Kenya: DHA CEO Explains Referral System Amid Sha Outpatient Access Concerns

NAIROBI — The Digital Health Agency (DHA) says it is working to connect hospitals, health insurers, patients and medicine suppliers through digital systems to improve the sharing of medical records, protect patient information and reduce administrative delays.

DHA Chief Executive Officer Anthony Lenayara made the remarks during an interview on Capital In The Morning, where he explained the agency’s mandate and addressed concerns about access to outpatient services under the Social Health Authority (SHA).

Lenayara maintained that SHA was working despite complaints raised by Nairobi County Chief Officer Geoffrey Mosiria about patients experiencing difficulties accessing outpatient services at a Level 5 referral hospital.

“First, SHA is working. I want to confirm that SHA is working,” Lenayara said.

He explained that patients seeking routine outpatient care should ordinarily visit Level 2 to Level 4 facilities, while higher-level hospitals handle cases requiring more specialised treatment.

Lenayara said the DHA addresses gaps in healthcare coordination by enabling hospitals, health financing systems and other providers to exchange information through digital platforms.

He said the agency’s responsibilities include protecting health data, ensuring interoperability between different systems and standardising digital processes to improve access to healthcare services.

The agency was established under the Digital Health Act, 2023, which provides the legal framework for digital health services in Kenya and the development of an integrated digital health information system. The law also outlines provisions for managing health information and protecting personal health data.

“Our health data is very sensitive, and as well as very strategic as a country. And Digital Health Agency first protects and ensures that the health data of every Kenyan is stored properly, is transmitted properly, and is only accessible to correct people,” Lenayara said.

He explained that the agency seeks to ensure patients can move between hospitals without having to repeat tests simply because their medical records are unavailable at the next facility.

“If you’re a patient as you walk in from Hospital A to Hospital B, you will want to walk with your records. You don’t want to have repeated tests. You will want the doctor to see your history, and that is happening across the world,” he said.

Lenayara said the agency also supports the standardisation of digital systems to reduce paperwork, administrative costs and waiting times in hospitals.

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He cited the multiple forms patients are often required to complete when seeking medical services as an example of processes that could be simplified through digitisation.

The DHA is responsible for developing, operationalising and maintaining the Comprehensive Integrated Health Information System and the infrastructure required for health information exchange.

Its mandate also includes supporting the portability of personal health records, enabling authorised healthcare providers to access relevant information when patients move between facilities.

The agency’s role is distinct from that of SHA, which manages the country’s social health insurance system. While SHA is responsible for health financing under the social health insurance framework, the DHA focuses on the digital infrastructure supporting the exchange and management of health information.

On outpatient services, Lenayara said patients seeking routine treatment should use Level 2 to Level 4 facilities rather than going directly to Level 5 or Level 6 hospitals for basic care.

“We did not expect a patient to walk to a Level 5 or Level 6 for simple outpatient services. That’s why the structure is, you should be able to go to a lower-level facility, which is a Level 2 to 4, and access those outpatient services,” he said.

He added that directing routine cases to lower-level facilities was intended to prevent overcrowding at referral hospitals and ensure patients requiring critical care receive appropriate attention

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