were expecting from the IMF.
A senior Treasury official told me yesterday that the borrowing is within the limit it has set for business borrowing in the current financial year and should not be construed as additional borrowing. He also clarified that the money coming from the Emiratis does not replace what we expected from the International Monetary Fund.
But what is clear is that bailout money does not come without strings attached. Egypt, which loaned the Emiratis $35 billion in March this year, was forced to authorize one of the largest land sales to the UAE’s sovereign wealth fund.
Under the IMF programme, Egypt must raise billions from the sale of state assets. As a result, UAE sovereign wealth funds began acquiring the privatized state assets one by one.
Is it just a coincidence that the UAE company providing us with the bailout money, IHC, has strong investment links and relationships with UAE entities that want to invest in both JKIA and the Health Information Exchange Project? I have no news.
The writer is a former managing editor of The EastAfrican newspaper
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