The Data Use Community (DUC) is an open global community passionate about improving health and healthcare data sharing. It is a forum of virtual meetings and an online discussion board for sharing and learning from peers and country experiences. On February 22, 2023, Dr. Joseph Sitienei with the Ministry of Health in Kenya shared the Kenyan experience with Unique Patient Identification. 


Background:

Uniquely identifying patients is a critical component of Kenya’s efforts to deliver Universal Health Coverage (UHC) to everyone living within the country.  To facilitate the provision of high-quality health care for all Kenyans, the government embarked on a unique patient identification (UPI) strategy.  Without UPI the health care system was subject to unnecessary duplication of medical services, increased costs, medical errors, and an overall inefficient use of resources.  Establishing an effective UPI system that can reliably identify individuals across the health care system can help improve quality, safety, and access to care as well as promote more efficient use of resources.  A UPI system would benefit the country’s goal of UHC in several ways:

  • At the patient level, a UPI strategy would improve individual quality of care by facilitating record sharing across the continuum of care.  Health care providers at disparate facilities would now have the necessary information to deliver optimum care at any delivery point across the country.
  • At the service delivery level, A UPI system would also provide efficiency in health care delivery by helping to avoid unnecessary or repeat procedures at different clinics while improving scheduling, billing, and insurance procedures.
  • At the public health level a UPI system would provide improved surveillance such as avoiding double counting of cases for more effective and efficient public planning.


Challenges:

Embarking on a national UPI system was not without its challenges. 

  • Existing health care systems in Kenya were not optimally configured for UPI.  There are many different health care facilities in the country with disparate health information systems, including paper-based systems, that are not set up to capture unique numbers. 
  • While biometric identifiers may be optimal, biometric systems are expensive and the tools for this are not yet in place country-wide.
  • Healthcare facility staff and consumers may not always understand the importance of unique identification and may be resistant to changes

 

Solutions:

To help overcome some of the challenges, the Kenyan government took a variety of steps. 

  • The government recently moved to establish a national person identification (ID) process for storing and using identification data to implement UHC.  The Ministry of Health (MOH) leveraged this process to the UPI system, which offered the means to help identify patients within the healthcare system across the country and help maintain a centralized repository of all patients through a master patient registry.  This helped form an important piece in creating unique identification tied to the government ID.  The unique government ID is linked to the patient registry that along with other attributes such name, sex, and data of birth help to uniquely identify patients. 
  • Involve the community to get widespread buy-in.  Another important component of the government’s UPI work was to involve the community.  For a UPI system to be accepted in Kenya the community needed to be brought into the process early and often.  In involving the community, the MOH was guided by the Partnership Coordination Framework, which provided a path for involving key players in both the private and public sector.  Bringing all stakeholders together to discuss the policy provided a way to ensure that the policy was “owned” by all parties.  Additionally, to help alleviate fears and concerns with data security and privacy, the Kenyan government pointed to the data protection act of 2019, which recognized health data as sensitive and provided provisions for its collection, storage, and processing. 
  • Gain political support of the President and administration. The new Kenyan Government is supportive of UPI and has put UPI into law to help overcome resistance and challenges.


Partnership Coordination Framework:

 

 Tools: 

 

Conclusions and Lessons Learned

The Kenyan government took a variety of steps to help ensure the implementation and acceptability of a UPI system to uniquely identify patients and deliver optimum health care.   These steps included leveraging the country’s national person identification system and involving the community to “own” the process.  As a next step the government and MOH will work to implement the UPI policy country-wide and eventually expand it to include biometric identifiers. 

 Lessons Learned

 

  • It was important to involve diverse stakeholders so that the community had “ownership” to help ensure widespread buy-in from all parties.
  • Having government issued IDs helped facilitate the process of identifying patients.
  • Biometric systems are expensive and tools for this are limited at the moment in Kenya.
  • Gaining widespread political support was very important and helped facilitate the process.


References: 

February 22, 2023 DUC Meeting

Health Sector Unique Patient Identification Framework - August 2022

 

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