Kiambu county rolls out digital health system in public hospitals

Kiambu County Government has digitised health services by installing a Hospital Information Management System (HIMS) in public hospitals to streamline healthcare.

The newly implemented system, part of the county's Enterprise Resource Planning (ERP) system with automated county services, is operational across all five and level four hospitals, linking them to a comprehensive computerised platform that effectively monitors and evaluates service delivery.

County Executive Committee Member for Health Services, Dr Elias Maina, said plans are underway to deploy to the level 2 and 3 health facilities to ensure all the 123 county hospitals are integrated into the system.

The system, which is a holistic automation of services, can track patients' records, monitor human resources, manage medical supplies, and improve the overall efficiency of the healthcare system.

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Dr Maina said the system ensures single-view dashboards with insight into hospital operations and statistical and analytical reporting capabilities.

Since all facilities use the same system, it also enables drug sharing among facilities.

"This allows for ease of sharing of drugs amongst the facilities through the system, which avoids drug wastage and proper utilization of the drugs," Mr Maina said.

The system also ensures effective resource planning and management by tracking pharmaceuticals, blood, and non-pharmaceuticals using multiple stores and authorization rules.

Further, it ensures direct integration with laboratory and radiology, improving imagery processing, management, and patient turnaround time. Dr Maina said this feature has addressed facility delays and congestion.

Previously, Kiambu hospitals struggled with outdated equipment and manual processes that delayed patient care.

But today, the county administration has equipped all Level 4 and 5 facilities with digital diagnostic equipment, such as X-rays, Ultrasound, dental X-rays, and endoscopy, among others, that are integrated with the HIMS system.

According to Dr Nyagah, the old X-ray machines would frequently break down, with repair costs shooting to the roof.

Others used analogue processing units, which were cumbersome and time-consuming. For example, a single chest  X-ray could take up to 30 minutes, and films were often damaged.

However, the new digital radiography units, which have been installed in various hospitals across the county, produce crystal-clear X-ray images in just two minutes using the digital processing system and flat panel detectors. 

When a digital X-ray is taken, it automatically uploads to the patient's record in the system through a computer, where any authorized clinician can access it.

Dental clinics used slow X-rays with developing times exceeding 30 minutes. Ultrasound examinations depended entirely on the operator's immediate interpretation, with scans not stored digitally for comparison or specialist review.

Today, they use intraoral sensors that capture detailed images instantly, eliminating the cumbersome process.

"These modern devices integrate directly with the county's ERP system, creating a seamless diagnostic workflow. Where radiologists previously waited days for physical films to be transported between facilities, they now instantly access digital images through the ERP portal. A dental surgeon in Kiambu can immediately view a digital X-ray taken in Ruiru, while an obstetrician in Thika can remotely analyze ultrasound scans from Limuru. This integration has slashed diagnostic waiting times for most imaging procedures," Dr Nyagah said.

The HIMS system also features a human resource management feature with employee records, appraisals, leave management, system audit trail, and payroll and biometric attendance integration options.

Dr Hillary Kagwa, the County Director of Health, says the HIMS incorporates advanced HIMS technology with telemedicine functionality, adding that the system is also being rolled out in all 123 health facilities.

"Our integrated telemedicine platform allows doctors from different hospitals to consult remotely, enabling quality healthcare delivery. Our goal is to make quality healthcare accessible to every resident, regardless of location," Dr Kagwa said of the system.

Rita Muthambi, a pharmacist at Kiambu Level Five Hospital, said the pharmaceutical management component of the system has also addressed drug shortages.

She said that compared to the previous arrangement, when pharmacists working in the drug sections had to prescribe medications manually, they can now track patients from the registration desk to the exit once they have picked up their medications.

Thika Level Five Hospital administrator Ruth Mwaura said the system has transformed the operations through migration from paperwork to digital operations, saying previously the facility workers spent hours managing paperwork, but they now generate reports instantly."

This digital transformation has benefited patient record management," Mwaura said.

Grace Kibubu, the County Clinical Officer, said that healthcare workers can access complete medical histories with a simple click.

For example, a physician at Lari Level Four Hospital in Lari Sub-County can access patient records treated at Igegania Level Four Hospital in Gatundu North Sub-County, without any physical file transfer," Muthoni said.